6 February 2017

Africa: Bird Flu in Uganda Highlights Gaps in Africa's Plans to Manage Pandemics


The strain of avian influenza detected in wild and domestic birds in Uganda recently is the same virus that has spread through Asia and Europe over the past four months. Revealed as the H5N8 avian influenza strain, it is thought to have spread across continents via wild migratory birds.

In Africa, aside from Uganda, the H5N8 outbreak has also been recorded in Nigeria and Tunisia this year. The risk of humans being infected by H5N8 is low, but should this happen, the virus can cause severe illness and death.

Since the outbreak in Uganda was reported, a number of East African countries have increased their monitoring while the Democratic Republic of Congo, Kenya, Rwanda, South Sudan, and Tanzania have imposed a ban on poultry from Uganda.

But African countries face challenges in detecting such outbreaks because they have weak avian influenza surveillance systems.

A comparative analysis of national preparedness plans published in 2011 showed that African countries were least likely to have a comprehensive pandemic influenza preparedness plan in place. The analysis included 29 of 46 African World Health Organisation member states.

Few African countries had surveillance and early warning systems.

Without comprehensive plans in place, African countries struggle to mobilise a prompt response to new cases of avian influenza. If people become infected, they are also not equipped to provide vaccines. This is because most African countries don't have manufacturing capability and rely on supplies from the rest of the world.

These challenges are partly addressed by the World Health Organisation's Global Influenza Surveillance and Response System. It has strengthened country surveillance and response systems globally. This is true in a number of African countries too.

And the organisation's Pandemic Influenza Preparedness framework increases developing countries' access to vaccines in case of a pandemic.

But African countries must improve their preparedness plans if they're going to deal adequately with outbreaks in the future.

Proper management

Bird flu is transmitted to people through direct contact with infected birds, or indirectly by touching environments contaminated by sick birds.

Not all forms of bird flu are severe. But the highly pathogenic avian influenza strains, such as H5N8, cause severe illness and death among animals and people.

Early detection and response is crucial to prevent the disease from spreading further.

Measures include:

  • housing domestic animals to prevent contact with infected ones,
  • restricting transport of both animals and people,
  • banning bird and egg sales, and
  • screening or selectively slaughtering infected animals.
  • Other preventative measures include disinfecting sites that house sick animals, using protective personal equipment when handling sick animals and giving protective vaccines to people who handle animals.
  • Vaccination may be the most popular method to prevent the pandemic but there are several challenges.

Challenges of vaccination

Once a new strain of influenza circulates, a new vaccine specific to the pandemic needs to be manufactured. It can take several months between the time that the virus is detected and the vaccine is manufactured.

In this time many people could have contracted the virus and there may be too few vaccine doses produced to distribute to all the affected regions globally.

Given this possibility countries may stockpile vaccines anticipating future pandemics - but the challenge lies in accurately predicting the future strain of pandemic influenza.

In the early 21st century, countries in Asia and Europe controlled the spread of bird flu through early detection and quick implementation of control measures, the most common of which was culling. As a result there were few cases of bird flu in people.

An improved plan

The detection of bird flu in Uganda is a reminder to all eastern African countries that it is critical to have a functional pandemic preparedness plan.

Failure to adequately respond to bird flu outbreaks has far reaching health and economic consequences beyond the affected country.

Its a global concern.

Disclosure statement

JEANETTE DAWA receives funding from the Consortium for Advanced Research and Training in Africa (CARTA) fellowship, the German Academic Exchange Service (DAAD) in-country scholarship and the Tropical Diseases Modelling (TDMOD) network of the Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University for her doctoral research on the influenza virus.


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