China faces long struggle to contain bird flu

BEIJING, Mar 16: China faces an uphill struggle to contain bird flu ahead of an expected spike in infections during spring, hampered by surveillance problems, ignorance and the country's sheer size, health and government officials said.

Though China is taking the health risks seriously and has learnt its lesson from SARS, when an initial cover up of the respiratory disease in 2003 led to panic, much work remains to be done, they said.

Few doubt the seriousness of the situation, especially as Spring is arriving and migrating birds, some of them believed to be carriers of the H5N1 avian flu virus, are heading back north to their summer nesting grounds.

China's agriculture minister, Du Qinglin, last month warned of a ''massive'' threat from bird flu in a country where 10 people have died from the H5N1 strain and there have been more than 30 poultry outbreaks in a dozen provinces in the past year.

''Now the virus is becoming crazy. The virus is becoming unpredictable,'' said Noureddin Mona, the Food and Agriculture Organisation's (FAO) representative in Beijing, referring to bird flu's rapid spread in recent weeks deep into Europe, Africa and other parts of Asia.

''They are doing their best,'' he added, speaking of China's efforts to contain the virus, which has killed about 100 people in Asia and the Middle East since 2003.

Yet experts say with only half of China's population able to afford health care, sick people might not even go to a doctor, which could mask human cases.

''The surveillance system depends on people showing up in hospitals or health care centres. The Ministry of Health recognises this is an issue,'' said Julie Hall, who oversees the World Health Organisation's fight against bird flu in China.

''But they admit investigative capacity at the grass roots level does require strengthening,'' she told Reuters.

Human cases now being reported in areas with no apparent poultry outbreaks is another concern. For example, earlier this month experts began questioning if apparently healthy but infected birds might be the culprit when a man died in southern Guangdong province after visiting several poultry markets and an abattoir to carry out a market survey.

''Essentially it is human cases that are triggering investigations to find animal cases,'' Hall said. ''We need to raise public awareness and include the message that die-offs (of birds) can be small.'' The H5N1 virus remains hard for humans to catch from infected birds. But scientists say it is not yet fully understood how the virus spreads nor do they know all the species of birds it can infect.

Some species of waterfowl can act as carriers and don't show any symptoms. But recent studies also showed that a small percentage of healthy chickens, ducks and geese in southern China were infected with the virus, increasing the risk to humans.

As the virus spreads in China and elsewhere, fears are growing H5N1 could eventually mutate into a form that passes easily from person to person, sparking a pandemic that could kill millions and cripple the world economy.

China's remote, poor, western province of Qinghai is a case in point for how hard it will be to control bird flu in the world's most populous nation.

Last spring, an H5N1 outbreak in Qinghai killed thousands of migratory birds and marked the beginning of dozens of outbreaks of the virus in poultry and wild birds across parts of China.

Qinghai is on a major route for migratory birds, which pass over the province on their way to and from India and spend time at Qinghai Lake, China's largest.

The government has set up special monitoring stations by the lake, but migratory birds come under the purview of the forestry department and not the agricultural ministry in China.

''They have complained they lack technical expertise,'' said the FAO's Mona. ''Monitoring is not an easy job, but what they are doing is better than nothing.'' Local authorities say they have mobilised thousands of people as part of an intensive education campaign, going house to house and using television, radio and posters to spread the message, but admit controlling bird flu will not be easy.

''Our biggest problem is all the migrating birds that come from all over the world to Qinghai Lake, and it's harder to do prevention work on this aspect,'' Li Yulan, a delegate to this month's annual parliamentary meeting, told Reuters.

In northern Hebei province, which has yet to report either human or poultry flu cases, local governments have set up teams to go into villages, especially those that raise poultry on a large scale, and spread the prevention message.

''Bird flu is in itself not scary,'' said Wu Xianguo, mayor of Hebei's Shijiazhuang city. ''What is scary is if there is a lack of importance attached to it, or lack of knowledge.''

REUTERS