Global spread of H5N1 in 2006

The global spread of (highly pathogenic) H5N1 in birds is considered a significant pandemic threat.

While prior H5N1 strains have been known, they were significantly different from the 2006 strain of H5N1 on a genetic level, making the global spread of this new strain unprecedented. The 2006 strain of H5N1 is a fast-mutating, highly pathogenic avian influenza virus (HPAI) found in multiple bird species. It is both epizootic (an epidemic in non-humans) and panzootic (a disease affecting animals of many species especially over a wide area). Unless otherwise indicated, "H5N1" in this article refers to the highly pathogenic 2006 strain of H5N1.

In the first two months of 2006 H5N1 spread to Africa and Europe in wild bird populations possibly signaling the beginning of H5N1 being endemic in wild migratory bird populations on multiple continents for decades, permanently changing the way poultry are farmed. In addition, the spread of highly pathogenic H5N1 to wild birds, birds in zoos and even sometimes to mammals (example: pet cats) raises many unanswered questions concerning best practices for threat mitigation, trying to balance reducing risks of human and nonhuman deaths from the current nonpandemic strain with reducing possible pandemic deaths by limiting its chances of mutating into a pandemic strain. Not using vaccines can result in the need to kill significant numbers of farm and zoo birds, while using vaccines can increase the chance of a pandemic.

By April 2006, scientists had concluded that containment had failed due to the role of wild birds in transmitting the virus and were now emphasizing far more comprehensive risk mitigation and management measures.

In June 2006 the World Health Organization predicted an upsurge in human deaths due to H5N1 during late 2006 or early 2007. In July and August 2006, significantly increased numbers of bird deaths due to H5N1 were recorded in Cambodia, China, Laos, Nigeria, and Thailand while continuing unabated a rate unparalleled in Indonesia. In September, Egypt and Sudan joined the list of nations seeing a resurgence of bird deaths due to H5N1; followed by Vietnam and South Korea in December.

January

January 5, 2006
*A second Turkish child from the same family died from bird flu on Thursday at a hospital in eastern Turkey, where she was being treated, a regional governor said. Her brother, 14-year-old Mehmet Ali Kocyigit, had already died of the H5N1 strain of bird flu, officials said on Wednesday, confirming the first human death from the disease outside Mainland China and southeast Asia. "We lost Fatma Kocyigit this morning", Niyazi Tanilir, governor in the eastern province of Van, said on the CNN Turk news channel. Newspapers said Fatma was 15 years old. She died around 6:30 a.m. (0430 GMT).

January 7, 2006
*Two more children in Turkey are hospitalized after contracting bird flu like symptoms then later test positive for H5N1. They are both from the same area as the prior three children that died from H5N1 bringing the total number of cases in Turkey to 5, with 2 of them fatal. 76 people have died since the outbreak began in 2003.

January 8, 2006
*Three people are hospitalized after developing suspected H5N1 in the Turkish capital.

January 10, 2006
*A woman is diagnosed with bird flu, as Turkey struggles to contain the outbreak.
*China announces that two more people had died of bird flu before 2006 began.
*Indonesia confirms that a 29-year-old woman has died from suspected bird flu.
*Birds begin dying in Nigeria. It is not known until February that it is an H5N1 outbreak.

January 16, 2006
*A 15-year-old Indonesian girl from Indramayu, West Java, dies of bird flu.

January 18, 2006
*China and Turkey each confirm another human death from H5N1.
* A 13-year-old boy dies in Indonesia, he is the brother of the girl who died on January 16.
* Donor nations pledge US$1.85 billion to combat bird flu at the two-day International Pledging Conference on Avian and Human Influenza held in China.

January 21, 2006
* The WHO confirms that the two Indonesian children died of H5N1.

January 29, 2006
* H5N1 is found in dead birds in northern Cyprus. The European Commission freezes transfers of animals and animal products from the north of the island through the green line to the areas controlled by the Republic of Cyprus and to the rest of the European Union.

January 30, 2006
*According to WHO:
:The Ministry of Health in Iraq has confirmed the country's first case of human infection with the H5N1 avian influenza virus. The case occurred in a 15-year-old girl who died on 17 January following a severe respiratory illness. Her symptoms were compatible with a diagnosis of H5N1 avian influenza. Preliminary laboratory confirmation was provided by a US Naval Medical Research Unit located in Cairo, Egypt. The girl's 39-year-old uncle, who cared for her during her illness, developed symptoms on 24 January and died of a severe respiratory disease on 27 January. Both patients resided in the town of Raniya near Sulaimaniyah in the northern part of the country, close to the border with Turkey. Poultry deaths were recently reported in their neighbourhood, but H5N1 avian influenza has not yet been confirmed in birds in any part of the country. Poultry samples have been sent for testing at an external laboratory. A history of exposure to diseased birds has been found for the girl. The uncle's source of infection is under investigation. The Ministry of Health has further informed WHO of a third human case of respiratory illness that is under investigation for possible H5N1 infection. The patient is a 54-year-old woman, from the same area, who was hospitalized on 18 January. Specimens are on their way to a WHO collaborating laboratory in the United Kingdom for diagnostic confirmation and further analysis. An international team, including representatives of other UN agencies, is being assembled to assist the Ministry of Health in its investigation of the situation and its planning of an appropriate public health response. WHO staff within Iraq have been directly supporting the government's operational response, which was launched shortly after the girl's death. Iraq is the seventh country to report human H5N1 infection in the current outbreak. The first human case occurred in Vietnam in December 2003.

February

February 4, 2006
*Indonesia confirms three new cases, two of which were fatal.
*A dead swan near the city of Vidin, Bulgaria is found to contain the H5 strain. Further testing begins to determine if the bird died from the H5N1 type of the disease. Over 20 dead birds are found along the Danube and in lakes near the Black Sea.

February 6, 2006
* Preliminary report is sent from Nigeria to OIE on a massive bird die off that began January 10. Report was sent by Dr. Junaidu A. Maina, Acting Director, Department of Livestock and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria.

February 7, 2006
* OIE/FAO Reference Laboratory for avian influenza and Newcastle disease in Padova, Italy, confirmed highly pathogenic avian influenza virus subtype H5N1 in Nigerian isolates from samples taken January 16.

February 8, 2006
*The Nigeria situation is announced to the world. Nigeria is the first African country to have an H5N1 outbreak confirmed. It affected a commercial chicken farm (owned by Nigeria's sports minister, Saidu Samaila Sambawa) in which ostriches and geese were also kept, in Jaji village in Igabi administrative division (local government area or LGA) in Kaduna State in Nigeria. The control measures said to be used include killing poultry, quarantining poultry, poultry movement control, and disinfection; however there are complaints that these measures are in fact not being carried out. 40,000 out of 46,000 caged chickens died of H5N1 despite being treated by their owner with broadspectrum antibiotics. The remaining 6,000 have been killed to try to control spread of the disease.

February 9, 2006
*Four new farms in Nigeria are confirmed to have H5N1 outbreaks: two in Kano State, one in Plateau State and a second farm in Kaduna State.
*Veterinarians from Onderstepoort Veterinary Institute, Faculty of Veterinary Science, University of Pretoria in South Africa offer their expertise to assist in tracking occurrence of the virus in Nigeria and elsewhere in Africa.
*The United States, OIE and WHO are sending experts, supplies and money to Nigeria to help with this H5N1 crisis.
* H5N1 flu in Africa is expected to spread and create a very severe situation.
*Farmers in northern Nigeria are rushing to sell dead chickens at cut-price rates before government bans are put into place. Promised measures to contain the disease are still not in place.
*European countries are facing an increased probability that spring bird migrations from Africa will bring H5N1.
*Countries in Africa near to Nigeria are responding with "dread" and import restrictions.

February 10, 2006
*Officials in Azerbaijan say H5N1 virus has been identified in wild birds floating dead in the Caspian Sea near Baku

February 11, 2006
*The government of Italy confirms that H5N1 has been found in wild swans in Sicily and elsewhere in the country. It is also found in wild birds in Greece and Bulgaria.

February 12, 2006
*The government of Slovenia confirms that the virus subtype H5 has been found in a wild swan by the Drava river near Maribor. The samples have been sent to the United Kingdom to determine if it is the deadly H5N1 strain.

February 13, 2006
* Nihat Kabil, Bulgaria's Minister of Agriculture and Forestry, confirms a second case of a swan with the H5 virus. While the first case was in Vidin (in the country's northwest), the second one was near Krajmorie, a Black Sea port in the Burgas region (in the country's southeast), about from an egg farm. Several other cases have been reported in other parts of the country, and Mr. Kabil has said that there is a high probability that Bulgaria will have its first mass case within days.

February 14, 2006
*Health authorities report the first case of the H5N1 virus in Austria. Two dead swans at Mellach near Graz were found to be carrying the virus.
* Following the discovery of four dead swans suspected of carrying the H5N1 virus on the island of Rügen in North-east Germany, authorities in Germany and several other EU countries make it compulsory for all poultry to be kept inside enclosures effective as of February 20.

February 15, 2006
*Slovenian Ministry of Agriculture, Forestry and Food declares entire Slovenia a bird-flu high risk zone after tests confirmed the dead swan (found on 9 February) was carrying H5. It is sent to Great Britain for further subtype determination.
* Avian influenza H5N1 is identified in some dead swans in Hungary. Not known until the end of February whether they carried the human-infecting strain (genotype Z) of H5N1.
*Iran reports cases in wild birds.

February 17, 2006
*The presence of H5N1 in Slovenia is confirmed.
*Egypt has detected its first cases in several parts of the country, the government detailed three separate sites where birds were found carrying the virus.
*France has recorded a case of a duck infected with the H5 virus in Ain, near Lyon. It was later confirmed that the duck was infected with the H5N1 strain of the virus. A swan earlier tested negative for the disease.
*Iraq confirms a second person has died of H5N1 - he was the uncle of the country's initial death.

February 18, 2006
*Officials in India's western Maharashtra state are planning a poultry cull after the country reported its first cases of the deadly H5N1 strain of bird flu.

February 19, 2006
*First suspected bird flu human death reported from Surat, Gujarat, India.

February 20, 2006
*Croatia has recorded a new case of a swan infected with the H5 virus in Ciovu, near Trogir. In the same time, H5 is confirmed in dead swan found in Jajce, Bosnia and Herzegovina.
* A United Kingdom laboratory confirms the three cases of H5N1 in dead swans found near the cities of Dobrich, Varna and Burgas, in Bulgaria's northeastern and southeastern regions. The previous H5N1 case was recorded near Vidin in the northwest.

February 21, 2006
* The Malaysian government confirms 40 chickens died of H5N1 in Selangor.
* Croatia confirmed the previous day's case to be H5N1.
*Professor Neil Ferguson, Imperial College London biologist, says:
:"This is a disease which doesn't go away so we are going to be living with H5N1 in Western Europe, I believe, in wild bird populations - even endemic in wild bird populations - for decades perhaps, or even sporadically in those populations every year."
*The respected science journal Nature says:
:"''The virus is highly likely to become endemic,'' says Peter Openshaw, head of the respiratory viral infections section at the National Heart and Lung Institute in London, UK. ''We have to change the way poultry are farmed.'' ..Jan Slingenbergh, an animal health expert at the United Nation's Food and Agriculture Organization (FAO) in Rome, Italy, points out that H5N1 may survive in icy lake waters over European winters, potentially infecting any migratory birds that subsequently arrive. The virus could also become established in permanently resident European birds; Openshaw notes that H5N1 has so far been able to infect a wide range of species. If this happens, farming practices will have to be changed, says Neil Ferguson, an epidemiologist at Imperial College London, UK, who is advising the British government on how to deal with possible future outbreaks."

February 23, 2006
*Slovakia has become the latest EU nation to confirm cases of the virulent H5N1 bird flu strain. One of the dead birds was found in the capital, Bratislava, the other in Gabcikovo, southwestern Slovakia

February 25, 2006
*France For the first time an EU farm becomes infected and 80% of the more than 11 thousand birds die for the H5N1 flu in the previous week

February 27, 2006
*Niger

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