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Two diseases, the same lessons


March 13, 2015
By Leslie Ballentine

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Photographs of people dressed in hazmat suits and face masks dominated the news this past fall — photos that came from two parts of the world reflecting the response to two different, but in many ways similar, disease outbreaks. Two diseases that kill.

What, one might ask, does Ebola have to do with Avian Influenza (AI) and what can we learn from the two?

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H5N8 and West African Ebola are new virulent strains of existing pathogens that made significant impacts since emerging in February 2014.

Although discovery of AI and Ebola were 100 years apart, they share many commonalities. Both diseases have strong connections with wildlife, known as zoonotic diseases in the medical world (meaning they cross the species barrier).

Both are viruses that have mutated into different strains and disease types. Ebola is a disease that can be caused by five different viruses, with various strains leading to mortality rates of between 20 to 90 per cent. AI comes in a growing number of mutating strains — some more fatal in chickens (and people) than others.

Like all diseases, both spread more rapidly in high density populations. It takes close contact with bodily fluids or aerosols to catch and spread the diseases and under the right conditions, both can remain infective on surfaces and in matter for days or weeks.

Once outbreaks originate both can become difficult to contain, control and eliminate. Symptoms mimic other diseases. Incubation times can run up to 21 days. Both can cause massive hemorrhaging and rapid death. Both have the same range of mortality averaging about 30 per cent. Neither respect borders and both have affected the livelihoods of people, trade and economies. And while H5N8 has led to far more poultry deaths by both disease and culling, it hasn’t received nearly as much public attention as West African Ebola has.

On November 6, German authorities reported an outbreak of the highly virulent strain H5N8 at a turkey farm in the northeast of the country. Then on November 17, the U.K. Department for Environment, Food & Rural Affairs reported an outbreak in a flock of 6,000 birds at a duck-breeding farm in northern England. The same day it was found on a laying farm near Utrecht in the Netherlands.

In all cases containment measures went into place. Several hundreds of thousands of birds in infected areas were destroyed, full clean-out measures taken and “no movement” protection zones established. By week’s end the disease had been found at more farms.

The European Commission imposed additional containment measures including banning the sale of poultry products and live birds from the infected areas of Germany, the U.K. and the Netherlands. At a news conference in Geneva, the World Health Organization warned European countries to be “vigilant.” WHO researcher Elizabeth Mumford told reporters that affected countries should “kill all sick birds” and closely monitor anyone who has been in contact with infected poultry, especially if they have a fever. The two global animal health agencies, FAO and OIE, urged at-risk countries to step-up prevention efforts through increased biosecurity and reminded the general public that the risk to human health is very low. The containment measures seemed to take hold.

In much the same time frame, a new strain of Ebola had turned up in three West African countries, and had been carried to Spain, the Philippines and the U.S. By the end of November, official reported cases totaled over 17,000 with over 1,600 reported deaths and growing. Unlike AI, the infrastructures, planning and quick response were not in place for Ebola. Despite many of the same containment and isolation measures advised by the WHO, 10 months in and the disease continued to spread. In both cases, it is less-wealthy countries that are in the greatest danger, having low-biosecurity conditions, and limited veterinary/medical preparedness and slow response times.

The point is: the best way for countries to safeguard against these impacts is to encourage, finance and develop better biosecurity and surveillance systems that detect outbreaks early and enable a rapid planned response, just as we have done in Canada. Progressive control efforts for both human and animal disease must be maintained and sustained. Lives and livelihoods depend on it.