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Africa has little ability to achieve any of the priorities identified by the WHO to fight avian influenza, warn Folorunso O. Fasina, Shahn P. Bisschop and Robert G. Webster in The Lancet Infectious Diseases.

The African strain of H5N1 has acquired "troubling" properties such as respiratory rather than faecal transmission in poultry and a mutation associated with increased spread of disease in mammals, including humans.

Moreover, the probability of human infection on the continent is increased by inefficient diagnosis, denial of outbreaks, inter-ethnic crises, politicisation of the issue, and poor reporting, surveillance and communication of risks.

Control remains problematic because of ineffective border controls and overtaxed health-care systems, as well as inadequate biosecurity.

The crowding of poultry farms and burgeoning live poultry markets promote the rapid spread of disease, as do high-risk conditions and practices, such as the slaughter of sick birds in homes.

Only 40 Africans are known to have been infected. But because of Africa's limited capacity to cope with a pandemic, this still represents a grave danger, warn the authors.

They call for each African nation to realistically assess its status, conduct regular active surveillance and be more forthcoming with data.

Link to full article in The Lancet Infectious Diseases*

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