The recent reports of bird flu among humans in both Asia and Europe have thrown the world into a panic. It seems that an outbreak is imminent and that even Taiwan might not escape such a pandemic.
To tackle this threat we should first seek to prevent the spread of new cases and then reduce the number of seriously ill patients to keep the death toll down. Therefore, we need a systematic review of our preparedness, based on the following questions:
Is the government capable of preventing a bird flu epidemic? Is our public health monitoring system able to track the progress of the disease? Is our disease reporting system capable of discovering new cases in time? Are our labs experienced in conducting the required tests? Do we have enough disease prevention professionals? Do we have sufficient equipment and materials to fight the disease? Does the nation have enough money to deal with a worst-case scenario? Do we have adequate medical support? Is the general public well-informed about avian flu?
We should not mislead ourselves into thinking that we will be safe just because there is a huge disease prevention program in operation. In fact, we will be wasting national resources or creating panic if we do not approach this issue in an more organized manner. The disease control and prevention program should, based on epidemiological and other medical knowledge, be directed at combating the disease head on, in a practical way.
An effective surveillance system is needed to discover the origins of an outbreak and any new cases of bird flu. The first reaction is to take people's temperature on a daily basis. As of yet, there have been no proven cases of human-to-human bird flu transmission and only around 120 confirmed cases of bird flu being transmitted to humans globally. Therefore, finding cases of actual bird flu given the amount of people who have a fever is like finding a needle in a haystack. Disease prevention personnel may well overlook an actual case given the sheer amount of data to review. To ensure an effective surveillance system, there should be a stricter definition of which symptoms characterize the onset of bird flu. Once a case of bird flu is confirmed in Taiwan, the government should amend its definition to be more inclusive. Only by doing so can the government get the situation under control and prevent panic from setting in.
A disease prevention program should be specific, flexible and able to change depending on how the disease behaves. The recent cases of bird flu have all been reported among people who have had frequent contact with fowl. Therefore, the government should strengthen its efforts in this regard.
A local outbreak will increase demands on human and material resources. Therefore, the government has to come to grips with the pandemic at an early stage and prevent the disease from spreading within the nation.
We should also make good use of the anti-flu drug Tamiflu, since it is capable not only of curing the disease but also of preventing the spread of the bird flu virus. However, we should not regard it as a wonder drug and distribute it to everyone in Taiwan.
Rather, we should envision a simulated "worst-case" scenario, estimating the number of people who might be in danger and prioritizing those who need vaccinations.
Adequate public information about what the government is doing will prevent panic.
Only with adequate, accurate information -- including data on bird populations and high-risk groups -- and an effective disease prevention strategy can public safety fears be addressed.
Chen Kow-tong is an associate professor in the Department of Public Health at National Cheng Kung University.
TRANSLATED BY DANIEL CHENG
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