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Tackling bird flu is a matter of right decisions, right actions
posted by admin on 18/10/06

Indonesia has become the focus of the fight against the virus.

With the world's highest death toll from bird flu, Indonesia has become the focus of the fight against the virus. Neighboring and far-flung countries alike worry about the repercussions of Indonesia's failure to get the disease under control. The Jakarta Post's Emmy Fitri was invited by the Honolulu-based East-West Center to take part in its first Health Journalism Fellowship program. She spoke to experts and looked at conditions in Vietnam, Hong Kong and Thailand. Below are her reports.

It is still too early to know whether the emerging avian influenza virus will become a human pandemic.

The deadly flu virus, H5N1, has successfully made the leap from fowl to humans, having the same devastating effect on human lungs as it does on those of birds.

After the first known bird-to-human transmission occurred in Hong Kong in 1997, the disease began cropping up in other places in less than a decade. As of this week, 130 people have died from the virus -- 54 of them from Indonesia. The number will likely increase soon.

Indonesia's growing number of family cluster cases leads to the frightening idea that it is no longer a question of whether, but when, the virus will become capable of being transmitted more easily among humans.

H5N1 is on the loose, traveling like wildfire and leaving many unanswered questions in its wake. Science has relentlessly sought answers to the one big question: how to stop the virus from killing more people.

True to its nature, the disease emerges and reemerges when people are off guard.

Eradicating H5N1 will be next to impossible if people continue to believe they can raise chicken, birds, quails and ducks in their backyards without proper controls and hygiene.

Perception leads to behavior. Therefore, health authorities must draw up an effective set of guidelines and make sure people follow them.

Richard Fielding, an associate professor of medical psychology at the University of Hong Kong, said varying perceptions among people about backyard farming or the sale of live chickens explained why it was difficult to draw up a single set of rules about what is healthy.

"Public health workers see wet markets as risky. Many consumers do not. In Vietnam, buying chicken is seen as more risky than raising them. This may, in fact, be true," said Fielding, who heads the university's behavioral sciences unit at the Department of Community Medicine.

Wet markets, traditionally scattered throughout Asia, are home to many microbes, both harmful and harmless, that can possibly make the leap from animals to humans. "If not avian flu than hordes of other viruses" can be present at markets, Fielding noted.

Fielding's colleague, Gabriel M. Leung, pointed out that Asia has been (and will be) a hotbed of disease. This is caused in part by the traditional methods of poultry farming.

"When you have poultry and pig being such close neighbors it is hard to imagine them not swapping any virus genes," Leung said.

Asia's fast population growth is increasing its human density, which, as Leung said, creates a "perfect Petri dish".

"Increased population mixing is inevitable in a highly dense population. The mixing becomes a perfect vessel for transmitting microbes from one individual to another," he said.

Health authorities must take stern measures in times of emergency, if necessary invading people's privacy and hampering their freedom.

"Hong Kong confined people during SARS (Severe Acute Respiratory Syndrome, a deadly virus that broke out in 2003), and in fact we removed them from their homes. Think about that," he said.

"Unless you have a Hong Kong infrastructure in rural China or rural Thailand, it's hard to stamp out the flu virus from its source," he concluded.

Hong Kong is fortunate to have extensive resources in terms of finances, facilities, networks and experts, but those all could have been wasted if they did not come up with the right decisions.

The government rapidly took the right steps to wage war on the emerging disease.

However, because Hong Kong is precariously situated in close proximity to mainland China and other countries that are struggling to stamp out bird flu, it must remain on alert.

Chinese virologist Guan Yi, an associate microbiology professor at the University of Hong Kong, has meticulously collected 100,000 virus samples from southern Chinese markets. He believes there is a genetic sequencing in the bird outbreaks in many parts of Southeast Asia.

"The virus is closely linked to the H5N1 strain in Southern China," he said.

His research found infected bar-headed geese at Lake Qinghai, a protected nature reserve in China's Qinghai Province. The finding shed light on the likelihood of migratory birds bringing the virus to Europe and across the Atlantic Ocean to North America.

Mysteries remain, however; such how the birds got the virus, and why some birds got infected and died while many others flew further, bringing the disease across the ocean.

As award-winning author and professor Jared Diamond notes, history is full of diseases that once caused terrifying epidemics and then disappeared as mysteriously as they had come.

As long as diseases like these as with us, much of the defense will depend on human beings. How we relate to the environment determines how it will relate to us.

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