First bird flu death in country exposes to passive surveillance and poor preparation – Nepal



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The 21-year-old case is the world's first human H5N1 infection since February 2017

– ARJUN POUDEL AND ARPAN SHRESTHA, Kathmandu

The H5N1 avian influenza virus, which has been confirmed as the leading cause of death in Nepal, 10 years after its discovery in birds in 2009, is the first human infection in the world caused by the H5N1 virus since February 2017 and has raised public health emergency issues at the international level. concerned at the refusal of the Government and WHO officials to provide additional information on this case.

"We seek the help of the UN organ to contain the disease," Mahendra Prasad Shrestha, spokesperson for the Ministry of Health and Population, told the post.

While experts from the headquarters of the World Health Organization and its Delhi office meet in the capital to take stock of the situation, Mr. Shrestha said the government was taking the case at seriously and that he adhered to the standard protocols of the international health regulations to which Nepal was bound.

The deceased, a 21-year-old man from Kavrepalanchok district, residing in Bhaktapur and whose identity was not disclosed by the government, was admitted for the first time to Nepal Medical College on March 24 after have shown signs of fever and cough.

Doctors suspected of influenza infection then sent samples of throat swabs to the National Public Health Laboratory on March 25th. The same day, before the announcement of the results of the laboratory badysis, the patient was badociated with oseltamivir, an antiviral antiviral drug extracted from the Epidemiology and Disease software. Control Division. But the lab has failed to identify the strain of the virus, the ministry said Thursday in a statement.

The patient, who was working as a driver, was then transferred to the Om hospital, his condition becoming critical, according to a manager who wanted to remain anonymous. Four days later, on March 29, the patient died of respiratory complications during treatment.

Samples of throat swabs were then sent to the WHO Collaborating Center for Influenza in Japan, according to the ministry, and laboratory results received on April 30 had tested positive for influenza A (H5N1).

H5N1 is a deadly strain of the highly pathogenic avian influenza virus. The first human infection was reported in 1997 in Hong Kong and the virus has since spread to Asia, Africa, the Middle East and Europe, as well as in other parts. of the world, causing millions of poultry infections.

Although rare, confirmed human cases of avian influenza reported by WHO, reported from 2003 to April 9 this year, amount to 860 human cases and 454 deaths. According to the UN organ, almost all cases of H5N1 infection have been badociated with close contact with live or dead infected poultry or a contaminated environment.

Although the virus does not seem to be transmitted from human to human, scientists worry however that it could be transformed or combined with another influenza virus into a more infectious virus. which can lead to a pandemic.

However, few steps have been taken since the 21-year-old boy was first admitted to a hospital with flu-like symptoms and little has been done to isolate the family members in mourning and those with whom patient had come into close contact after his death.

In addition, nothing was done to contain the two hospitals in which the patient was admitted. However, five weeks after the boy's death, EDCD Director Dr. Bibek Kumar Lal said that epidemiological investigations had now begun and his office had strengthened surveillance to control the disease.

"The good thing is that no one has come into contact with the virus. The incubation period of the virus is one week, but we have no case of infection after five weeks, "Lal said in the mail. "No other patients in the area or elsewhere have been diagnosed with the disease as shown by our laboratory records."

Nepal has been declared free from H5N1 virus in 2012, but this strain of the deadly bird flu virus continues to be found in poultry in Nepal and, more recently, even in some 350 crows in the capital.

According to Dr. Bansi Sharma, General Manager of the Department of Livestock Services, 52 samples taken from poultry farms examined by the Central Veterinary Laboratory were tested positive for the deadly H5N1 virus.

As a result of the confirmations, veterinary technicians' Rapid Response Teams were deployed to poultry farms in Kathmandu, Bhaktapur, Lalitpur, Makwanpur, Morang, Sunsari and Kaski and more than 100,000 infected chickens were slaughtered.

"The epidemics of H5N1 have serious consequences for public health, the economy and society. That's why its prevention is a worldwide priority, and human infection is a clear consequence of diseases that are transmitted by zoonoses, "said Manisha Bista, supervisor of the Nepal Molecular Dynamics Center.

"This is an opportunity to spot vulnerabilities in our pbadive surveillance programs and invest in technical and human capabilities to detect disease, investigate epidemics and inform the general public without creating public outcry.

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