Bioscope ‘06

by Dr. Barbara Price

2006 African Flu?

          Will we be telling our grandchildren about the 2006 African Flu?

          Avian flu, H5N1, is now in Africa, with infected birds found in Nigeria and Egypt and birds that are suspect in Chad, Mali, Mauritania and Niger. This is worrisome; poultry in Africa, is often the difference between life and death. Poultry in much of rural Africa, as in many rural areas of the world, is raised on small farms, with the children and family.

          The expansion of H5N1 into Africa is potentially catastrophic. Most of Africa cannot afford to slaughter flocks suspected to be at risk. Families raising chickens to feed themselves are not likely to kill their birds if there is a chance they are not infected. Africa is in the fly path for many migratory birds, and so even those domestic flocks not yet infected are at risk. But before this virus can mutate or drift to become a real human threat, most scientists believe it will mix in people who have one of the human influenza viruses, probably H3N2/A or H1N1/A (the most common of those in current circulation).

          What is the typical incidence of influenza in Africa? In 2003, a year dominated by the emergence of Ebola in Africa, only one outbreak of influenza was reported, affecting 3963 people, (fatal for 126 people, a case fatality rate of 3%). http://medilinkz.org/HealthTopics/statistics/outbreaksafrica2004.asp

          But this is not the entire story. The population in many African countries has been hit hard with AIDS, to the point where 20-50 % of the populations are infected. Those with AIDS are more susceptible to other infections. Influenza, an opportunistic infection, is one of the most common causes of death frequently associated with AIDS, and the number of such deaths from influenza and pneumonia increased in South Africa for example by 197% from 11,503 to 31,495 from 1997 to 2001. http://www.africafocus.org/docs05/tac0502.php

          Africa’s vulnerability is the World’s vulnerability. Healthy populations may be able to ward off both avian flu and human influenza, but a weakened population is at greater risk for both and thus may be the “stew pot” H5N1 needs to become a human influenza. In US, the peak of the 2004-5 flu season was at Christmas; in 2003-4, the peak was later, around the end of February. The peak flu season in the southern hemisphere is usually between May and September. For a large part of Africa, the flu season will not peak for almost 8 weeks.

          Will the avian influenza still be spreading when the flu season peaks?