Sun, Apr 09, 2006 page5

• Vietnamese learning to live with bird flu virus

  NO NEED TO PANIC Bird flu has become part of everyday life in Vietnam as people in the cities and in the countryside have learned to deal with the threat

  • THE GUARDIAN
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  The smell of roasting chicken wafted out of the open-fronted Happy Life restaurant in central Hanoi and into the open road.

  "It would have been a waste of time and money cooking these a year ago, as everyone was too scared to eat chicken," said Hoang Nguyen as he basted the birds before turning them over.

  "But now life is returning to normal. People are no longer afraid, they're no longer panicking. They understand the situation much better than before." The diners agreed.

  "Bird flu is part of our lives now, we know how to live with it," said Le Minh. "We've been taught that as long as it's cooked properly and comes from a reliable source then there is nothing to worry about."

  The calmness extends beyond the better-educated urban areas, according to Jeff Gilbert, the avian influenza expert, at the UN's food and agriculture organization office in Vietnam.

  "I think that even in the countryside the majority of people now have some understanding of bird flu, even if it's not yet a complete understanding," he said.

  The government had listened to advice, he said, and implemented effective strategies. Live animal markets had been banned and people given incentives to report sick birds and animals.

  The impact has been startling. After 29 human cases and 21 deaths in 2004 and 61 cases and 19 deaths last year, there have been no cases so far this year.

  It is a similar story in Thailand. The government covered up the outbreak in January 2004 but has learned that secrecy is the worst possible approach.

  "If we make everything very transparent and act in a timely manner then people will believe what we say," said Kumnuan Ungchusak, the director of epidemiology at the public health ministry. "But if you delay people will always put a question mark against what you say."

  In Thailand, anyone with remotely suspicious symptoms is investigated. This year there have been about 800 notifications but not one positive case.

  Another measure the Thais have adopted is to train tens of thousands of rural volunteers to monitor any suspicious illnesses in animals and humans.

  "Having the same person at the community level chase down animal and human cases makes such a difference," said Bill Aldis, the head of the WHO in Southeast Asia.

  "If you link it to the same reporting chains from the outset then the sensitivity and specificity of human cases rises significantly," he added.

  But there was no single right approach, he said, pointing to the fact that Vietnam had vaccinated birds but Thailand had chosen to cull.

  Both approaches had proved effective. Indonesia is proof of what happens if governments do not react decisively.

  Twelve people have died this year from 13 cases, following on from 11 deaths from 17 cases last year -- the only country in the region that has witnessed an increase in cases over the past 18 months.

  "Things are starting to get into place now," said Peter Roeder of the UN's Food and Agricultural Organization. "There's a new coordinating body for bird flu and the surveillance system is starting to get up to speed."
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