Avian Flu: Far Yet Near

Whether in Bangkok or in Beijing, many people in the Mekong region find avian flu something far removed from their everyday lives. Yet the signs are all around, as the disease, which affects animals and humans, continues to spread in the region.

For instance, passengers aboard a Bangkok-Beijing flight in late 2007 were requested to fill in a health statement form. It included questions such as: “Have you ever come into contact with poultry or birds over the past seven days? Have you ever come into contact with patients or suspected patients affected by bird flu over the past seven days?”

Over in China, the Ministry of Agriculture called a meeting on Nov. 12, 2007 to assess the state of the prevention and control of major animal diseases. Its conclusion: “The general situation concerning major animal diseases has been kept stable, with the cases of bird flu continuing to drop despite the frequent occurrence of epidemics in neighbouring countries and the spread of epidemics among migrant birds.”

Data released Jan. 3, 2008 by the China Disease Prevention and Control Centre on the geographical distribution of human cases of bird flu (confirmed by the World Health Organisation) showed that Indonesia had suffered the most with 41 cases with 36 deaths. Among the Mekong countries, Laos had two cases, all leading to deaths; Vietnam had eight with five deaths; Cambodia with one case with one death; Myanmar with one case; and China with five cases with three deaths. There was no reported human case of bird flu in Thailand in 2007.

“The epidemic was something that happened two years ago, and now everything is very calm,” a staffer of the Yunnan Provincial Disease Prevention and Control Centre said when asked about bird flu.

Gao Wenbin, whose chicken farm in Chuxiong prefecture of Yunnan province was struck with bird flu in November 2005, continues his business in another farm after the earlier contract expired. He remains the No. 1 chicken breeder in the locality.

“I don’t worry about bird flu,” farmer Xu Hailing told this reporter. What she worries about are economic losses that can come from the manipulation of the market. Some people have introduced non-local species of chicken, which might force down the prices of local ones, she explained.
“The bird flu vaccine is absolutely necessary,” added Xu. “We must be responsible ourselves. I feel that chickens have stronger resistance after being injected with bird flu vaccines. On the other hand, the amount of medicines taken has also been reduced. In the past, the bird flu vaccine cost 60 yuan (8.78 U.S. dollars) per bottle. After the end of 2005, we have been free (of outbreaks).”

But while the bureau’s routine work involves the enforcement of the compulsory immunisation of poultry and other domestic animals, it does not include responsibility for cooperation and information sharing with neighbouring countries. “We don’t have such tasks at our level of government. It is up to the provincial departments and above to undertake international cooperation,” said Duan.

The prevention and control of avian flu is a global concern, making international cooperation around it of paramount importance.

By the end of June 2007, Qiang said, his division has provided WHO with eight strains of H5N1 virus and shared with it the whole genome sequencing of seven strains of viruses.

In 2007, China called an international seminar on research and development and on strategies for vaccination of humans against bird flu. There has also been a Sino-French symposium on bird flu among humans, a Sino-Association of South-east Asian Nations (ASEAN) seminar on bird flu control, a Sino-Russian conference on communicable diseases and the first Sino-Korean forum on communicable diseases.

WHO representative in China Dr Han Troedsson told ‘Science Times’ that the United Nations has three specialised organisations that look after the control and prevention of bird flu on a global scale. The Food and Agriculture Organisation (FAO) and the World Organisation for Animal Health, known by its French acronym OIE, are responsible for the control of bird flu among animals. WHO looks after cooperation among member states in the control of bird flu among humans.

There are also two major global networks whose work feeds into the control of avian flu and health security. First is the Global Outbreak Alert and Response Network (GOARN), which focuses on the technical collaboration of institutions and groups that pool together human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance. Then there is the WHO’s Global Influenza Surveillance Network (GISN), founded more than 50 years ago. This, plus the International Health Regulations (IHR), can ensure timely and frequent information exchange and improve the health security in the world. (The IHR, which are legally binding for most countries, aims to prevent the spread of diseases from one country to another.)

China is an important member of the two global networks, said Dr Troedsson.

An international fundraising conference, hosted by the Chinese government, EU Council and the World Bank, was held in Beijing in January 2006. Representatives from more than 20 international organisations and more than 100 countries and regions, including WHO, FAO and OIE, evaluated the the spread of bird flu and discussed the technology and funds needed in preventing and controlling it, as well fund management and coordination mechanisms for this effort.

Current cooperation efforts by China include assistance to neighbouring countries Laos, Myanmar and others in the construction of epidemic monitoring stations, provision of equipment, technology and training, and in return, getting information about avian flu outbreaks should they occur.

STILL A LOT TO LEARN

“Although there are some difficulties in exchange and cooperation, such as language barriers, different cultures, different backgrounds that might lead to misunderstanding, all problems can be resolved,” said Prof. Ratanakorn. “There are not so many cases of bird flu among animals and humans in Thailand. Despite all these, it has provided neighbouring countries with assistance such as training in prevention and control.”

At the January 2006 fundraising conference for avian flu, China donated 10 million dollars. It was also listed as one of the six major aid recipient countries at the meeting.

If information on how a disease spreads from one country to another is delivered correctly to the public, they would better know how to prevent its spread. For outbreaks of diseases in which capacity and experience are as yet lacking, such as in bird flu, information on how they are spread should be shared with specialised laboratories, which would then analyse samples and later produce corresponding antibodies and preparations.

Since the first outbreak of avian flu in 2002, Brown said in late 2007 that there remain gaps in the full understanding of bird flu among humans and that these need to continue to be studied. It’s very difficult for one country to carry out studies of bird flu by itself, he added.

“Now, there are more funds available to support the study of bird flu,” added Brown. “We should do much better than before.”