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09 June 2005

Cases of Polio, Bird Flu Mounting in Asia

More bird flu cases reported in Vietnam; Indonesia battles polio outbreak

By Charlene Porter
Washington File Staff Writer

Washington – Health authorities in Vietnam are reporting three new human cases of bird flu infection with one death.

Vietnam is having the most widespread occurrence of human infection with bird flu since the current outbreak began in December 2003. The H5N1 virus, which has infected birds in 10 nations, has infected humans in only two other nations, Thailand and Cambodia.  Vietnam has reported a total of 79 cases, according to case reporting maintained by the World Health Organization (WHO), while Thailand has had 17 and Cambodia only four.

The total of human cases in the region discovered since December 2003 has now reached 100 with 54 deaths.  More than half of that total – 52 cases – have occurred in Vietnam since December 2004. 

An estimated 140 million birds have died or been destroyed across the region as authorities try to control avian influenza.  The latest report comes from the Xinjiang region of the People’s Republic of China where more than 1,000 geese were infected with H5N1, according to a June 8 accounting from the World Organisation for Animal Health. More than 13,000 birds have been culled in order to limit the Xinjiang outbreak.

The rash of human bird flu cases over the last year and a half is the first time H5N1 has occurred so widely in humans. Because of the lack of exposure to this pathogen, humans carry no immunity to the highly infectious flu strain. International health officials watch of the situation closely, fearful that H5N1 might mutate into a form that is easily transmissible between humans. That mutation would allow the disease to take hold after exposure to merely a cough or sneeze from an infected person.  So far humans are most often infected through direct contact with birds. If H5N1 finds a way to leap from human to human, authorities fear a worldwide flu pandemic with millions of deaths.

POLIO IN INDONESIA

It is an older disease that troubles Indonesian health authorities.  Polio is back for the first time in a decade, and the discovery of newly paralyzed children is increasing.  The World Health Organization reported June 9 confirmation of six new cases of the childhood crippler, which was thought to have been eradicated from Indonesia in 1995. Since the disease first reappeared in April, 34 cases have been detected, according to WHO. In response, health authorities have rapidly organized widespread immunization campaigns, with the goal of immunizing 6.4 million children under 5 against polio by the end of June.

As health officials examine the children afflicted with the acute flaccid paralysis that marks the disease, they are learning that the virus has a genetic link to pathogens that caused a polio outbreak in West Africa in 2003 and 2004, according to a WHO summary issued June 9.  Officials believe this virus might have traveled from West Africa to Sudan, and on to Indonesia.

Cases traced to the same strain have also recently been found in Saudi Arabia and Yemen.  Both nations had been considered polio-free for some years. Globally, polio has recurred in 16 nations where the disease had been eradicated, WHO reports, all stemming from that West Africa outbreak.

In Indonesia, a house-to-house search is under way for paralyzed children who have gone undetected by medical professionals.  The Ministry of Health has also stepped up its surveillance in order to detect any further cases of paralysis. 

A risk remains that polio might still be spreading in and around the West Java district where the cases have been detected or elsewhere in Indonesia.  The June 9 WHO summary does express optimism about the effectiveness of immunization campaigns in containing outbreaks of this kind if efforts are made to reach every child under the age of 5.

The U.S. Centers for Disease Control and Prevention is a partner in the Global Polio Eradication Initiative that has reduced the world’s annual number of disease cases from 350,000 to 1,266 in 2004.  WHO, UNICEF and Rotary International are other major partners who have been working since 1988 to conquer this disease. 

As a result of this effort, polio is considered endemic in just six nations now: Afghanistan, Egypt, India, Niger, Nigeria and Pakistan. The disease is considered re-established in six nations previously considered polio free: Burkina Faso, Chad, the Central African Republic, Cote d’Ivoire, Mali and Sudan. This reclassification comes when an imported virus of the same genetic strain continues to circulate in a country for six months.