The fact that the flu has reached
, the globe's poorest continent - already heavily burdened with AIDS and malaria
- is extremely worrisome, the experts said.
United Nations agencies are scrambling to form medical and veterinary response
teams and to reorient a polio surveillance network they have created in
to search for avian flu.
"These are horrendous developments, whether you're a
human or if you're a bird," said John Oxford, professor of virology at
Queen Mary's college at the
. "Everyone wondered what would happen if avian influenza came to
, but no one really prepared. They waited. Now it's there - and this is not the
most organized continent in the world."
Most bird flu cases have been in
. On Sunday,
said two women had died last week from bird flu, pushing the death toll from
the disease there to 18, The Associated Press reported from
European officials announced Saturday that the deadly H5N1
strain of the virus had been detected in wild birds in
, the first time its presence has been detected in the European Union, and also
had been found in
"The bird flu virus has arrived in
," Francesco Storace, the Italian health minister, said at a news
conference, announcing that 17 swans had been found dead in three southern
. Tests on samples from the swans at the Italian National Avian Influenza Lab in
were positive for bird flu, he said.
The arrival of bird flu in in the European Union had been
predicted for months, as the virus has marched steadily from eastern Asia to
to the Balkans and, in the last week, to
. Experts said the virus was being carried by migrating birds, so all countries
on their flight paths were vulnerable.
World health officials said they have not had the
cooperation they need from many poor countries, even those on the flight paths
of migrating birds known to carry flu.
Because of poor surveillance and rudimentary laboratory
capabilities, they often receive lab samples for testing weeks or months after
problems begin. For that reason, they worry that the disease is already much
more widespread than they can prove.
"We are fighting the good fight, but to win it we'll
need a lot more proactive surveillance and prevention," said Juan Lubroth,
a senior veterinarian at the UN Food and Agriculture Organization in
There is strong evidence that bird flu took root in Nigeria
"a few months ago," Lubroth said, even though it was confirmed only
last week, after veterinary officials there had said last Monday that bird flu
was not in the country.
The outbreak gained official attention only after 40,000
birds died on a commercial poultry farm in January. But such farms are generally
the last place to have outbreaks, Lubroth said, because they are relatively
isolated from the general poultry stock.
The virus may have percolated in backyard flocks for
months, he said.
"How long has it been trickling around, with five
deaths here and five deaths there, and owners would possibly not be aware of the
problem?" he asked.
, which reported its first cases on Friday, bird flu was only "picked up
because of international pressure to come clean," Lubroth said.
There may be more unreported outbreaks in Africa and the
, he said.
"We've been repeating over and over to countries that
they have to be vigilant, but in most countries it's business as usual. They
say, 'Avian influenza isn't here now. We'll deal with it when it arrives.' But
then it's too late."
Maria Cheng, a spokeswoman for the World Health
Organization, said the agency suspected there might be human cases of bird flu
in Africa, but had no way to confirm that yet.
"We're getting a team ready to go," she said,
"but we're waiting to get the invitation from
Thanks to a massive infusion of cash from a World Bank
donors conference on bird flu in
last month, the UN food and agriculture agency now has almost 30 million to
help poor countries combat the disease.
But even when scattered UN teams are in place, the disease
could spread faster than they can track it, experts said. The health care
systems of most African countries are so broken down that most are unable to
vaccinate children or distribute AIDS drugs without Western financial aid and
The only WHO-licensed laboratories in Africa that are
sophisticated enough to sequence flu viruses are in
Little is known about the spread of even regular seasonal
flu, said Michael Perdue, a scientist with the World Health Organization
influenza program in
"We get samples that
takes from neighboring countries," he said, "but we know very little
Also, confusion about avian flu is clearly rife in
On Monday, the chief of veterinary services in the Nigerian
assured the country that the epidemic, which had killed 60,000 chickens in
mid-January, was avian cholera - a disease with different symptoms that is
caused by bacteria, not a virus.
The Nigerian government announced Saturday that the U.S.
Embassy had promised 25 million in aid and 2,000 protective suits for use in
fighting the outbreak.
is one of the world's last outposts of endemic polio and a major eradication
drive is going on there now.
David Heymann, who is in charge of the World Health
Organization polio campaign, said the 300 Nigerian health workers now trained to
spot paralysis cases in children and collect fecal samples for polio tests could
be trained to look for cases of flu and pneumonia and possibly to collect nasal
"They have vehicles and cellphones, so they're a valuable resource,"
he said. "It's a logical piggyback."
With little accurate information about the disease's
spread, scientists have been left to speculate about the possible impact of the
Population density is lower than in
, Heymann noted, which could slow the spread.
"Flu could wipe out all the chickens in a village, but
there's still savannah or jungle between the villages," he said. Also,
living with birds under the same roof is somewhat less common than in
also has the worst AIDS epidemic in the world in some countries nearly a third
of the adult population is infected.
In the initial stages, having a depressed immune system
could have a protective effect, said Michael Osterholm, director of the Center
for Infectious Disease Research and Policy at the University of Minnesota,
because virulent flus set off a powerful immune reaction that can drown the
lungs in fluid.
However, he added, it would probably hurt patients trying
to fight off secondary immune reactions.
But HIV-infected people who managed to fight off bird flu
would become ideal crucibles in which the H5N1 virus could exchange genes with
other viruses, dramatically increasing the likelihood of a bird flu strain that
could readily infect humans.
"If H5N1 gets into people with AIDS it would likely
persist and throw off mutants left, right and center,"