Editorial

Control measures

  • To prevent potential pathogenic outbreaks, the authorities need to respond better

May 6, 2019-

The recent case of a 21-year-old man dying after being infected with the Influenza A (H5N1) virus is worrying--not least because this was the first reported human infection from this strain in more than two years, globally. The actions of the authorities concerned in this case have been worrying. It seems that proper quarantine procedures were not put in place once a serious flu infection was suspected. Such lapses show that we are not really prepared to handle serious pathogenic outbreaks.

The H5N1 strain of Influenza A, commonly known as the bird flu, is known to cause severe respiratory problems in birds and is highly infectious to them. While cases of humans being infected with the bird flu are relatively rare, the mortality rate among those infected is 60 percent. Seasonal flu vaccines do not seem to work in reducing the effects of the H5N1 infection among humans. Treatment using Oseltamivir, an antiviral initially created to treat H1N1 infections, seems to work in reducing the chance of death among humans--but is not a guaranteed cure.

This is the reason cases of bird flu cause international concern. Though infection is rare, the infected are in mortal danger. Moreover, a major anxiety is that the H5N1 strain might mutate, as influenza strains do, and become highly contagious. In fact, the concern is so great that until recently, research on H5N1 that could potentially create mutated strains were banned. Even after the United States Department of Health and Human Services recently allowed such research to continue in two labs, the outcry among scientists worried about the potential dangers has been immense. The presence of bird flu in poultry also causes massive economic loss if infected birds are not isolated and eliminated in time.

Although Nepal declared itself free of H5N1 in 2012, and again in 2014, cases of its presence in poultry have been reported many times since then. This time, serious flaws in the government’s response has been exposed. The National Public Health Laboratory failed to identify the strain of flu the patient was infected with, and a sample was sent to Japan for identification. The patient was also transferred from Nepal Medical College to Om Hospital as his condition worsened. Meanwhile, an isolation centre built at the Sukraraj Tropical and Infectious Disease Hospital--created with financial support from the WHO--was unused, and has been idle due to the lack of manpower and required infrastructure. Moreover, no steps were taken to identify and isolate the people that came in contact with the patient since his infection.

The director of the Epidemiology and Disease Control Division has stated that no one in contact with the patient has developed flu symptoms. However, with the lack of a proper quarantine, it seems that this was more due to luck. If the flu strain had mutated, Nepal could have become ground zero for a major pandemic. Given the danger such a mutation poses, government measures need to be stringent and immediate. The time between detection of H5N1, or any type of pathogenic zoonoses, and extermination of the carriers--chicken in this case--needs to be minimised. Proper measures for quarantine, including a time-bound perimeter, are essential in preventing the potential spread of any pathogen.

Published: 07-05-2019 07:00

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