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H5N1 Surveillance In Europe and Africa
Recombinomics Commentary
February 1, 2006
Over the past few months, there have been occasional reports of large- scale bird deaths in both Iran and northern Iraq, places that veterinary officials had tagged as high risk because they are on bird migration routes. But H5N1 was never implicated.
In October, there were large-scale deaths on commercial farms in northern Iraq, Dr. Kennard said. Birds were tested and "we were told it was negative," he said, "but we're not entirely sure how reliable that is."
The above comments focus on limited or misleading surveillance in Iraq. The positive human cases in the absence of any reported H5N1 strongly suggests that that many H5N1 infections in wild and domestic birds have gone undetected or unreported. However, these shortcomings are not limited to Iraq. The widespread confirmed outbreaks in Turkey indicate the tire region is H5N1 positive. Moreover, since the outbreaks in the region trace back to October, migratory birds would have carried H5N1 throughout the Middle East and into Africa. However, to date none of these countries have filed an H5N1 OIE report.
The deficiencies in reporting in the Middle East and Africa probably also extend into western Europe. H5N1 infections were widespread in Siberia, Mongolia, and Kazakhstan. In Siberia there were approximately two dozen species of wild birds shot down by hunters that were H5N1 positive. The transfer of H5N1 between species in Siberia suggests H5N1 would be widely distributed throughout Europe by migratory birds. The H5N1 positive region in Siberia is at the intersection of three major flyways. One of these flyways passes over western Europe and into northern and central Africa.
The failure of European countries to detect and or report H5N1 is cause for additional concern. There are still unexplained die-offs reported in western Europe and investigations fail to test for H5N1. The failure to report and cull allows for H5N1 to become endemic, which leads to more recombination and more rapid evolution.
As the migration schedule advances, new H5N1 will be flying out of Africa and back into western Europe to recombining with unreported H5N1. HA S227N way have been generate by such recombinations in the Middle East. Other recombinations with H5N1 found in swine in western Europe has been noted in the Qinghai H5N1 strain currently circulating in the Middle East and Africa.
Although countries in the Middle East and Africa lack resources for adequate surveillance, western Europe has the means, but not the will for effective monitoring. As H5N1 continues to evolve, the consequences of the failures to report will become increasingly obvious.
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