Jul 7, 2005 (CIDRAP News) – International health agencies said yesterday that their plan to battle avian influenza will focus on educating small-scale farmers, segregating animal species on backyard farms, and vaccinating poultry.
At the end of a conference in Malaysia, officials said their multi-pronged plan still has a chance to prevent a human flu pandemic by reducing opportunities for the H5N1 virus to spread from poultry to humans. Officials estimated the cost of the plan at about $250 million, which will have to come mostly from donor countries.
"The meeting agreed that the avian influenza situation in Asia was extremely serious but determined that there was still a window of opportunity to ward off a pandemic," the United Nations Food and Agriculture Organization (FAO) and the World Health Organization (WHO) said in a joint statement.
The H5N1 virus has infected 108 people and killed 54 since late 2003, according to the WHO. Disease experts fear that the virus will spark a pandemic if it acquires the ability to spread easily from person to person; so far it has not shown that ability.
Delegates at the meeting in Kuala Lumpur concluded that the battle against the virus should focus on small-scale and backyard farms, with which most human cases of H5N1 infection have been linked, the FAO-WHO statement said.
The plan has four objectives:
- To educate farmers and their families about the dangers of high-risk behavior and how to change their farming practices
- To ensure the segregation of different species, including chickens, ducks, and pigs, and to eliminate mingling of these animals with humans
- To provide adequate incentives for farmers to report suspected avian flu outbreaks in their flocks and to apply control measures
- To pursue the vaccination of poultry flocks as part of a multi-element response to the avian flu threat in high-risk areas
Authorities are also concerned about "wet markets, where animals are often slaughtered in unsanitary conditions," said Dr. Joseph Domenech, the FAO's chief veterinary officer.
Wet markets and the mingling of species on small farms increase the risk that avian flu viruses will pass between species and exchange genes with other flu viruses, potentially giving rise to dangerous new viruses, the agencies said.
Dr. Shigeru Omi, the WHO's regional director for the western Pacific, said the avian flu plan would give the world a "fighting chance" to stop the H5N1 virus. "We have no illusions about how hard the job will be, but we are not powerless," he said. "This plan gives us a real chance to make a mark on history—as long as we work together with maximum energy and commitment."
Dr Dewan Sibartie, deputy head of the Scientific and Technical Department of the World Organization for Animal Health (OIE), welcomed the agencies' decision to include vaccination of poultry in their strategy, according to the FAO-WHO statement.
"The acceptance of vaccination by WHO and the international scientific community as an important additional tool in the control of the disease in animals is particularly welcome, provided that the vaccine used complies with OIE standards and that vaccination is carried out under the supervision of OIE and veterinary services," Sibartie said.
To carry out the plan, it will cost the FAO and OIE about $100 million for surveillance, diagnosis, and vaccination, the agencies said. The WHO estimated the cost of public health efforts under the plan, including support for laboratory diagnosis, vaccine development, surveillance, and public education, at about $150 million.
"Without international support, poor countries will not be able to battle bird flu," said Domenech.
According to an Associated Press (AP) report yesterday, Omi said the international agencies would organize a meeting by the end of this year to encourage wealthy countries to commit at least $250 million to help affected countries battle avian flu over the next 3 years.
In related news, a WHO official voiced pessimism about the chance of containing an emerging pandemic if the H5N1 virus evolves into a form that spreads rapidly among people, according to an Agence France-Presse (AFP) report published yesterday.
Hitoshi Oshitani, a Manila-based WHO expert in disease surveillance and response, said that if the virus mutates and erupts in one of Asia's large cities, it will be impossible to prevent a pandemic, AFP reported.
"If a pandemic starts we cannot do anything to stop it," he said. "What we can do, once a pandemic starts, is just to reduce the negative impact by being better prepared."
Compared with flu, SARS (severe acute respiratory syndrome) was easy to control, because it was spread only by people who had fever, Oshitani told AFP. "Usually for influenza, it's almost impossible to control," he said. "That's why we have huge outbreaks every year."
Control measures under consideration include treating infected people and surrounding communities with antiviral drugs and restricting their movement, Oshitani said. But if people with no symptoms were spreading a deadly flu in a country that couldn't afford expensive medicine, stopping the disease would be almost impossible, he said.
He said the WHO has 60,000 to 70,000 doses of antiviral drugs in its Manila regional office, but getting them to a remote community in time to stop the disease would be difficult.
In Vietnam this week, authorities culled more than 7,000 ducks infected with avian flu in the central province of Quang Tri, according to a report yesterday by China's People Daily. The story cited the Vietnam News Agency as its source.
In Cambodia, tests have ruled out H5N1 avian flu in a 20-year-old man who died earlier this week and in 13 children who were hospitalized after eating cooked chicken, according to an AFP report today.
The test results came as Cambodian hospitals were coping with an unusually large number of children suffering from an ordinary form of flu, the story said. More than 1,000 children have been hospitalized there in recent weeks.
FAO-WHO news release