2006-01-11-Bird Flu HarbingersUnderstanding Avian Influenza
2006-01-11-Bird Flu Harbingers
HERE'S THE GOOD news: The discovery of a clutch of new bird flu cases in eastern Turkey does not -- yet -- signify the onset of a global human pandemic. So far, it appears that everyone who came down with flu caused by the H5N1 avian virus was in close contact with poultry. That probably means the virus has not yet mutated in such a way as to allow people to catch it from other people. If it never does, then it will remain a large economic problem -- poultry farmers across Turkey are being forced to slaughter their flocks -- but a relatively small health problem, confined to farmers and isolated rural villagers.
Now here's the bad news: If the virus really were to become a global human pandemic, the behavior of the Turkish government, neighboring governments and international institutions demonstrate that, for all the hype about bird flu, the world is totally unprepared. Certainly most health officials in that region are unprepared, judging by the drastic, frightening and almost certainly pointless steps they have taken. Turkish officials have set up quarantines around parts of their cities, Russian officials have advised their citizens not to travel to Turkey, neighboring countries are spraying disinfectant on cars coming from Turkey and Iran has closed its border with Turkey -- all in the name of a disease that is being transmitted around the world by wild birds that are unlikely to obey quarantines, respect borders or ride in cars. Turkish officials have also announced they have enough retroviral medicines to deal with the disease, a claim that will certainly prove false -- no one has enough retrovirals to deal with the disease -- if any significant number of people get it.
The World Health Organization, which is charged with monitoring the progress of the flu and conveying information around the world, has done its best to keep up with the multiple cases in different cities. But with only a dozen employees dispatched to Turkey and only a few dozen flu specialists worldwide, the WHO has been quite slow to confirm reported cases of the disease. This means not only that the organization will be overwhelmed if the numbers grow larger, but the lack of information has led to the publication of widely varying estimates on the numbers of cases and constant rumors that there are far more. Already there are reports of public attacks on rural health officials. Since chickens are being culled without any compensation, there are also reports of farmers hiding the birds to have something to eat.
It is true that in the absence of a vaccine, there are only a few useful things governments can do: prepare hospital isolation wards, for example, so that patients can be treated safely if the disease begins to spread -- or provide the public with better, clearer information, so panic doesn't increase. The only genuinely satisfying solutions are all still long-term. The World Health Organization needs more funding and more employees. The world needs a high-priority, international program to create a bird flu vaccine. These steps, and not useless quarantines and empty promises about nonexistent cures, are what we hope the United States and the rest of the world's rich countries will be talking about when they meet to discuss bird flu in Beijing next week.