Use Hong Kong model to control bird flu - expert

The methods that Hong Kong used to get rid of bird flu in flocks of fowl should be used across Asia to wipe out the virus before it causes a human pandemic, an influenza expert urged on Tuesday.

Separating ducks and geese from chickens is one inexpensive approach, and the outside world could help pay for culling and vaccination, said Robert Webster of St. Jude Children’s Research Hospital in Memphis, Tennessee.

“Hong Kong has developed a strategy for dealing with this that has been rather largely ignored in the rest of the world,” Webster told a conference on avian flu organized by the Institute of Medicine.

The H5N1 strain of avian influenza has killed 49 people since late 2003 and has been extremely difficult to stamp out in Thailand, Vietnam and Cambodia.

If it acquires the ability to pass easily from human to human, it could kill millions or even hundreds of millions of people, experts say.

Webster, who helped formulate an experimental bird flu vaccine now being tested in people, was also one of the first to warn that H5N1 flu posed a threat to the world.

The World Health Organization and U.S. Centers for Disease Control and Prevention now agree that avian flu may be the single biggest health threat the world is facing.

Bird flu was first seen to jump from birds to people in 1997 in Hong Kong, when it infected 18 people and killed six.

Health officials there immediately went to work to try to identify the virus despite a lack of biosafety equipment.

Countries now are advised not to even try such a thing, Webster said. They are told to send samples to the experts such as CDC and WHO instead. “I think this is a mistake,” he said. “We should have been building infrastructure in these countries from the word go.”

BANNING DUCKS AND GEESE

Simple changes were made in the bird markets, Webster added. “Ducks were banned, geese were banned,” he said.

While avian flu is deadly to chickens, it is not lethal in ducks, which can spread it around without showing symptoms.

When it was learned that quail could carry the virus, they too were banned.

Hong Kong instituted a policy of two “clean days” a month, when all markets are emptied and cleaned. Many experts have agreed that these policies helped rid Hong Kong of the H5N1 flu in 1997.

“So why hasn’t this system been copied throughout the rest of Asia? The response I get is this is too expensive. I say balderdash,” Webster said. “It is a lack of political will.”

In Thailand, Webster said the government has paid compensation to farmers whose flocks have been destroyed. “Maybe we should be paying for the stamping out in Vietnam,” Webster said. “We being the outside world.”

Webster said vaccinating flocks will help control the virus, too, and keep it from mutating as it spreads unchecked among flocks of birds.

“The immediate issue is to reduce the likelihood of human to human transmission by reducing viral load in poultry,” Webster said. But that would take good vaccines.

David Swayne of the U.S. Department of Agriculture said there was little government control of vaccine manufacturing in some countries, with batch-to-batch variation.

The result can be animals look healthy but still spread virus, while complacent officials allow it because they believe the vaccinations have been effective, Webster said.

Provided by ArmMed Media
Revision date: June 14, 2011
Last revised: by Sebastian Scheller, MD, ScD