Chinked armour

Chinked armour

H5N1, the lethal avian influenza virus strain, was first reported in 1996 in China. The virus was transmitted to humans during an outbreak in 1997 in Hong Kong. Nineteen people were affected. Since then, it has struck with alarming frequency, affecting both humans and birds. It has claimed nearly 250 people across the world since 2003.60 countries have been affected so far; five in 2007. H5N1 has become persistent in Egypt and Indonesia.

"Bird flu sweeping continents is a danger signal. The number of deaths is high considering the disease is not supposed to afflict humans. Chances of pandemic are rife," said Rajan Patil of the division of epidemiology at the School of Public Health, srm University, Kanchipuram, Tamil Nadu. But the speed at which the disease can spread is in the realm of speculation.Timm Harder of the Institute for Diagnostic Virology at the Friedrich-Loeffler Institute, Germany, said, "It is not clear if H5N1 will cause a human pandemic. There is greater risk when more humans are exposed. H5N1 has already assumed pandemic proportions in poultry."

REUTERS

A study by researchers of the High Security Animal Disease Laboratory, Bhopal, showed that the virus which struck Maharashtra, Gujarat and Madhya Pradesh in 2006 had a Eurasian lineage and came to the country via China. Experiments on chicken and mice have shown that H5N1 has become more lethal compared to 1997. Studies have showed that the virus has developed several deadlier sub-strains.

In May 2007 who sounded alarm bells it announced that an avian influenza pandemic was inevitable and that the world should be prepared for it. An international ministerial conference was convened in December 2007 in Delhi to assess the world's preparedness. The union agriculture and health ministries were asked to present a roadmap to check bird flu. The document presented at the meet was based on the country's experience in successfully containing outbreaks in Maharashtra in 2006 and Manipur in 2007. "The government's containment measures were more intensive than those known to be followed internationally," minister Ramadoss had said.

It's true that avian flu had been checked in Manipur in 10 days. But the outbreak was of a far lower scale then--a small farm of less than 150 birds--and the lessons learnt from it didn't evidently help check the pestilence in West Bengal. This didn't stop Ramadoss from exuding confidence "The number of birds dying is going down. The disease has not spread to humans. We have banned transport of poultry between states and districts."

Onus of reporting bird flu cases is on the very people who stand to lose from such reporting. So they don't

Besides the roadmap, the country also has an Action Plan for Preparedness, Control and Containment of Avian Influenza, drawn up in November 2006. Both documents recommend active surveillance as a bird flu control measure. The cabinet secretary is supposed to monitor the country's preparedness on a monthly basis. The prime minister, and the union health and agriculture ministers are also supposed to keep regular vigil and states should have a system of regularly testing birds for the flu virus. But testing has obviously not been up to the mark, as the West Bengal experience shows. Cabinet secretary K M Chandrasekhar pointed out as much in a letter to the chief secretary of states on January 17. The letter noted that feedback from states suggested that surveillance needed to be stepped up.

But the West Bengal case showed that the onus was on the public to report mass poultry deaths to local veterinary authorities, which were slow to respond. The national plan requires that samples be sent for testing at the earliest. Testing takes about 24 hours. But the West Bengal veterinary authorities took more than 10 days to find out if the birds were dying of avian influenza.

The authorities initially ascribed the deaths to the Ranikhet virus, also called the Newcastle disease virus. The H5N1 virus is often confused with this virus because it also causes influenza and leads to high mortality. But only in birds. Laboratory confirmation is required to distinguish h5ni from Ranikhet Virus. This was not done early enough in West Bengal.

Money matters
While the initial detecting mechanism remains inadequate, the country is not short on surveillance programmes (see box Check them out). But most of these put the impetus of reporting bird flu cases on the public.

Surveillance programmes also require funds. At the New Delhi ministerial, international donors pledged us $400 million to combat bird flu-in addition to the us $2.3 billion pledged at earlier ministerial conferences at Beijing and Bamako in Mali.

Earlier, most of the money was provided as grant (see graph Stingy donors). Now grants are fewer to come by and developing countries have come to depend on loans. But the loans even are not readily available-of the us $983 million committed by donors, approximately us $600 million wasn't disbursed by end of June 2007. At the ministerial, Ramadoss asked the funding agencies to increase grants. Money is important. But the scores of prevention and control strategies in the policy books of the government have to be implemented for the money to count. For that, there must be an efficient system to track animal health. West Bengal-in fact most places in the country-is ideal breeding ground for H5N1. Infected birds live in close proximity with people here.

It would be preposterous to believe that the country would somehow escape the disease that is killing thousands of birds across the border in Bangladesh. In West Bengal, health authorities did not act till bird flu assumed menacing proportions. That was because the onus of reporting the disease was left to the public. It's a ludicrous strategy farmers with infected birds are unlikely to report the affliction because that will hit their livelihoods. That's exactly what happened in West Bengal poultry farmers tried to minimize losses by transporting the 'seemingly' healthy birds outside the affected areas. There is a lesson in this failure without a strong veterinary support system and compensation mechanism, the country will remain vulnerable to avian influenza.

With reporting by Alok Kumar Gupta in Jharkhand and S Raza Hassan in Karachi, Pakistan
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