A 15-year-old girl has died of the bird flu in Iraq, health officials there and abroad said today, a finding that indicates that the virus has arrived in yet another country -- one whose ability to control contagion is likely to be hampered by war.
The girl, Shengeen Abdul Qadr, died this month in Sulaimaniyah, in the Kurdish region in northern Iraq, three days after touching a dead bird infected with the virus, the Iraqi health minister said today. The girl's uncle, who died last week, is also presumed to have succumbed to the disease, although test results are pending.
At the moment, humans can only contract bird flu through close contact with infected poultry, and about 150 people worldwide have contracted the disease. But scientists worry that the virus may mutate and spread between humans, setting off a worldwide pandemic.
The test on samples from the Iraqi girl were performed at a lab in Cairo this weekend and samples are being sent to the official World Health Organization reference lab in England for confirmation. Because of this, the organization considers the result a "preliminary positive." But in Turkey all "preliminary positives" were all later confirmed.
Over the past few months, there have been occasional reports of large- scale bird deaths in both Iran and northern Iraq, places that veterinary officials had tagged as high risk because they are on bird migration routes. But H5N1 was never implicated.
In October, there were large-scale deaths on commercial farms in northern Iraq, Dr. Kennard said. Birds were tested and "we were told it was negative," he said, "but we're not entirely sure how reliable that is."
In most countries with serious bird flu outbreaks, including Turkey, the military has provided the manpower required to contain them, going door-to-door to find chickens to cull. That is not an option in Iraq.
The problem of course, should this virus choose Iraq as the place to mutate and jump species, is that a conflict zone with itinerent troops is a perfect set up for a repeat of the Spanish Flu outbreak of 1918.
Most strains of bird flu do not cross species and end up infecting humans. However the H5N1 strain that has in the last decade been known to infect humans, and kill them in 5 out of every 10 cases, clearly has surmounted the first of two barriers that must be cleared before a bird flu pandemic can take hold in the human population. The second barrier will be surmounted when this strain acquires the ability to jump from one human to another. This may never happen, and hopefully will not. But based on the history of pandemic flu, it seems more likely that this is just a matter of time. Whether this takes one year or twenty is just impossible to say.
The World Health Organization has estimated that a human-to-human strain of bird flu could result in an influenza pandemic with the potential to cause between 2 and 7 million fatalities worldwide. Considering the underwhelming state of health services offered by the majority of countries in the world today, these numbers do not appear to be overhyped estimates of the potential lethality of a bird flu pandemic. Should a bird flu pandemic break out with a lethality approaching that of the 1918 Spanish Flu pandemic, it is probably fair to state that the WHO prediction is likely to fall far short of the actual death toll.