Trafficking brings H5N1 threat home

From ANIMAL PEOPLE, December 2005:

NEW HAVEN–Pickled “jellyfish” could bring the potentially
deadly H5N1 avian flu virus to the U.S., a courtroom learned on
December 15 in New Haven, Connecticut. Food King Inc. owner
Vichittra “Vicky” Aramwatananont pleaded guilty to smuggling more
than 27,600 pounds of chicken feet into the U.S. from Thailand,
mislabeled “jellyfish” to evade inspection. The chicken feet were
sold in 11 states.
“Aramwatananont faces up to six months in prison, but is not
expected to receive jail time when she is sentenced on March 24,”
reported Associated Press writer Matt Apuzzo. “Food King will pay
$170,000 as part of a plea agreement.”
Still passing mostly from bird to bird, rarely crossing into
humans and even more rarely into other mammals, H5N1 has killed 71
people in Indonesia, Thailand, Vietnam, China and Cambodia since
2003: just over half the total number of people known to have become
infected. Most victims were poultry workers, cockfighters, or
members of the families of poultry workers and cockfighters, who
shared their homes with sick birds.

“There are some subtle changes in the genetic makeup of H5N1
which suggest that it is making some of the mutations that would
enable it to have a higher likelihood of being able to become a
human-to-human transmitted virus,” warned senior United Nations
coordinator for avian and human influenza David Nabarro during a
December 16 visit to Pnom Penh, Cambodia.
“Virologists who study these things say ‘Do not get
complacent,'” Nabarro continued. “The fact that it has taken some
years should not lead you to believe that we are through the worst.”
Preparing for the worst–at least in human terms–a National
Institutes of Health immunology team has already mouse-tested a live
version of a genetically weakened strain of H5N1, Lauren Neergaard
of Associated Press disclosed on December 17. Tests on human
volunteers are to follow. The idea is to produce an anti-H5N1
version of the nasal inhalant FluMist.
U.S. experts expect H5N1 to arrive at some point with
migratory birds, probably waterfowl who congregate with Asian and
European flocks inside the Arctic Circle each summer. Migratory
birds have been involved in many fall 2005 H5N1 outbreaks, but so
far have not traveled far after becoming infected, indicating that
the present form of the disease has a short incubation time. Neither
has H5N1 appeared near the northern end of migratory routes. If H5N1
had reached the Arctic, it might have hit Canada, the U.S., and
northern Europe by now, instead of advancing laterally through
Central Asia to eastern Europe.
“Migratory wild birds are blamed for spreading bird flu west
from Asia, yet there has been no spread back eastward, nor to South
Asia and Africa this autumn,” BirdLife International chief executive
Michael Rands told BBC News on December 8. “Wild birds occasionally
come into contact with infected poultry and die,” Rands explained,
“but they are victims, not vectors of H5N1.”
At the southern end of migratory bird routes, in Southeast
Asia, outbreaks of H5N1 since 2003 remain most closely associated
with cockfighting, especially in Thailand. More than 63 million
domestic fowl have been killed in the Thai effort to stop H5N1, but
few have been gamecocks.
Thai cockfighters have vehemently resisted enforcement of
regulations meant to curb the spread of H5N1 by controlling gamecock
transport. Thai agriculture minister Khun Ying Sudarat Keyuraphan
estimated on November 20 that only about 40,000 of up to a million
fighting cocks in Thailand were properly registered. Cockfighting in
the Lopburi district was voluntarily suspended, but Khun Ying
Sudarat Keyuraphan pledged that it could resume by January 1, 2006
if more fighters would register their birds.
“The figure cited–a million fighting cocks!–illuminates the
significant role of this sector in the epidemiology of avian
influenza in Thailand,” commented Arnon Shimshony, a member of the
Koret School of Veterinary Medicine faculty at the Hebrew University
of Jerusalem and zoonotic disease moderator for the ProMed
information network maintained
by the International Society for Infectious Diseases. “Similar
situations may prevail in other southeast Asian countries, and
probably elsewhere,” Shimshony added, recalling the role of
cockfighting in spreading the fungal disease Newcastle in southern
California and New Mexico in early 2003.
Despite the laxity of law enforcement against cockfighting,
some cockfighters have tried to conceal their involvement, from fear
that the birds might be confiscated and killed. This had tragic
consequences in Nakkon Nayok province, where a five-year-old boy
developed a fever on November 21, was hospitalized on December 5,
and died two days later.
“He wouldn’t have died if his parents had told the doctors
about the fighting cocks raised at their home,” fumed Thai public
health minister Phinij Jarsombat.
The boy’s family and all their neighbors were placed under
close surveillance, and more than 500 domestic fowl in the
neighborhood were culled, Apinya Wipatayotin of the Bangkok Post
reported.
As fall turned to winter, new H5N1 outbreaks occured mostly
near the Black Sea.
Romania had detected 18 H5N1 outbreaks in 70 days as of
December 16, chiefly in the Danube delta region. More than 100,000
domestic fowl had already been killed to contain H5N1, widely
believed to have arrived with wild waterfowl during winter migration
despite a lack of evidence as to where the waterfowl might have been
exposed.
The Veterinary Lab Agency in Wey-bridge, U.K., on December
16 confirmed a Russian finding from three weeks earlier that H5N1 had
infected birds in 15 villages of Crimea, scattered throughout the
Black Sea peninsula. Wild migratory waterfowl who stop at the Sivash
saltwater lake during winter migration were blamed for the Crimean
outbreaks. About 62,000 domestic fowl had been killed in Crimean
“stamping out” efforts.
Turkey, where H5N1 was detected on October 5, claimed on
December 9 to have eradicated the disease after killing just 10,147
domestic birds, an unusually low toll for a “stamping out” exercise.
Three thousand bird carcasses were spot-checked for signs of H5N1.
Vietnamese deputy prime minister Pham Gia Khiem on December
16, 2005 announced in Hanoi that the number of farming communes
harboring H5N1 had been cut from 164 in mid-October to just 64.
Vietnam had found no new human cases since November 14. However,
H5N1 stll afflicted 15 provinces.
Chinese chief veterinarian Jia Youling told reporters on
December 14 that no new H5N1 outbreaks had occurred in China since
the end of November. China vaccinated 6.85 billion domestic birds
against H5N1 during 2005, including more than five billion in the
last quarter, Jia Youling said. Efforts to vaccinate all domestic
fowl in China started in October after 26 outbreaks occurred almost
simultaneously in nine provinces. Jia said the October outbreaks
killed 151,200 birds, and “stamping out” to contain H5N1 killed 22.3
million.
Taking the opposite approach to vaccination, Indonesian
health minister Siti Fadilah Supari on December 9 announced plans to
vaccinate all 47 million humans, among the 220 million human
residents of Indonesia, who might have exposure to poultry. H5N1
has appeared so far in 23 of the 33 Indonesian provinces.
In almost the same breath, Siti Fadilah Supari acknowledged
that the Indonesian government does not have the money to undertake
the projected vaccination campaign.