Stage Set for a Bird Flu Pandemic

[Guest guest]

By Alan Sipress

BANGLANE, Thailand -- Prathum Buaklee stepped nimbly along the aging

planks running between the cages of his chicken farm, shoveling grain with

his meaty hands from a bucket into the feed trays. His feet were bare and

caked with dirt. The old plaid shirt hanging on his stocky frame was soiled.

And the air was rank with the smell of feathers, droppings and feed.

This soft-spoken farmer is part of an agrarian revolution in Southeast Asia

and China that has more than doubled poultry production in barely a decade,

bringing pickup trucks, air conditioning and other trappings of prosperity

to long-destitute peasants and more protein to the diets of hundreds of

millions of ordinary Asians.

But with chickens now packed into farmyards alongside other livestock,

international health experts warn that conditions are set for a bird flu

pandemic that could kill millions worldwide if the virus developed into a

form capable of spreading among humans.

In its current form, the disease kills about three-quarters of the people

who catch it from birds. Since the beginning of last year, 45 people in the

region have been infected. Twelve Vietnamese and one Cambodian have died

this year.

A year ago, as Thailand became the epicenter of an avian influenza

outbreak, local officials descended on Prathum's farm and put his chickens

to death along with tens of millions in the rest of the country. The

campaign was meant to stem the spread of a disease that has struck nine

Asian countries.

The mass culling, however, did not stop the virus. And now, many poultry

farmers are back in business, again raising their birds in unsanitary

conditions that health experts say pose a threat unprecedented in modern

agriculture.

Prathum, 54, has restocked his farm in central Thailand, rebuilding his

flock though not his confidence. His brown eyes have grown heavy. Bags hang

low on sunbaked cheeks, and a deep furrow cuts across his broad forehead.

" Even if we're afraid of the disease returning, what can we do? Nothing, "

he said. " We can't run away. "

U.N. agriculture officials say farmers can take simple steps to prevent the

disease from spreading. They can require that workers disinfect their shoes,

change clothing and spray their vehicles before entering a poultry farm.

They can ban outsiders from chicken sheds, keep other animals away and keep

egg trays and cages clean.

But farmers resist such measures, health and agriculture experts say. And

governments in the region lack the money, manpower and, at times, political

will to enforce these requirements on an industry that has become a vital

component of economic growth.

As a result, the prevalence of the infection in birds makes a new, more

deadly human outbreak likely. Public health experts say it is only a matter

of time before the flu strain remakes itself, unleashing a disease that is

both highly lethal and as easy to catch as an ordinary flu bug.

If this occurs, World Health Organization officials predict that, in the

most optimistic scenario, 2 million to 7 million people would die worldwide

and that the toll could potentially reach 100 million. Health experts say

the virus has already exhibited traits similar to those that caused the

Spanish flu pandemic of 1918, which is estimated to have killed about 40

million people.

Tommy G. , former U.S. secretary of heath and human services, told

reporters at his farewell news conference in December that avian flu was his

greatest health fear. He called it a " really huge bomb " that concerned him

even more than bioterrorism.

Poultry and Prosperity

Until 15 years ago, Prathum and other farmers said the area around Banglane

was an uninterrupted expanse of glistening emerald rice paddies where

villagers traveled in small wooden boats along countless canals. The few

roads were dirt tracks navigated by ox cart.

Prathum, whose forefathers had been rice farmers in the wetlands of central

Thailand, dropped out of school after fourth grade to follow in the family

tradition. The income he earned was " just barely enough to make a living, "

he recalled.

In the late 1980s, as he continued to toil in the rice fields, Thailand was

undergoing far-reaching economic changes. It was becoming a manufacturing

center in the globalized market, recording growth rates of nearly 10 percent

a year. Rising incomes for many Thais meant greater demand for a better

diet, in particular animal protein.

Nowhere was this truer than in Bangkok, the booming capital. Prathum's home

province of Suphan Buri, 70 miles to the north, was strategically located to

meet this demand for chicken, duck and eggs.

Taking the lead from a neighbor, Prathum started in 1991 with 300 hens and

began selling eggs. His flock grew steadily until it reached 15,000. He

bought about 20 acres of land, more than tripling the size of his farm, and

ultimately erected seven open-sided poultry sheds suspended above artificial

ponds, which he stocked with fish to supplement his income. Each shed

stretches about 40 yards under a pitched metal roof. Wood planks splattered

with droppings run between the cages.

He bought a pair of Ford pickups, replaced his leaky clapboard hovel with a

home three times as large and outfitted it with a color television,

refrigerator and air conditioning. He gave each of his three children a

computer and sent two sons to college, one of whom is studying veterinary

science.

" I feel grateful to the chickens, " Prathum said. " Chickens are like human

beings. You take care of them well and they'll take care of you. "

So when livestock officials came to the farm in December 2003, the order to

kill the chickens was a great shock. " They came by the hundreds in trucks,

bringing soldiers and prisoners to kill the chickens, " said Prathum's wife,

Samrouy, 47, her leathery hands raised in exasperation. Avian flu had been

discovered in a poultry shed down the road. Thai officials were demanding

that all poultry in the area be culled as a precaution. Workers dug a mass

grave at the end of the property with a backhoe and buried the birds alive.

" It broke my heart, " Samrouy recounted between rounds of collecting eggs.

She wiped her rich brown eyes with a red-and-green checked scarf. " I felt

that the chickens were like my children. "

After nine months, weary of sitting idle, Prathum decided to restock his

farm. He draped fishing nets over his sheds, as required under new

government regulations, to keep out wild birds that local officials said

might carry the disease.

But Prathum adopted none of the other safeguards that veterinary officials

recommended, such as barring visitors and other animals from the farm. He

continued to raise fish in the ponds, which attract waterfowl that could

spread the virus. Neighboring farmers in filthy work clothes visit with

Prathum inside the sheds as he feeds the flock and collects the eggs. Even

his black dachshund follows him on his rounds.

A Perfect Viral Storm

In Thailand, Vietnam and Indonesia, the number of chickens nearly tripled

from the late 1980s until early last year, according to figures from the

U.N. Food and Agriculture Organization. China recorded a doubling in its

poultry population, adding 2 billion chickens since 1988.

This meant that ordinary citizens across these countries were getting much

more protein in their diets, with daily intake of chicken doubling in some

places and tripling in others. Consumption of eggs increased nearly as

quickly.

The number of ducks, another common source of meat in this part of the

world, was also up sharply. In retrospect, that was particularly worrisome

because experts believe ducks play a crucial role in spreading the disease

among birds, because they remain symptom-free longer and wander more widely

than chickens.

So far, researchers believe two people have caught the virus directly from

another person, according to an article published last month in the New

England Journal of Medicine examining how the disease spread within one Thai

family.

It will take more for avian flu to spread rapidly among people. The current

H5N1 strain would have to acquire genetic material from a human flu bug in a

process called re-assortment. The worst fears of public health experts could

come true if a person caught both flu strains at the same time. Scientists,

however, have demonstrated that this mixing of strains could also occur in

other mammals, notably pigs. Ominously, the Asian swine population has also

increased significantly.

It could be the gathering of a perfect storm: dense concentrations of

chickens, pigs, aquatic birds and people. " It's clear that Southeast Asia

poses the greatest risk today of a new virus unfolding and coming forward as

a pandemic strain, " said Osterholm, director of the Center for

Infectious Disease Research and Policy at the University of Minnesota.

" Darwin could not have created a more efficient re-assortment laboratory if

he tried. "

Counting on Good Fortune

U.N. and other agriculture experts say the cost of adopting simple

safeguards is low but requires a change in attitude, as happened in the

United States and Europe when they went through their own chicken

revolutions nearly four decades ago.

The dramatic increase in poultry production on both sides of the Atlantic

was fueled by rising incomes after World War II, rapid urbanization and

technical breakthroughs.

The U.S. Department of Agriculture launched an aggressive campaign to

educate farmers about safety, said Carol Cardona, a poultry veterinarian at

the University of California at . Farmers, who realized they had much

to lose if disease broke out, readily adopted the measures, she said.

Nirundorn Aungtragoolsuk, director of disease control in the Thai

department of livestock development, said his government recently adopted

strict regulations for large, export-oriented chicken farms. But the rules

do not apply to most Thai farms.

" They have done it their way for a long time and we cannot change it

overnight, " Nirundorn said, adding that his department was too understaffed

to enforce requirements.

Prathum admitted he was counting on good fortune to avoid a bird flu

outbreak among his flock. " I'm still scared, but what can I do? " he said.

" We'd never had bird flu before. It just came. "

He acknowledged that his sons had been encouraging him to adopt modern

safeguards. His older son, the student of veterinary science, had been

particularly outspoken. " I may not be able to learn about these as fast as

young people, " Prathum said. " I'll retire after a while and pass the farm on

to my son. Then he can do what he wants. "