Bird Flu in Bangladesh - Event Date: February 14 2007

Storms lash villages in Netrakona, Gazipur and Sunamganj Thursday and Friday, injuring at least 50 people and damaging houses and crops.
   Two boys were killed by lightening at Atpara in Netrakona while a nor�wester swept over Chandapara under Kendua pazila on Friday.
   The victims were Kamal Mia, 17 of village Baniajan and Nizam Uddin, 12, of village Mongolsiddha under Atpara upazila, local administration confirmed.
   Strong wind damaged over hundred houses and uprooted trees, injuring four at Chandapara.
   More than 50 were injured and hundreds of houses and trees were damaged in a tornado that swept over three villages � Mulaied, Rangila Bazar and Mauna Uttar Para � at Shreepur Thursday night.
   Critically injured Tayab Ali, 80, Jarina Khatun, 35, and Shahidul, 25, were sent to the National Institute of Traumatology and Orthopaedic Rehabilitation in Dhaka.
   Of the remaining injured, Joynal, 40, Minara, 39, Anwar, 40, Arjina, 4, Raisuddin, 45, Sabuj, 28, Jharna, 16, Hanif, 12, Mariam, 30, Eiti, 22, Julhas, 18, Rekha, 40, and Karimunessa, 70, were admitted to local clinics.
   At least 20 families lost their homes to the tornado.
   A medical team from Shreepur upazila health complex rushed to the spot Friday morning and gave treatment to about 20 injured people.
   The Gazipur deputy commissioner, Sayed Mizanur Rahman, Shreepur upazila nirbahi officer, Sayed Jalal Uddin Ahmed, and Shreepur police officer-in-charge, Khandaker Jahidul Islam visited the area in the afternoon.
   Shreepur upazila administration sources said a total of 113 families were affected by the tornado. The administration distributed Tk 17,000 among the affected people as immediate relief.
   UNB reports from Sunamganj, A powerful storm accompanied by hailstorms lashed three villages in Tahirpur upazila Thursday night damaging an unspecified number of houses and standing crops.
   Locals said the roofs of 20 dwelling houses were swept away in Surjargaon, Roypara, and Khalahati villages by the storm.

Laboratory tests confirmed infection of the virus at Laura Poultry Farm at Aukpara in Savar yesterday evening. A total of 2,000 chickens were culled as of 10:00pm yesterday.

All the chickens at the infected farm will be culled, Livestock Department Director Abdul Motaleb told reporters last night.

The army and police cordoned off the infected farm.

Suspicion arose that the farm was infected with avian influenza--bird flu--after a considerable number of chickens died there on Friday, sources in the Savar Upazila Livestock Office said.

Upon receiving information, livestock officers from both the capital and Savar rushed to the farm yesterday morning and sent sample of chickens to the laboratory in Dhaka for testing.

Four teams of the Savar Livestock Office have been conducting drives in the area to investigate if there is any fresh infection of the avian flu virus at any farm or place in the upazila.

Meanwhile, our Narayanganj correspondent reports: Fisheries and Livestock Adviser Dr Chowdhury Sajedul Karim visited two bird flu-infected poultry farms in the district yesterday and urged all to remain alert about the virus' infection.

"Although infection and spreading of the virus has been prevented temporarily, everyone should always remain alert to keep the poultry farm industry alive," said Sajedul Karim at a meeting with poultry farm owners, local journalists and government officials.

"The [fisheries and livestock] ministry will sort out a working plan by next week to determine how to help or compensate the affected poultry farm owners," he added.

Earlier, Sajedul visited Mukta Poultry Farm in Narayanganj sadar upazila and Chistia Poultry Farm at Shiarchar in Fatulla.

The adviser gave assurance to provide modernised instrument, increase trained manpower, and other laboratory facilities for testing bird flu infection.

He also directed the deputy commissioner (DC) to take necessary measures to provide the tuition fees and other necessary academic facilities for the children of the affected poultry farm owners.

Livestock Secretary Syed Ataur Rahman, Joint Secretary Khalilur Rahman Siddique, Deputy Secretary Anisur Rahman, Deputy Commissioner Ahsan Habib and Superintendent of Police Sibgatullah were present at the meeting among others.

There are 989 poultry farms in Narayanganj. A total of 2,476 chickens have so far died since the detection of the virus while 12,004 chickens were culled at the bird flu-infected farms in the district.

This has created panic among people as the number of patients are increasing everyday.

Doctors at the hospital said that more than 50 people attacked with the disease are being treated at the hospital. Of them, 12 were admitted yesterday. The numbers of patients are increasing day by day.

Sources at the hospital and Civil Surgeon's office said the disease first broke out in Khajanagar and Kaburhat villages in Sadar upazila about a week ago.

Those attacked with the disease were aged between 12 and 60.

According to Kushtia General Hospital doctors, initially the victims died for lack of proper treatment as the disease could not be unidentified.

The symptom of the disease is high fever. At one stage the patient loses sense, doctors said.

The doctors said the disease is caused by a virus. The patients should be kept quarantined during treatment.

Most of the patients were treated for fever by local doctors, mostly quacks, which was wrong, they said.

Civil Surgeon Dr Abu Taher with a team specialist doctors from Kushtia General Hospital visited the areas.

The six people who died of the disease are Hazera Khatun, 45, Mina Khatun 30, Asia, 27, Abdus Salam, Jahangir Alam and Tofazzol Hossain.

Civil surgeon Dr. Abu Taher told to local newsmen that he has already informed about the disease to his higher authority.

A specialist doctors team might have visited to Kushtia, civil surgeon said.

The Dengue fever season in Bangladesh is due to start soon . It

typically coincides with the Influenza season .

Below is a bar graph of flu types and number of cases in the Year 2000/2001 .

A

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Influenza occurred during the rainy season (June-August) (Figure1) and was the predominant cause of febrile respiratory illness during that period. Extrapolations of data to a full year among all children <13 years of age in the cohort suggest an annualised incidence rate of 5.0 episodes of influenza per 1000 children.

Comment

The findings of this report suggest that influenza is an important cause of respiratory infection in children in Bangladesh. Influenza has been isolated among hospitalised children with acute lower respiratory infection in Bangladesh in earlier studies (5,6), however recent data have not been available. The disease burden estimate is likely to be markedly underestimated due to strict criteria used to select sera for testing (e.g.only persons with a measured temperature >38.5 o C were included) and likely under-reporting and incomplete follow-up for paired blood sample collection among study participants. In addition, young children with influenza may be less likely than adults to sero-convert, thus underestimating the number of influenza infections. This may be even more so with moderately malnourished children, who have blunted immune responsiveness. In contrast to

the influenza illness rate estimated in this study, typical yearly influenza infection rates measured among children in temperate zones range from 10-20%(7 ). Forty percent of the study population had titres = 40 to influenza A(H3N2)and influenza B/Sichuan-like viruses, indicating high levels of prior infections with influenza.

These data confirm that influenza may circulate within an urban community in Bangladesh and cause a substantial proportion of febrile respiratory illnesses. The serologic data showed evidence of infection to influenza A (H1N1), A (H3N2), and influenza B (8, 9). Strains included in the 2001-02 influenza vaccine included all 3 circulating strains seen among study participants. The peak occurrence of influenza in temperate zones of the Northern Hemisphere is generally December-March, and is June-August in the temperate zones of the Southern Hemisphere. In 2001, influenza was in active circulation in Bangladesh when it was not in circulation elsewhere in the northern temperate zone. Bangladesh is at a junction between temperate and tropical zones and it is between South and Southeast Asia which may make it a conduit for spread of new strains between two densely populated regions of high global traffic. Viruses introduced into Bangladesh from the Southern or Northern Hemispheres could rapidly circulate within densely populated areas and then to other regions.

Influenza is the prototypic emerging infectious disease, known for its ability to undergo genetic and antigenic change. New strains of influenza emerge frequently through the accumulation of point mutations during viral replication, a type of c< id="WebWizRTE" ="http://www.avianflutalk.com/RTE_.asp?mode=reply&POID=0&ID=1900" style="border: 1px solid rgb(165, 172, 178);" onload="initialiseWebWizRTE();" height="250" width="490">hange referred to as drift. Antibodies made against earlier strains may not be effective in preventing infection against new strains of the same influenza type (A vs. B)or influenza A subtype (H3N2 vs.H1N1). Thus, influenza epidemics can occur yearly and individuals can become infected with influenza many times during their lifetime. Influenza viruses infrequently undergo a more drastic change referred to as shift. Shift occurs when a new influenza A subtype emerges and against which the human population has little or no immunity. A new subtype may emerge directly from an animal source, particularly pigs or birds, or may arise from reassortment of an animal influenza virus with a human influenza virus. New influenza A subtypes, which can cause illness in persons and can be readily transmitted from person to person, may cause a global pandemic. Three pandemics of influenza occurred during the twentieth century, in 1918-19,1957-58 and 1968-69.The most devastating of these pandemics, the 1918 pandemic, resulted in 20-50 million deaths worldwide. Early detection of a potential pandemic virus is an international public health priority. A new strain or new influenza A subtype could emerge in Bangladesh and circulate widely, but not be detected until it had spread to another part of the world where surveillance was in place.

Given extreme population density, Bangladesh provides an environment that could promote the rapid spread of epidemic disease caused by either a new epidemic strain of influenza or a new influenza A pandemic virus. In addition, given the close proximity of humans,fowl, and other animals in Bangladesh, the environment may also support potential reassortments of animal with human influenza viruses and the genesis of a novel, virulent influenza A subtype with pandemic potential.

During the peak influenza season in Bangladesh in 2001,the dengue season was also underway. Similar features of these two illnesses may be difficult for health providers to distinguish. Clinically defined "dengue fever" may actually be caused by influenza or other pathogens, underscoring the importance of use of reliable, affordable diagnostic tests of acceptable sensitivity and specificity to confirm dengue diagnosis.

More than 10,000 ducks died of duck plague at different districts under the Barisal division in recent days, creating panic among the duck farmers.
   The district and divisional livestock directorate offices claimed the situation is now under control and they are keeping a close eye on it.
   The district livestock officer of Bhola said that samples had already been sent to Dhaka for test to find out the real cause for the death of ducks. The divisional livestock officer said duck plague which spreads rapidly can destroy the livestock sector in the region, if it is not checked timely.
   Sources in the livestock office said there are more than 5 million ducks in six districts under the division. There are more than 3.5 lakh ducks in Bhola while more than two million ducks in coastal districts like Barguna and Patuakhali, they added.
   There are about 2,000 farms in the division for rearing ducks on commercial basis
   Treatment by antibiotics may save the lives of about 25 per cent of ducks infected with duck plague, the divisional livestock officer said, adding that sufficient vaccines are not available in public and private veterinary hospitals and medicine shops.
   The vaccines are very costly and have to be preserved under 5 degrees Celsius. �We are trying to make the people aware of duck plague,� the official said.