India’s long wait for bird flu
India’s government has today confirmed that the avian influenza outbreak in Manipur was caused by the highly pathogenic H5N1 virus strain.
Imphal is the capital city of Manipur state in north-east India. The region has been facing a danger from the H5N1 strain of highly pathogenic avian influenza (HPAI) following repeated outbreaks over several years in Myanmar, which it borders on two sides, and northern Bangladesh where the disease is scything through poultry flocks.
AI was first suspected at a farm at Chingmeirong in the Imphal municipal district on 7 July this year, when samples were sent for testing. After 18 days of rumour and speculation, AI was finally confirmed on 25 July. The accumulated worry engendered for 18 days amongst producers in north-east India and the country as a whole has probably done as much damage to the poultry industry and general confidence as the disease is likely to do.
The following article traces the tortuous 18 days from when the samples were sent until the results were announced and emphasises danger of governments taking unnecessarily long times to ‘come clean’ on AI.
The long wait
There were repeated scares along India’s eastern and north-eastern borders, but from the very start, the July 2007 ‘scare’ based on unexplained deaths in poultry in the Imphal region of Manipur appeared much more ominous.
On July 17, Imphal Free Press (IFP) claimed reliable sources had confirmed existence of a low pathogenic strain of the virus, although state officials were reticent over the report.
Testing of blood and serum samples from affected chickens at the High Security Animal Disease Laboratory in Bhopal and subsequent arrival in Imphal of officials from the Union Ministry of Veterinary and Animal Husbandry increased suspicions and heightened fears. State authorities said that there was no confirmation of AI but stepped up surveillance and sample testing nevertheless. A report by E-Pao claimed the government also sent samples to the National Institute of Virology at Pune to be doubly sure.
First samples were sent to Bhopal on July 7 followed by more four days later but no results had been received by state authorities by July 20. Dr Th Dorendra Singh, director of the state veterinary department told IFP that surveillance and sample collection concentrated in 5km radius around Imphal would be extended to 15km and beyond. Officials said no highly pathogenic strain had been found but were non-committal about low pathogenic strains.
Dr Singh asked people to report any unusual deaths in poultry, birds and other domestic animals, claiming it would help to target testing and sampling.
Death of chickens in the Imphal area could have been due to any number of factors since there are many diseases with symptoms similar to bird flu. If HPAI were to be confirmed in Manipur, the authorities would ensure immediate declaration of the epidemic by the Union (Central) Government which is the only body with authority to do this, said the director.
By July 18, over 200 samples including nasal fluids and cloacal samples had been sent to Bhopal but the earliest results were not expected until July 21. Causing alarm was the death of over 100 chickens at a private poultry farm north of Imphal city centre on 7-10 July.
A report by E-Pao (quoting Sangai Express) said on-the-spot observers had described many symptoms – including swelling of the head and face, excessive lachrymation and liquid faeces – to be consistent with AI. Newcastle disease is common amongst poultry in the region and symptoms are not dissimilar. The state veterinary hospital where some of the dead birds were taken failed to mention Newcastle disease in the post mortem report, claimed the report by E-Pao.
Government officials continued to stress there were no positive indications of AI although the family running the farm were placed under medical observation and provided with the anti-viral drug, Tamiflu. The arrival and stay in Imphal since July 15 of two top officials from the Union Ministry of Agriculture and the National Institute of Communicable Diseases (New Delhi), together with 2000 personnel protection kits, did nothing to allay local fears. According to E-Pao, a Rapid Response Team was put together and all poultry including those at village level were to be vaccinated if necessary.
According to IFP, State Chief Secretary, Jarnail Singh, held an emergency meeting with concerned officials of the state veterinary and health departments. Blood and serum sampling of poultry and other livestock continued within the 15km radius from the affected farm while everybody awaited results from the laboratory in Bhopal.
Results from the Bhopal laboratory sent on July 7 and July 11 failed to arrive by the promised date of 21 July. IFP said its source could not reveal outcome of the tests conducted so far. Konsam Gopal, a disease specialist of the State Veterinary Department told Sangai Express that test results would certainly be available by 23 July.
The plot thickened when an official meeting was called on July 22 to devise an action plan in case the samples turned out positive. A meeting, chaired by Dr Th Dorendra Singh, discussed the feasibility of organising an action plan similar to that carried out during the previous Indian outbreak in Maharastra.
The long wait for confirmation did nothing to improve confidence within the poultry industry.
This latest experience proves once again the need to rapid testing so that either an ‘all-clear’ can be given or prompt action is taken and reassurance given if the worst happens, as in this latest case in India.