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on June 30, 2009

Web Exclusive: Laos loosens up as H5N1 tightens grip

The latest reports point to the development of serious avian influenza (AI) difficulties in Laos.

Reliable information is difficult to obtain from land-locked Laos. While H5N1 raged in neighbouring Vietnam and Thailand, Laos reported little except several outbreaks from 2004 to 2006. But a recent (February 2007) outbreak in the capital Vientiane accompanied by the first two ever reported human cases (both fatal) for Laos has apparently focussed minds and loosened tongues about the ongoing situation.

Suspected outbreaks in two southern provinces – Champasak which borders Thailand and Cambodia and Savannakhet sandwiched between Thailand and Vietnam – elicited an unusually fast response from central government, which plans a big cull of birds to stop spread. Government spokesman Yong Chanhthalansy told Reuters “Although tests have not confirmed they died of H5N1 our policy now is to kill them all” he said referring the outbreak in Savannakhet.

WHO said there was no apparent link between the two human cases, a 15-year-old girl and 42-year-old woman, except that both came from villages near Vientiane capital city of Vientiane province and the country of Laos.

Two fatal human cases from just four outbreaks in poultry over three years means Laos is very unlucky or serious under-reporting of H5N1 in poultry is prevalent. The population of 5.6 million in communist-led Laos is relatively small and almost entirely rural. In spite of central government’s contingency plans to combat AI, South-east Asian news agencies report 90% of Laotians know nothing about AI and continue to eat meat and eggs from diseased poultry.

Laos is clearly in a strategic position for H5N1 with long and porous borders with Thailand, Cambodia and Vietnam. Government spokesmen say the virus may be spreading through illegal trade in fowl despite a ban on imports clearly pointing fingers of blame at neighbours such as Thailand, although if anything the virus appears to be passing in the other direction.

Dr Itthipol Sungkhaeng public health director of Nong Khai province in Thailand, where the 15-year-old Laotian girl was treated and where previous outbreaks in poultry were traced to contaminated egg trays from Laos, was cautious. “All hospitals and health centres along the border have been instructed to closely watch their patients. Extra precautions are necessary”, he said, “and especially during the current dry season when the water level in the Mekong River is shallower and hence more convenient for informal boat crossings.”

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