Jaime Lim – Newsmekong*
CHIANG RAI, Thailand, Oct 16 2007 (IPS) – Four years after the first outbreak of avian flu, experts say many key questions hover around the disease: what kind of contact between fowl and humans leads to its transmission to people, and how effective can poultry vaccination really be.
The H5N1 strain of avian flu, which has led to the culling of millions of birds and poultry with compensation payments to farmers running into millions of dollars, is now adjudged to be endemic in places like Indonesia and Vietnam.
In truth, there are still huge gaps in our knowledge of the virus , explained Richard Brown, public health specialist from the World Health Organisation (WHO) in Bangkok.
The outbreak has gone on for a long time (since 2003), but there are no breaking developments in the research of the virus, he said at a discussion on the cross-border challenges of avian flu at a workshop for journalists in the Mekong region here recently.
As of Oct. 12, 2007, 331 human cases of avian flu in 12 countries in East Asia, Europe and Africa have been reported to the WHO. Of these, 203 have resulted in deaths. Indonesia has been the worst-hit with 87 deaths out of 109 cases, or a mortality rate of 80 percent.
Unresolved questions include at exactly what stage do humans get infected with avian flu on handling the sick birds, or from eating birds that were sick and died?
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There is not enough knowledge about individual human cases of avian flu which have occurred at different times of the year and in different places, Brown explained. Not even the incubation period among humans which WHO officials put at between two to 10 days is certain.
Media reports focus on what might happen if the virus mutates to become freely transmittable to and among humans, and many predict huge numbers of deaths if this happens.
In terms of death statistics so far, human avian influenza is not a huge public health issue. As Brown put it, there are 40 million people living with HIV around the world. More people die of traffic accidents in Vietnam than of avian flu.
But a mix of fear, disaster and the unknown makes avian flu a topic of concern. Other factors add to this that avian flu marks the arrival of a new emerging infection has a large impact on the poultry industry, a high mortality rate, and the potential to cross national boundaries.
There was a perception of a dangerous virus moving with ease through the region, and predictions of gloom and doom rapidly made the outbreak news, Brown said. The prediction of a pandemic created a fertile ground for speculation and rumours.
In the case of Severe Acute Respiratory Syndrome (SARS) in 2002-03, after the initial panic there was soon a lot of information to identify risk factors linked to it. But this has not happened with avian flu, added Brown, who was also involved in addressing SARS in China.
Brown emphasised the importance of the availability of reliable information, likening the spread of rumours to a pandemic. The truth becomes distorted and, like a virus, becomes mutated, he said.
There also remain different views on key aspects of the avian flu issue, such as the role of wild birds and the impact of vaccination of poultry against avian flu.
While Brown said that wild birds are unlikely to have a big role in spreading avian flu, Parntep Ratanakorn of Mahidol University said at the same seminar that he thought otherwise.
Different countries have also chosen different responses to avian flu. The fact that Thailand s neighbours, China and Vietnam, vaccinate their poultry has put this country s ban on vaccination under closer scrutiny.
Thailand has avoided vacciantion, largely because it is among the largest exporters of poultry products and vaccinated products cannot be exported. Over 90 percent of Thai poultry exports go to the European Union. The country earns some one billion dollars a year from exporting more than 300,000 tonnes of cooked and semi-cooked chicken meat.
The stagnation in research can be traced to countries unwillingness to share information, especially when they see themselves as losing face if an outbreak occurs.
In previous outbreaks in Thailand, some blamed neighbouring Laos for being the source of avian flu. At one point, this led to a postponement of a senior officials meeting to discuss bird flu.
The vaccination question is not a black-and-white issue, explained Christine Ahlers, animal production officer from the Emergency Centre for Transboundary Animal Diseases of the U.N. Food and Agricultural Organisation (FAO).
Parntep added that the decision to use vaccination entails not just the actual use of vaccines on birds, but monitoring its use well, deciding and controlling in which outbreak areas to use them.
If a country can do all these things, apart from undertaking bio-safety measures in poultry farms, then it can be a viable option, he explained.
Vaccination is not the final solution to controlling avian flu, Ahlers said. By vaccinating you prevent them from getting sick, but not from carrying the virus. This is why vaccinated poultry meat is unexportable, because the virus can still be spread through such meat.
Vaccination is a useful tool to control avian flu in areas where it is endemic, but it alone cannot eradicate the virus, she explained. She believes that if outbreaks of avian flu are sporadic, eradication is still the best option.
(*This story was written for the Imaging Our Mekong Programme coordinated by IPS Asia-Pacific)
