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a) Bird Flu Crisis Overview
The first reported case of bird to human transmission of the H5N1 virus was discovered in Hong Kong in the 1997. At first, it was observed that the poultry, particularly chickens, in the area were dying off at an alarming rate. The world brushed this aside as it was simply a virus killing of birds. Then, a boy was brought in to a hospital with a strange and unknown illness. It was later identified as the H5N1 avian influenza virus. Then, more cases emerged. The scientific community was alarmed, and after talks with Hong Kong authorities, the islands entire populations of birds ¨C over a million, were culled. The scientists briefed a sigh of relief, they had thought the virus had been stopped in its tracks.
However, unknown to them, the virus was being spread by wild birds who acted as asymptotic carriers, carrying the disease without displaying any of its symptoms, bringing it along on their intercontinental migrations.
Six year later, in the late 2003, the disease once again surfaced, this time in South East Asia . It spread like wildfire amongst the poultry farms of the region and within nine months, there were over forty reported cases, with 32 dying from the disease. A mortality rate of 70%! Unheard of in the diseases of recent times!
At around that time, outbreaks of avian influenza H5N1 occurred among poultry in eight countries in Asia ( Cambodia , China , Indonesia , Japan , Laos , South Korea , Thailand , and Vietnam ). More than 100 million birds either died from the disease or were killed in order to try to control the outbreaks. By March 2004, the outbreak was reported to be under control. Since late June 2004, however, new outbreaks of influenza H5N1 among poultry were reported by several countries in Asia ( Cambodia , China [ Tibet ], Indonesia , Kazakhstan , Malaysia , Mongolia , Russia [Siberia], Thailand , and Vietnam ). It is believed that these outbreaks are ongoing. Thailand had instated measures to combat the virus, sending in personnel to spray disinfectant on afflicted areas.
By the end of 2004, the bird flu had spread across all of South East Asia . It had been reported in Thailand , Vietnam , Cambodia among other countries. Even more alarming, it was recently discovered that the 1918 virus also originated from birds and H5N1 is mutating in similar ways. As Southeast Asia struggled to contain the disease, the virus spread across the globe. Recently, the avian influenza has been observed among birds as far away as Europe .
H5N1 infection also has been reported among poultry in Turkey Romania, and Ukraine . Outbreaks of influenza H5N1 have been reported among wild migratory birds in China , Croatia , Hong Kong (SARPRC), Mongolia , and Romania .
As of February 2, 2006, human cases of influenza A (H5N1) infection have been reported in Cambodia, China, Indonesia, Thailand, Turkey, Vietnam, and most recently, Iraq.
In early 2003, the virus started killing aquatic birds which originally carried the virus asymptotically. The scientific community was alarmed as this meant a mutation in the virus, which could bring it one step closer to being easily communicable amongst us.
In a zoo just outside Bangkok , 45 tigers died after being fed infected chicken. But what was more disturbing was that it was discovered that the virus was spreading between the tigers. At the same time, it was observed that the virus was spreading through laboratory cats in the same way. This raised an alarming possibility, the transmission of the virus amongst mammals of the same species.
The question now was: Was this happening amongst humans?
In 2004, an eleven year old girl was rushed to a provincial hospital in Thailand . Only a few days ago, she had fallen sick from playing with infected chickens. However, she was by the time she was brought in, she was already having difficulty breathing. The doctors did all they could, but after three hours, the girl died. Soon after, the mother and aunt became sick with viral pneumonia. Twelve days after her daughter's demise, the mother passed away as well.
Currently, the main fear is that the virus would mutate into a virus that is easily communicable among humans-via air, body fluids, etc., exploding across the globe and spreading at an exponential rate.
In light of this situation, governments across the globe have begun to initiate measures to safeguard their country against a possible pandemic. The British government, for example, has stockpiled 14.6 million doses of the anti-viral drug, Tamiflu, and is preparing to obtain more supplies. It has said that in the event of an outbreak, it will ensure that everyone in the country will get vaccination and treatment if necessary.
As can be seen, early on, the virus did not seem much of a threat. However, as time progressed and the virus spread and mutated, more people are beginning to take notice, and governments are starting to pay heed to the warnings. And there's still much to be done.
b) Reactions worldwide
The scientific community is not sitting idle while the events unfold. Work is underway to develop a new vaccine for the disease. Vaccines are developed by cultivating the virus in chicken eggs, however, H5N1 attacks and kills chicken eggs, rendering efforts to cultivate it useless. The answer the scientific community has come up with to combat this problem is reverse genetics , making the H5N1 virus harmless to chicken eggs and facilitating the development of a vaccine. Scientists are also exploring other options available as Tamiflu production is limited. Research is being done to develop other drugs that might be as effective, or perhaps more effective at combating this deadly virus.
In the wake of the spread of the H5N1 virus, the world has begun to take notice, and many countries are rushing to stockpile drugs and draft preventive measures. More funding has also been channeled towards development and research into combating this disease.
Britain for example has stockpiled 14.6 million courses of Tamiflu , and has measures in place for physical prevention in the case of an outbreak. Thailand has deployed personnel to spray disinfectant on infected farms and villages. Many countries in Southeast Asia have to date culled millions of birds in an effort to stem the spread of the virus.
However, it is still spreading at a frightening pace. Recently there have been reports of bird flu in birds as faraway as Germany , France and other European countries.
c) Present Problems
The main fear of the scientific community now is that the H5N1 virus might mutate into a disease that is easily communicable among humans. Scientists hypothesize that this may occur when a human infected with human flu contracts the H5N1 virus as well. As we have mentioned in the scientific background, the influenza genes, being made of RNA are highly volatile and easily mutate. Thus if the two influenza viruses were to ¡°meet¡±, an exchange of genetic material could take place, forming a deadly virus that will spread like wildfire through the human population. In Europe and developed countries, this threat is relatively negligible. But it is in countries in regions like South Asia , with many families farming and raising livestock as a livelihood, that this threat is a very real and present danger. A boy infected with flu might be out tending to his chickens, which are infected with H5N1 and end up being infected with both viruses. It is in such an environment where the virus is most likely to mutate.
The problem with this is that it is such a difficult problem to tackle. With many countries in the world poverty-stricken or with a backward countryside, it is difficult to force the people to give up their livelihood, or provide compensation for the many millions affected should a culling scheme come into effect.
On the subject of the situation in developing countries, there is also another major problem, rural farming and culture. The rural farmers of the tropical regions in South-East Asia, such as Vietnam and Thailand , do not have the expertise, knowledge or capital to implement preventive measures such as species separation and bird vaccination. Thus propagating the spread of the disease.
Another problem is the relative lateness that this H5N1 problem has received the attention it requires from the global community. Vaccine production has only begun recently and it would be a year or two before it is ready for use in terms of quality and quantity. Production is slow and the development tedious, therefore it would take a combined effort of the global scientific community to develop effective drugs, vaccines and counter-measures against a pandemic of the scale expected of a human H5N1 virus.
The lack of availability of these drugs has also led to stockpiling by many countries, communities, families and people. The increase in demand has led to a shortage of drugs limiting the availability to the richer developed countries, leaving the poorer under-developed countries in the lurch. This is a serious problem as the countries currently most heavily affected and expected to be most heavily affected by the H5N1 outbreak are not getting the supplies they need. Patent issues are also limiting the production of drugs like Tamiflu to singular companies, greatly lowering the production limit and resulting in further shortage.
If these problems are not solved before the outbreak of a human H5N1, the consequences would be dire indeed. Drug shortage would lead to limited access, resulting in social unrest as people struggle to obtain these silver bullets. Thus it is very important that present issues are resolved.
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