Transcript of WHO podcast - 9 February 2007
Avian influenza; health risks after floods in Indonesia
Christine McNab: You're listening to the WHO podcast for the week of the 5th of February. I am Christine McNab.
In this episode:
- has the pandemic flu threat increased? WHO's top disease expert explains why not; and
- people in Jakarta, Indonesia are facing some of the worst flooding in several years. What are their health risks?
This week, the owners of a turkey farm in the United Kingdom had to act quickly after they found H5N1, the highly pathogenic avian influenza virus, in their flocks. The story made front page headlines, and people were worried wondering whether the discovery increased the global risk of an influenza pandemic. Dr David Heymann, WHO's head of Infections Diseases, made clear during a news conference this week that there is no change in WHO's assessment.
Dr David Heymann: It's a very complicated mechanism by which an influenza virus would eventually cause a pandemic. All of the risk factors that would cause this to happen, this mutation which could cause a pandemic, are not completely understood. But it is a false statement to say the risk has changed in any way. As long as H5N1, the current avian influenza virus is circulating any where in the world, there is a risk that it could undergo the mutation which would lead it to a pandemic strain. So the risk remains the same, and the phase of alert remains at phase three.
Christine McNab: WHO stresses that H5N1 is still primarily an animal disease. Millions of birds have been infected worldwide, but fewer than 300 people are known to have had the disease in the last three years. Those who had been infected were known to have had close contact with infected birds. Dr Heymann said in a country like the United Kingdom, safety measures are well enforced and the public risk is very small.
However, safety measures are not always so easy to follow in a country like Nigeria. It is more difficult to control bird markets, and people rely heavily on chicken as a source of food. The country recently reported its first human case of H5N1 - a 22 year-old woman. The virus was known to be in birds in Nigeria already. WHO is working with the authorities to investigate the source of the woman's infection, and to date, her contacts have been followed and no one else has tested positive.
Dr David Heymann: The government and the local team have investigated all the contacts and assured that those contacts have not become ill. They have take blood specimens from them and the investigation has now been enlarged to cooperation with FAO in trying to help in better understanding the situation among the flocks, looking mainly at the markets.
Christine McNab: One last note on bird flu this week, there was concern about reports that Indonesia had stopped sharing H5N1 samples with WHO's influenza network. WHO encourages all countries to share samples so that scientists can track whether the virus is mutating. Samples also allow research into vaccines which will be critical to protect people should there be a pandemic. During the news conference, Dr Heyman said vaccine production capacity globally was still too low, at about ½ million doses per year. He said WHO was working with governments and vaccine manufactures to ensure that developing countries in particular could have better access to influenza vaccine.
Dr David Heymann: In a pandemic, there would be a requirement for over 6 billion doses of vaccine, should there be an effective vaccine. And, therefore, countries are very interested in having vaccines. One of our major strategies is the global action plan on pandemic vaccines, which has as one of its objectives the transfer of technology of production of vaccines to developing countries, so that they can add to the world's production capacity and satisfy developing country needs for vaccines.
Christine McNab: WHO's 193 Member States will discuss a resolution this May which urges all countries to share new influenza viruses with the WHO network.
Torrential rains in Indonesia over the last few weeks have caused rivers in Jakarta to spill over their banks flooding more than half of the city with up to 3 metres of water and forcing nearly 400 000 people to abandon their homes. A WHO team is providing the government of Indonesia with emergency health supplies, four-wheel-drive vehicles and boats to reach stranded people. The top priority is preventing the spread of disease. Dr Vijay Nath Kyaw Win with WHO in Indonesia has seen the devastation first-hand, and took a few minutes to talk to Christy Feig from WHO's Health Action in Crisis team.
Christy Feig: What are some of those diseases that are at risk right now and are you seeing any of them?
Dr Vijay Nath Kyaw Win: First thing is the one that we are seeing is the acute respiratory tract infection. It has been caused by the season itself and the affect of the water and the affect of the cold. Then second thing is diarrhoea cases because of the water that they are drinking at the same time the condition of the food and the way they are cooking. The third thing is we are seeing skin infections; of course they do not have proper water that they to use to bathe so they have skin infections. Then the fourth thing that we've been noticing is minor injuries because you don't wear the shoes and you have to go into the water and then drag things so you don't see what is inside so you have lots of minor injuries.
Christy Feig: What kind of needs are you seeing right now locally in the people there?
Dr Vijay Nath Kyaw Win: For the needs of the people, of course, once you have that then they need the water, first clean water to drink then food especially for the children. We are encouraging breastfeeding, but still they need a lot of food. Then the third is the shelter and the blankets, that is because of the weather. Then for the medicine, the government has supported quite a lot and then all the health centres and facilities have the medical needs. The government has announced about the free medical services. The major, major thing that people now need is to supply with safe water. And then when they go back, waste management.
Christine McNab: Dr Vijay Nath Kyaw Win and his colleagues are also working with the government to create ways of teaching people how to stay healthy when surrounded by contaminated water. For example, the importance of boiling water or using purification tablets before drinking it, washing hands with soap and water, cooking or washing food to avoid contamination and not going into the water unless absolutely necessary.
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