Bird Flu Moves To Human Transmission In Thailand

Published: Fri 1 Oct 2004 12:58 AM
Thailand's Bird Flu Moves To Human Transmission
by Richard S. Ehrlich
BANGKOK, Thailand -- Thailand has declared bird flu as its ''enemy'' after the world's first ''probable'' human-to-human infection killed at least one Thai woman and perhaps infected her relatives.
International health officials dampened fears of a mutant virus evolving in Thailand. But they warned of a worst-case scenario if avian influenza's deadly H5N1 virus invades a person already ill with human influenza and the two viruses mix.
The viruses could then mutate into a never-seen-before, uncontrollable "submicroscopic parasite" capable of mass human death, similar to the 1918 Spanish influenza which killed tens of millions of people.
Health officials insist that mutation has not occurred, because Thailand's current cases involved only healthy people who contracted bird flu.
Shaken by the mounting risks, Thai Prime Minister Thaksin Shinawatra told his government, "I have 31 days [for you] to stamp out bird flu, from October 1 to October 31.
"Bird flu is our common enemy and needs to be destroyed," the prime minister declared on Wednesday (Sept. 29).
In reality, his deadline appeared to be merely a rhetorical wake-up call and not a final solution.
"It has taken some countries seven to 10 years to end the disease," his deputy prime minister Chaturon Chaisang warned.
"For us, we are talking at least three to five years," Mr. Chaturon told a Bangkok radio station the same day.
"There are no fences along borders of countries in Asia to block migrating birds," Mr. Chaturon said.
Thailand's virus monitoring system suffers weak links including secretive officials, under-funded hospitals, defiant chicken owners, and a Buddhist tradition of cremating the dead often before detailed autopsies are performed.
Other Southeast Asian countries stricken by bird flu share the same problems, as does China, delaying containment of bird flu outbreaks there.
"Bird flu is a crisis of global importance," said He Changchui, assistant director-general of the UN's Food and Agricultural Office (FAO).
"There have been fears since the beginning of the crisis that human-to-human transmission could occur. FAO shares with WHO [World Health Organization] this concern," Mr. He said in a statement on Tuesday (Sept. 28).
"The virus continues to circulate in the region and will probably not be eradicated in the near future," Mr. He said.
The FAO official was referring to China, Vietnam, Cambodia, Malaysia and Thailand, where more than 100 million chickens perished or were slaughtered this year because of bird flu, mostly during the winter.
At least 30 people died in Asia from the virus this year, including 10 people in Thailand and 20 in Vietnam.
"FAO is eager to see further evidence and information to help us to understand if, and what, may have changed in the biology or genetic makeup of the incriminated virus to give rise to this probable human-to-human transmission," Mr. He said.
In June, Thai officials congratulated themselves when the death toll stopped after eight fatalities from an initial winter outbreak.
Their cheerful boasts were overconfident and the disease infected more chickens and people in July.
Among the dead was a person who bred so-called "fighting cocks" who apparently contracted the disease from sick roosters raised to battle in bloody contests which attract rural audiences and gamblers.
Some owners of fighting cocks earlier vowed to hide their prized contenders from government culling teams because the roosters are valuable and many did not exhibit signs of illness.
An international alarm sounded earlier this week when United Nations medical officials realized bird flu virus may have been transmitted from a Thai daughter to her mother -- possibly the world's first case of human-to-human transmission.
The mother, Pranee Thongchan, visited her 11-year-old daughter, Sakuntala Prempasee, in northern Kamphaeng Phet province hospital.
Both people soon died.
The child apparently contracted bird flu from live infected chickens while staying in her aunt's village, doctors said.
When the daughter died in early September, unsuspecting Buddhist priests cremated her body without an autopsy.
Sakuntala's mother then died on Sept. 20 from a confirmed case of bird flu, leading officials to declare the world's first, "probable" human-to-human transmission.
Mrs. Pranee, 26, experienced "very close and face-to-face exposure" to her sick daughter in hospital, the Health Ministry said.
Before she died, the mother also met her elder sister, Pranom, who was later confirmed suffering from bird flu. Both women were in close physical contact with the feverish girl.
Doctors spent Thursday (Sept. 30) monitoring Pranom's illness and that of her sick, six-year-old son who apparently also caught the virus.
All four victims appeared to have contracted the same H5N1 bird flu virus, UN health officials said.
Thailand's lucrative poultry industry, which depends on massive international exports, was bracing for a downward spiral amid fears that Thais and foreigners would shun Thai chicken even if it is confirmed to be safe to eat.
"Avian influenza usually spreads when live birds carrying infection are bought and sold, and by contact of birds with bird droppings on dirty equipment, cages, feed, vehicles or shoes and clothing," the FAO said.
"Although the finding of probable human-to-human transmission is clearly of concern, there is currently no evidence of ongoing chains of transmission, or risk to persons outside of the affected province," a Health Ministry statement said.
Richard S. Ehrlich, a freelance journalist who has reported news from Asia for the past 26 years, is co-author of the non-fiction book, "HELLO MY BIG BIG HONEY!" -- Love Letters to Bangkok Bar Girls and Their Revealing Interviews. His web page is

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