Date: Sat 11 May 2019
Source: The Kathmandu Post[edited]
The Epidemiology and Disease Control Division says it is preparing to send specimens collected from the people who came in close contact with the person who died after contracting the H5N1 (bird flu) virus on [29 Mar 2019]. The division, under the Department of Health Services, had formed a team of medical doctors and lab technicians to carry out an epidemiological investigation after the death of a 21-year-old from Kavrepalanchok district [Province Three] from the bird flu virus. "We have collected specimens from doctors, nurses, close family members, relatives, and hospitals -- and also from homes," Dr Bibek Kumar Lal, director at the division, told the Post.
The name of the deceased has not been disclosed yet, but he was said to be residing in Bhaktapur [district, Province Three] in a rented room and worked as a driver. The Health Ministry, however, announced only on [30 Apr 2019] that the man had died from H5N1. Throat swabs of the deceased had been sent to the World Health Organisation's Collaborating Centre for Influenza in Japan, which confirmed that he had contracted influenza A(H5N1), which caused his death.
Following the confirmation of deadly virus responsible for the death, health experts from the WHO's headquarters and its regional office in New Delhi, India arrived in Kathmandu to assist Nepali health officials to carry out an epidemiological investigation.
According to Lal, his office would send samples to the country recommended by the UN health agency. Earlier, WHO officials suggested that specimens be sent to the Collaborating Center for Influenza in Japan that confirmed the virus. Such labs are in several countries and the UN health body may recommend any one of them. "We are working closely with them and will decide our next step accordingly," said Lal.
The division has secured all collected samples in the biosafety level-3 laboratory of the National Public Health Laboratory.
Health officials say it takes time to send samples to laboratories abroad, as manpower trained to handle the biohazard are required for that.
Airlines do not easily carry such specimens and for that, protocols of international health regulations need to be followed, according to officials at the Health Ministry.
Meanwhile, the ministry said it was still tracking some people, who came in contact with the deceased but are out of home for personal business.
The death of the 21-year-old from H5N1 virus, the 1st bird flu casualty in Nepal and 1st in the world since February 2017, has been a cause for concern. H5N1 is a lethal bird flu virus strain that is highly pathogenic. [Byline: Arjun Poudel]
[According to WHO guidance on regulations for the Transport of Infectious Substances 2015-2016. Annex 2 (<https://apps.who.int/iris/bitstream/handle/10665/149288/WHO_HSE_GCR_2015.2_eng.pdf
>); and the available list for classification of infectious substances prior to shipment, highly pathogenic avian influenza 'Cultures only' are classified as category A shipments. These have more stringent shipping regulations and require certified shippers to package them and complete the relevant documentation.
The same classification does not apply to suspected samples/sample materials from patients that require testing for confirmation.
The report above highlights one of the key areas in outbreak response and preparedness, that is, availability of trained and/or certified shippers to prepare the shipments for international transport. Having mentioned that, use of national/WHO guidelines for safe transport of infectious materials must also be ensured during domestic or in-country transportation. - ProMED Mod.UBA]
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