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Building strong defences against bird flu

Birds are culled at a recent outbreak site of avian influenza.
(Biotec)

As avian influenza continues to surface in poultry farms across northern Thailand, health officials say they are fully prepared. “Right now we are ready for the pandemic virus,” Thawat Suntrajarn, director-general of the Disease Control Department, told IRIN. “We are sure the pandemic strain will not originate in Thailand.”

Even though, despite this confidence, nobody knows when or where the pandemic strain will originate, local and international specialists agree Thailand deserves credit for its preparedness measures.

Bird flu outbreaks on poultry farms have been confirmed in Nakhon Sawan and Phichit provinces and are suspected elsewhere, killing thousands of birds and leaving several people under surveillance for possible infection.

Nonetheless, the last confirmed human case of bird flu in Thailand was in August 2006. In the three years before that, 25 Thais were infected, with 17 dying from the virus.

However, the foundation for the country’s success in fighting bird flu was laid nearly two decades before, when the government set up a network of about 800,000 trained volunteers across the country to provide free medical advice to villagers and information on sanitation, HIV/AIDS and malnutrition.

The system was used effectively during the outbreak of severe acute respiratory syndrome (SARS) in 2003, and then for bird flu. Now the network allows officials to quickly respond to any suspected outbreaks among animals or humans.

Rapid response

“This is the strength of the Thai system, that we have a well-established surveillance network so we know rapidly if there are any sick chickens,” Thawat said. “We use this information to immediately send out a report to people.”

Government officials and scientists now say speedy information sharing is essential to keep the virus in check. Yet when SARS first hit, the government, led by deposed Prime Minister Thaksin Shinawatra, tried to control information.

“When bird flu happened, people were thinking the crisis could be managed using a top-down approach, that some wise guys know how things should be done,” said Prasit Palittapongarnpim, deputy director of the National Center for Genetic Engineering and Biotechnology (Biotec). “But we found from SARS that it seemed not to be the case, because the top doesn’t know much about this. So we think there was more of a need to strengthen the bottom-up approach to deal with the disease.”

Now when bird flu breaks out, the government immediately publicises the information. A team of doctors, veterinarians and local officials went to the scene of the recent outbreak; experts culled sick animals, gave suspected patients oseltamivir (Tamiflu) and sprayed the area with disinfectant.

Provinces where humans have died from bird flu are declared “red zones”, in which local officials must carry out drills for responding to avian flu every three months. Areas where only animals have died are “yellow zones”, where practice runs are conducted every six months.

Thailand’s quick-response system not only helps save lives, but can also rapidly cull chickens, which helps to prevent the virus from mutating into the human-to-human pandemic strain.

Countries without strong preparedness systems, such as Vietnam and Indonesia, provide the virus with more opportunities to mutate, scientists say.

Blueprint for continuity

In addition to the rapid response system, government officials possess a blueprint for dealing with a pandemic to ensure hospitals function and that the economy, including public services, communication networks and the electric grid, does not shut down in the event of a full-scale health crisis.

Thailand is stockpiling Tamiflu and building a factory that would help produce a vaccine for seasonal flu. Its scientists are also sharing flu virus samples with the World Health Organization (WHO) so companies can develop vaccines, and hopes to secure access to such vaccines if commercially developed.

Virologist Pilaipan Puthavathana cautioned that the virus could become resistant to Tamiflu if the drug is overused. “It’s like antibiotics; the more people use them the more the disease will become resistant,” she said.

However, even though Thailand appears well prepared, the best efforts may prove fruitless depending on the virility of the strain. It could break out anywhere at any time, and it would take at least six months thereafter to develop a vaccine, according to Thai specialists.

“It’s like you’re playing a slot machine; the jackpot could happen at any time,” said Somchai Peerapakorn, a medical officer for WHO Thailand, referring to the pandemic strain.

“If we think globally, then the chain is only as strong as its weakest link,” he added. “We can’t let any country be the weakest link.”

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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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