New Cases Of
Bird Flu Underscore Dangers Of A Global Pandemic
By Dragan Stankovic
01 April, 2005
World
Socialist Web
The
appearance of new cases of the bird flu virus HIN5 among poultry and
humans in Asia has prompted urgent warnings about the potentially catastrophic
consequences of a deadly worldwide pandemic. At present, the virus is
transmitted to humans via infected birds. With the virus entrenched
in parts of Asia, what concerns scientists and health workers is the
possibility that a mutant strain will emerge that can spread directly
from human to human.
In late February,
Dr Julie Gerberding, director of the US Centres for Disease Control
and Prevention, told a convention of the Association for the Advancement
of Science: Our assessment is that this is a very high threat.
Each time we see a new H1 antigen emerge, we experience a pandemic of
influenza. She explained that a similar influenza virus killed
an estimated 20-40 million people in 1918-1919.
World Health Organisation
(WHO) director general Lee Jong-wook told the Financial Times in early
March: Nobody knows how bad it will be. But there is no disagreement
that this is just a matter of time. We cant be optimistic.
WHO estimates that a pandemic could kill 8 million people and put another
30 million people in hospital. Other virologists put the figures even
higher.
British newspapers
last week reported the comments of a senior government official to a
security conference in London, warning that the number of deaths from
an influenza epidemic in the United Kingdom alone could reach 750,000.
Up to a quarter of the workforce could be absent through sickness. Professor
Hugh Pennington, president of the British Society for General Microbiology,
said the death rate could be even higherup to two million.
At this stage, a
mutant strain has not emerged. The deaths have been limited to relatively
small numbers of people in South East AsiaVietnam, Thailand and
Cambodia. But as Dr Shigeru Omi, a senior WHO official, warned at a
conference last month in Vietnam, the longer the virus circulates among
animals, the greater the risk for humans and the potential for a pandemic.
North Korea is the latest country to report the disease in its bird
population.
Vietnams death
toll from bird flu reached 35 last Friday when a 17-year-old woman from
Nam Dinh province succumbed to the disease. Authorities also confirmed
that a 40-year-old woman from Quang Ninh near the border with China
had contracted the virus.
Two people have
died in Cambodia, the most recent on March 22 in the southern province
of Kampot. A third person, who had close contact with the latest victim,
also has the disease. Another 12 people have died in Thailand, bringing
the overall deaths to 49 since 2003.
The fatality rate
from the diseasethe ratio of deaths to the number of casescurrently
stands at 70 percent. Health authorities suggest, however, that the
actual rate may not be so high as a number of less virulent cases could
have gone unreported.
Health investigators
have been concerned to identify quickly any possible cases of human-to-human
transmission of the disease. One case in Vietnam early this year involved
two brothers.
The elder brother
died after eating raw duck blood porridge at the funeral of his son.
He was hospitalised on December 31 and died on January 9, but was not
initially diagnosed with bird flu. His younger brother, who looked after
him in hospital, also became ill and tested positive for the disease.
Doctors retested the dead brother and found he had contracted the virus,
but eventually ruled out human-to-human transmission. The younger brother
survived.
WHO officials are
also investigating the case of Cambodian woman Tit Sakhan who died on
January 30. Her younger brother died nine days earlier and two other
family members are sick. Tit Sakhan was only diagnosed with the disease
because she crossed into Vietnam to seek medical attention. Compared
to Vietnam, Cambodias health system is even more rudimentary.
An article in the
Washington Post this month highlighted the limited character of preventative
efforts in Cambodia. Surveillance for the bird flu virus consists of
a network of informants connected via cell phone to an office in Phnom
Penh. Cambodia is seeking $10,000 in international assistance to pay
for prepaid phone cards. Overall annual per capita spending on health
care, amounts to just $US3.
Poor communications
and the lack of trained medical personnel and equipment are hampering
control of the disease in all three countries. More fundamentally, however,
lack of education, endemic poverty and economic backwardness are creating
the conditions for new cases of bird flu. Many small farmers are reliant
on raising fowl to survive and live in close proximity to their birds
thus increasing the chances of contracting the disease from sick birds.
In Vietnam, the
virus has spread to poultry in almost half of the countrys 64
provinces. Since December, 800,000 birds have been culled in an effort
to eradicate bird flu. Some 40 million of Vietnams 258 million
chicken and ducks have been slaughtered since the disease emerged in
late 2003. Around 80 percent of poultry producers are small-scale farmers
who raise a few dozen birds to eat or sell.
Most fatal cases
in Vietnam have been in the Mekong Delta. Authorities in Ho Chi Minh
City have ordered the slaughter of all fowl in the city. But there is
reportedly a thriving black market in live chickens, which still can
be bought in the city for $2.50 each and a 60-cent finders fee.
While South East
Asia would bear the immediate blunt of any pandemic, these countries
are least able to cope with such an outbreak. Wealthier countries like
Australia, the UK and the US are building stockpiles of anti-viral drugs
that have proven effective in limiting the impact of flu viruses. Britain
has ordered 14.6 million doses of the drug oseltamivir.
Poorer countries
cannot afford to stockpile these expensive drugs. Oseltamivir, for instance,
costs $US120 for a six-week course. At a WHO meeting in January on bird
flu, a Thai delegate, Dr Viroj Tangcharoensathien, suggested that drug
patents be set aside in the case of a pandemic to enable the production
of cheap anti-virals in the affected countries. US and French delegates
immediately rejected the idea declaring that it could lead to smuggling
and profiteering.
Research is also
underway into the development of a vaccine. Three potential vaccines
are already undergoing clinical trials. The value of a vaccine in combatting
a mutant virus that is yet to emerge is unknown, but researchers hope
that it could at least attenuate the disease. Thailand and Vietnam provided
samples of the human H5N1 virus to help develop a vaccine and are asking
for assistance to inoculate their populations but have received no guarantees.
At a regional conference
in Vietnam in late February, UN Food and Agriculture Organisation (FAO)
official Samuel Jutzi expressed concern at the lack of financial support
for preventing bird flu. I perceive an alarming lack of commitment
among the donors and also among the affected countries, he declared.
Last year donor countries gave $18 million dollars but Jutzi estimated
that $300 million was needed.
In late January,
the FAO warned that the Asian tsunami may have compounded the dangers
of bird flu. The organisation pointed out that the devastation may lead
to a large-scale movement of poultry into affected areas under conditions
where any ability to monitor outbreaks of the disease has been destroyed.
It noted that one of the worst affected areasthe Indonesian province
of Acehwas along the route of migratory birds that have been identified
as possible carriers of the virus.
Writing in the International
Herald Tribune, Dr Hans Troedsson, WHO representative in Vietnam, and
FAO official Dr Anton Rychener drew a parallel with the December 26
Asian tsunami. For the tsunami, the world had no warning. For
the avian influenza, the world is constantly being alerted about the
danger. Let us all heed the warning, the authors pleaded.
What is common to
the tsunami disaster and the danger of a bird flu pandemic is that the
risks are known, preventive and curative methods either exist or are
being developed, and yet the major powers treat the fate of millions
of people in countries like Vietnam with complete indifference. In the
event of an outbreak, it inevitably will be the poor of South East Asia
and other countries, including the US and Europe, who will be the hardest
hit.