Real Voices interview: Tran Tinh Hien
Clinician on ward D of the Hospital for Tropical Diseases in Ho Chi Minh City, which looks after avian flu patients in the southern provinces of Vietnam
What happens when a suspected avian flu case is admitted?
In addition to routine medical examination, laboratory tests will be performed to confirm infection of H5N1. However, the results of those tests are only available in 12–14 hours so we have to decide treatment based on epidemiological and clinical factors such as exposure to ill poultry, fever, cough and chest X-ray. The physician, based on this assessment, has to decide whether or not a patient should be sent to the isolation area and receive oseltamivir treatment.
How is avian flu perceived in Vietnam?
In Vietnam the outbreak of H5N1 (2004) followed SARS (2003); therefore it was a great public concern. The national and regional governments have seen the overall problem. Unfortunately, people – particularly those who live in the remote areas who lack information about the disease, or think that ill or dead poultry is still edible – ignore the risk of de-feathering, gutting and preparing chicken or duck or handling fighting cocks. Poverty is another important factor: knowing that any infection in the poultry will have serious consequences for them, farmers try to escape culling poultry in outbreak areas by taking them to untouched places.
Is a pandemic likely?
If the situation is not brought under control in the backyard farms in Asia, the virus will continue to spread country to country and year after year, and this continent will be the most dangerous focus for global public health. Having some degree of immunity after several exposures, Asia may not be the victim of a pandemic but it may occur in Europe and America.
How well prepared do you think the world is?
I am afraid to say that the preparation is not enough in terms of controlling the outbreak in poultry. My personal impression is ‘too many conferences’.
We could use those funds to pay compensation for farmers’ culled flocks or to encourage vaccination of poultry. How can we prevent the pandemic while the outbreaks in poultry and cases in humans still occur in Asia every year and farmers refuse to slaughter their poultry? The situation in Vietnam and Indonesia is an example. We overemphasise the threat but do not implement effective measures for control!
Do you ever fear you might contract avian flu?
Yes, but that is the fear of getting avian flu from patients not from poultry, because I and my family have given up chicken and duck including eggs (the most delicious and my favourites) since 2004. I do hope that I am becoming immunised after four years of treating avian flu patients!