The recent discovery of bird flu in Suffolk, England has focused world attention yet again on this disease.
The debate still rages as to whether this was the result of an infected migratory wild bird or the import of infected materials from the company’s counterpart in Hungary, where there have been recent outbreaks of bird flu. But the situation is far more severe than just an outbreak of bird flu among commercially farmed turkeys in an affluent part of the world.
Recently, Japan, Korea, Nigeria, Hungary and Russia have reported new cases of the virus, and there have been outbreaks in at least six other countries over the last few months. The current outbreak in Russia seems particularly severe with thousands of citizens reputedly undergoing tests after bird flu broke out on a number of chicken farms close to the capital.
Our nearest neighbour, Indonesia has commenced a major cull of infected and threatened birds in and around Jakarta and has banned households from keeping chickens in their backyard. There would also appear to be evidence that the virus is mutating and adapting to mammalian hosts such as cats, tigers and pigs.
In addition, a new strain of the virus has emerged in China and spread to parts of South-East Asia. Some Asian countries have been attempting the mass vaccination of poultry flocks, but others have rejected this as not being completely effective and because vaccinated birds may still harbour the virus.
In terms of our health, the risk from bird flu is no greater than it was a year ago. But recent events indicate that bird flu will continue to circulate as a largely benign infection of bird populations throughout Asia, occasionally spreading further afield, and that where governments lack the resources and or the will to intervene, human populations will remain at risk.
More than a decade of research, driven largely by the fear of another flu pandemic to rival that of 1918-19, has so far delivered relatively little. We still do not understand the behaviour of the disease in wild or domesticated bird populations, the mechanisms of its spread, the role of intensive poultry farming as an instigator-nurturer of the disease, or bird flu’s potential to mutate into something far more deadly.
More importantly perhaps, Tamiflu is no longer a magic bullet, and it is possible that a Tamiflu-resistant strain has already emerged, and while many developed countries have been stockpiling the drug, supplies in many poorer countries remain widely inadequate. Even in some of Asia’s richer countries, supplies are limited. South Korea, for example currently only holds about one million doses for a population of about 50 million.
Further, an elaborate surveillance and quick response system only exists in a handful of countries. How do countries with limited resources and poorly developed transport networks, monitor hundreds of thousands of tiny farms and households where close human-bird contact is a feature of everyday life?
There would seem little doubt that bird flu, both in birds and humans is under-reported in many parts of the world. In parts of Africa for example, the disease is probably much more widespread than current official indications would suggest. Some countries, like China also remain stubbornly opposed to international surveillance.
In an interconnected world, where infections such as bird flu acknowledge no national boundaries, international co-operation is the only way we can track and respond to epidemic outbreaks.
Bird flu has not gone away. It remains permanently entrenched among wild birds and some domestic birds throughout many parts of the world. In addition, throughout Asia, billions of birds continue to be raised in intensive factory farms with high antibiotic use, maximum reuse of all carcass parts, and the recycling of wastes and faeces into poultry feed. Perhaps the real origins of bird flu lie here as much as they do in the natural environment?
As long as all this remains the case, the threat of the infection spreading to human populations will remain. A few months ago the United Nations Coordinator for Bird Flu declared that despite recent donations, the world needed another $US1 billion to combat the disease. The WHO has gone further, and stated that at least $US10 billion is needed to adequately prepare the world for a possible human flu pandemic.
Be that as it may, what money that has so far been made available has largely gone to European countries and not to countries at the forefront of the disease in South-East Asia.
Without access to substantial resources how can we expect huge decentralised countries such as Indonesia, with an array of internal social and economic problems, a propensity for natural disasters, and a host of other infectious disease problems such as dengue and malaria, to monitor and control infections like bird flu?