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    Southeast Asia
     Nov 3, 2005
Bird flu fearsome but fickle
By Marwaan Macan-Markar

BANGKOK - Despite the doomsday scenarios being painted by some media now that Europe has detected its first signs of bird flu, the virus has left only a small signature in Asia since it first surfaced in January 2004.

After two winters, and with a third cold season approaching, the H5N1 strain of the bird flu virus has still not mutated into a strain capable of being transmitted among humans - much less triggering a global pandemic, observe public health experts in Southeast Asia.

"The virus has been changing in the normal way we expect it to, but it has not mutated into a critical level that could be worrying," said Dr Supamit Chunsuttiwat, senior medical officer at the department of disease control in Thailand's Public Health Ministry. "We have no evidence to suggest that the [H5N1 strain of the]

virus that has been detected in Thailand has mutated to one that could cause a pandemic."

That diagnosis comes after Thailand was shaken by a bird flu-related death last week, the first such fatality in the country this year. The death of Bang-orn Benpad, 48, due to infection from H5N1 avian influenza brought to 13 the number of fatalities in the country out of 19 cases detected since the beginning of 2004.

The latest victim from the Kanchanaburi province, west of Bangkok, had shown up with flu symptoms October 13 and was hospitalized four days later. But he only survived two more days.

His death was linked to the close contact he had had with infected poultry, including slaughtering diseased chickens, according to reports from the ministry.

This week, Thai health authorities confirmed that Bang-orn's seven-year-old son had developed symptoms of the same killer flu and has been hospitalized. Three other patients are also being treated and are under observation for a possible bird flu-related illness in the same area.

In neighboring Indonesia, new cases of human infections with H5N1 also have been reported in recent weeks. The youngest among them was a four-year-old boy from Sumatra. He had shown flu symptoms on October 4 but responded well to treatment and was discharged from hospital, fully recovered.

Not so fortunate was a 23-year-old man from Java, who was admitted to hospital on September 28. He died two days later.

These were but a handful of bird flu stories dominating the headlines in the last few weeks:
  • US President George W Bush announced on Monday a $US7.1 billion strategy to prepare for a possible worldwide outbreak. He wants to overhaul the vaccine industry so eventually every American will be inoculated within six months of a pandemic beginning. Critics say it isn't enough and point out that it will take at least until 2010 to implement. As part of the initiative, Washington will spend millions to make and test a human flu vaccine in Vietnam.
  • Disaster and pandemic coordinators from the Asia-Pacific Economic Cooperation (APEC)are working toward a plan to fight diseases such as bird flu. And APEC countries hope to hold a mock disease outbreak to see how well they respond.
  • China has suspended imports of poultry from 14 countries that have seen outbreaks. Also, Shanghai Pharmaceutical, China's largest drugmaker, is seeking a license to make Tamiflu. Media reports indicate that demand for the drug is by far outstripping supply, though Roche has doubled production every year for three years.

    Meanwhile, Thailand and Indonesia, along with Cambodia and Vietnam, are the only countries in the world that have seen human fatalities due to the strain, which began spreading through the region's poultry population since an outbreak in the winter of 2003. To date, 62 people have died out of 121 cases.

    Vietnam remains the worst hit, with 41 deaths out of 91 cases, followed by Thailand, then Indonesia, with four deaths from seven cases, and Cambodia, with four deaths from four cases.

    Yet, in neither Vietnam nor Thailand, dubbed in some quarters as the "ground zero" for a global pandemic triggered by the H5N1 strain of bird flu, has the virus triggered alarm bells since making its presence felt nearly two years ago.

    "It still remains a very fickle virus," said Peter Cordingly, spokesman for the World Health Organization's (WHO) Western Pacific regional office.

    But that is little reason for public health authorities to be less vigilant, he added, given the threats posed by this particular strain. For one, it contains a combination of proteins that could contribute to rapid mutation into a flu virus that could result in a deadly contagion, say researchers.

    Viruses caused by "A strains of the influenza virus", of which the H5N1 strain is one, have characteristics that cause great public-health concern and require constant vigilance, states the Geneva-based WHO. "Influenza A viruses, including subtypes from different species, can swap or 'reassort' genetic materials and merge."

    The outcome could be a "novel subtype [of virus] different from both parent viruses," the WHO adds. "For this to happen, the novel subtype needs to have genes from human influenza that make it readily transmissible from person to person for a sustainable period."

    And what makes people vulnerable in the face of such virus mutations is the lack of immunity to such new subtypes of virus, compounding an already prevailing worry that humans lack the immunity to fight infections caused by the strain.

    It was a virus with somewhat similar properties and also one that crossed over to humans from birds that was behind the flu pandemic of 1918, which killed close to 50 million people.

    "Of the 15 avian influenza subtypes, H5N1 is of particular concern for several reasons," states the WHO. "H5N1 mutates rapidly and has a documented propensity to acquire genes from viruses infecting other animal species."

    But for now, after infecting poultry for nearly two years in the region, resulting in tens of millions of chickens dying from the virus or being culled, the H5N1 virus continues to remain only a threat due to the pace of its mutation - "fickle" but not strong and fast enough to trigger deaths of doomsday proportions.

    (Inter Press Service)

  • A dose of double standards over bird flu (Oct 25, '05)

    Time the enemy in bird-flu fight (Sep 23, '05)

    Something foul with bird flu program (Sep 8, '05)

    Deadly avian flu on the wing (Aug 18, '05)

    Bird flu: An ill wind from the East (Jul 1, '05)

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