Taiwan has lots of contact with China, much more frequent than 10 years ago. Just look at the tourism sector, there are more than 7 million Chinese visitors coming to Taiwan yearly. More worrying is the active cross-strait agricultural trade and poultry smuggling.
Therefore, to prevent a large-scale outbreak of H7N9, basic preventive measures, such as screening people at airports are not enough. We must also monitor the ‘small three links’ and cargo shipments, and be particularly on guard against the smuggling of poultry and agriculture products.
Also, whenever a major disease outbreak occurs in China, many China-based Taiwanese return to Taiwan in panic mode. As such, they could become another possible conduit for the latent transmission of the H7N9 virus. Therefore, the government is advised to prepare medicine for travelers who have to pass through infection regions in China. This would help ease worries and avoid panicked population movement between China and Taiwan.
LT: During the SARS outbreak, you took on the responsibility of heading the Department of Health’s Centers for Disease Control [CDC] and were in charge of combating the outbreak. Do you think the standard operating procedures set up in the past is still effective against this new virus outbreak?
Su: When I was at CDC in 2004, I prepared a plan to enable the development of our own vaccines against possible avian influenza outbreaks. The goal was for Taiwan to produce vaccines, so that we would not have to rely on imports.
The H1N1 influenza outbreak of 2008 marked the first time mankind won a battle against an unknown new strain of influenza virus. The WHO mobilized countries to combat the epidemic and coordinated with pharmaceutical companies to produce Tamiflu and vaccines.
That was also the first time that Taiwan developed our own vaccines, working with Adimmune Corp and other private sector companies to establish a government-certified development program for producing vaccines against the virus.
Looking at the H7N9 virus strain, Adimmune could expand human trial testing of avian influenza vaccines and could be able to convert human influenza vaccines into avian influenza vaccines.
LT: Do you think Taiwan’s prevention and control measures need to be upgraded? Any suggestions?
Su: Not only do we have to confront infections from abroad, we also have to deal with our own indigenous avian diseases. For example, in 2004, the low-pathogenic H5N2 avian influenza virus caused the deaths of a large number of chickens at poultry farms in central and southern Taiwan. The National Health Research Institutes (NHRI) has developed the world’s first human vaccine against the H5N2 avian influenza virus. It is to undergo clinical trials soon. This would provide Taiwan with the capability and experience to develop vaccines that could be expanded to counter all types of avian influenza virus.
With the H7N9 virus, once the WHO is able to verify and announce the virus strain, the NHRI can start developing a vaccine and then pass it on to Adimmune for mass production.
For Taiwan, we have the professional know-how to respond to the situation, from monitoring and medical treatment to the development of vaccines.