Monday, July 04, 2005

Meeting in Malaysia

Today some 60 bird flu experts convene in Malaysia in a meeting convened by three UN agencies on the front lines for the bird flu problem: the Food and Agriculture Organization (FAO), the World Organization for Animal (OIE) Health and the World Health Organization (WHO). ONe of the main topics of discussion will be animal husbandry, marketing and agricultural practices that might have public health implications (China Post).

A WHO team recently in Vietnam has said the virus has not yet mutated to allow efficient human-to-human transmission, although the grounds for this judgment were not made public and are considered doubtful by some. The thinking is that there is still some time to make important changes that would lower the risk:
They will "hammer out a strategy which will be comprehensive and focused to stop the spread of viruses from the animal to the human world," said WHO spokesman Peter Cordingley.

Recommendations for disease prevention will then be passed on to countries affected by the bird flu outbreak, he said.

Avian influenza can be transmitted to humans through close contact with infected birds, and therefore this week's discussions will focus on small-scale farming which is seen in villages all over Asia.

"We want an improvement in the way animals are raised, mainly in backyard farms," Cordingley told [Agence France Presse, AFP].

The mingling of humans, pigs, chickens and ducks in backyard farms increased the chances of animal and human viruses mixing and mutating into a new virus, he said.

Another focus will be on Asia's "wet markets" -- open markets where live domestic and wild animals are kept, often in cramped and unsanitary conditions, before being slaughtered and sold for consumption. (AFP)
I hope I may be forgiven for thinking this is a ridiculous idea. The genie is out of the bottle. Period. What will happen or not happen now is going to happen or not independently of any efforts of this kind. Even worse, there are agendas and forces at work that could make what emerges from this conclave counter-productive. Policies that encourage continued growth of huge industrial poulty farming operations are thought by some to be a prime risk factor for zoonotic disease, including avian influenza (see series of posts here, here, here and here).

The great Law of Unintended Consequences operates inexorably.

Addendum: Media coverage of the opening session suggests WHO was not as reassurred by their visit to Vietnam last week as widely (mis)reported (WHO spinmeisters must take some of the blame for this). Today from AP (via CNN):
KUALA LUMPUR, Malaysia (AP) -- Asia's bird flu outbreak is at a critical stage where it could easily become a human pandemic and officials should help prevent that by launching mass vaccinations of poultry, U.N. health experts warned Monday.

Dr. Shigeru Omi of the World Health Organization said at the opening of a three-day U.N. conference on bird flu that the virus has "tightened its grip" on the region and is capable of springing major surprises.

"We believe we are at the tipping point. Either we ... reverse this trend or things will get out of hand," Omi said. "We must have an all-out war against this virus."


The pandemic threat posed by the virus has been reinforced by its re-emergence in China, where it killed 6,000 wild migratory birds last month in the remote Qinghai province, Omi said.

He said wild birds had previously been considered "reasonably resilient" to H5N1, and their deaths in such large number shows the virus can have unexpected consequences.

Omi noted that there have been 64 human cases in Asia this year, mainly in Vietnam, compared to 44 cases in 2004. Of the 64, 22 died, compared to 32 fatalities for all of last year, he said.

Vietnam is now "chronically infected," while Cambodia and possibly Indonesia also have reported their first human cases, he said.
Poultry vaccination may well be an important tool to slow the spread of this disease in domestic flocks. But since vaccination may also allow birds to be asymptomatically infected but still shedding virus (albeit at a much lower level) it poses difficult problems for surveillance and detection of viral spread into new areas.