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.
