Four Years On Questions Hover on Bird Flu

This article, written for the Imaging Our Mekong Programme of the Inter Press Service International Association (IPS), discusses key questions surrounding the transmission of the H5N1 virus between birds and humans, which arose at a cross-border journalism workshop in the Mekong Region of Southeast Asia. According to the workshop experts, the virus is now endemic in places like Indonesia and Vietnam, causing the culling of millions of birds with associated costly compensation payments. However, the answers to questions of how effective poultry vaccination can be and what kind of contact between human and fowl leads to transmission, are still not clear.

The article recounts information given to journalists by a variety of speakers inlcuding speaker Richard Brown, public health specialist from the World Health Organisation (WHO) in Bangkok, Christine Ahlers, animal production officer from the Emergency Centre for Transboundary Animal Diseases of the U.N. Food and Agricultural Organisation (FAO), and Parntep Ratanakorn of Mahidol University. Brown offered the following statistics on the occurrence of the disease: "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."

According to Brown, there "are no breaking developments in the research of the virus." In addition, unresolved questions remain, including the stage of poultry handling or consumption at which humans can be infected, whether there are variations in the likelihood of infection based on the season or location, and the incubation period of the virus in humans - which WHO officials put at between two to 10 days.

With such uncertainty, and despite statistics showing little occurrence in humans, the media emphasis on the possibility of the virus mutating into a freely transmittable pandemic virus in humans provides, according to Brown, ground for rumors and speculation. In contrast, Brown cited the case of Severe Acute Respiratory Syndrome (SARS) in 2002-03, in which risk factor information became available early, which has not been the case with avian influenza. He emphasised the importance of reliable information, likening the spread of rumors to a pandemic. "The truth becomes distorted and, like a virus, becomes mutated," he said.

However, the article points to differing views on, for example, both the transmission through wild birds and the impact of poultry vaccination. Christine Ahlers, animal production officer from the Emergency Centre for Transboundary Animal Diseases of the U.N. Food and Agricultural Organisation (FAO), spoke of vaccine use as "not a black-and-white issue." Parntep Ratanakorn of Mahidol University added that the decision to use vaccination entails not just the actual use of vaccines on birds, but monitoring its use, as well as deciding and controlling in which outbreak areas to use them. Thailand has, as stated here, avoided vaccination, which renders poultry unsaleable on the export market, because of its large poultry export business. Though the vaccinated poultry may not become ill, it can still carry the disease. Thus, Ahlers stated that eradication is the method most effective in endemic areas.