THAILAND: Health Officials Get Serious Over Bird Flu Watch List

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

BANGKOK, Oct 12 2004 (IPS) - Faced with a high fatality rate from bird flu since July, Thailand has mounted a vigorous campaign to strengthen its public health surveillance system that is meant to detect signs of infectious diseases.

The first phase of this drive, due to last till the end of October, includes an army of public health volunteers visiting communities affected by the lethal H5N1 avian flu virus to conduct tests on people with respiratory illnesses.

”This is one way to improve our efforts to check for bird flu and where it has spread now,” Deputy Prime Minister Chaturon Chaisang, who is heading a government committee to combat the virus, told IPS.

Within the first week of this drive, the estimated 900,000 public health volunteers who have fanned out across the infected areas have put close to 100 people with symptoms of the disease on a bird flu watch list.

In addition, Thailand’s department of disease control has urged the medical community to gather more evidence about patients who die due to respiratory illnesses.

”We have informed the health personnel that they must screen all cases with respiratory illnesses to get the history of exposure and then we will do tests for the influenza,” Dr. Supamit Chunsuttiwat, senior medical officer at the department of disease control, said in an interview.

These efforts come in the wake of Thailand being found to be slack in its health surveillance system following the death of an 11-year-old Thai girl from a probable strain of the bird flu virus last month.

A similar lapse was revealed with the death of the girl’s mother a couple of weeks later, also from bird flu.

Doctors at a provincial hospital treated Sakuntala, the child, for dengue fever but there was no mention of avian flu at the time of her death. Her mother, Pranee, was treated for pneumonia.

”The doctors didn’t diagnose that the mother had bird flu,” Dr. Supamit told a press conference on Monday. ”We didn’t know before the child died that she may have had avian flu.”

What the doctors, who treated Sakuntala, were not aware when she was admitted to the hospital was the information that is currently posted on the Food and Agriculture Organisation’s (FAO) website: ”The girl raised poultry at home, all of which died the previous month.”

”However, the mother who lived in Bangkok had no contact with the affected chicken,” the U.N. food agency adds.

Since the second outbreak of bird flu this year hit Thailand in July, three of the four people infected with the H5N1 virus have died. ”That is a 75 percent fatality rate during the second round. This is very high,” Dr. Supamit told the media.

The three deaths bring to 11 the number of people who have died in Thailand due to the lethal virus since the first outbreak in January. In Vietnam, Thailand’s South-east Asian neighbour, the H5N1 virus has killed 20 people this year.

That this region faces a mounting challenge in combating bird flu was revealed last week when the World Health Organisation (WHO) warned Indonesian authorities that the strain of bird flu sweeping across the archipelago was lethal to humans.

Concern over human-to-human transmission of the virus has gained ground following the possibility – still unproven due to on-going laboratory tests – that Pranee, the Thai woman, may have got the virus from her daughter, who she cared for in the hospital.

During the first outbreak of bird flu early this year, the WHO sounded the alarm about the danger of the H5N1 virus mutating to become a lethal influenza strain that could be transmitted from human-to-human.

That could result in a pandemic more deadly than HIV/AIDS and could kill millions, given the ease with which the flu could spread and that human beings lacked an immune system against such a potential virus, the U.N. health agency warned.

Of the six Asian countries currently hit by the second outbreak of bird flu, five are from South-east Asia – Cambodia, Indonesia, Malaysia, Thailand and Vietnam. The other is China.

Yet even now, nine months after Thai authorities admitted that bird flu had infected the country’s poultry, officials at the department of livestock are unable to identify the original cause of the virus.

”We cannot say what is the real cause of the first outbreak. It could have been migratory birds,” Chaweewan Leowijuck, deputy director-general of the livestock development department, told the media this week.

Consequently, livestock development officials are pressing the case for breeding poultry under the ”closed farming system,” where the chickens are kept in enclosed areas with no exposure to wild birds in addition to other bio-security measures.

Thailand, the world’s fourth-largest chicken exporter, slaughtered over 40 million birds during the first episode of avian flu, which had swept through two-thirds of the country’s 76 provinces.

Across Asia, an estimated 100 million chickens were killed or died due to the disease in the first outbreak. Eight Asian countries were affected at the time, including Thailand, Vietnam and China.

The number of poultry culled in Thailand during the second outbreak is far less, according to officials, with over 100,000 birds slaughtered during the first week of October.

”Controlling bird flu is not very simple,” said Chaweewan. ”We are still using the stamping out policy and not using vaccines.”