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Hold your breath
for a global kill |
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A BIRD SNEEZES and the whole world jumps. The avian influenza or bird flu is putting countries on edge as they struggle to stop the deadly H5N1 virus from triggering a human pandemic that could kill millions. Global health experts, including the World Health Organization (WHO), say no one knows when it will happen but it is just a matter of time before it does. "No society will be exempt and no economy will be unscathed. "We don't know when but we know it will happen. The signs are clear that it is coming," WHO director-general Lee Jong-Wook had said when addressing officials from 100 countries who had gathered in Geneva for three days recently to hammer out a bird flu war strategy. According to WHO, each additional human case makes it easier to develop human-to-human transmission. The H5N1 strain of bird flu has caused millions of birds to be killed and the death of more than 60 people, mainly in Southeast Asia. The H5N1 strain first surfaced in Hong Kong in 1997, killing six people. The strain resurfaced in Asia in 2003 and triggered culling of millions of poultry and birds. Since October this year, the virus has spread its wings to at least 11 countries worldwide. WHO says a pandemic, when it happens, will most likely begin in Asia where as of Nov 8, 64 people have died. Why Asia? In many parts of Asia, humans and farm animals live in close proximity. Animals are reared and slaughtered in unhygienic ways. Rapid clearing of forests, bird and other wildlife habitats forces wild animals and whatever virus they carry, to come into closer contact with humans. Countries are doing their best to arm themselves against the virus but many Third World countries lack the resources to protect their vulnerable population. Malaysia, too, is bracing itself. Health Minister Datuk Dr Chua Soi Lek had announced that the ministry is stockpiling antiviral medication like Tamiflu, flu vaccines and protective gear which cost in total about RM500 million. Malaysia has ordered 600,000 Tamiflu tablets but it needs another RM189 million to buy enough to treat 10% of the population. Previous pandemics indicate that about 30% of a country's population could become infected. Malaysia is still free from the virus but once it rears its ugly head, it is hoped that the virus could be stopped in its tracks before it affects Malaysians, says Veterinary Services Department director-general Datuk Dr Hawari Hussein. This would need speedy detection and eradication. "That would be our approach in managing the threat of bird flu. We want to be able to detect the infection early and then get rid of it |
speedily," he says. The National Preparatory Committee Against Avian Influenza has also drawn up a contingency plan. Hawari says the department, with other relevant agencies such as the wildlife department and health authorities, have stepped up surveillance and monitoring in order to detect the virus quickly if there is an outbreak. A main focus of the surveillance is the 3,000 commercial poultry farms in the country. "We tell farmers to inform us if there is any sudden high mortality among their poultry. For instance, if there is a sudden increase in the number of dead chickens in one day, report to us," he says. "We also do routine checks and take random samples for tests." Malaysia has also banned the import of poultry and pet birds from infected countries. But this may not deter smugglers, hence border surveillance is crucial and the relevant security agencies, especially border security patrols and customs at entry points, are on the alert to prevent any such smuggling into the country. It is possible that the virus will enter the country through migratory birds. Hence, surveillance at bird sanctuaries is of the utmost importance. The authorities are also keeping a very close eye on migratory birds which are potential bird flu carriers. Every winter, thousands of migratory birds from as far as Siberia, Mongolia, China and Japan transit at bird sanctuaries in the country such as the Kuala Gula Bird Sanctuary in Kerian. As part of the surveillance, these wild birds are caught and their saliva tested for the disease. Apart from surveillance, veterinary diagnostic laboratories are prepared to come up with quick diagnosis on par with that of advanced nations. They are equipped to help field staff conduct initial tests while the reference lab at the Veterinary Research Institute in Ipoh is used for confirmatory tests which can be done within eight to 12 hours. The veterinary department's Rapid Action teams are already on standby and would be activated immediately once a case is detected. "Our teams are ready to go down to the infected location as soon as bird flu is detected, to put in place movement control, disinfecting and culling," says Hawari. The teams have had some experience last year when bird flu struck several villages in Kelantan. Thousands of chickens were culled when the first outbreak was detected among fighting cocks smuggled in from Thailand in a village in Pasir Pekan in August. The flu then spread to several neighboring villages and a 10kmquarantine was imposed. At that time, six people were hospitalized for suspected bird flu but none tested positive. The last case was detected on Nov 22 and the country was declared free from bird flu in January this year. |
According to Hawari, if bird flu strikes, one of the first and most important things to do is to impose quarantine measures where no movement of birds and poultry is allowed. The birds in the area are then culled. After the Nipah virus outbreak among pigs, the Severe Acute Respiratory Syndrome (SARS) and last year's bird flu incident, Malaysian authorities, says Hawari, are now more aware of the dangers and measures in dealing with outbreaks of diseases. "We are prepared to expect the unexpected. We try to anticipate what can happen, keep reminding ourselves not to be complacent, not to be put off-guard. The threat is real. The disease seems to have struck all around us. It can happen to us so we are on our toes all the time," he stresses. He also emphasizes the importance of public information and cooperation. "The farmers and the public must keep us informed. Don't try to bring in birds of whatever kind illegally. When we say don't move your chickens, don't move. If we say don't bring in chickens from outside, don't bring in. Abide by our instructions. People who rear poultry in their backyards in residential areas should know the risks involved. When there is a threat of bird flu and the authorities need you to give up your fowl, you must surrender them." On the other hand, people should not be unduly concerned. "We must have the confidence that the government has put things in place and be able to handle it well if it strikes. "We are transparent. We are not hiding anything. When we say we are free from bird flu, we are free. So far we are free from the flu," says Hawari. Vaccination is not among the department's initial strategies in tackling bird flu. One reason is because a vaccine must be specific to the virus and this takes time to develop. "If the virus is already here, we would need several weeks to come up with a vaccine specific to the virus. So it takes time. Vaccination also needs good coverage to be effective." But most of all, Malaysia just wants to keep the virus away for as long as possible. "We do not want it in the country at all, whether in the form of disease or vaccine. We want it to be free from the virus and we can keep the country free of the virus if the disease is detected and eradicated at an early stage," says Hawari. However, vaccines are useful in a situation where culling alone is not enough. Hence, a regional avian influenza research centre will be set up at the Veterinary Research Institute to develop a local bird flu vaccine and RM13 million has been allocated to acquire equipment and manpower needed to do so. The other thing to do is to hope and pray.
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