The danger hiding in Vietnam's hen coops
By Sebastien Berger
(Filed: 16/04/2005)
The next influenza pandemic, one that could kill millions around the world, will probably start in surroundings similar to the home of Vu Van Son.
Behind his house in the Vietnamese village of Hung Dao, Mr Vu used to keep more than 300 chickens and geese.
But last month some of them fell victim to the outbreak of flu ravaging Asia's poultry.
Shortly afterwards, so did he.
"The first day I felt very tired. The second day I felt hurt all over my body, my chest, my head. I didn't want to move my hand or my leg," he said.
"Then I was taken to hospital and I don't know anything."
Asked if he thought he was going to die, he answered: "I didn't care."
Mr Vu and his three-year-old daughter were diagnosed as having the H5N1 avian influenza, or bird flu, virus. His wife and two other children also became ill.
At that point the family could have become the 21st-century equivalent of Typhoid Mary, but on a much larger and more devastating scale than the Irish-American cook who infected dozens.
But in a preventative strike, the family's entire flock was slaughtered within two hours of animal health officials arriving, poultry within a two-mile radius was put under surveillance and the Vus taken to a hospital isolation ward. They returned last week.
Such measures may seem draconian but they are more than justified by the threat from the H5N1 virus, which has killed more than 50 people in the past 18 months, most of them in Vietnam but also some also in Thailand and Cambodia.
In its current form it cannot easily be contracted by, or passed between, humans - the Vus were all exposed to sick poultry. But viruses mutate over time.
If this one does, it could "reassort", or swap one of the eight segments of its genetic code with one from another, easily human-transmissible flu organism.
"Suddenly it's a very different virus that might suddenly become extremely transmissible," said Peter Horby, a medical epidemiologist with the World Health Organisation (WHO) in Hanoi.
"It's impossible to predict when it will happen but we know this is how influenza viruses behave."
Mr Horby said H5N1 was a "prime candidate" to cause a pandemic, putting the likelihood at "above 50 per cent", despite the fact that reassorting has yet to happen in the hundreds of cases recorded so far.
"We know it can infect humans, it has some ability for human to human transmission, and nobody in the world has any immunity," he said.
"If it happens there may be millions of deaths globally."
Alternatively, a mutation could leave the virus weakened to a point where its effects are barely noticed.
But western governments, including Britain's, are taking no chances.
Tamiflu, the only antiviral drug known to be effective against H5N1, is being stockpiled and they are rushing to develop a vaccine.
On the front line, while the Vietnamese are taking the outbreak extremely seriously and have accepted technical help from WHO, its assistance in field investigations has been declined.
Questions have also been raised over openness.
Nonetheless, being one of the world's last communist dictatorships may have its advantages when trying to combat the disease.
"If there's a need for drastic action - movement restrictions, banning mass gatherings, quarantine - this is one of those countries where you probably could implement it," said one foreign specialist.
At the Hospital for Tropical Diseases in Ho Chi Minh City in south Vietnam, where no human H5N1 cases have been reported for two months, Tran Tinh Hien, the deputy director, said: "It's very difficult to stop the outbreak in poultry but I think it's possible to stop the disease in humans."
People were learning not to use sick poultry for food, he said, and patients were reporting to hospital sooner than before, especially those with coughs or fever, making them easier and quicker to treat. The message does not always get through, however.
In the impoverished coastal province of Thai Binh, two of Nguyen Sy Tham's three children fell ill after the family ate a wild goose bought in a market. His daughter has recovered, but nearly two months after developing the disease her brother remains in hospital, unable to eat, drink or walk.
"We are afraid of poultry now," said the boy's father, a farmer of rice and tobacco. "Even if the epidemic passes, we will never eat wild goose again."
Yet a few yards from his house a restaurant was still serving soup made from raw duck blood, a delicacy blamed for infecting some bird flu victims.
http://www.telegraph.co.uk/news/mai...16.xml&sSheet=/news/2005/04/16/ixnewstop.html
By Sebastien Berger
(Filed: 16/04/2005)
The next influenza pandemic, one that could kill millions around the world, will probably start in surroundings similar to the home of Vu Van Son.
Behind his house in the Vietnamese village of Hung Dao, Mr Vu used to keep more than 300 chickens and geese.
But last month some of them fell victim to the outbreak of flu ravaging Asia's poultry.
Shortly afterwards, so did he.
"The first day I felt very tired. The second day I felt hurt all over my body, my chest, my head. I didn't want to move my hand or my leg," he said.
"Then I was taken to hospital and I don't know anything."
Asked if he thought he was going to die, he answered: "I didn't care."
Mr Vu and his three-year-old daughter were diagnosed as having the H5N1 avian influenza, or bird flu, virus. His wife and two other children also became ill.
At that point the family could have become the 21st-century equivalent of Typhoid Mary, but on a much larger and more devastating scale than the Irish-American cook who infected dozens.
But in a preventative strike, the family's entire flock was slaughtered within two hours of animal health officials arriving, poultry within a two-mile radius was put under surveillance and the Vus taken to a hospital isolation ward. They returned last week.
Such measures may seem draconian but they are more than justified by the threat from the H5N1 virus, which has killed more than 50 people in the past 18 months, most of them in Vietnam but also some also in Thailand and Cambodia.
In its current form it cannot easily be contracted by, or passed between, humans - the Vus were all exposed to sick poultry. But viruses mutate over time.
If this one does, it could "reassort", or swap one of the eight segments of its genetic code with one from another, easily human-transmissible flu organism.
"Suddenly it's a very different virus that might suddenly become extremely transmissible," said Peter Horby, a medical epidemiologist with the World Health Organisation (WHO) in Hanoi.
"It's impossible to predict when it will happen but we know this is how influenza viruses behave."
Mr Horby said H5N1 was a "prime candidate" to cause a pandemic, putting the likelihood at "above 50 per cent", despite the fact that reassorting has yet to happen in the hundreds of cases recorded so far.
"We know it can infect humans, it has some ability for human to human transmission, and nobody in the world has any immunity," he said.
"If it happens there may be millions of deaths globally."
Alternatively, a mutation could leave the virus weakened to a point where its effects are barely noticed.
But western governments, including Britain's, are taking no chances.
Tamiflu, the only antiviral drug known to be effective against H5N1, is being stockpiled and they are rushing to develop a vaccine.
On the front line, while the Vietnamese are taking the outbreak extremely seriously and have accepted technical help from WHO, its assistance in field investigations has been declined.
Questions have also been raised over openness.
Nonetheless, being one of the world's last communist dictatorships may have its advantages when trying to combat the disease.
"If there's a need for drastic action - movement restrictions, banning mass gatherings, quarantine - this is one of those countries where you probably could implement it," said one foreign specialist.
At the Hospital for Tropical Diseases in Ho Chi Minh City in south Vietnam, where no human H5N1 cases have been reported for two months, Tran Tinh Hien, the deputy director, said: "It's very difficult to stop the outbreak in poultry but I think it's possible to stop the disease in humans."
People were learning not to use sick poultry for food, he said, and patients were reporting to hospital sooner than before, especially those with coughs or fever, making them easier and quicker to treat. The message does not always get through, however.
In the impoverished coastal province of Thai Binh, two of Nguyen Sy Tham's three children fell ill after the family ate a wild goose bought in a market. His daughter has recovered, but nearly two months after developing the disease her brother remains in hospital, unable to eat, drink or walk.
"We are afraid of poultry now," said the boy's father, a farmer of rice and tobacco. "Even if the epidemic passes, we will never eat wild goose again."
Yet a few yards from his house a restaurant was still serving soup made from raw duck blood, a delicacy blamed for infecting some bird flu victims.
http://www.telegraph.co.uk/news/mai...16.xml&sSheet=/news/2005/04/16/ixnewstop.html
