To rip off a Bob Dylan lyric, avian influenza is a slow train coming. And it appears to be building steam. Despite the culling or vaccination of millions of Asian and European birds, the virus continues its push west. Showing up in some 30 new countries over the past two months, H5N1 is expected to soon reach North American shores, vectored by migrating birds.
Despite having killed over 100 people worldwide since 2003, the virus has yet to mutate to allow it to jump from human to human.
Gaining such ability is the great fear of those trying to prevent a flu pandemic. But the flip side to that fear is any mutation could actually make the virus harmless to humans.
Scientists insist the fears are legitimate and the U.S. government appears to be listening. Vaccines, and methods for delivering them, are being prepared and stockpiled. Large municipalities, reportedly, are also putting in place contingency plans should the virus hit and keep large numbers of city workers from their jobs.
As the story continues to percolate, “we're certainly looking at (avian flu) with all the seriousness it requires,” says Phil Wyrick, executive director of the Arkansas Livestock and Poultry Commission. “At the same time, I have to emphasize there's an element of overreaction in some of the stories on this. We do not have H5N1 bird flu in Arkansas — or the United States, for that matter. We do so much testing, we'd know if it had arrived almost immediately. That's the truth. Surveillance on commercial operations is excellent”
One hundred percent of the poultry flocks in Arkansas (the largest poultry-producing state in the nation's $29 billion industry) that go to slaughter are tested for the disease. Further, 98 percent of the flocks in the country are tested.
To give an idea of Arkansas' ramped up testing, Wyrick says in January 2005, “we tested a bit over 7,000 samples. In January 2006, over 19,000 samples were tested. That's a considerable jump and is further illustrated by looking at February testing numbers: in 2005, there were over 8,000 samples while last month there were over 19,000 samples. The surveillance work should give everyone concerned a great deal of confidence that the safety of Arkansas chickens, the safety of U.S. chicken, is the best in the world.”
On March 20, Mike Johanns, Gail Norton and Mike Leavitt — heads of the USDA, the U.S. Department of the Interior and the U.S. Department of Health and Human Services respectively — held a press conference on avian flu.
If nothing else, H5N1 has proven capable of capturing headlines. Johanns, who spoke first at the press conference, acknowledged that, repeatedly telling the press to choose words wisely in order to avoid panicking the public.
“Clear and comprehensive reporting of this story will make the difference between informing and alarming the public,” said Johanns. “We stand before you today confident that there is no need to alarm the public, but there is a need to inform the public.
“The American people deserve the facts. They need accurate information about where the threat exists and where it does not exist. The fact is that a detection of highly pathogenic (high-path) H5N1 virus in birds in the United States would not constitute a reason for panic. That's an important message that we leave with you today.”
Norton said an interagency plan to deal with H5N1 establishes a “comprehensive framework” for early detection of the disease in wild birds. Using five major strategies, the plan calls for testing wild birds that are sick or have died; sample testing of live wild birds; sample testing of hunter-killed birds; monitoring and testing of sentinel animals; and testing of environmental samples.
“Interior and its partners including state (wildlife) agencies routinely investigate when groups of wild birds become sick or die,” said Norton. “This happens quite frequently. There are many instances every year when groups of birds become sick or die for a variety of different causes. The systematic investigation of sick or dead wild birds offers the highest and earliest probability of detecting the high path H5N1 strain…
“Using these strategies and techniques, field specialists and wildlife biologists…plan to collect between 75,000 and 100,000 samples from live and dead wild birds in 2006.”
Perhaps most significantly, Norton said announcements of “presumptive H5N1 results” could occur between 20 to 100 times in 2006. Anticipating public angst between any initial announcement and a determination of whether the virus is high-path or a low-path variety, Norton urged calm.
“During this (five- to 10-day) wait, the press and the public will need to realize two things: first, this is a disease of birds and not humans; and, finding a bird with the disease does not signal a pandemic.”
Vaccines and precedent
Asked about a vaccination stockpile and plan for poultry, Johanns promised an “aggressive” response to any case of high-path H5N1 in the United States. “We will cordon off the area, movements in and out will be prohibited and monitored…We will destroy the poultry. We will then test in that area to make sure that we've gotten rid of the virus and we will disinfect.
“There are instances where we might use the vaccine to, in effect, build a rim around an infected area, but our preference is to be much more aggressive and just simply eradicate the birds, eliminate the virus, do the disinfectant and literally end it right there.”
Perhaps the most disturbing response to a question came when Leavitt was asked about the threat of a pandemic in light of the government's often controversial response to Hurricane Katrina.
“Let me describe some of the lessons I believe were learned from Katrina (that can be carried to) pandemics,” said Leavitt. “The first is that what happens before a disaster is of prominent importance in being able to assure damage is minimized. The second is you have to think about the unthinkable, because often it occurs. The third lesson I would point to is, how much different a pandemic is from any other natural disaster.
“In Katrina we saw major portions of Louisiana, (Mississippi and Alabama affected). But at least it was constrained to those three states. I walked through medical shelter after medical shelter for weeks after and saw people who came from all over America to help them.
“That could not and would not happen in a pandemic. Why? Because (such workers) would be in their homes either handling the same dilemma or preparing to handle the same dilemma.
“In other words, a pandemic is different than anything we've dealt with before in terms of natural disasters. And consequently local preparedness will be of paramount importance…I will tell you straight out, no one in the world is well prepared for a pandemic. We're better prepared now than we were before, and we'll be better prepared in the future than we are now. But it's a continuum of preparation.”
Back in Arkansas
While Arkansas' poultry industry is well-tested, Wyrick continues to be concerned with backyard flocks.
“The commercial industry flocks are so well covered by the oversight of poultry companies that regulators have a lot of help. But the backyard flocks are a bigger challenge.
“So, we're continuing to do much testing of these flocks. We just finished another big round of tests with over 4,000 samples taken. That represents many, many birds. Testing is typically done on a couple of birds in one flock and then we move to another flock and test one or two more.”
Arkansas has been so aggressive in backyard testing “that USDA asked us to do an additional 460 tests. That takes a lot of labor when there are only a few birds tested in each flock. We're about 350 tests into that 460 and should be finished with that surveillance quickly.”
How are backyard flocks found?
“We have a testing school and many backyard flock owners apply for testing in certain poultry diseases. We already have a record of those flocks. Plus, we do surveillance in all flea markets. There are several of those around the state and that gets us into the heart of many backyard flocks.”
A third avenue of testing is county fairs. “We go and check exhibits. Those three things, along with our lab's necropsies on dead birds brought to our attention, give us lots of leads.
“And, quite frankly, the commercial industry is always interested in where backyard flocks are located. They're constantly giving us information, as well.”
Remember SARS or West Nile before it? Wyrick certainly does. “Remember, only a couple of years ago, there were huge concerns about those diseases. These were both introduced as major threats. Thank God they didn't cause what many were predicting.”
While H5N1 is “a real, justifiable concern and needs to be watched, there have only been around 100 deaths since this landed on the radar screen. Now, that is absolutely horrible for the families that lost loved ones and I don't want to downplay their grief.
“But in terms of a worldwide disease, that number of casualties isn't all that alarming. (In that time frame), how many more people have died from a minor wound that gets infected and isn't treated? We're constantly being confronted with threats. We have to take each seriously but must also not overreact.”