IT'S NOT THE BIRD FLU VIRUS INDONESIAN VILLAGERS FEAR, IT'S THE "MAGIC"

LOCALS CLAIM "BLOOD CURSE" WAS RESPONSIBLE FOR SEVEN DEATHS

At least seven members of the same family have died from the bird flu virus in the Indonesian village of Kubu Simbelang. World Health Organisation officials rushed to the village to try and contain the spread of the virus, which they now appear to have done successfully.

But during their visit, the officals discovered the work involved in stopping future outbreaks may not be all that they had planned for. In the village, locals now fear 'curses' killed their friends and neighbours, instead of the bird flu virus, and are wary of taking the anti-viral Tamiflu that WHO officials have been distributing.

A fascinating story from the Seattle Post-Intelligencer that gives vast insight into how the largest bird flu death cluster, thus far, has affected one small village in Indonesia :

Some neighbors insist, however, that bird flu is not to blame. They are convinced black magic is at work, that ghosts now haunt their quiet Christian community of about 1,500 people.

Many are too scared to even pass by the family's houses, and some who live nearby are awakened by nightmares that they will be the next to die.

"We are so afraid just to step into that house," said a 37-year-old woman who identified herself only as Sembining. "We can't tell what we're afraid of - we're just afraid."

"I think the family was cursed," she said. "It must be, because if it's bird flu, why only their family? Their blood?"

As their neighbors started dying, confusion and mistrust prompted villagers to stop cooperating with officials. Many refused to give blood samples, fearing they would later fall ill and suffer the fate of their neighbors.

The case has been a powerful lesson for WHO officials in understanding the importance of early communication and education.

"We're seeing what problems we're going to run into on the ground," WHO spokesman Dick Thompson said. "We're learning with every step."

Jules Pieters, manager of WHO's rapid response and containment group in Geneva, said it is clear that people familiar with the culture, language and customs of this area should have been involved earlier to help villagers understand what was happening, how to protect themselves and the importance of allowing treatment if they develop symptoms.

Instead, many people who were never scared of doctors before are now terrified of them.

"We are afraid to be sent to an isolation room. You know an isolation room is a slaughtering room - a room for the people who want to die," said villager Caranta Perangin-Angin. "Therefore we are afraid of (letting doctors) take blood. Taking the blood, for me, symbolizes going to die."

...some villagers began associating Tamiflu, the chief drug to treat bird flu, with death because members of the infected family - most of whom were given the medicine too late to help - were dying after taking the pills.

Interesting piece here from the LA Times on how Darwin's theory of natural selection may play against the breakout of a human bird flu pandemic :

The H5N1 virus faces several barriers in jumping to and transmitting among humans. The most important is its ability to replicate in and adapt to human tissues, specifically the upper respiratory tract (not in deep lung tissue, where it now seems to grow). In the windpipe, the virus would be more likely to spread in a cough or sneeze, infecting other humans.

Some mutant strains have appeared repeatedly and independently in different humans infected with the bird flu virus. In one patient in Turkey, about half the H5N1 strains detected appeared to be viruses that had adapted to humans. But...the changes were a dead end — the victim died without passing on the disease.

(The process of mutation-adapatation) is probably how pandemics begin. The World Health Organization recently proposed a plan to move experts and resources to any area afflicted with clusters of viral infection; a plan that, given this evolutionary logic, makes eminent sense. At the beginning, viral adaptation to a host is slow. A disease just beginning to transmit is controllable. Surveillance, flexibility, willingness to impose or undergo quarantines, along with international cooperation, will be necessary to stop pandemic flu...

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