HEALTH-ASIA: Experts Use SARS Lessons for Bird Flu Preparedness

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

BANGKOK, Apr 9 2005 (IPS) - As public health experts lay the groundwork to combat a possible pandemic triggered by the lethal bird flu virus in Asia, they have an equally lethal infection that struck two years ago – SARS – to thank for the current state of readiness.

Severe acute respiratory syndrome, or SARS, killed 774 people worldwide during an outbreak in 2003, which compelled governments to overhaul hospitals to treat patients with the deadly virus. In Asia, that included the setting up special wards to quarantine large numbers of people and strengthening hospital labs to identify the virus rapidly.

”SARS enabled the ministries of public health to progress with bird flu pandemic prevention plans,” Dr. Richard Brown, an epidemiologist at the World Health Organisation’s (WHO) Western Pacific division, told IPS. ”They all have hospitals ready to take on a pandemic caused by respiratory diseases.”

However the quality of health care services varies across Asian countries, said Brown at the end of a meeting held last week in Bangkok for public health officials from the 10 South-east Asian countries and Asian powers such as China, Japan and South Korea.

The health systems in the advanced economies of Japan and South Korea, for instance, clearly emerged as the best prepared to respond to a bird flu pandemic as against what prevails in poverty-stricken countries like Cambodia and Laos.

”The WHO needs to support the weaker countries due to their limited resources,” added Brown.

At the same time, a South-east Asian country like Thailand has proven its efficiency in another quarter – containing the spread of the bird flu virus among poultry through a regular monitoring of farms. Consequently, Bangkok is on the verge of announcing that the country is free of the bird flu virus, since the last detected case was on Mar. 15.

SARS, which spread to human from animals, had flu-like symptoms, such as high fever, headache and respiratory problems. It was transmitted when infected patients coughed or sneezed and over 8,000 people in over 20 countries in Asia, Europe and the Americas were infected.

So far, the lethal avian flu has not been as contagious among humans.

On Sunday, the death toll from the H5N1 strain of bird flu passed the 50th mark since outbreaks were reported in South-east Asian countries in January 2004. The 51st victim was an eight-year-old girl in Cambodia – becoming the latest victim to die in the kingdom, a health official said.

However, it is the high fatality rate among those who are infected by the virus that worries public health experts. Over 60 percent of people infected by the virus have died.

In Vietnam, the worst affected country, there have been 36 fatalities from 60 reported cases; while in Thailand there have been 12 deaths from 17 reported cases. In Cambodia, the only three patients reported with the virus have died.

And it is the threat of H5N1 mutating into a lethal virus that can be easily transmitted between humans, like SARS, that has made the Geneva-based WHO raise the alarm about a possible global pandemic.

That stems from the world still lacking a vaccine to inoculate people from a deadly virus that evolved from bird flu. Moreover, humans have no natural response to fight the H5N1 virus.

This concern has been heightened following revelations in April that another strain of bird flu virus – H7 – has been detected in North Korea. ”Three farms near the capital Pyongyang had outbreaks in their poultry,” Hans-Gerhard Wagner, a senior animal production and health officer at the U.N. Food and Agriculture Organisation (FAO), told IPS.

”There is no indication still of how the virus spread,” said Wagner, following his return from the Stalinist North Korea, where over 218,000 chickens have been culled in the infected farms.

While H7 is not lethal as a virus strain as H5N1, it is more easily transmitted among humans, added Wagner.

And the fear among public health officials is that the two virus strains in Asia may combine to form a deadly flu that could spread rapidly, triggering a pandemic.

Since the outbreak in January last year, over 140 million chickens and ducks have been culled or died due to avian flu in Asian countries that include Vietnam and Thailand, the epicentre of the disease, and Cambodia, Indonesia, Malaysia and China.

It was in 1997 that this lethal virus was reported to have jumped from bird species to people in Hong Kong, resulting in 18 people being infected and six dying.

But public health officials have another year – 1918 – when they talk about a global pandemic. An estimated 50 million people across the world died that year from a flu pandemic triggered by an influenza linked to birds.

For the moment, though, public health experts are relieved that the H5N1 virus in places like Vietnam and Thailand are part of the same group and they have not appeared strong enough to be passed on between humans as, say, SARS had done.

”Even in the human clusters under investigation, it appears that the virus has not been passed beyond one person,” said the WHO’s Brown. ”But we have to find out why it is happening and keep monitoring the pattern of bird flu’s spread.”