03 November 2005

Scared of the bird flu?

Until this week, it was beginning to look like the biggest obstacle to a workable strategy to anticipate the day when the avian flu mutates into something that can spread among humans was the anti-intellectualism of the Bush administration. But the other day even Bush conceded that the scientists might have a point, and he announced a strategy to do something about it.

The plan has myriad shortcomings, but it turns out that there remains a much greater threat from those who remain skeptical of the value of the scientific method. Over in southeast Asia, where bird flu is now a serious problem, and the most likely site for that feared genetic mutation, the prevalence of superstitions could be undermining what little effort exists to "block bird flu at its source," as the New York Times reports today in a frightening article.

The Times only allows you to read its new stories for free for a week, so check it out now. The main thrust of the piece is Cambodian villagers, mostly subsistence farmers with next to no education, tend to rely on non-rational explanations for disease, rather than trust medical experts. Under most circumstances this would be a tragic, but local problem.

But, as reporter Keith Bradsher writes:
If the disease does make the jump from transmission by birds to person-to-person transmission, the crucial question will be whether the first few cases can be isolated quickly. If not, frightened people nearby could start fleeing, carrying the disease to big cities and then around the world by jet...
Then we would be big trouble. And Bradsher doesn't paint a very optimistic picture when it comes to that very scenario. He relates the story of a recent outbreak of what medics diagnosed as run-of-the-mill influenza, which can be deadly in poverty-stricken communities, but is not nearly as threatening as avian flu. He writes:
Some blamed bird flu and took their weakened children to a clinic in a nearby provincial city, where a medic diagnosed human influenza instead. But other residents said it was witchcraft by the only village resident not born here, 53-year-old Som Sorn, who moved here eight years ago when she married an elderly local farmer.When Mrs. Som Sorn's husband went into the jungle to cut wood one afternoon and she began cooking rice over a fire on the dirt floor of her hut, a local man with a machete took action and later collected $30 in donations from grateful neighbors, a month's wages.
The good news is the assassin was caught and sentenced to 15 to 20 years in prison. The bad news is superstition still holds sway in rural Cambodia:
Besa Korn, a 51-year-old village resident who was not among those making donations to the killer, said the true cause of the summer illnesses might never be known. But life has clearly improved since Mrs. Som Sorn's death, she added. "Everyone in the village has been very happy since then," she said. "And we have had no more illness."
Nipping the avian flu in the bud will be nearly impossible if the first victims of a mutated strain react this way instead of seeking the help of those understand the true nature of the virus. But the fact is, the chances of wiping out the superstitious belief system is probably even less than the chance of eliminating the disease.

And let's not get smug about our own society. New Scientist just reported on attempts to take advantage of avian flu fears by those who prey on westerner's weakeness for snake oil:

Even worse are the herbal remedies claiming to "prime" the immune system to increase the effectiveness of Tamiflu, or to treat the symptoms of avian flu itself. "Show me the hard evidence for these claims and I might believe it," says Karl Nicholson, an expert in infectious disease at the University of Leicester, UK.
We have to get past this sort of nonsense. After all, we don't have decent stocks of the only vaccine that might prove effective. Even the anti-viral drug Tamiflu, on which Bush's plan relies, may not do the trick. And don't get me started on Tamilflu's sole manufacturer, the Swiss pharmaceutical giant Roche, which has until recently resisted calls to let other companies copy the drug because there's no money in it for them.

Clearly, we've got enough problems in the so-called developed world, without having to worry about sorcerers and curses.


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