It is absolutely astounding that officials at the Bureau of Animal and Plant Health Inspection and Quarantine chose to delay relaying information about an outbreak of a highly pathogenic strain of H5N2 avian influenza virus in Changhua County and Greater Tainan. And the fact that they waited a full 70 days before deciding to cull tens of thousands of chicken in Changhua leaves us shaking our heads in despair.
Only in the past few days has the Centers for Disease Control (CDC) seen fit to inform the public that they should avoid contact with birds that have died of the disease, seemingly contradicting the advice of former bureau director Hsu Tien-lai (許天來). Hsu had previously said that the H5N2 avian influenza virus posed no threat to humans. His resignation did not come a day too soon.
An outbreak of any highly pathogenic strain of avian flu, be it H5N1 or H5N2, demands a high level of vigilance. The earlier officials had investigated how the pathogen was being spread, the earlier they could have eliminated one of the sources — migratory and wild birds — and protected chicken farms against infection.
To hold an emergency cull of tens of thousands of chicken 70 days after the first case really is the worst form of a head-in-the-sand approach. The H5N2 virus won’t just disappear naturally: As soon as the winter avian flu passes, it will be back again in spring and with a vengeance. An outbreak of H5N1 in Southeast Asia in 2005 occurred in spring.
We know from the experience of the Southeast Asian H5N1 outbreak that the mortality rate is above 50 percent and that it is transmitted mainly through direct contact. If children come into contact with high concentrations of the H5N1 virus, they are very vulnerable to contracting a large number of complications originating in infection within the digestive and lower respiratory tracts, with major symptoms including diarrhea, encephalitis and acute respiratory distress syndrome. Moreover, the situation is more serious in the spring.
H5N2 follows a similar pattern of infection, although it is not quite as virulent as H5N1. The CDC’s advice to avoid contact with birds that have died of the flu is consistent with current scientific knowledge. Bird fatalities at present are quite likely to be infected with the highly pathogenic H5N2 strain, and as such are quite infectious, so caution is advised.
As to whether the H5N1 virus can be transmitted from human to human, it would require the avian flu virus to adapt so that it can bind to the human respiratory tract receptors and be carried through airborne transmission. At present, avian flu viruses like H5N2 or H5N1 are unable to do this in nature. However, US and Dutch researchers have demonstrated that it is possible to synthesize a variant of the H5N1 virus in the lab that can do both of these things.
Shouldn’t the head of the bureau be aware of what scientists the world over are worried about? It is the transmission of H5N1 from human to human, not whether the highly pathogenic H5N2 avian flu is harmful to humans. Chicken farmers, parents and children beware.
Mayo Kuo is a Taiwan-based pediatrician and his brother, Max Kuo, is a US-based pediatrician.
Translated by Paul Cooper
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