Vietnam's effort key to stopping spread of avian flu
HANOI - Villagers of Nam Trieu commune in Ha Tay province 30 miles southwest of Hanoi carry their squealing chickens and waterfowl by hand or in wire cages and baskets on the back of bicycles to a vaccination area.
One by one, animal health workers in protective masks, gowns and caps inject the chickens and ducks with serum, which costs about 8 cents a dose.
"This vaccination is not only for chickens but also for people," said chicken breeder Nguyen Thi Xuan, 38, who brought her chickens by bicycle. "If the chickens still get infected after the vaccination, we will never keep them or eat them."
Similar scenes are being repeated in 47 of the country's 64 provinces. In a herculean program, animal health workers began injecting 60 million chickens and waterfowl owned by more than three million breeders last month, hoping to stop the avian flu virus before the onset of winter, when it appears to thrive in Southeast Asia.
Vietnam's fight against the deadly H5N1 strain of the virus, which has infected 116 people in Asia since December 2003, is vital to preventing a global flu pandemic, health experts say. Most of the 64 deaths so far have been in Vietnam, where 41 people have died from the virus.
The World Health Organization has warned for a year that the virus could kill up to 7.4 million people globally if it is not contained and mutates into a form easily transmitted between humans. Some estimates have gone as high as 150 million deaths.
In the past week, President Bush has issued dire warnings about a possible avian flu pandemic, suggesting on Tuesday that the military might be needed to enforce mass quarantines. On Friday, he convened a special meeting of vaccine manufacturers at the White House to urge a huge production of vaccine that would be needed in such a pandemic. The Senate, meanwhile, passed legislation last week authorizing $4 billion for the purchase of more bird flu medication.
Hoang Van Nam, deputy director of Vietnam's Department of Animal Health, said the country will import 380 million doses to cover the vaccination program this year and in 2006.
"Of course, you cannot manage absolutely 100 percent, only in the commercial poultry farms," Nam said. "In the backyard, it is very difficult."
The U.N. Food and Agricultural Organization (FAO) estimates that the imported vaccines will cost Vietnam $44 million. It said international donor nations had pledged only $16.5 million out of the $100 million the FAO said is needed to tackle the disease at its source throughout Southeast Asia.
Vietnam has "only a small window of opportunity" to control the infection, according to the FAO. In late January and early February, many of Vietnam's 82 million people will be killing and eating poultry as part of Tet, the weeklong Lunar New Year festivities. So far, about 150 million diseased poultry have died or were culled in the containment effort across Asia. The culling of about 50 million poultry in Vietnam alone cost nearly $190 million, the agriculture ministry said.
"A vaccination program is something the whole international community should support," said Astrid Tripodi, Vietnam coordinator for FAO. "It's in the interest of the whole international community to bring the virus load down, whether it is in Vietnam, Indonesia or another country."
Human cases of H5N1 have been confirmed in Vietnam, Thailand, Cambodia and Indonesia. On Sept. 30, these four countries and others in the 10-member Association of South East Asian Nations endorsed a blueprint for eradicating the virus in the next three years.
China has reported the same H5N1 strain in poultry. When it reached Mongolia and six regions of Kazakhstan and Russia during the summer, Europe and North America began to wake up to the possibility that migratory birds might carry the killer disease to those continents.
"If this outbreak had happened in New York, London, Berlin or Paris, we would have had much more attention, much more investment, much more control and prevention measures," said Hans Troedsson, the World Health Organization representative in Hanoi.
All of the fatalities so far came from close human contact with chickens and waterfowl, which are traditionally kept in village backyards to breed for market or family eating. Agricultural officials are debating how to reform poultry raising to limit cross-infection, which is more likely to occur when different poultry and waterfowl are kept together in close quarters.
Live poultry markets in villages of the northern Red River Delta close to the capital, Hanoi, illustrate the problem. Chickens, ducks, geese, quail and other waterfowl are often cooped up together in small wire cages. Killed and readied for market, they are de-feathered and the carcasses sliced into slabs that lie on wooden tables in the scorching heat and humidity.
"This is very dangerous," said Nam of the Department of Animal Health. "We have this culture in Vietnam and it has been so for a long time. We are asking them to separate the birds -- one place chicken and another place duck -- but this is actually difficult to change."
Farmers are raising free-range ducks and scavenging chickens together in the southern Mekong Delta without knowing the potential danger to humans, said Nam. Tens of thousands of wild ducks and domesticated ducks in the south show no symptoms but they have been found to be infected with the virus.
For these and other reasons, health officials believe a mass poultry vaccination program, such as the one that started last month and scheduled to run through November, is the best short-term option to try to prevent the spread of the virus.
Vietnam is also stockpiling Tamiflu, an antiviral agent that is the only treatment so far found to be effective against bird flu in humans, state media reported. The government said it plans to build two new labs for bird flu tests at a cost of $4 million each.
Michael Marine, the U.S. ambassador to Vietnam, announced last month that the United States would donate $2.5 million over the next five years for monitoring changes in the virus and improving surveillance for influenza in Vietnam.
"We are seeing more awareness now and understanding. It has been a bit of an alarm clock for many," Troedsson said.
By Grant McCool - San Francisco Chronicle - October 9, 2005.
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