The Game of Risk
I’m very glad to see so many comments from around the world. It’s clear to me that there’s a lot of anxiety about the potential for a pandemic bird flu strain, and that there’s a lot of conflicting information. Media reports about the risk are certainly running hot and cold.
I’m afraid those temperatures are subject to the hokus-meteorology of news markets. The answer to the question “what’s the risk for a pandemic?” truly depends on who you ask. I’ve talked to a lot of experts, and there just isn’t a lot of agreement. Today I talked with a H5N1 advisor for the Food and Agriculture Organization – he downplayed the risk and called himself an optimist. Others are trying to support Indonesia’s case for more funding from international donors, so you can hear them playing up the risk. The country is dancing with the World Bank right now about…well…money. It’s a complicated and clumsy dance – one is doing the Cha-Cha and one is counting T-A-N-G-O.
I think I can’t really comment on the risk level, but I can say that Indonesia does not have its prevention program together. Vaccination, public education, and culling are really the only tools for mitigating the risk. As far as I can tell, none of those are working here.
I should reiterate that bird flu is still extremely hard for humans to get, and still seems to require prolonged, high risk exposure. There is a pandemic in birds, however, so exposure will continue.
There is an investigation right now into another possible case of human to human transmission. Today epidemiologists clarified that it’s not a ‘cluster’ they’re looking at – because the infections come from five different district in Java.
In any case, I’d like to make an appeal for more questions. I may be in a position to ask the right person as I continue reporting on the disease. There are obviously some people out there following media chatter on this, and I say we work together to figure out where the information gaps are.
posted by Chad at 9:36 AM
7 Comments:
I addressed the human transmission issue in #3 in my post. Right out of the gate, I can tell you that what we have is the "high path" version of the virus in birds. John Weaver told me yesterday that the virus can live in feces for up to 3 weeks. And it's very easy for other chickens or ducks to get it. Ducks and other waterfowl are particularly problematic, because they are carriers without symptoms.
I'm going to address other questions in future posts. Keep 'em coming!
Hi Chad,
Perhaps you could comment on the level of education and availability of media in these rural areas like the Karo village and the Cikelet hamlets. Are the adults educated enough to read information provided by the government? Is there printed information about bird flu posted anywhere around these rural villages? Do they get television by satellite?
Stay safe.
bonjour CHAD
you are on a french site
do you speak french,english is difficult for me
learn you soon
louis
Indonesia seems fixated on poultry in contact with the sick but in a country where 80% of households keep poultry it would be hard not to find a poultry link somewhere. My question would be are they, or are they planning to, increase the testing to a wider species range (Dogs, cats, bats, rats, mice & wild birds). All the released sequences are from domestic poultry, humans and a cat (atleast that is all I have found at Los Alamos on the public side).
Waiting until you have a 'typical' human case who claims to have eaten sick poultry then testing them, and if positive, sweeping in with a masked hit squad to cull and disinfect is never going to work if the villagers then buy in new stock and the asymptomatic wild life then comes down to crap in thier drinking water.
Bonjour Louis -
Oui, je peut parler francais en peut, mais ce n'est pas facile pour moi. Surtout depuis j'ai commencez edudiez Indonésien! J'oubliez toutes! J'espere que vous allez lisez ma journal quoique je vais écrivez les histoire englais seulment.
jjackson, you raise some important points - waterfowl contact with other domestic birds is troubling, and ducks are also widely used as a source of food and eggs. There has been some testing of cats too, but they are not really considered to be a dangerous carrier to human or bird populations. The biggest threat to domestic fowl is other domestic fowl. Even the threat of infection from wild and migratory birds to domestic birds is just nowhere near the threat other infected domestic birds present.
Chad,
Your work was cited on flutrackers.com a few days ago and has generated much interest. As you inquire on case investigations see if you can get the authority to precisely describe the type of testing (swabs vs serum). WHO has a recommended algorithm for testing and sample case tracking forms. Keep up the good work and stay safe.
Oh by the way Google News this morning 2006-0820 is now headlining in the health section the suspected cluster in West Java.
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