20 December 2007
Vietnam's Vaccination Effort Helps in Fight Against Avian Flu
Eight human H5N1 cases feared in Pakistan, first human case in Burma
U.S. agencies, U.N. organizations help in nation’s response to H5N1
This is the second in a series of articles about the response to avian influenza in Southeast Asia.
Hanoi, Vietnam -- Vaccinating its highest-risk populations of chickens and ducks has been an expensive and logistically complex effort for Vietnam’s central government, but animal health officials say it has slowed deadly outbreaks of highly pathogenic H5N1 avian influenza among birds in the Southeast Asian nation and, critically, among people.
Many avian flu experts consider Vietnam a bright spot in the South and Southeast Asia regions, where many developing nations do not have systematic, coordinated processes for dealing with avian and human outbreaks.
An emergency situation is under way in Pakistan, for example, where the Ministry of Health reported its first human cases December 15 -- eight suspected cases of H5N1 in the Peshawar area -- to the World Health Organization (WHO). The infections arose after a series of culling operations of H5N1-infected poultry. So far, one person has recovered and two have died.
Of tests performed on 40 people so far, eight are suspected positive and scientists from the U.S. Naval Medical Research Unit No. 3 in Cairo, Egpyt, arrived in Pakistan December 18 with testing materials and equipment to confirm the results, WHO spokeman Gregory Hartl told USINFO.
The eight suspected cases are four brothers and a cousin in Abbottabad, a man and his niece in Abbottabad who may have worked on the same farm as the brothers, and a man in Mansherra who is a bird culler.
Limited person-to-person transmission is only one hypothesis so far, Hartl said. “It is too early to say definitively one way or another yet. Some or all of these people were involved in the culling of infected poultry,” and the four brothers and cousin kept chickens and quail at home.
WHO has sent three people to supplement its country staff to study and monitor the situation and provide technical support in epidemiological investigations to the Ministry of Health. H5N1 outbreaks have occurred in Pakistan in poultry since 2006 and in wild birds in 2007.
On December 14, the Burma Ministry of Health confirmed that country's first human case of H5N1, now recovered, found through routine surveillance after an H5N1 poultry outbreak in Kyaing Tone township, Shan state.
WAVES OF OUTBREAKS
H5N1 first affected birds in Vietnam in 2004, according to the U.N. Food and Agriculture Organization (FAO). In the first three waves of disease outbreaks in 2004-2005, some 93 people were infected and 42 died, and officials culled 51 million chickens and ducks.
In August 2005, Dr. Hoang Van Nam, deputy director of the Department of Animal Health in Vietnam's Ministry of Agriculture and Rural Development, told USINFO, the Vietnamese government undertook two pilot vaccination projects in Nam Dinh province in the north and Tien Giang province in the south, at a cost of about $500,000.
The move came following guidelines developed by FAO and the World Organisation for Animal Health to stop the spread of H5N1. The guidelines cover disease surveillance, quick destruction of infected birds, control of bird movement and closure of live bird markets in cities.
For Vietnam, Nam said, “vaccination was the last resort. We applied so many principles -- detection, isolation, stamping out. The international experts said if we applied all the measures but still had outbreaks, we could use vaccination. But it’s not easy -- it’s very complicated to use.”
Potential drawbacks of bird vaccines include the possibility that a vaccine would suppress a bird’s natural immunity to the virus, cause the virus to mutate to a more dangerous form, or -- because viruses continually mutate -- stop working.
CONTROLLING H5N1
On the second floor of the Department of Animal Health above Giai Phong Street, Nam said that after learning what they could from the pilot projects, Vietnamese officials began the labor-intensive, expensive work of vaccinating chickens and ducks in 33 of the country’s 64 provinces.
Experts disagree about whether bird vaccination is an effective way to prevent the spread of H5N1, but Vietnamese officials stand behind their results.
“From when we started vaccinating to now,” Nam said, “we found that the vaccine contributed to the control of the disease in Vietnam. For one year, from the middle of December 2005 to 6 December 2006, we had no outbreaks. And in human cases, we had no outbreaks for 17 months.”
In the fourth wave of outbreaks that began in December 2006, some 45,000 poultry were culled and sporadic outbreaks occurred in February and March. The fifth wave of H5N1 infection was May 1-6. Since May, according to FAO, bird flu has been reported in poultry in 22 provinces.
The Ministry of Health confirmed seven human cases between June and August, four of which were fatal, bringing to 100 the number of human H5N1 cases in Vietnam since 2003, with 46 deaths. Only Indonesia has a more lethal human situation -- 115 cases with 92 deaths.
“Even though we still have a problem with the prevention of avian influenza,” Nam said, “I think that compared with some countries in our region, Vietnam has been temporarily successful.”
See also "Vietnam Bird Flu Preparations Boost General Disease Capacity."
For more news stories, see Bird Flu (Avian Influenza).
(USINFO is produced by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
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