Human infection with Avian influenza A virus in Nepal: requisite for timely management and preparedness
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COMMENTARY
Avian influenza in human in Nepal: timely management and preparedness Krishna Prasad Acharya1 • Narayan Acharya2 • Sarita Phuyal3 Supram Hosuru Subramanya4
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Received: 30 November 2019 / Accepted: 24 April 2020 Ó Indian Virological Society 2020
Abstract Avian influenza virus infection in humans is an emerging zoonotic disease having high economic and public health impacts. Due to its capability for genetic reassortment, this virus can emerge as novel influenza strains with pandemic potential. Even though the first Avian influenza incidence in humans in Nepal was reported in April 2019, the threat of the disease remains unmitigated. Limited resources for surveillance, disease tracking, and weak health care facilities in low and middle-income countries will increase the possibility of the outbreak. Therefore, timely management and preparedness by strengthening veterinary and medical services, operational capabilities of laboratories, and surveillance programs through the ‘‘One-Health’’ approach could be crucial for the control of possible outbreaks in Nepal. Keywords Avian influenza Human One health
Introduction Approximately 66% of the population in Nepal depends on agriculture as a way of livelihood [25], and more than 70% of the population raises livestock and poultry [1]. Since & Krishna Prasad Acharya [email protected] 1
Animal Quarantine Office (AQO), Budhanilakantha, Kathmandu, Nepal
2
The Institute of Environmental and Human Health, Texas Tech University, Lubbock, USA
3
Central Referral Veterinary Hospital, Tripureshwar, Kathmandu, Nepal
4
Manipal College of Medical Sciences, Pokhara, Nepal
around 75% of the population of Nepal lives predominantly in rural areas with low socio-economic status and depends on subsistence farming [20], by no means they can get rid of direct exposure to poultry and their products. Urban Nepal, where less than 20% of the total population resides, relies on poultry meat as their primary source of animal protein. Increasing meat demand has ultimately led to intensive farming and confined animal feeding operations (CAFOs), which potentially amplify the possible public health threat of Avian Influenza (AI) [26]. Other factors, such as using poultry shed as a human shelter [12] and poor sanitation and hygiene status [5, 21], further substantiate the likelihood of AI transmission to humans. For example, recently, a 3-year-old girl in China tested positive for H9N2, possibly acquired the virus from poultry as she had contact with domestic poultry before falling ill [11]. Such an incidence of acquiring Avian Influenza from poultry is much likely in Nepal. Also, there are significant concerns over the co-circulation of avian, human, and pig influenza viruses in pigs with the potential of a genetic re-assortment and emergence of a genetically proficient virus than we have yet well-thought-out [23]. Considering widespread nature of the H5N1 outbreak in Asia, the capability of influenza viruses to jump across species barriers, and close association betwe
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