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Flu pandemic in South-East Asia is imminent - WHO
Oct 6, 2005, 21:17, Reviewed by: Dr.
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Countries in the South-East Asia Region have been alerted to an influenza pandemic in the future, similar to what was experienced in the last century. Dr Samlee Plianbangchang, Regional Director for the South-East Asia Region says,�The threat of a pandemic is very real. It is no longer a question of �if� it will occur. It is now only a question of �when�? When this happens, human casualties could be in the order of millions, and severe economic losses would result.�
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By WHO,
While it is not possible to predict the exact numbers who could be affected in a pandemic influenza outbreak, the three epidemics of the last century provide cause for serious concern. Dr Samlee said that two of three pre-requisites to start any influenza pandemic, have already been met. These are i) emergence of a new virus to which all are susceptible and ii) the new virus is able to replicate and cause disease in humans. The third pre-requisite, which has not yet happened, would be the ability of the new virus to be transmitted efficiently from human-to-human.
Dr Samlee said �Low income countries, which are ill equipped to handle a pandemic are likely to be the worst affected�. Not only would a pandemic make people sick, it would probably overwhelm health care systems, with an urgent need for unprecedented numbers of hospital beds, doctors, health care workers, vaccines and medicines. This would also likely bring to a grinding halt, normal life, affecting work places, industry, schools, tourism, travel, everything. The economic and social cost it would exact would be truly devastating.
He cautioned that all countries must be prepared to respond to this inevitable threat. �WHO is assisting countries to prepare National Pandemic Preparedness Plans, and also in investigating outbreaks of avian influenza. WHO is also procuring and stockpiling anitiviral drugs so they are readily available when an outbreak occurs�.
So far the H5N1 virus has caused 116 human cases of which 60 have been fatal. The two striking features of this outbreak are that 1) most cases have been apparently healthy children and young adults and 2) the case fatality rates are very high. So far, most human cases have been linked to direct exposure to dead or sick poultry.
Of the four countries where human cases have been reported so far, two are in WHO�s South-East Asia Region � Thailand and Indonesia. In Indonesia three fatal human cases of H5N1 influenza have occurred, while poultry outbreaks have been reported since January 2004.
The last case of laboratory confirmed H5N1 Avian influenza announced by the Ministry of Health in Indonesia on 29th September is of a 27-year-old woman from Jakarta who developed symptoms on 17 September, was hospitalized on 19 September, and died on 26 September.
Confirmatory testing was conducted at a WHO reference laboratory in Hong Kong. Initial investigation had revealed that the woman had direct contact with diseased and dying chickens in her household shortly before the onset of illness.
As a result of intensified surveillance and heightened public concern, growing numbers of people with respiratory symptoms or possible exposure to the virus are being admitted to hospital for observation and, when appropriate, treatment. Until a conclusive diagnosis is made, these patients are classified by the Ministry of Health Indonesia, as �suspect� cases. While many do not have symptoms compatible with a diagnosis of H5N1 infection, screening of patient samples is being undertaken in national laboratories as part of efforts to ensure that no new cases are missed.
According to FAO, highly pathogenic H5N1 avian influenza is now endemic in poultry in many parts of Indonesia. As influenza virus activity in Indonesia may increase during the wet season, from November to April, human exposure to animal virus could be greater during the coming months. Further sporadic human cases can be anticipated. 
- WHO Regional Office for South-East Asia
whosea.org
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