A YOUNG WOMAN died of H5N1 avian influenza virus in Beijing on Jan. 5. This should be a wake-up call for President Ma Ying-jeou’s (馬英九) administration as it opens up the direct three links. With the opening of direct cross-strait passenger flights, it only takes four hours for the virus to reach Taiwan. In addition, the National Immigration Agency’s computer system at Taiwan Taoyuan International Airport (and three others) crashed for 36 hours earlier this month, leaving national security wide open, thus causing a tremendous threat to public health in Taiwan.
Why is the world so scared of the bird flu virus? Because the 1918 human influenza epidemic — better known as the Spanish Flu — that killed between 20 million and 50 million people worldwide was also the result of a human-to-human spread of a different strain of bird flu. Bird flu is the source of human flu and the most direct example is chicken pox. Guangzhou is the main source of bird flu globally, with the world’s highest density of raised birds. Hong Kong and Taiwan are some of the closest located distribution channels.
The opening of the “small three links” posed a great risk and the opening of the direct three links on Dec. 15 made the risk even greater.
The main immediate cause of the human H5N1 outbreak in 2005 was the transmission of the virus through seasonal migration of wild geese from Qinghai Lake in Qinghai Province, spreading the virus from China and Southeast Asia to Turkey and Central Asia and further to Hungary in eastern Europe. Today, the threat has spread further to Western Europe, the UK and Canada.
The main distant cause, however, was the human H5N1 infection in Guangzhou in 1997 that resulted in the slaughtering of tens of millions of chickens in Hong Kong.
The case of a Hong Kong child infected with H5N1 while visiting relatives in Fujian Province in 1997 and the second wave of infections that swept Southeast and Central Asia in 2005 and 2006 showed that the virus can cause enteritis and encephalitis, but not pneumonia, a finding supported by The New England Journal of Medicine published on Feb. 17. It also showed that the virus tends to infect children and young adults in households raising birds and is accompanied by a death rate of more than 50 percent. The infection rate, however, is not high, and rather than droplet transmission typical in human flu, close contact is required for transmission.
Now that deaths from the virus have been reported in Beijing, Taiwanese businesspeople and tourists must take extra precautions. In the past, Hong Kong was a checkpoint for Taiwanese transferring to China, but with the opening of the direct links, the spread is no longer dependent on wild geese. In addition, it took more than one month for the Council of Agriculture to investigate the sudden death of chickens in Kaohsiung County. This is ridiculously inefficient and the public would probably be better served praying for protection.
The H5N1 virus can invade Taiwan in four hours and it is more powerful than missiles. The misery created by the SARS outbreak in 2003 should be sufficient to focus the mind. If the authorities are not alert to this situation, or if the media continue to ignore the situation intentionally or unintentionally, it is not impossible that deaths will occur in Taiwan. Should this happen, the country’s already ailing economy would suffer yet another blow. The Ma administration’s lopsided promotion of the benefits of the three direct links makes one wonder if the government is prepared for that possibility.
Mayo Kuo is a Taiwan-based pediatrician. His older brother Max Kuo is a US-based pediatrician.
TRANSLATED BY EDDY CHANG
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