Is Uganda ready for bird flu outbreak?
Mar 21, 2006
Dear Dr. William Olala Mukane, Director of Animal Resources in the Ministry of Agriculture. According to media report last Friday, Uganda has imported 1000 units of the influenza drug oseltamivir, known by the brand name Tamiflu.
PERSPECTIVE OF A UGANDAN IN CANADA
Opiyo Oloya
Dear Dr. William Olala Mukane, Director of Animal Resources in the Ministry of Agriculture. According to media report last Friday, Uganda has imported 1000 units of the influenza drug oseltamivir, known by the brand name Tamiflu.
The same report quoted you as saying that the importation of the drug offers some ray of hope that Ugandans would be safe in case of an outbreak of the much feared bird flu.
You were correct in reassuring Ugandans that there is currently no confirmed outbreak of bird flu in the region. However, in talking about Tamiflu, you may have given Ugandans false hope about their safety in the event of a flu pandemic. Foremost, the impression you gave to the people of Uganda is that Tamiflu is the definitive shield against bird flu H5N1—with Tamiflu, nothing can happen to you.
Secondly, you drive home the idea that 1000 units of Tamiflu is adequate amount of drug to serve the country. None of these could be further from reality. Here is why. As you know, the bird flu H5N1 is extremely infectious and transmissible in birds, and deadly for humans infected by it. As of Monday, March 20, 2006, of the 177 reported human cases of the bird flu in Southeast Asia, Turkey and the Middle East, there have been 98 deaths (52%) of those infected.
The latest reports suggest an Egyptian woman may have died from bird flu on Friday. Meanwhile authorities in the Democratic Republic of Congo suspect that bird flu killed as many as 100 fowl in a single day in Tshikapa, in the south-central province of Kasai Occidental. Tests are underway to determine whether the flu was to blame.
Given the nature of the virus, scientific experts believe that once the virus is transmissible from human tohuman (instead of from bird to human as is currently the case), the flu pandemic will move rapidly, infecting hundreds of thousands, even millions of people within a very short time. Estimates of global deaths from a possible bird flu pandemic run between a few millions to a billion.
The wildfire-like scenario to the spread of the H5N1 virus is what has got scientists extremely worried. In the 1918 pandemic, the strain of influenza called the H1N1, better known as the Spanish flu swept across the globe so rapidly that 20 to 50 million people perished in short order. The world generally, and Africa specifically, need accurate and straight information with no sugar-coating.
First, the drug Tamiflu being manufactured at a furious pace by Switzerland-based Roche Pharmaceutical and its affiliates is generally considered effective against the bird flu in its current state of bird-to human transmission. However, scientists are not sure that Tamiflu will provide effective treatment when the H5N1 virus evolves to human- to-human transmission. Flu researchers are aware of at least one human case in Vietnam where the Tamiflu was not effective against the virus. Indeed, some health experts are warning against over-confidence in Tamiflu.
On Friday, speaking to ABC Evening News, Dr. Anthony Fauci, director of US National Institute of Allergy and Infectious Diseases at the National Institutes of Health advised Americans not to stockpile Tamiflu because scientists still do not know how the H5N1 virus will behave once it starts moving from human to human.
Only when the pandemic has started can scientists isolate the new strain of the H5N1 in order to develop a vaccine, a process that could take up to six months.
Secondly, 1000 units of Tamiflu will treat exactly that many number of patients (According to information from Roche, each pack of Tamiflu contains the full treatment course of 10 capsules per patient).
In simple terms, the quantity of Tamiflu Uganda has imported will definitely not be enough to treat sick Ugandans in the event of a pandemic.
Truth be said, there is not enough Tamiflu around the world. For example, the US has currently stockpiled Tamiflu for less than 2 percent of its population; Canada has enough for about 6 percent of its population, while Britain has the largest cache for about 25 per cent of the population. So what good is stockpiling Tamiflu in fighting the H5N1?
Many countries consider the drug as an interim “fire barrier†to slow down the spread of H5N1 during the initial outbreak. WHO, which has a stockpile ready for deployment wherever it is required, specifically recommends that in the case of an outbreak, Tamiflu be provided first to essential workers such as doctors, nurses and other health professionals as a prophylaxis which protects them as they go about treating the sick or those showing flu symptoms. For Africa generally and Uganda specifically, therefore, health officials need to work very closely with WHO to develop advertisements for newspapers, radios and television and schools.
The entire population must be educated about vigilance to report to authority suspicious bird deaths as well as a cluster of people suffering from an unusually severe respiratory ailment.
Secondly, once international experts have confirmed the beginning of human-to-human transmission of the H5N1 flu virus, people must know that quarantine orders from public health officials must be obeyed 100 per cent to slow down transmission. The best time to prepare for this major war is now, doctor. It will be too late once the pandemic begins.
Opiyo.oloya@sympatico.ca
Opiyo Oloya
Dear Dr. William Olala Mukane, Director of Animal Resources in the Ministry of Agriculture. According to media report last Friday, Uganda has imported 1000 units of the influenza drug oseltamivir, known by the brand name Tamiflu.
The same report quoted you as saying that the importation of the drug offers some ray of hope that Ugandans would be safe in case of an outbreak of the much feared bird flu.
You were correct in reassuring Ugandans that there is currently no confirmed outbreak of bird flu in the region. However, in talking about Tamiflu, you may have given Ugandans false hope about their safety in the event of a flu pandemic. Foremost, the impression you gave to the people of Uganda is that Tamiflu is the definitive shield against bird flu H5N1—with Tamiflu, nothing can happen to you.
Secondly, you drive home the idea that 1000 units of Tamiflu is adequate amount of drug to serve the country. None of these could be further from reality. Here is why. As you know, the bird flu H5N1 is extremely infectious and transmissible in birds, and deadly for humans infected by it. As of Monday, March 20, 2006, of the 177 reported human cases of the bird flu in Southeast Asia, Turkey and the Middle East, there have been 98 deaths (52%) of those infected.
The latest reports suggest an Egyptian woman may have died from bird flu on Friday. Meanwhile authorities in the Democratic Republic of Congo suspect that bird flu killed as many as 100 fowl in a single day in Tshikapa, in the south-central province of Kasai Occidental. Tests are underway to determine whether the flu was to blame.
Given the nature of the virus, scientific experts believe that once the virus is transmissible from human tohuman (instead of from bird to human as is currently the case), the flu pandemic will move rapidly, infecting hundreds of thousands, even millions of people within a very short time. Estimates of global deaths from a possible bird flu pandemic run between a few millions to a billion.
The wildfire-like scenario to the spread of the H5N1 virus is what has got scientists extremely worried. In the 1918 pandemic, the strain of influenza called the H1N1, better known as the Spanish flu swept across the globe so rapidly that 20 to 50 million people perished in short order. The world generally, and Africa specifically, need accurate and straight information with no sugar-coating.
First, the drug Tamiflu being manufactured at a furious pace by Switzerland-based Roche Pharmaceutical and its affiliates is generally considered effective against the bird flu in its current state of bird-to human transmission. However, scientists are not sure that Tamiflu will provide effective treatment when the H5N1 virus evolves to human- to-human transmission. Flu researchers are aware of at least one human case in Vietnam where the Tamiflu was not effective against the virus. Indeed, some health experts are warning against over-confidence in Tamiflu.
On Friday, speaking to ABC Evening News, Dr. Anthony Fauci, director of US National Institute of Allergy and Infectious Diseases at the National Institutes of Health advised Americans not to stockpile Tamiflu because scientists still do not know how the H5N1 virus will behave once it starts moving from human to human.
Only when the pandemic has started can scientists isolate the new strain of the H5N1 in order to develop a vaccine, a process that could take up to six months.
Secondly, 1000 units of Tamiflu will treat exactly that many number of patients (According to information from Roche, each pack of Tamiflu contains the full treatment course of 10 capsules per patient).
In simple terms, the quantity of Tamiflu Uganda has imported will definitely not be enough to treat sick Ugandans in the event of a pandemic.
Truth be said, there is not enough Tamiflu around the world. For example, the US has currently stockpiled Tamiflu for less than 2 percent of its population; Canada has enough for about 6 percent of its population, while Britain has the largest cache for about 25 per cent of the population. So what good is stockpiling Tamiflu in fighting the H5N1?
Many countries consider the drug as an interim “fire barrier†to slow down the spread of H5N1 during the initial outbreak. WHO, which has a stockpile ready for deployment wherever it is required, specifically recommends that in the case of an outbreak, Tamiflu be provided first to essential workers such as doctors, nurses and other health professionals as a prophylaxis which protects them as they go about treating the sick or those showing flu symptoms. For Africa generally and Uganda specifically, therefore, health officials need to work very closely with WHO to develop advertisements for newspapers, radios and television and schools.
The entire population must be educated about vigilance to report to authority suspicious bird deaths as well as a cluster of people suffering from an unusually severe respiratory ailment.
Secondly, once international experts have confirmed the beginning of human-to-human transmission of the H5N1 flu virus, people must know that quarantine orders from public health officials must be obeyed 100 per cent to slow down transmission. The best time to prepare for this major war is now, doctor. It will be too late once the pandemic begins.
Opiyo.oloya@sympatico.ca