World mobilizes against flu

Health officials are working to contain spread of avian flu.

In Greece this week, health authorities disinfected a farm on an isolated Aegean Sea island after bird flu was found in a lone turkey there.

In China, the government has begun quarantine measures in a grasslands area of the country's north after the death of 2,600 birds was blamed on the avian malady.

In the United States - where the most dangerous strain has yet to appear - the State Department recently hosted officials from 80 countries to plot a collaborative defense against the disease. The Senate has voted to spend almost $4 billion on avian flu preparedness.

From Southeast Asia and North America, to Europe and Southern Africa, governments are scrambling to contain the spread of a specific type of bird flu.

So far, fear of the disease has outpaced its physical effects, particularly in developed nations outside the Asian heartland. The US Centers for Disease Control and Prevention has even felt it necessary to emphasize that it's still safe for Americans to keep bird feeders in their yards.

But the threat is being taken seriously across the globe.

"It's not a time for panic, it is a time for action," said Dr. Mike Ryan, director of the alert and response system at the World Health Organization (WHO), in a teleconference for reporters earlier this week.

It's important to note that bird flu is just that - something that primarily affects birds. So far, the WHO has attributed 60 human deaths, almost exclusively in Asia, to the H5N1 avian flu virus. But the primary concern right now is transmission from infected birds to humans. And some worry that the virus could mutate into a form more-contagious to humans. That development raises prospects for a scourge on the scale of the 1918 worldwide flu pandemic.

President Bush has discussed the possible use of the military to quarantine affected areas - but given the ease with which most flus can be transmitted, cordoning off anything larger than an airliner is unlikely to do much, say some experts.

Much of the $3.9 billion for flu preparation that the Senate has inserted in a defense bill would go to stockpile anti-viral drugs such as Tamiflu. But the efficacy of such drugs in the face of widespread outbreak is unknown.

"Measures we can take to handle pandemic flu if it emerges in the next six months are limited and bleak, but wise investments and strong science could well bolster the public health armamentarium considerably over the next five years," writes Laurie Garrett, senior fellow for health at the Council on Foreign Relations, in an avian flu update.

In Europe, tension over avian flu has tightened in recent days. Lab tests of stricken Romanian ducks this week confirmed that, for the first time, the H5N1 flu strain has arrived in mainland Europe.

Yet European governments have considerable resources, and can learn from Asian nations' missteps and successes in confronting the disease, say experts.

"We understand why Europe is alarmed, but [Europeans] shouldn't forget the real crisis, which remains in Asia," says Peter Cordingly, the WHO's western Asia regional spokesman in Manila.

Response in Asia to both the ongoing bird flu outbreak and SARS two years ago left a clear road map of dos and don'ts on how governments should deal with a public health crisis. The actions that have worked, health officials say, are openness, strict surveillance, accurate reporting, and broad public education.

Perhaps no place knows these lessons better than Hong Kong, which suffered heavy human and financial losses from bird flu outbreak in 1997, then SARS in 2003.

Earlier this year, the territory adopted a three-tiered outbreak response system that addresses everything from mobilizing healthcare workers before crises hit, to education for domestic workers from affected countries like Indonesia, to a plan to stockpile 20.5 million doses of antiviral drugs by 2007.

Dr. Ronald Lam, lead medical officer for the Hong Kong Health Department, said the region is prepared for when the flu pandemic arrives, not if.

"First of all, the government or political commitment is obviously important," said Lam. "The health sector alone cannot win this fight."

Asia has hundreds of thousands of "backyard farms" that are difficult to monitor, said Mr. Cordingly. "You can't sensibly expect a farmer with 120 chickens - and that's all he's got - to tell you that his chickens are sick if he knows that you're going to come 'round and kill his chickens and not compensate him for the loss," said Cordingly.

Now that the disease has appeared in Europe, avian flu is on the radar screens of the world's wealthiest nations and they may step in to help Asia out of crisis, he added.