Bird flu is not a rare phenomenon. Normally, there are 15 virus strains out of which H5 and H7 strains cause epidemic to poultry, and which is usually fatal. The recent H5N1 strain is more virulent in birds and is killing migratory birds too. During the bird flu epidemic in 1997, the first human case was established in Hong Kong with identification of H5N1, which killed six out of 18 persons in close contact with live infected birds. Immediate action by culling 1.5 million poultry averted a big outbreak in human beings. It proved the capacity of H5N1 to jump the species barrier from bird to humans. Similar incidents occurred in some South East Asian countries and over 60 people have died in Vietnam, Thailand, Cambodia and Indonesia.

The global situation can change any time with mutation of one strain of bird flu with that of human flu. This new virus would then contain enough human genes to enable transmission from one person to another faster. This would mark the beginning of influenza epidemic worldwide estimated to kill five to 150 million people.

What can Nepal do to protect its citizens? Bird flu has not yet struck Nepal and precautionary measures are underway. Strict vigilance is essential. The most important step is to create awareness with active media support. Guidelines must be issued about precautions like avoiding visit to poultry farms, eating well-cooked meat and eggs only of healthy birds, using handkerchief while coughing and sneezing, etc. It may be necessary to register all poultry farms for surveillance.

All stakeholders including private sector, poultry farmers, civil society organisations active in health and animal husbandry must be fully involved during the preparation of a time bound preparedness plan by the government’s task force for implementation, inclusive of WHO-recommended strategic plan to respond to the pandemic threat. The task force should be fully authorised to take necessary measures like immediate destruction of domestic poultry with proper disposal of carcasses and imposition of strict quarantine measures and disinfection of poultry farm if an outbreak is suspected. There must be very close working relationship between the health and animal husbandry sectors. Further, full community support is necessary.

All persons exposed to infected poultry should be put under vigilance. Flu-like symptoms — fever, muscle ache, sore throat, cough, etc. — must be taken seriously. Administration of antiviral drugs such as Tamiflu can slow or stop the spread of H5N1 strain. Besides, its rapid distribution to 20,000 individuals nearest to those infected is necessary soon after the virus is identified. Fortunately, Cipla, an Indian pharmaceutical firm, has lately announced manufacturing and sale of Tamiflu to developing countries.

In countries like Nepal, financial resources of poor farmers should also be considered as they should be adequately compensated for any eventuality. Nevertheless, the initial initiative must be taken to control bird flu from spreading.