Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Bird Flu Challenges
- Robert Kahn, Warrington WA5 2BJ (13 February 2007)
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Bird flu: priority for handling rumours and the weak
- Dr. Rajesh Chauhan, Shruti Chauhan, Shivendra Pratap Singh Chauhan, Sandeepa Chauhan. (14 February 2007)
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Robert Kahn, Co-ordinator, Avian Flu Action 40 St Stephen Road,, Warrington WA5 2BJ
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Your Editor's Choice, "Bird flu and transparency," rightly indicates that risk management for pandemic flu is highly problematic in terms of evaluating and distributing antiviral drugs. How effective either individual drugs or combinations of antivirals will be against different strains of H5N1 is not yet clear. Three further challenges await: (1) Can veterinary and human medicine be sensitively integrated in the search for vaccines against the emerging strains of H5N1, both for poultry and people? (2) How will the conflict between intellectual property rights and the need to develop a vaccine quickly be resolved? and (3) Will the rich nations recognise that in an interdependent global society the best health protection policy for the rich lies in helping the poorer nations to confront the spread of H5N1? Competing interests: None declared |
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Dr. Rajesh Chauhan, Consultant, Family Medicine, Communicable Diseases, Health & Hospital Administration Commanding Officer & SEMO, MH Baroda (Chauhan Medical & Research Centre, 309/9 A.V. Parishad, Sikand, Shruti Chauhan, Shivendra Pratap Singh Chauhan, Sandeepa Chauhan.
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Dear Editor, Rumours are rife about bird flu [1]. It must not be seen as if the inevitable doom is fast approaching. More than the bird flu per se, it is the rumours that can cause more harm. People all around are eager to catch on every tidbits and news on the latest developments on this score [2]. Not wanting to be sitting ducks, the clever may have already started taking proactive actions to fend against the doomsday, including stockpiling of antiviral drugs. Some Governments would likewise be stockpiling various antiviral drugs [3] or they may be forced to take similar proactive measures by public outcry or public demand, despite it being impossible to predict which drugs will be effective against the new pandemic strain of influenza that would be on the front at that point of time [4]. Panic and anxiety can be highly infective, much more than the H1B5 virus, sufficient to push the sales of antiviral drugs that may start selling faster than hot cakes and the multivitamins. For the developing world which already has its hands full with multitude problems, ‘bird flu’ would just be an extra burden to survive with, while having to divert some of their meager resources towards the cause of bird flu. Mankind has witnessed many pandemics having come and gone. Perhaps this one would be no different. Each and every new case may not be severe or life threatening as the severity of illness would depend on many different factors. Moreover, many persons would already have developed certain amount of immunity through undetected and undiagnosed clinical or sub-clinical infections. Sooner or later this pandemic would surely burn out to return some decades later. In the interim and thereafter too, there could be so many other ways as given in ICD (International Classification of Diseases) that a person may suffer from. Therefore must we start panicking for thousand different reasons as each of the listing therein can be potentially fatal? Notwithstanding their wanton culling, for all we know, the birds may be having a good time by having convincingly frightened the man. We do not intend to sound like being advocating complacency. Prophylactic measures must be instituted and re-emphasised. As is usual in any pandemic, the weak are the ones who will suffer the most if and when the bird flu strikes. Therefore the old and infirm, pregnant or nursing mothers and the young are to be specially protected, including timely vaccination. Furthermore, protection and support would also be required for the immuno-suppressed and their contacts [5]. Public has to be educated about the measures to check and prevent aerosol spread and the value of quarantine (forced or self imposed). Tips on self-care need to be disseminated and to be encouraged. Congregations as well as travel may have to be restricted in the affected areas. FLEXIBLE policy guidelines on prophylaxis, admissions/ discharges, and use of anti-virals and antibiotics will have to be formulated and disseminated. BMJ would surely want to dispel the notion of doom and help in setting the perspectives right. Warm regards. References: 1. Bonneux L, Damme WV. An iatrogenic pandemic of panic. BMJ 2006; 332:786-788. 2. Mayor S. People exposed to H5N1 in English turkey outbreak get antiviral and vaccination. BMJ 2007;334:275 3. Godlee F. Bird flu and transparency. BMJ 2007;334 (10 February), doi:10.1136/bmj.39119.594676.43 4. Tsiodras S, Mooney JD, Hatzakis A. Role of combination antiviral therapy in pandemic influenza and stockpiling implications. BMJ 2007;334:293-294 5. Chauhan R. Urgent course corrections needed for HIV management in view of the threat posed by flu pandemic. eCMAJ 16 Jan 2006. http://www.cmaj.ca/cgi/eletters/173/11/1311#3523 Competing interests: None declared |
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