Apart from Iraq, none of the 13 countries newly affected by the avian flu virus during February has reported human cases, said World Health Organisation (WHO), yesterday.

All available evidence indicates that the virus does not spread easily from poultry to humans. To date, very few cases have been detected in poultry workers, cullers, or veterinarians. Almost all cases have been linked to close contact to diseased household flocks, often during slaughtering, defeathering, butchering, and preparation of poultry for consumption.

As per the WHO data, 26 cases have been reported in 2006 and out of this, 16 deaths occurred so far. 92 deaths out of 160 cases were reported to WHO since 2003. Of this, Vietnam has the largest number of causalities, 42 out of 93 reported cases in the 2003-06 period. 19 deaths out of 22 cases reported in Indonesia and 14 deaths out of 22 cases happened in Thailand during the period. In Vietnam, 20 out of 29 people infected with the virus died in 2004 and 19 out of 61 cases died in 2005. In Indonesia, 11 out of 17 reported cases died in 2005 and 8 out of 9 cases died in 2005. In Cambodia, 4 cases were reported in 2005, and all the patients died. In China, 3 out of 4 cases in 2006 and 5 out of 8 cases died in 2005.

For human health, experience elsewhere over the past two years has shown that the greatest risk of cases arises when the virus is established in small backyard flocks, which allow continuing opportunities for close human contact, exposures, and infections to occur. Iraq has reported two human cases, both of which were fatal; samples from several other patients are currently undergoing tests. No cases have been linked to the consumption of properly cooked poultry meat or eggs, even in households where disease was known to be present in flocks, said WHO.

The occurrence of avian flu in India, reported on 18 February, is part of a recent pattern of rapid geographical spread of the virus in wild and domestic birds and India is one of the 13 countries that have reported their first cases of H5N1 infection in birds since the beginning of February,
The 13 countries, listed in order of reporting, are Iraq, Nigeria, Azerbaijan, Bulgaria, Greece, Italy, Slovenia, Iran, Austria, Germany, Egypt, India and France. (Two days ago, Bosnia also said it has detected H5N1 infection in birds).

WHO said on February 20, Malaysia reported a fresh outbreak in poultry after having been considered free of the disease for more than a year. The situation in these recently affected countries varies greatly. Most European countries with good veterinary surveillance have detected the virus in a small number of wild birds only, with no evidence to date of spread to domestic birds.

In Azerbaijan, detection of the virus has coincided with die-offs of domestic birds. In Egypt, outbreaks in domestic poultry have now been confirmed in 10 governorates; deaths have also been reported in exotic zoo birds. In Iraq, presence of the virus in birds was found only after the country confirmed its first human case. In Nigeria, as in India, the first cases were detected in large commercial farms, where the disease is highly visible and outbreaks are difficult to miss.