With the malaria outbreak barely under control in Jamaica, regional health and agricultural officials are emphasising the need for the Caribbean to brace its risk outbreak communication machinery, in the event that the deadly H5N1 Avian Influenza virus (bird flu) spreads to the region.

The officials aired their concerns on Thursday at a Risk and Outbreak Communication Workshop, convened by the Pan American Health Organisation (PAHO) and the World Health Organisation’s regional office at the Caribbean Food and Nutrition Institute at the University of the West Indies in Kingston.

PAHO/WHO representative in Jamaica Dr Ernest Pate told workshop participants that the rapid spread of the disease in Asian countries increased the likelihood of it spreading to the Americas and, by extension, the Caribbean.

“Highly Pathogenic Avian influenza and Influenza pandemics have historically taken the world by surprise, leaving minimal time for preparedness. The present situation is markedly different as this region has been warned in advance. We have the opportunity to prepare for both bird flu and a human pandemic influenza, and develop programmes to mitigate their effects,” Pate said.

Noting that a pandemic could have a devastating effect on the Caribbean’s economy and the nutrition of the populace based on the popularity of the poultry industry, Pate said it became even more critical that effective communication systems be put in place.

“These are not ordinary sessions, all the planning and programmes that we develop will be no good without the population fully sensitised and educated to this most dangerous situation we as a people could face. As communicators… you have a critical and sustained role to be a main partner in the fight against this most serious disease,” Pate emphasised.

In the meantime, he said the concern was even more real as the “highly pathogenic flu virus had crossed the barrier to infect humans”.

“While this disease in animals could have devastating effects on the economy and the nutrition of our people, we need to emphasise that our main fears go beyond the birds,” he continued. He said 263 human cases were reported up to January 9, 2007, with 157 deaths from the disease,(representing) a case fatality rate of 59.6 per cent.

“Every case,” Pate said, “increases the risk for emergence of a virus strain that could be transmissible between humans…once this adaptation occurs, it will no longer be a bird virus – it will be a new human influenza virus and an influenza pandemic might then be expected.”

Pate said a preliminary modelling for Jamaica of the potential consequences of the disease (utilising the CDC software Flu-aid and based on the mild 1968 Hong Kong influenza pandemic) shows that the health services for Jamaica will be under tremendous stress should this occur. He said the model for an eight-week outbreak projects that there would be need for space for more than 7,000 hospital admissions and the possibility of more than 1,000 deaths.

“This shows that we need to look at development plans so if it occurs it can be dealt with. One of the big problems we will have is that if there is a pandemic we will have a serious problem with communication. What-ever plans we develop will be of very little use if we don’t communicate to the populace”, Pate warned. In the meantime, he said PAHO had pledged to provide any supporting data and additional training to the communication sector in the task of preparing the Caribbean nations.

Meanwhile, acting chief medical officer in the Health Ministry, Dr Sheila Campbell-Forrester, said the recent malaria outbreaks were a fresh reminder that the country needed to be prepared for risk communication.

Agriculture and Land state minister Errol Ennis, for his part, noted that the imminent threat of the virus and the potential for pandemic influenza were issues “high on the agenda of the Jamaican government”. In this regard, he said Cabinet had approved a $13.5 million allotment to put the necessary mechanisms in place. Ennis, however, pointed out that much more funding was needed to effect a complete preparedness programme.

In 2005, the agriculture ministry was instructed by Cabinet to activate the national animal emergency multisectoral task force to address the potential threat of the virus.

The disease, which has spread from Asia to the Middle East, Europe and Africa first infected humans in Hong Kong in 1997, causing 18 cases, including six deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. In December 2003, infections in people exposed to sick birds were identified.

Since then, more than 100 human cases have been confirmed by laboratory tests in four Asian countries (Cambodia, Indonesia, Thailand, and Viet Nam), and more than half of these people have died. The virus does not jump easily from birds to humans or spread readily and sustainably among humans. Should H5N1 evolve to a form as contagious as normal influenza, a pandemic could begin.