Wednesday, February 07, 2007

Fear The Chickens In Java More Than The Turkeys In Suffolk

Mike Davis wrote a clear, precise and comprehensive book, 'The Monster At The Door : The Global Threat Of Avian Flu', that we should have reviewed here, and still might.

For now, Davis has a good piece up on the UK Guardian's 'Comment Is Free' site, about how avian influenza disappears and resurfaces, year in, year out, and why outbreaks in Indonesia are more worrying than 2600 dead turkeys in Suffolk, England.

Here's a few excerpts from his piece :
...virologists have yet to understand avian flu's enigmatic behaviour: burning like a wildfire one season, going to ground the next. However, since the original outbreak in Hong Kong in 1997, one trend remains consistent: after each hibernation or disappearance, H5N1 re-emerges with its virulence intact and its geographical and species ranges extended.

The World Health grimly mobilising to confront imminent worst-case scenarios. The proposed response remains the same as last year: rely on local early-warning systems to quickly identify sustained human-to-human transmission and then squelch it with massive saturation of the exposed population with the antiviral Tamiflu. This strategy is based on a dubious perfect-world model of pandemic emergence and medical response, and is overwhelmingly contradicted by the WHO's own recent experiences in the field.

...Tamiflu is no longer a magic bullet: several recent deaths in Egypt have been attributed to a Tamiflu-resistant strain and this resistance is likely to spread through the larger population of H5N1 subtypes.

Second, the elaborate system of outbreak surveillance, immediate poultry slaughter, and isolation of human victims that has been painstakingly established in China, Vietnam and Thailand simply doesn't exist in many areas of recent outbreak, and will never come into being without a massive, urgent international effort.

Davis describes the possibility of greater outbreaks in shanty towns in Nigeria, and across sub-Saharan Africa as "horrifying" and "virtually apocalyptic" , but reminds that Indonesia remains the most likely start point for a global pandemic.

...years of heroic work in Vietnam to contain an explosive H5N1 outbreak that most experts feared was the likely pandemic trigger have been more or less annulled by the rampant and preventable spread of the disease across Indonesia's thousands of islands over the past 18 months.

This has been a defeat for the WHO's containment strategy. For fear of losing their base of operations in the country, the WHO and other international agencies acquiesced in the Indonesian government's negligent failure to aggressively cull infected birds or to contain the early human outbreaks.

Critics of the disastrous and failed campaign were censored and, in the case of the most senior foreign expert on the scene, even purged for leaking details of the fiasco to the international science press.

Be more worried, in other words, about the chickens in Java than the turkeys in Suffolk. While it is unnerving to have such a notorious virus unmasked in East Anglia, killer influenza is still most likely to reach London via Heathrow as a result of failed containment efforts elsewhere.

Avian flu will be the first plague in history to be preceded by a vast and lurid advertising campaign...

Read Mike Davis' Full Opinion Piece Here

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