subject: Outbreak Investigation of Avian Influenza in Humans - Kabul, Afghanistan 2007 [print this page] Outbreak Investigation of Avian Influenza in Humans - Kabul, Afghanistan 2007
Background
On 07th March 2007, the laboratory of the Afghanistan Ministry of Agriculture detected four positive H5N1 cases in backyard poultries in an area of Kabul city. Thus far, Afghanistan has had no H5N1 confirmed cases among humans. The Outbreak investigation and human case detection were initiated on 08th March 2007. This was the first avian Influenza experience of Disease Early Warning System of Afghanistan, which was established in December 2006.
Afghanistan has alsodetected outbreaks ofH5N1 influenza in 2006, in nine provinces of the country but Ministry of Public Health could not investigate these outbreaks because of having no epidemiological capacity in the Ministry of Public Health. Ministry of Public Health Afghanistan with the technical support of World Health Organization established, Disease Early Warning System in the country. Main time National Influenza Center of Afghanistan established with the assistance of NAMRU-3, Center for Disease Control and Prevention and UNICEF.
Methodology:
A random sample of all residents in the radius of three kilometers from the index case (IC) was checked for Influenza like illness (fever 38C, sore throat, cough and dyspnea). The area, defined by five clusters, had 25 teams of three people conduct fever monitoring by going door to door up to the three Km border. To identify patients with fever who may have been missed during home visits, a fever monitoring clinic was established in the area. Suspected cases were examined for Influenza type A, and if positive, further investigated by Real time polymerase chain reaction (RT-PCR).
Result
We investigated 2491 families; 17,437 individuals were examined for ILI signs and symptoms. Fourteen people met the suspect case definition. Throat swabs were collected and Tamiflu was administered at the time of visit No positive human case for H5N1 was found. Convalescent samples were collected from the fourteen cases after six days and all were negative for H5N1 antibodies.
Conclusion
A thorough investigation performed in the area of initial poultry outbreak cases detected no human cases of H5N1. MOAI culled more than 3500 chickens and decontaminated all infected areas with bleaching powder. The success of this investigation was due to a positive and coordinated response between the Ministries of Public Health and Agriculture.
