The United Nations said Cameroon so far lost $20 million due to an outbreak of bird flu which continues to threaten farmers’ livelihoods after the West African nation became the sixth country in the region to detect the disease.

Poultry farms and markets in Nigeria, Burkina Faso, Niger, Ghana and Ivory Coast have had outbreaks of avian influenza since the H5N1 virus first started spreading 2013, causing the deaths of tens of millions of poultry, according to the UN’s Food and Agriculture Organization.

“We’re looking at a quickly spreading disease that has devastating effects on livelihoods in communities,” Abebe Haile Gabriel, Deputy Regional Representative for Africa at the FAO, said Wednesday in an e-mailed statement. “A major concern is that the disease may become endemic in the entire region.”