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Vietnam takes steps to head off flu pandemic
(NPR)
Updated: 2005-11-04 09:14 Bui Quang Anh is in charge of animal health in Vietnam's Ministry of
Agriculture. When he talks about the live poultry markets, urgency is written
all over his face.
"We cannot continue this kind of reckless slaughtering and buying and selling
of potentially infected poultry," he says.
Anh says Vietnam is imposing a number of revolutionary measures -- a national
moratorium on duck production and a ban on poultry-raising in cities. The
government is also prohibiting the sale of a delicacy called duck blood soup,
which has been linked to human cases of bird flu. And most startling -- for a
society that insists on fresh-killed meat -- Vietnam plans to centralize the
slaughter of poultry in factories and sell it in plastic-wrapped packages.
"By 2006, the Vietnamese people will be going to the grocery store to buy
their poultry," Anh says. "We can get it done."
But Anh is frustrated. Local governments aren't eager to destroy the
livelihood of farmers and butchers.
The virus, however, isn't going to wait around for all these things to work.
It's out there busily mutating. Whether it happens in Hanoi or in a rural area,
a pandemic strain will emerge if the bird virus acquires the changes it needs to
spread freely among humans.
Early Detection
Vaccinating poultry might slow that process, but not prevent it. So Vietnam
will soon release another plan aimed at stopping the spread of H5N1 after it
becomes a human virus.
This is called "pandemic containment": stopping the pandemic at its source.
Nobody's ever tried that before. Nobody's ever been in a position to. Previous
pandemics came unannounced.
Dr. Peter Horby is with the World Health Organization's office in Hanoi. He
says everything depends on spotting the very first cases, fast.
"The thought has been around the area of 20 to 50 cases occurring over a
period of several weeks would be the kind of alarm bell," he says.
Earlier this year, World Health Organization officials thought an outbreak
actually was happening in Thai Binh province, a couple of hours southeast of
Hanoi. It started with a 21-year-old man named Nguyen Sy Tuan. He helped his
parents slaughter chickens. Then he fell ill. His 14-year-old sister became
sick, too.
Tuan's mother and aunt took him to the Thai Thuy District Hospital. A nurse
named Nguyen Duc Thinh helped him to his bed and took care of him through the
night.
"First, because we didn't have an X-ray, I was just thinking it was fever,
high fever. We were thinking of pneumonia," he says.
It wasn't pneumonia. It was bird flu. Then a few days later, something
alarming happened. Nurse Tinh fell ill himself, with high fever and difficulty
breathing.
"I thought I might die," he says. "I was in crisis. I am frightened at that
time. Spiritually, yes, I'm afraid."
Experts feared the virus had learned to spread from person to person.
But no more cases occurred in Thai Thuy. Investigators say the nurse might
have been exposed to sick poultry. But the possibility of human-to-human
transmission galvanized officials here. Now they know they have to watch for
signs of flu not just in birds but in people.
"We need to have medical workers at the grass roots level so that when there
are some cases, they will be able to detect [them] at the very beginning, you
know?" says Dao Chung Binh, an administrator at Thai Thuy's hospital.
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