TREATING, COMBATING AND CONTAINING BIRD FLU

TAMIFLU AND BIRD FLU TREATMENT

There is no human vaccine for bird flu. Human bird flu patients are treated with antivirals. The primary treatment, an expensive anti-viral called Tamiflu, appears to only be effective if it is given within 36 hours days of the onset of symptoms. The drug does not cure people but reduces the length of illness bay a day or two and decreases somewhat the severity of the symptoms/ Tamiflu is also given as a kind of vaccine. It was widely used during the global H1N1 (swine flu) outbreak in 2009.

Tamiflu is produced by the Swiss pharmaceutical company Roche, which has provided tens of millions of doses of the drug for free or at cost to countries threaten by bird flu and other influenza. There are cases of people taking Tamiflu and dying but it is not clear what role if any the drug had in their deaths. There have also been reports of hallucinations and abnormal behavior associated with the drug as well as counterfeit versions of Tamiflu. Gilead Sceinces invented Tamiflu and receives royalties from its sales. Roche has an exclusive patent on the drug until 2016.

Relanza made by GlaxoSmithKline is another drug used to treat bird flu. It is difficult to use because it is a powder that has to be inhaled. Neither Tamiflu or Relenza is that great because you can’t get them directly into the bloodstream. The worst case scenario os if the bird flu virus becomes resistant to Tamiflu, a scenario which experts say is not that unlikely, especially if the drug is handled by inexperienced personnel who give incorrect does and improper times, enabling the virus to build up resistence.

Influenza Vaccines

In 1934, microbiologist Thomas Francis confrimed the identification of the influenza virus. In 1941 Francis and Jonas Salk developed a flu vaccine used in World War II. The first flu vaccines were given whole---the entire virus was inactivated and then injected. This caused numerous side effects, some of which were worse than the flu. In the 1960s the virologist Robert Webster and his colleagues had the idea to break up the virus with detergents, so that only the immunity-producing particles need be injected to spur an immune response. Most standard flu shots still work like this today. [Source: Michael Rosenwald, Smithsonian magazine, January 2006]

One of the main problems with influenza vaccines is that often can not be made fast enough to deal with fast-developing outbreak. Many flu vaccines are made from viruses grown in fertilized chicken eggs. Because flus are always changing, new vaccines have be created each flu season for the flu strains that are expected to be a problem. The reason that we are able to easily fend off most flus is that our bodies have seen them before or at least ones similar enough to them that our immune systems can muster an appropriate response. Flus that are deadly are the ones that are different enough from the others that our immune system can not adequately provide protection. Many of these are flus that have made a recent leap from another species to humans.

Drug companies typically need about four months to make a vaccine from the time they are informed about a new strain to the time the first doses are available. The primary technique is to grow virus samples using the slow and clumsy but time-tested method of producing them in the embryos of chicken eggs. If a full scale pandemic were to break out it could take 18 months to four years to produce all the necessary doses, which would probably be too late. More efficient methods are expected to reduce the time to between one and 2½ years. Under these conditions, tough decisions have to be made about who gets the doses first as they become available.

New techniques of producing vaccines, such as from cell cultures, are still being developed and in the experimental stages. One technique that shows promise reverses genetics to remove the gene that makes the virus deadly. The altered seed virus has been used by Sanofi Pasteur to produce a vaccine in chicken eggs. Scientists at the Center for Disease Control said they had success making bird flu vaccines using a genetic engineering technique that

Bird Flu Vaccines for Birds and Humans

There is a vaccine for birds and the United Nations has recommended that it be widely used because H5N1 seemed to firmly rooted in ducks and wildlife and culling is not enough. Each dose of the vaccine costs 5 cents. Up to three doses may be necessary. The vaccine has to be injected, which often presents the greatest expense and challenge. Strains resistant to the vaccine have appeared. In February 2005, Chinese scientists developed a bird flu vaccine for poultry and mammals.

Trials were conducted for a U.S.-produced H5N1 vaccine in 2005 but by the time it was ready the virus had changed. Test also showed that two doses of the vaccine were needed and it needed to contain several times more material than a conventional influenza vaccine. This meant that the vaccine was complex and hard to make and the fact that two doses were necessary meant that already-strained factories would have to produce twice as much to get the same results of a vaccine in which only a single dose was necessary.

A truely effective vaccine cannot be produced until a pandemic strain emerges (to ensure the best match) but then, production capacity is limited by the fact that the vaccine would need to be cultured in chick eggs (and is thus dependent on egg supply). All the while, H5N1 remains a moving target: it has already diverged into two clades (families), with each family further split into various subtypes. [Source: Anjana Ahuja, The Times, October 30, 2006]

A new vaccine made by Baxter International announced in June 2008 made with monkey cells instead of chicken eggs appears o be safe and effective. The new vaccine is regarded a major breakthrough because he right kind of chicken egg are difficult to obtain and chickens with H5N1 dies quickly.

Sometimes vaccines are not even used because by the time they are developed it is too late to use them. That was the case in bird flu in Hong Kong in 1997. A vaccine was developed for the bird flu virus that struck then---a strain of A (H5N1)---but by the time it was ready the virus had already been stopped or its remnants mutated into a new strain.

Bird Flu Vaccine using Antibodies of Survivors

The Hospital for Tropical Diseases in Ho Chi Minh City in Vietnam and the National Institutes of Health in Maryland has isolated antibodies to H5N1 in the blood of bird-flu survivors. Anjana Ahuja wrote in The Times: “Mice that are first immunised with these antibodies and then infected with the virus survive the ordeal, raising the prospect that the antibodies could form the basis of a future vaccine. The Wellcome Trust, which is fast-tracking influenza research and has funded much of the unit’s work, has awarded the project £385,000. [Source: Anjana Ahuja, The Times, October 30, 2006]

“We believe that part of surviving H5N1 involves individuals making antibodies capable of killing the virus,” explains Dr Cameron Simmons, who is leading the unit’s involvement with the project. But, Simmons says, antibodies are not the only key to survival: “It’s partly how soon you get medical care and Tamiflu, how much virus you got initially, how old you are, and what your flu infection history is. Although H5N1 is very different from human flu, parts of it are very similar. So adults who have a long history of flu exposure could potentially have an immune response that helps them to fight H5N1.” [Ibid]

“The idea of mining survivors’ blood for lifesaving chemicals dates back to 1918, when doctors transfused the blood of flu survivors into new patients. This roughly doubled the chances that the recipient would survive. The technique was also employed on a smaller scale during the Sars outbreak, although success rates are hard to pin down. Latterly, however, the threat from blood-borne diseases such as HIV and hepatitis B dampened enthusiasm for serum therapy. [Ibid]

“Simmons has isolated the H5N1-killing antibodies from the blood of four survivors. He says: “We’ve shown that if you give these antibodies to mice before they’re infected,you can protect the animal from what is rapidly lethal.”The antibodies can quash the strain of H5N1 circulating in Vietnam (this strain is also circulating in Thailand and Cambodia)but are only partially effective against the other major strain of H5N1, which has cornered China, Indonesia, Japan and South Korea. Any mass-produced vaccine using this method would need to contain antibodies to both strains. [Ibid]

The mice are also protected if the antibodies are given 24 hours after infection. The researchers are now trying to gauge how long the delay between infection and immunization can be. The atmosphere in the unit, Simmons says, is one of measured optimism: “It’s difficult to extrapolate from a mouse to a human, so there’s doubt as to what our experiments will mean for people.

Treating the “Immune Storm” of Bird Flu

Anjana Ahuja wrote in The Times: “Dr Menno de Jong, has been studying the impact of H5N1 on the immune system of patients. He recently reported, in Nature Medicine, that the patients who died displayed a particularly fierce immune response. Flu experts are now wondering whether this ability to provoke an “immune storm” in the lungs accounts for the virus’s deadliness. Immunosuppressants might be another therapeutic prospect. [Source: Anjana Ahuja, The Times, October 30, 2006]

“De Jong, who helped to define the WHO’s diagnostic criteria for H5N1, is now trying to discover whether some individuals are immune to it. Together with health officials in Ho Chi Minh City, he has collected the blood of hundreds of poultry workers and individuals involved with culling infected birds. It has been noted, anecdotally, that no poultry workers or cullers have ever come down with H5N1. The plan is to test the blood for H5N1 antibodies, to see whether these workers actually encounter the virus but don’t succumb to it.

Bird Flu Drug Given to Chickens in China Rendered Useless on Humans

Alan Sipress wrote in the Washington Post, “Chinese farmers, acting with the approval and encouragement of government officials, have tried to suppress major bird flu outbreaks among chickens with an antiviral drug meant for humans, animal health experts said. International researchers now conclude that this is why the drug will no longer protect people in case of a worldwide bird flu epidemic. [Source: Alan Sipress, Washington Post, June 18, 2005]

“China's use of the drug amantadine, which violated international livestock guidelines, was widespread years before China acknowledged any infection of its poultry, according to pharmaceutical company executives and veterinarians. Although China did not report an avian influenza outbreak until February 2004, executives at Chinese pharmaceutical companies and veterinarians said farmers were widely using the drug to control the virus in the late 1990s. [Ibid]

“The Chinese Agriculture Ministry approved the production and sale of the drug for use in chickens, according to officials from the Chinese pharmaceutical industry and the government, although such use is barred in the United States and many other countries. Local government veterinary stations instructed Chinese farmers on how to use the drug and at times supplied it, animal health experts said. [Ibid]

“Amantadine is one of two types of medication for treating human influenza. But researchers determined last year that the H5N1 bird flu strain circulating in Vietnam and Thailand, the two countries hardest hit by the virus, had become resistant, leaving only an alternative drug that is difficult to produce in large amounts and much less affordable, especially for developing countries in Southeast Asia. [Ibid]

"Amantadine is widely used in the entire country," said Zhang Libin, head of the veterinary medicine division of Northeast General Pharmaceutical Factory in Shenyang. He added, "Many pharmaceutical factories around China produce amantadine, and farmers can buy it easily in veterinary medicine stores." Zhang and other animal health experts said the drug was used by small, private farms and larger commercial ones. Amantadine sells for about $10 a pound, a fraction of the drug's cost in Europe and the United States, where its price would be prohibitive for all but human consumption. Two months before China first reported a bird flu outbreak in poultry to the World Animal Health Organization in February 2004, officials had begun a massive campaign to immunize poultry against the virus. They have now used at least 2.6 billion doses of a vaccine. [Ibid]

“In 1987, researchers at a U.S. Department of Agriculture laboratory demonstrated that bird flu viruses developed drug resistance within a matter of days when infected chickens received amantadine. Still, a veterinarian with personal knowledge of livestock practices across China said Chinese farmers responded to the bird flu outbreak by putting the drug into their chickens' drinking water. The veterinarian asked that his name not be published because he feared for his livelihood. A popular Chinese handbook, titled Medicine Pamphlet for Animals and Poultry, provides farmers and livestock officials with specific prescriptions for amantadine use to treat chickens and ferrets with respiratory viruses. The manual, written by a professor at the People's Liberation Army Agriculture and Husbandry University and issued by a military-owned publishing company, prescribes 0.025 grams of amantadine for each kilogram of chicken body weight. [Ibid]

“Farmers also use the drug to prevent healthy chickens from catching bird flu, giving it to their poultry about once a month or more often when the weather is liable to change and chickens are considered susceptible to illness, veterinary experts said. The antiviral is often mixed with Chinese herbs, vitamins and other medicine. International health experts stressed that amantadine could have been vital in stanching the spread of the bird flu virus in the early weeks of an epidemic.Now, the only alternative is oseltamivir and closely related zanamivir, which stop the flu virus from leaving infected cells and attacking new ones. Oseltamivir is easier to use and has far greater sales. [Ibid]

Fighting Influenza Pandemics

The World Health Organization (WHO) pandemic alert system for new influenza strains is as follows: Phase 1): virus found circulating among animals but no infections of humans; Phase 2): an animal influenza is known to have caused an infection in humans; Phase 3): an animal- or human-animal reassortment influenza is known to have caused sporadic or clusters of infections in people, but no human-to-human transmissions have been reported; Phase 4): verified human-to-human transmissions of animal- or human-animal reassortment influenza able to cause community-wide outbreaks occurs; Phase 5) : human-to-human transmissions of the virus occur in at least two countries in one WHO’s six regions. ; Phase 6) the pandemic phase, characterized by community level outbreaks in at least one country in a different WHO region.

Preparations for a major influenza pandemic in the developed world include having: 1) systems and facilities in place that allow medical laboratories around the globe exchange samples of viruses and rigorously study them: 2) stockpiles of antiviral drugs like Tamiflu inhaler-based treatments; 3) a carefully rehearsed emergency plan for screening ports of entry, isolating suspected cases and shutting down public gatherings; and 4) arraignments with drug makers to quickly produce and distribute vaccines. Many of these measures were put in place after the 2002-2003 SARS outbreak and implemented to varying degrees during the H1N1 flu epidemic in 2009. In the developing world, most countries have minimal or no pandemic plans.

Combating the Bird Flu Virus

The most effective way to fight bird flu is kill every bird that has the disease and then slaughter all the domesticated birds in the area, often for a several mile radius. Sometimes millions of healthy birds are killed after the appearance of one sick bird. Hong Kong has been able to avoid a return of bird flu by taking the above measures and regularly the sick chickens pe birds and even wild birds shutting down hundred fo live-poultry stalls twice a month to disinfect them and aggressively inspecting farms and markets.

Other measures including giving millions of birds vaccines, banning the import of wild birds and poultry, improving the hygiene at live animal markets, and educating villagers about the disease. People were encouraged not to eat potentially sick birds. Not because there is a danger of contacting the disease from eating (little chance of getting it from well cooked meat) but from preparing it.

In November 2011 international health experts unveiled a $1 billion plan to halt the spread of bird flu. Reuters reported: World Health Organisation (WHO) chief Lee Jong-Wook said the plan aimed to boost early warning systems, strengthen veterinary services, make access to antiviral drugs fairer and step up research into pandemic vaccines.

Asian governments agreed to create a regional stockpile of bird flu drugs and vaccines so that adequate supplies would be on hand to deal with both avian and human cases of the disease to keep bird flu contained and prevent it from spreading.

In 2007, Roche increased production to 300 million treatments a year. That was a tenfold increase from 2004. Still shortages were reported and countries and organizations clamored for supplies. Roche was more willing to hand out millions of doses to needy countries than it was let foreign governments and companies have access to its patents and know how. The company did provide some sunlicenses and form partnerships to make the drug is bird-flu-hit countries for pandemic use only.

Malaysia was given credit for moving swiftly and decisively to contain bird flu. When the disease appeared among birds in a remote corner fo the country near the Thai border the Malaysian government quickly to cull all birds in the area. Malaysia has had no human cases or deaths connected to bird flu.

There were warnings that if a bird flu pandemic hold hundreds of thousands of people would die and drastic measure would be taken such as “ending international travel.” Vietnam and Australia held exercises involved the police, military and health officials on handle a situation in which hundreds or thousands became infected. China said it developed plans on how to dispose of thousands of bodies and provide enough food in the event of shortages and panic buying.

Combating First Cases of Bird Flu in Hong Kong and the Return of the Disease in 2001 and 2003

It was first thought the “bird flu” case that killed the three-year-old boy was a fluke. After three more people form the same disease died in December 1997 the Hong Kong government and disease experts decided that drastic measures were needed to prevent the disease from spreading and a major calamity from occurring. The flu season was just starting and officials were concerned bird flu strains mixing with seasonal human strains, producing deadly mutations.

Worried about the possibility of a worldwide pandemic, Hong Kong’s health director---now head of the World Health Organization (WHO)---Margaret Chan ordered every chicken in Hong Kong killed during the last week of December. Over 1.6 million chickens, geese, partridges, and quails were slaughtered. Secretaries, dog catchers and park rangers were recruited for the effort. Some of the birds had their throats slit. Others were stuffed into garbage bags and gassed with carbon dioxide. This operation took 1,300 government workers and farmers three days to complete. Some 1,300 tons of bird remains were disposed of in makeshift gas chambers. Killing the chickens ended the outbreak because the disease was not spread person to person.

After 1997 bird flu outbreak, the handing procedures of poultry was changed. Waterfowl, which can carry H5N1, were kept separated from chickens. Quails, also H5N1 carriers, were banned. Markets were required to undergo intensive cleaning twice a month. A H5N1 vaccine was developed and chickens were required to get shots.

The tactics appeared to have worked. "We felt we had dodged a bullet," Keiji Fukuda, the World Health Organization's assistant director-general for health, security, and environment, told The New Yorker. During the Hong Kong bird flu outbreak in 1997 he was the chief influenza epidemiologist at the Centers for Disease Control and Prevention, in Atlanta, He told Specter he spent a few tense weeks in Hong Kong, searching for clues to how the virus was transmitted from chickens to humans and whether it would set off a global pandemic. "It was a very scary time," he said, "and we were bracing ourselves for the worst. But by the end of the month nobody else got sick, so we crossed our fingers and went back to Atlanta." [Source: Michael Specter, The New Yorker, March 12, 2012]

A kind of bird flu returned to Hong Kong in May 2001. No people were killed. It was caused by a slightly different strain of H5N1. More than 1.2 million chickens were ordered slaughtered after 1,000 chickens with the disease were found at seven markets. H5N1 bird flu returned to Hong Kong in January 2003, killing a man and his daughter and sickening his son and wife. The family became ill after a trip to Fujian Province in southern China. The strain was similar but not identical to the one that struck in 1997. An investigation by a government commissions found that disease was likely to keep on recurring as long as live poultry was sold in markets. At that time the Hong Kong government spent $5 million annually to monitor farms and markets for outbreaks. It has also dished out $15 million in compensation payments for the culling that took place in previous outbreaks.

Combating Bird Flu in China

During the outbreaks of bird flu between October 2005 and January 2006 thousands of teams on motorcycles fanned out across China, going from village to village and house to house, vaccinating chickens, geese and ducks for bird flu. Each team handled about 600 birds a day. The goal of the nationwide effort was to innoculate all of China’s 14.2 billion domesticated birds. Nearly a million officials and soldiers were mobilized in Liaoning Province alone. The government is worried about migratory workers from the countryside bringing the disease to the cities.

Typically the team had little training. Often one person held the bird, while another swabbed it and a third person injected the needle. Many workers failed to take even the most basic hygienic measures such as wearing rubber gloves and masks. Sometimes used needles were simply discarded on the ground. There were worries the teams might catch and spread the disease.

Production of bird flu vaccines were stepped up. Nine plants worked around the clock producing 100 million doses a day. The inoculation effort proceeded relatively smoothly and rapidly in poultry farming areas but was slower going in hard-to-reach areas. Many places complained about receiving supplies late or receiving far less vaccinations than they needed.

The pharmaceutical giant Roche and the state-owned Shanghai Pharmaceutical company reached an agreement to make the bird flu drug Tamiflu in China. The Chinese government was criticized all the misuse of amantadine an effective bird flu drug intended for humans. Farmers used the drug on poultry which can make the virus resistant to the drug in birds and then make it useless in human cases.

The WHO complained that China refused hand over samples of the disease collected during the outbreaks in 2005 and 2006. Some speculated that China failed to do this so it could make a vaccine and reap huge profits before foreign competitors could make one. Researchers from Hong Kong complained that Chinese authorities interfered with their studies of the disease.

In 2006, 100 hundred monitoring stations and 1,000 workers were spread along bird migration routes in Jiangsu Province eastern China to monitor if the disease was being spread by migrating birds. An estimated 3 million birds pass through the area being monitored. The raising of chickens in urban areas was banned in Shandong Province, where a 27-year-old woman died of bird flu in the city of Jinan.

Efforts to Contain Bird Flu

Because the majority of human bird flu cased occurred on small-scale farms where farmers didn’t even know the disease existed the effort by the United States to control bird flu was focused on such farms, particularly in Asia where the the disease was most widespread. Evelyn Rusli wrote in the New York Times, “Farmers learn about high-risk farm practices, simple sanitation measures and the importance of separating livestock by different species. The new strategy also targets Asia's wet markets. These large open markets, where consumers can purchase live poultry or fresh meat, are often considered bastions for infectious diseases because of unsanitary conditions and lack of governmental regulation, a senior officer of the Food and Agriculture Organization, Anni McLeod, said in an interview. [Source: Evelyn Rusli, New York Times, July 7, 2005]

"We agreed that it is vital to urgently change or even end a number of farming practices that are dangerous to humans," the FAO said in a press release. "These include the way chickens, ducks and pigs are raised in close proximity to each other, often with no barriers between them and humans." Health experts called on affected countries to increase poultry vaccinations and to encourage farmers to report bird flu outbreaks through incentive-based systems, including financial packages, which will help offset related costs, such as culling. [Ibid]

Small-scale farmers, a majority of which are poor in Asia, are usually afraid to report suspected outbreaks because they are worried about losing their poultry and their livelihood, Dr. Shigeru Omi, the regional director for the World Health Organization, said in an interview Tuesday. It is difficult to calculate the economic costs of a massive prevention campaign in Asia's poultry industry, but aggressive programs, which may be needed in the most affected areas, could disrupt economies, the Fao said. The European Union banned the import of captive live birds from outside the bloc. [Ibid]

Culling Large Numbers of Birds to Contain Bird Flu

In January 2006, as bird flu was going global,Donald G. McNeil Jr. wrote in the New York Times, With migratory birds spreading avian flu, the disease is popping up from Asia to Turkey and from Siberia to the equator, often in spots that are isolated, rural and unprepared. Many governments, veterinary specialists say, know little about killing millions of animals - especially when the aim is to spill as little blood as possible and to dispose of the bodies so they cannot spread the highly contagious virus to birds or humans.[Source: Donald G. McNeil Jr., New York Times, January 29, 2007]

“Problems are cropping up everywhere. In Vietnam, for example, flocks range free across muddy rice paddies, where chasing them is next to impossible. High water tables mean they cannot be buried, and poor farmers cannot spare the gasoline or wood to incinerate them. In villages from China to Turkey, cullers wearing biohazard suits recruit barefoot children to catch chickens for them. Older children kick dying turkeys around like footballs or play with severed heads. Farmers hide prize roosters or bribe cullers to spare their flocks. Chickens are buried alive or burned alive. [Ibid]

"We need an international culling task force, a reliably robust, incorruptible public service to go around killing chickens," said David Nabarro, special representative for avian flu for the UN secretary general. Juan Lubroth, senior animal health officer for the UN Food and Agricultural Organization, said he would like to have at least 20 more veterinarians to send immediately to Indonesia and Turkey simply to train "brigades of cullers," and would need more for each country the disease reaches. The total cost, he said, would depend on whether he can borrow government veterinarians from wealthy countries or has to hire privately, and whether he sends a few to lead workshops in the capital or dozens into small villages to supervise culling. He is also negotiating with a Dutch company to bring its portable chicken-killing machines to Southeast Asia, he said. [Ibid]

When even one bird with the virus is found on a farm, its flock and those in a large circle around it must be exterminated. “Until recently, Lubroth said, he had no money for any of this. But since January 2006, when 33 countries and international institutions at a meeting in Beijing pledged $1.9 billion to fight avian flu, "all of a sudden, I'm able to make some decisions." His agency already has advisers in the field, but they are overwhelmed. [Ibid]

Methods and Problems Culling Large Numbers of Birds to Contain Bird Flu

Donald G. McNeil Jr. wrote in the New York Times, There are many ways to kill a chicken. Those approved by the Paris-based Organization for International Epizootics, which tracks diseases that cross between animals and humans, include firing bolts to the skull, shocking with bare electrodes, dipping in electrified baths, gassing with carbon dioxide or nitrogen, lethal injection or lacing feed with barbiturates. For small numbers, neck-breaking and decapitation are approved as long as the animals are already unconscious.[Source: Donald G. McNeil Jr., New York Times, January 29, 2007]

“But poor countries cannot always afford such methods, although some are using variants. In Vietnam, said Tony Forman, a UN veterinarian consulting there, cullers have begun collecting chickens in large plastic bags and gassing them with carbon dioxide, which is available from any soda bottling plant. In Thailand, said Wantanee Kalpravidh, the regional head of flu surveillance for the UN agriculture agency, cullers pack chickens into the backs of trucks and run in a hose from the tailpipe. But in Indonesia, Roeder said, "Cullers kill in the traditional fashion - cutting their throats." That is risky: Cut hands can be infected by chicken blood, although there have not been any confirmed cases of avian flu among cullers. [Ibid]

“Killing chickens in large poultry and egg farms was not difficult because the birds could easily be rounded up. "Backyard birds" presented the biggest problems because they can flee faster than big-breasted commercial birds, they are found in mall numbers all over the place and their owners are often attached to them. "People love their animals," one veterinarian told the New York Times. "In many cases, they were pets." Farmers persuaded to cooperate can collect roosting flocks at night, or lure them in with corn. By contrast, Roeder said, Indonesian government teams often arrive in villages at midday, "when birds are running all over the place." Then, he said, "They go in ordering people about with the attitude that the authorities know best." [Ibid]

“Also, farmers will not cooperate without compensation, and most countries are paying relatively little. In Turkey, farmers get up to $3.50 a chicken, which Lubroth said was about 60 percent of market value. Vietnam pays $1, about half the market value there. Indonesia, which is wealthier, pays about 80 cents, less than a third of market value.In China, the government officially pays 60 cents, and farmers complain that vouchers go unpaid. In Cambodia and Laos, farmers are offered only 10 percent to 20 percent of market value, and only for flocks, said Kalpravidh, the flu watcher in Thailand, "so we don't see much cooperation." In the case of fighting cocks - entrenched in Southeast Asian culture and worth up to $5,000, she said - the breeders "sneak their chickens away," unwilling to sacrifice them. [Ibid]

“Disposing of the carcasses so they cannot be dug up and eaten by people, wild animals or birds is also important. Shallow graves and composting are discouraged, although Forman said he had seen farmers "piping methane out of compost piles and boiling tea with it." Furnace incineration is fine, but expensive. Open burning is not, and it is best not to truck birds from the killing site because the flu is so contagious that it can travel in dander and feathers blown off the corpses. [Ibid]

Containment of Bird Flu

By 2007 the virus was eliminated from most of the 63 countries infected at its peak in 2006, but it remained endemic in six countries: Bangladesh, China, Egypt, India, Indonesia and Vietnam. The number of outbreaks in poultry and wild bird populations shrank from a high of 4000 to 302 in mid-2008, the FAO said, but warned “Egypt, Indonesia and Nigeria have not yet been able to contain the disease, effectively making them reservoirs of the virus for possible introduction to other countries.”

In 2007, Donald G. McNeil Jr. wrote in the New York Times, “Today’s H5N1 flu is probably changing more slowly, because health officials have been vigilant about attacking clusters of cases, which presumably wipes out the most dangerous strains. Whenever several human cases appear, even in remote villages in Indonesia or Egypt, local officials and World Health Organization teams move in to kill all the local poultry and dose all the humans with antiviral drugs---the so-called Tamiflu blanket strategy. Each stifled outbreak robs the virus of the chance to carom wildly through dozens of human hosts as it does in a flock of chickens or ducks. That fends off what virologists most fear: gene-swapping in people infected with both human and avian flu. But the Tamiflu blanket may not be able to smother every spark, especially if countries cannot get their poultry epidemics under control.[Source: Donald G. McNeil Jr., New York Times, March 27, 2007]

Resurgence of Bird Flu Since 2008

Outbreaks have risen progressively since 2008. In January 2008, a A major outbreak of the H5N1 virus occurred in West Bengal, India. It lead to the culling of 2.6 million birds. Twenty countries had outbreaks of the disease in the first nine months of 2008, with worrisome outbreaks in Thailand and Bangladesh.

In June 2008, Hong Kong ordered the slaughter of all chickens in the city's markets after the H5N1 virus was detected in birds for sale. In February 2009, at least 21 dead birds, including ducks and chickens, wash up on beaches in Hong Kong. At least three of them test positive for the H5N1 avian flu virus. An outbreak of bird flu in December 2008 was blamed on smuggled fertilized eggs from China containing infected chicken embryos.

Almost 800 cases of bird flu reported in 2010-2011, The FAO said in August 2011 that bird migrations over the past two years have brought H5N1 to countries that had been virus-free for several years, including Israel, the Palestinian territories, Bulgaria, Romania, Nepal and Mongolia. "Wild birds may introduce the virus, but people's actions in poultry production and marketing spread it," said FAO's chief veterinary office Juan Lubroth in urging greater preparedness and surveillance.

Bird Flu in 2011 and 2012

In February 2012, AP reported: Recent human deaths in Asia and Egypt are a reminder that the H5N1 virus is still alive and dangerous, and Vietnam is grappling with a new strain that has outsmarted vaccines used to protect poultry flocks. Ten people have died in Cambodia, Indonesia, Egypt, China and Vietnam since December during the prime-time flu season when the virus typically flares in poultry. "We are worried, and we will be very cautious," said To Long Thanh, director of Vietnam's Center for Animal Health Diagnostics in Vietnam. [Source: AP, February 17, 2012]

Vietnam has long struggled to control the virus, but it has made progress - going 21 months before reporting its two most recent deaths in the past month. It has also experienced a burst of poultry outbreaks in 11 provinces nationwide over the same period.

In August 2012, AP reported that bird flu had killed a man in central Indonesia, marking the country's ninth fatality attributed to the H5N1 virus in 2012. The victim, 37, died July 30 in Yogyakarta province after spending five days in hospital, the Indonesian Health Ministry reported on its website on Monday. It confirmed the man, who lived near a chicken slaughterhouse, had been infected with the virus, also known as bird flu, after apparently coming into contact with sick birds. [Source: Associated Press, August 13, 2012]

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Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Global Viewpoint (Christian Science Monitor), Foreign Policy, Wikipedia, BBC, CNN, NBC News, Fox News and various books and other publications.

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© 2008 Jeffrey Hays

Last updated November 2012

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