Fri, Mar 25, 2005 - Page 9 News List

New bird flu menace waits in the wings

In the past two months, a lethal new strain of avian flu has killed 14 people in Vietnam. And experts warn it is only a matter of time before the virus mutates to become a devastating pandemic. If that happens, millions could die

By Mark Honigsbaum  /  THE OBSERVER , LONDON


To say that the Lunar New Year, Tet Nguyen Dan, is an all-consuming holiday in Vietnam is something of an understatement. Imagine Christmas, New Year and America's Thanksgiving rolled into one and you begin to grasp the scale of the Tet festival and the centrality to it of food -- especially poultry. During the run-up to Tet, millions of chickens and ducks change hands as Vietnamese families stock up for the coming festivities. The celebrations begin around 23 December with the Feast of the Kitchen Gods, or Le Tao Quan, and continue right into February with an orgy of culinary delights, at which a duck or chicken, either roasted or live and awaiting slaughter, is never far from the table.

In Hanoi, and other parts of northern Vietnam, one of the most popular dishes of all is duck's blood pudding -- a hearty soup made from simmered duck innards and raw duck blood. Traditionally eaten on the eve of Tet -- which this year fell on Feb. 9 -- it is meant to mark the passage from the old to the new. On New Year's Day, and for two weeks after Tet, it is considered bad luck to eat duck. That's when the chickens make their culinary appearance. From the point of the avian flu virus, H5N1, Tet is an accident waiting to happen.

On the morning of Feb. 8, Nguyen Sy Tuan, a 21-year-old man from Thai Binh, a province 160km southeast of Hanoi, visited a neighbor who, like millions of rural Vietnamese, raises chickens and ducks in his yard, and bought some duck for the pot. With the help of his mother he slaughtered the fowl in the kitchen, then poured the duck's blood into a bowl and added vinegar to stop it congealing. He then set about preparing the broth.

Within an hour or so the pudding was ready and he, his mother, his father and his two sisters, aged 14 and 27, sat down to consume several bowls. Five days later, on Feb. 13, Sy Tuan began to feel unwell. He had a headache and a slight fever. Thinking he had common or garden flu, his family dosed him with aspirin and tucked him up in bed. But two days later, on Feb. 15, his fever shot up to 40 ℃. On Feb. 20, he started coughing and complaining of chest pains.

By the time Sy Tuan was transferred from the local Thai Binh hospital to Hanoi's Institute for Clinical Research into Tropical Diseases two days later, the damage had been done. According to Dr Nguyen Tuong Van, the director of the hospital's emergency ward, it was like looking at a patient "in the advanced stages of HIV."

"When I examined his chest X-ray there were white shadows everywhere," she told me in her consulting office in Hanoi, on a brief respite from her rounds. "I had no choice but to intubate and put him on a respirator."

The shadows were a sure sign that the infection had already invaded Sy Tuan's respiratory tract and begun eating away at his lung tissue. That evening, mindful of scientists' warnings that H5N1 was on the brink of mutating into a virus that could transmit itself between humans, I donned a surgical gown and mask and went to see Sy Tuan for myself.

I found him in a room off a corridor marked "quarantine." A plastic hose led from his mouth to a respirator beside his bed. Although the machine was the only thing keeping him alive it was doing little to ease his breathing. His knees were doubled up in pain and beneath the blanket I could see that his heart was pounding furiously.

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