San José, Costa Rica, since 1956

Avian Virus in ‘Pre-pandemic’ Stage, Authorities Denounce Flu Frenzy

Alarmed by the national and internationalmedia frenzy surrounding avian flu, CostaRica’s health authorities have asked that peopleremain calm and informed regarding the threatof a possible pandemic, or global epidemic.At the press conference following PresidentAbel Pacheco’s Cabinet meeting, where avian fluwas first on the agenda this week, Public HealthMinister Rocío Sáenz said that “people shouldremain informed about avian flu, but they shouldnot be alarmed.”Carlos Jiménez, director of the school of veterinarymedicine of the Universidad Nacional (UNA) in Heredia,north of San José, reiterated this idea, explainingthat, although the press may have raised fears about animpending apocalypse, Costa Rican health officialsstarted taking preventive measures a long time ago, andthe country has by no means entered a state of emergency.IN previous weeks, officials warned that a pandemiccould begin at any time. Sáenz said it could occur in “two years, two months or two days,” and Daniel Salas, of the ministry’s HealthVigilance Unit, said it is certain that a pandemicwill take place (TT, Oct. 21).According to Minister Sáenz, the country’sofficial plan for responding to a worldwidehealth crisis will be ready Nov. 17.Work on the plan, drawn up by membersof the Health Ministry, the Ministry ofAgriculture and Livestock (MAG), theNational Emergency Commission (CNE)and public hospitals, among other institutions,started four months ago (TT, Oct. 21).The World Health Organization hasadvised countries to create these plans.U.S. President George W. Bushannounced Tuesday that the U.S. plan willinclude the allocation of $7 billion to preventavian flu from emerging in his countryand to contain outbreaks worldwide incase of a pandemic, the daily La Naciónreported.AVIAN flu has so far affected a total of15 countries, including two Europeannations, causing heavy economic lossesand 61 deaths as of last week, according toJiménez.He said the flu, recently diagnosed inpeople in Greece and Turkey, has left 250million dead birds and approximately $500million in losses worldwide so far.Of the 118 people the virus has struck,61 died, giving it a mortality rate ofapproximately 50%, Jiménez said during apress conference at UNA last week.However, Jiménez explained the virusdid not spring up “yesterday,” but wasdetected in humans almost a decade ago,emerging in Guangdong, China in 1996and spreading to Hong Kong in 1997.In 2003, the virus struck theNetherlands, infecting approximately1,200 people, he said.Of that number, only 89 people developedthe virus and became ill, and of these,one – a fellow veterinarian – died, Jiménezsaid, showing the virus does not alwayspresent the high mortality rate it has inAsia.He said that the aviculture industry inCosta Rica, from which 12,000 familiesmake a living, has standards as high as inany developed nation, unlike the Asiancountries where the flu has emerged.AVIAN flu is only transmitted tohumans who are continuously exposed toinfected birds. It is in no way associatedwith poultry consumption, Jiménez said.“Only through intense human-birdrelationships, such as those where peoplesleep at their farms and live closely withthe animals, could you develop the flu,”said Jiménez. Activities such as birdwatching do not present danger of humaninfection.The UNA director and virologist saidavian flu has evolved for millions of yearsin wild aquatic birds, such as ducks, whichhave transmitted it to other species, includinghumans and domesticated birds, inrecent years.In China, for example, some people gointo the countryside and capture wildducks and geese, taking them home withthem in cages.When the wild birds, which are naturalgenetic reservoirs for the virus but neverdevelop the flu, come into contact withdomesticated birds and other species, suchas humans and pigs, these may becomeinfected, the expert said. Bird migrationstaking place around the globe (see story inWeekend) have increased concern aboutthe spread of the virus, Jiménez said.IN humans, avian flu symptoms aresimilar to a common respiratory infection,according to Salas of the Health VigilanceUnit. They may include a fever of morethan 38 degrees Celsius, a sore throat,coughing and breathing difficulties, andcan only be identified as avian flu overtime.Among birds, the flu, transmittedthrough mucous secretions and feces, caninclude symptoms of depression – observablewhen birds keep their feathers fluffedfor long periods of time – and internal aswell as external bleeding, according toJiménez.The World Health Organization hasdetected five phases of transmission of thevirus, beginning from bird to bird at phaseone and ending as a pandemic at phasefive.According to Health Minister Sáenz,the virus remains at phase three – the pre-pandemicalert phase in which the virus istransmitted from bird to human. If it entersphase four, human-to-human transmission,the virus’s severity will increase.No known cure exists for avian flu.However, Tamiflu, an antiviral medicinefrom Roche pharmaceutical company,reduces chances of contracting the virus,according to Jiménez.

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