Bird flu distracts from real killers

The death of a 15-year-old Lao girl from bird flu at the Nong Khai provincial hospital last week marked a tragic and unwanted first for her country. She apparently contracted the H5N1 virus from infected poultry in a suburb of Vientiane in January. Despite their lack of experience, the Lao authorities lost no time in stepping up avian flu surveillance and public awareness efforts, culling birds that might have been infected.

Her death brought to 17 the number of known bird flu fatalities in Thailand and Laos and raised the total of all those who are known to have died to 168. All caught it from handling or being in close proximity to infected birds and there have been been no proven cases of human-to-human transmission or any indication of a mutated H5N1 strain.

Yet this disease remains one of the scariest around because of the potential it possesses of making the long-feared evolutionary jump to human-to-human transmission. While this will always be a source of concern, we must retain a sense of perspective and avoid the panic and mild hysteria that all too often accompanies any mention of the bird flu virus.

This hypersensitivity was well illustrated by an editorial published on the opinion pages of the prestigious Wall Street Journal Asia on Tuesday which, in part, recounted a statement alleged to have been made in Geneva by Thailand's representative to the World Health Organisation, Dr Suwit Wibulpolprasert. The newspaper said that during the executive board meeting of the WHO in January, Dr Suwit, who is also special adviser to the public health minister, declared that if an influenza pandemic hit, he would advise Bangkok to hold Western tourists hostage until those countries gave Thailand the necessary vaccines.

The US government has lodged a formal protest letter and requested an apology. Dr Suwit's comments ''appear to contravene the spirit and provisions of the revised International Health Regulations'', US Health and Human Services Secretary Michael Leavitt wrote in the letter dated March 7, referring to the WHO's rules on how countries cooperate to curb the international spread of diseases. ''Voicing support for these counter-productive policies at a multilateral, intergovernmental meeting ... can impair global influenza preparedness efforts,'' the Journal quoted Mr Leavitt as saying.

Apart from avoiding diplomatic incidents, there is another reason why keeping a balanced perspective and cool head is so important. Exaggerated fears and scaremongering tactics divert attention _ and funding _ from research into the real global killers: tuberculosis, HIV/Aids and malaria. These are the diseases causing widespread illness and severe economic harm to developing countries. TB alone kills between two and three million people annually and yet research and eradication programmes have lost much of their funding to more fashionable avian influenza research projects.

Concern about the potential of bird flu to wreak global havoc is understandable and by no means exclusive to Thailand. But let us not forget that four years ago we successfully weathered the severe acute respiratory syndrome (Sars) health crisis and are constantly on alert for avian influenza and other threats.

With so much experience, we should be confident of our ability to handle medical emergencies and have quarantine and control honed to a fine art. Governments, NGOs and commercial groups have produced detailed reports about preparedness and strategies in case of an outbreak and we stand ready to combat any mutated form of H5N1.

We must, and are, taking it seriously. But we will only be in serious danger if it crosses over, mutates and becomes a human-to-human strain. Then, and only then, are we at risk of an epidemic which could spiral into a pandemic if a vaccine could not be synthesised and distributed in time. Even so, it could get severely diluted in making the jump to humans and turn out to be little more than a particularly nasty flu bug. And such a jump, if it ever happened, could take years. Medical technology, in the meantime, is moving fast to combat the threat. This is not 1918 when 50 million died in a global flu pandemic. Health services, communications and information-sharing no longer rely on primitive technology.We have come a long way, and if we are faced with a large-scale health emergency, we do have the proven ability to contain it. There is no need for anyone, anywhere to overreact.

Bangkok Post

Saturday March 17, 2007