Africa/Indonesia Region Research Report • The mission conducted sensitization for 50 health workers in Sunyani Regional Hospital, 10 district health workers in Berekum, 20 medical officers at Komfo Anokye Hospital. There is a need for similar activities on a larger scale in the two regions. • Public education campaigns on AI are needed in Brong-Ahafo. Previous and current education campaigns have focused on the veterinary health side and on washing hands. More emphasis should be placed on adding appropriate human health messages, such as “do not touch sick or dead birds,” “eat only well cooked poultry products,” “wash your hands after touching chickens”, and “go to you health care facility if you have a fever/cough/sore throat after being in contact with sick/dead birds.” Evidence for unreported or undetected HPAI The opinions of experts from the FAO and Veterinary field staff suggest that a few cases may go unreported as a misdiagnosis of Newcastle disease. However, it is claimed that the alarmingly high mortalities associated with the disease may make it difficult for HPAI cases to go unreported except in isolated areas with no veterinary coverage. There are concerns on the use of vaccination in neighboring countries, specifically in Cote d’Ivoire, which could mask HPAI outbreaks in Ghana. Even though Ghana has a “No HPAI vaccination” policy, there is information that some farmers in neighboring countries were unofficially vaccinating their birds. According to Marangon et al. (2007), if protective vaccination is to be used during an HPAI epidemic, there is the need for proper management of early detection of any HPAI affected flocks. Furthermore, it is fundamental for disease control and eradication purposes that the capacity exists to discriminate between infected and vaccinated birds and flocks. Unfortunately, this capacity is currently non-existent in the West African sub-region. Current situation of HPAI in Ghana After the three outbreaks in Ghana in 2007, there have been no further outbreaks. The country is in a state of high alert because of the circulation of the virus in West Africa, as there are continued outbreaks in Nigeria and recently (December 2007) in Benin. In September 2007, MOFA lifted the quarantine measures and restrictions on movement of live poultry products in and out of the Tema and Sunyani Municipalities and the Ketu District. This has allowed restocking to take place. A revised Action Plan for Avian and Human Pandemic Influenza 2007-2008 has been prepared to guide all activities. This Plan has incorporated all the lessons learned during the outbreaks. HPAI situation in neighbouring countries As introduced in section 2, among the countries bordering Ghana are Cote d’Ivoire, Burkina Faso and Togo. Cote d’Ivoire had an outbreak in the Abidjan area that was confirmed on May5, 2006. Ghana placed a ban on the importation of all live poultry, poultry products and by products from countries reporting outbreaks of HPAI H5N1. Burkina Faso had an outbreak in April 2006 in Houet, Kadiogo and Sanguie. The outbreaks in Togo were in Siegbehoue and Agbata (Lacs, Region Maritime), and Tonoukout (Zio, Region Maritime) in June 2007. With the outbreak in Benin in December 2007, there was a continuum of affected countries along the West African coast from Cote d’Ivoire to Cameroon. In total, 8 countries in West Africa have recorded HPAI: Benin, Burkina Faso, Cameroon, Cote d’Ivoire, Ghana, Nigeria, Niger and Togo. All of these countries are of the Economic Community of 48 .