Our achievements in controlling emerging and re-emerging infections

Our research has identified and helped to control several outbreaks of emerging infectious disease in Bangladesh. 

Our surveillance and outbreak investigation activities have led us to identify a range of outbreaks of emerging infectious disease in Bangladesh. This knowledge has enabled us to support outbreak control and develop new interventions to limit the transmission of novel infections.

Human avian influenza infection

• An icddr,b-led team identified the first death from H5N1 influenza in Bangladesh in 2013.
• The interdisciplinary team, put together with the Institute of Epidemiology, Disease Control and Research, identified H5N1 as the likely cause of death of a two-year-old boy exposed to infected poultry entrails. 
• Ongoing surveillance of bird markets suggests that occasional transmission of H5N1 to humans may be occurring but disease is generally mild.

Nasreen S et al. Highly pathogenic Avian Influenza A(H5N1) virus infection among workers at live bird markets, Bangladesh, 2009-2010. Emerg Infect Dis. 2015;21(4):629–37.

Nipah prevention intervention

• In 2007, a team of anthropologists identified a traditional method – ‘bana’ (a skirt-like barrier) – that some gachhis (sap harvesters) used to cover the shaved part, sap flow and sap collection pot of the date palm sap trees to exclude bats. An icddr,b team confirmed that bana can successfully prevent bats’ access to the date palm sap and were well accepted by gachhis when promoted.
• In 2012–14, a multidisciplinary icddr,b team in collaboration with Institute of Epidemiology, Disease Control and Research (IEDCR) launched a behaviour change intervention in two Nipah-affected districts. The behaviour change communication strategies included key messages such as ‘do not drink raw sap’ and ‘only safe sap’ (drink only bana-protected sap) which were disseminated through community mobilisation, interpersonal communication, posters and broadcasting public service announcements. Some 24% of residents abstained from raw sap consumption and 40% consumed only bana-protected sap.
• These positive results provided a platform for a partnership with the Government to scale up the intervention nationwide. As part of this collaboration, the public service announcement on ‘do not drink raw sap’ has been broadcast on Bangladesh national television. IEDCR has also distributed the announcement among all the district-level offices of the Health Education Bureau of Bangladesh.          

Nahar N et al. (2010) Date palm sap collection: Exploring opportunities to prevent Nipah transmission. EcoHealth 7: 196–203.

Khan SU et al. (2012) A randomized controlled trial of interventions to impede date palm sap contamination by bats to prevent nipah virus transmission in Bangladesh. PLoS ONE 7: e42689.

Nahar N et al. (2014) Piloting the promotion of bamboo skirt barriers to prevent Nipah virus transmission through date palm sap in Bangladesh. Global Health Promotion 21: 7–15.

Nahar Net al. (2013) Piloting the use of indigenous methods to prevent Nipah virus infection by interrupting bats' access to date palm sap in Bangladesh. Health Promotion International 28: 378–386.