The discoordinated message on bird flu

Sometimes it's good to have a "coordinated message" and sometimes it isn't. The UN agencies dealing with bird flu certainly don't have a coordinated message and that's just fine with me. I don't trust anybody to have the right "message" and we're better served by each agency calling it as they see it. Even if the way the see it seems, well, distinctly odd:

Avian Flu Virus May Be Nearing End as Fewer Birds Die, OIE Says

The avian flu virus that threatens to spark the first pandemic in almost four decades may be nearing the end of its natural cycle after it killed fewer wild and migratory birds this year, an international veterinary body said.

Kuwait, Bangladesh and Ghana reported initial outbreaks of the H5N1 strain of avian influenza between late February and early April, according to the World Organization for Animal Health, or OIE. In comparison, 38 countries reported initial H5N1 infections in the first seven months of 2006.

"In the first half of 2007, countries reported fewer deaths of wild and migratory birds, which could indicate the disease is coming closer to the end of a cycle," the Paris-based group said in a statement today. (Bloomberg)

Here's a story, the same day (May 21), from the UN's Food and Agriculture Organization:

UN agency urges response to bird flu outbreaks in Bangladesh

The U.N. Nations Food and Agriculture Organization (FAO) Monday warned that the bird flu situation in Bangladesh remains serious and called for action to get it under control. "In response to recent outbreaks, the government and veterinary authorities have applied immediate control and containment measures in affected areas," said Joseph Domenech, the Rome-based FAO's Chief Veterinary Officer. "But there is an urgent need for vigorously stepping up and extending current H5N1 control campaigns in order to prevent the virus becoming widely entrenched."

Since the first officially announced avian influenza outbreak in Bangladesh in February, the virus has spread to eleven out of 64 districts, the agency said.

"Bangladesh has already prepared a National Avian Influenza and Human Pandemic Preparedness Plan and an Emergency Operational Plan to meet the threat of bird flu and is implementing these plans to control the disease," Mr. Domenech said, adding, "The situation remains of serious concern and will require further national engagement and coordinated international support." (AP/Pakistan)

In fairness to OIE, the FAO goes on to say Bangladesh has a real change to get the virus under control if it commits itself to a huge effort. So the two stories don't contradict each other. But the tone and emphasis are distinctly different. How much of that is the headline writer and reporter is hard to say, but those are the things that filter agency messages, so it doesn't matter in practice.

He said Bangladesh has a "real chance to get the virus under control, if it commits itself to a full-scale comprehensive national control campaign" and pledged FAO's assistance in this effort.

There have so far been over 280 confirmed human cases worldwide, more than half of them fatal, the vast majority in South-East Asia, FOA said. The so-called Spanish flu pandemic of 1918-1920, which also originated from birds, is estimated to have killed from 20 million to 40 million people worldwide.

Just a few days before this, WHO (another UN agency) confirmed 15 bird flu cases in Indonesia that had occurred during the hiatus in reporting three and a half months ago.

The 15 Indonesian cases, which include 13 deaths, push the global count of human infections to more than 300 since this outbreak of H5N1 began in late 2003. The global case count now stands at 306 confirmed cases, including 185 deaths, stretched over 12 countries.

The WHO statement announcing the development notes that seven of the newly confirmed cases were known to have been exposed to sick or dead poultry. No source of infection was found for the remaining eight cases. (Helen Branswell, Canadian Press)

Ten of the cases occurred in the month of March. Not exactly a slacking off. Then there's Vietnam, considered by many the model for bird flu control:

Bird flu has infected several duck farms in a central Vietnamese province, the third infection detected in the region in less than a month, local health authorities said Monday.

Tests found the H5N1 virus among the samples taken after some 400 ducks died in a farm in Nhan Thanh commune, Nghe An province on May 18, the local Animal Health Department said.

Other nearby farms also reported dead ducks in the following days. (Thanhnien News)

As far as we can see, things remain pretty much as they have been. Lots of virus in birds, especially poultry. Human cases still occurring at a reasonable clip. Mode of transmission unclear.

So maybe the OIE has it right. But I have some questions. What, exactly, is "the natural cycle" of a disease whose behavior we barely understand at all? And why does OIE think we know how to control it?