Friday, August 12, 2005
H5N1 Update - US Armed Forces At Risk?
Reports of odd illnesses in the affected areas continue (largely associated with contaminated natural bodies of water?), and authorities now seem to be quarantining the human population of some areas. It's too early to tell whether this will be broadly necessary. If it really has made it to the Volga delta, it is likely that a lot of birds will become infected and fly south in a month or two. Russia wants to vaccinate all poultry workers. The flu is believed to be spreading in the feces of migratory birds, so there is concern that the wheels of vehicles could carry the virus from one place to another. Poultry farmers are trying to establish heightened security and quarantine measures to prevent infection. Russian authorities now admit that the disease will remain endemic in Siberia.
If this has made it to the Caspian Sea our military forces are likely to encounter the virus with 3-6 months. Iran is to the south and Turkey is west of the Caspian Sea. Both have borders with Iraq. In the south of Iraq are wetlands and birds will fly in there. See this map. The Caspian Sea is the body of water extending down from Russia and Kazakhstan to Iran. The Volga runs into the Caspian Sea and the Volga delta is in the top left of the Caspian Sea.
This map shows a more detailed outline of the area. Note that the outbreaks and protective measures have been reported to the far north in Udmurtia, Omsk, Kurgan, the Altai and Novosibirsk. Novosibirsk and Krasnoyarsk were reporting sudden pneumonia cases and some sudden deaths last week in humans. Mongolia has had outbreaks. Kazakhstan has outbreaks. Krygzstan may have outbreaks. The virus has emerged in Tibet. As the dots fill in, it becomes clear that the Qinghai strain is moving as rapidly as migrating birds. Unfortunately, our soldiers will soon be in the path of this disease.
H5N1 does not appear to have achieved efficient human-to-human transmission, but neither has West Nile virus. Yet WNV is a significant threat to human health in some areas. Our armed forces need information and protection; they are now vulnerable. A person died in Vietnam from H5N1 recently. He had eaten a bird which had become ill from the virus. At a minimum the Armed Forces should forbid eating any local poultry for troops deployed in Central Asia, Afghanistan or Iraq. A different strain of this virus killed over 100 tigers in India. It is also known to infect swine. Unofficial reports of tests in China claimed it killed mice.
Unofficial reports from Qinghai in China were of over a hundred human deaths. Most were attributed to eating o being in contact with the sick birds. The virus does present a signficant threat to human health in its present form, and no one can properly assess how significant that threat is because we don't yet have enough experience with it. But there should be enough information to warrant stockpiling of drugs for the military (the strain which is spreading so rapidly probably is not amantadine/rimantadine resistant), isolation of the new strain with the purpose of preparing a vaccine likely to be effective against it, institution of sanitary measures and a ban against buying meat to serve to the troops from local markets.
Furthermore, we have at least some responsibility for the public health of the people of Iraq and we should be preparing to help the Iraqi government meet that responsibility. This situation is developing incredibly quickly. From the focal point in Qinghai Lake, China, this strain appears to have spread over a vast land area in three months. The time for the US Army to prepare to the extent possible is now.
This post is also available at Blogger News Network.
I don't think anyone can stop it from spreading with the birds, and I don't think anyone can stop it from becoming endemic in most areas in which wild birds flock. A week ago in Russia they were announcing the epidemic was almost over. Two days ago they greatly expanding culling and quarantines, and now have conceded that it will remain endemic in Siberia.
So that leaves only limiting human exposure. History tells us that deployed military forces are at high risk for breakouts of illnesses. I don't think history can be ignored safely in this instance.
I do not understand why there are protocols for actions, etc, to be taken in the event of an (inevitable) outbreak.
But this is a new thing. There are more reports of bird flu this morning, and more reports of illness in Udmurtia. At least one official has now been fired in Russia for covering up an outbreak in a poultry processing facility.
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