About time

It's about time. The International Herald Tribune has a story that WHO is doing a seroprevalence survey (looking for blood evidence of past infection) of a "healthy village" in Indonesia. We have long called for this and the failure to do it prior to this is inexplicable.

The researchers are part of a team of about 20 who have been studying 42 villages in Bali over the past three weeks, taking blood samples from 800 humans and 1,800 animals. So far, it is one of the largest and most comprehensive studies on bird flu in Southeast Asia.

The team, working with the World Health Organization, is conducting extensive interviews to find out just how humans and animals interact here. The experts hope they will then begin to understand a relationship between the interaction and the distribution of the disease.

Apart from the potential scientific benefits, officials would like the study to help educate ordinary Indonesians, many of whom live in isolated villages and remain, like Kenori, ignorant of the disease.

Officials of the World Health Organization also said the study should help local health officials develop an efficient procedure for response to bird flu outbreaks, one that could be imitated in other rural areas in Indonesia, including the tsunami-devastated province of Aceh, which reported its first bird flu outbreak last week. (IHT)

The article also comments on Indonesia's unwillingness to undertake mass bird culls. But the question is more complicated in Indonesia than the problem of government "unwillingness," as we noted in a post last September. Here's the relevant part of an excellent BBC article we were linking to at that time:

As human deaths from bird flu begin to mount in Indonesia, the dilemma for the Indonesian authorities is as much how to save the birds as how to save the people.

To say that Indonesians love their caged birds is a serious understatement. Almost every house has at least one cage, and often a row of them, hanging from the eaves.

Every major town has a crowded bird market lined with hundreds of cages, where a top-quality singing dove can sell for the same price as a house.

As in several other Muslims countries, doves occupy a special place of honour in the culture, with streets, companies and even a domestic airline - Merpati - named after them.

The doves are not merely kept for decoration - they are taken out and handled, treated as much-loved pets and taken to vets when they fall ill.

Tapes of champion singing doves are available in cassette shops, and are played at home to birds in the hope that they will learn to emulate the champions, and become champions themselves.

In Javanese folklore, a man is only considered to be fully a man if he has a house, a wife, a horse, a keris (traditional dagger) and a singing dove in a cage.

Given this background, it seems the most important part of doing a study like the one described here is to find out more about the true prevalence of H5N1 infection in the population, not as an adjunct to "risk communication." Seroprevalence studies should be done all over southeast asia and China as well.

Why they haven't been done remains a mystery to us.