Second Farm in Ghana Harbors the Lethal Avian influenza strain H5N1
By Solomon K. Sackitey
Date published: 09 May 2007
Date posted on the web: 10 May 2007
In this report, a second farm has been recorded as Ghana’s bird flu incidence since the first one was reported barely a week ago. The H5N1 cases in Ghana do not involve any human infections. Efforts made by the Ghana government to contain the situation have been stated. In addition, future plans have been outlined. A cross-functional Avian Influenza Working Group(AIWG)preparedness plan involving National and International experts which could serve as a model system for the rest of Africa is also highlighted.
Nearly a week after the Ghana government announced the country’s first bird flu case on a small poultry farm at the port city of Tema, another incidence has occurred in the same Tema municipality. If WHO tests prove to be affirmative, the list of African countries with H5N1 cases will increase to eight. The other countries are Djibouti, Egypt, Cameroon, Burkina Faso, Sudan, Cote d’Ivoire (Ivory Coast), Niger and Nigeria. Egypt, Djibuoti and Nigeria are the only three African countries with recorded human cases. While thousands of birds have been culled in Africa, only fifteen people have so far died on the continent from the H5N1 infection. There are no clinical signs of human infection in the bird flu cases in Ghana.
According to Dr. Harry Opata, World Health Organization (WHO) National Program Officer-Disease Prevention and Control, “a national preparedness plan has been put in place since Nov 2005. It has addressed communication to the public, surveillance of bird and human flu, preventive and control measures and finally, strengthening the health system to manage human infections. The government and other agencies like the African Development Bank and the USAID have provided funding for implementation of these actions”. A national Taskforce has been meeting regularly to review how the situation is evolving, he added.
In a statement from Dr. Opata, on 8th May 2007, the National Taskforce on Avian Influenza was informed by the Veterinary Services that a second farm, located within 8 km radius from the initially reported outbreak had also tested positive for H5N1. This is a larger farm; 11,698 fowls had been culled and 9,840 eggs destroyed in response.
Dr. Opata added, “so far, 68 samples have been taken from 29 farms in active surveillance by the Veterinary Services of the Ministry of Food and Agriculture. These farms are all located within 10 km off the farm that was first diagnosed as having been infected with H5N1 virus. Further active surveillance activities are being carried out in the whole of the Tema Municipal Area”.
The Tema Municipal Health Directorate has kept the two farm-communities under surveillance since the outbreaks were declared. In the first farm, the total of 25 community members were line-listed and visited alternate daily and checked for signs of flu-like illness. 13 of these persons had been working directly on the farm or took part regularly / most recently in handling poultry. 9 days after the culling of the fowls none of these persons under surveillance has developed signs of flu-like illness. Similar surveillance activities have been initiated at the second farm, where the community numbered 36.
In a second statement by Dr Opata, under the auspices of the National Disaster Management Organization (NDMO) of the Ministry of Interior, the National Taskforce on Avian Influenza has held three meetings since the onset of the outbreak and has served as the major source of advice to the Ministries of Agriculture, of Health and of Information.
Technical support has been provided to the Taskforce by USAID, WHO and other partners. A communications’ sub-group has been charged to respond to concerns arising from the current outbreak situation from the general public and such bodies as the Poultry Farmers Association.
The Human Health Sub-group of the Taskforce has held two meetings and issues that are being addressed are:
• the rapid response team should continue to support the various district health teams in the response activities
• sentinel sites for surveillance of influenza be set up in the Greater Accra Region to monitor current situation and for early identification of changing trends in human influenza
• a rapid assessment of selected health facilities be carried our and support provided to improve ability to handle human influenza. These facilities include the Military and Police Hospitals which have provided support to the general public in emergencies.
• pre-positioning of surveillance equipment (PPEs and Lab Sample collection tool) and Tamiflu in strategic institutions and with the 10 Regional Pharmacists
Actions to be carried out
Dr. Opata’s statement also elaborated on actions to be carried out as follows:
•The communications sub-group to come out by the end of current week with modalities to expand the capacity of the information control post and relocate it to the premises of the National Disaster Management Organization. Information had been handled by the Veterinary Services and the Disease Surveillance Department hot-line arrangements until the onset of the outbreak.
•Health Sub-group to advise Taskforce on how to keep surveillance of laboratory staff and other staff that regularly handle H5N1 infected materials
•Veterinary services to collaborate with NADMO to support the Tema Municipal Administration in enforcing sanitary regulations in the Municipality and surrounding areas.
•Veterinary Services to collect samples in parallel and send one to the NMIMR while the other is sent through the veterinary laboratory system to Podova – Italy. Further, all samples that have tested negative at the veterinary laboratory should be retested at the NMIMR with the real-time RT-PCR
•Department of Wildlife of the Ministry of Forestry and Mineral Resources to start ringing of migratory birds, especially at the Sakumono Ramsar site that is adjacent to Tema
•Veterinary services advocate of early compensation of affected farmers so as to allay fears of the public and improve farmers support to surveillance and containment activities
Ghana’s first case of bird flu
On 02 May 2007, poultry had tested positive for H5N1 at the Noguchi Memorial Institute for Medical Research (NMIMR) in Accra. The positive test had been corroborated within 36 hours by The U.S. Naval Medical Research Unit No.3 (NAMRU-3) – Cairo, Egypt, where the samples had been forwarded through the NMIMR. NAMRU is charged with research and surveillance functionalities for the US military deployed to Africa, the Middle East and Southwest Asia. Their mission also includes the evaluation of vaccines, therapeutic agents, diagnostic assays, and vector control measures.
Following the first outbreak, emergency steps to contain the outbreak were quickly outlined to the public and other governmental agencies. The Ministry of Food and Agriculture (MOFA) Minister, Mr. Ernest Debrah had ordered the indefinite suspension of import/export activities of birds and had instructed the culling of nearly 2000 birds on the farm
Preparedness strategies put in place in Ghana since 2005
A multifaceted Avian Influenza Working Group (AIWG) whose mission was to devise a risk assessment and Preparedness Plan, was drawn with members from the Ghana Health Service-Ministry of Health, Veterinary Services-Ministry of Food and Agriculture, Wildlife Division-Ministry of Lands, Forestry and Mines, World Health Organization, Food and Agriculture Organization of the United Nations (FAO), United States Agency for International Development (USAID), Quality Health Partners, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon and the National Disaster Management Organization (NADMO) of the Ministry of the Interior. In addition, the AIWG developed a document which included cost estimates for resource mobilization and implementation of the plan in both the human and animal health perspectives.
The five-category plan centered around
A.Planning and coordination
: to devise strategies for preparedness and response policy actions, among others.
B.Surveillance, situation monitoring and assessment:
involves multiple agencies to develop surveillance, monitoring and risk assessments and management in humans, wildlife and in animals.
C.Prevention and containment:
the task of systems implementation and containment measures were assigned to the Ministry of Health whilst the Noguchi Memorial Institute for Medical Research would be responsible for the design and development of quick and sensitive methodologies for the isolation and detection of the virus. Prevention and containment of a possible pandemic in animals was a dual role to be undertaken by MOFA and the Veterinary Services and Wildlife Department.
D.Health System Response:
involves all public health stakeholders in the private and public sectors.
When the audience is confused or unclear about what is going on with the bird flu, the general public is apt to making uncomfortable decisions and taking misguided policy actions. With this in mind, the plan has provided measures to aid in spreading the word about this threat in an expeditious manner. The Health Promotion Unit of the Ghana Health Service was assigned the role to coordinate communication actions of the lead technical Ministries, their Public Relations Units and other agencies.
While several African governments and public health groups in Africa and abroad have provided series of precautionary measures in an effort to prevent a pandemic, the preparedness and implementation strategies in the Ghana plan could be taken in concert with other plans for an effective mobilization of a continental policy action.
Worldwide Bird flu cases since 2003
It started like a little drop of water in Southeast Asia in 2003. Then steadily and slowly, the dreaded Avian influenza virus strain popularly known as bird flu appears to be gaining momentum to form a mighty global ocean with no boundaries.
As of 11 April, 2007, two hundred and ninety-one humans have been infected in Asia, Europe and Africa out of which 172 people have died, 14 of the dead were in Africa.
Several African governments and public health groups in Africa and abroad have provided series of precautionary measures in an effort to prevent a pandemic. When the audience is confused or unclear about what is going on with the bird flu, the general public is apt to making uncomfortable decisions and taking misguided policy actions. With this in mind, the following resources are provided to aid in spreading the word about this threat in an expeditious manner:
(1) Questions and answers on pandemic influenza vaccine
(2) Avian influenza H5N1 Regulatory Updates and Vaccines Initiatives
(3) Avian influenza H5N1 (bird flu) human cases in three African Countries
(4) Avian influenza control and eradication
Solomon, a Datelinehealth-Africa (DLHA) News Service Avian influenza (H5N1) Alert sub-editor is DLHA award winning United Nations Online Volunteer of the Year 2006
. The research work of Solomon and his colleagues includes publications on HIV/AIDS DNA Vaccines, E. coli O157:H7 detection and Maize Transposable Elements. He has authored series of articles on the bird flu through which he contributed to developing and managing knowledge by stimulating the formulation of action plans, guiding policy processes and supporting research on Avian influenza for African countries. (UNV news release December 2006)