Some Facts On Turkey And Avian Flu

As everyone keeps saying, the important thing in circumstances like these is not to panic. But the best defence against panic is information, and after that knowledge. So here goes:

1/. The flu virus was actually first detected in the laboratories of the Turkish Agriculture Ministry on December 9 2005, despite the fact that a ministry statement on the same day denied the existence of the disease in Turkey. So when I implicitly questioned the Turkish Health Ministry version in this post on 2 January it seems I was right to be sceptical.

2/. Nearly 100 people are currently receiving treatment in suspected bird flu cases across Turkey. Since there have only been 142 confirmed cases across the globe since the H5N1 strain was first identified in 2003, the New York Times is undoubtedly right to suggest that the flu is spreading faster than expected.

3/. Elizabeth Rosenthal of the NYT is however not quite right when she says that “the Ankara cases have the most alarming implications because….. it is a relatively well-off area, where it is not the norm for humans and animals to live under one roof. ” This is a misunderstanding, since on the outskirts of Istanbul there is a large Kurdish migrant population, which basically lives in shanty towns, and in shanty towns people often keep their own hens:

Five of eight chickens owned by Ramazan and Muhittin Mentes, living in a shanty house in Ikitelli, Istanbul, reportedly died one by one after the New Year. Members of the Mentes family who ate the remaining three sick birds last Tuesday were taken by ambulance to hospital after neighbors notified officials. Members of the Mentes family immigrated to Istanbul from the Baykan district of Siirt, a southeastern Turkish province, two years ago, and have been earning a living selling lemons in the street markets.

There is a blurring of boundaries here, since many of the people affected may simply live outside the formal limits of Istanbul. However, according to this article:

The Governor of Istanbul has announced quarantine measures will be applied in the areas of Istanbul within a three kilometer radius of regions where poultry samples tested positive to bird flu.

4/ The shanty-town structure is important, since it means the bird/human interface is much larger, and thus the possibility of transmission much greater. The speed of the spread may thus not be a function of virus mutation, but rather of the high ratio of birds to humans in some areas.

There is still no evidence whatever of human/human transmission, although obviously the more human cases there are, the higher the possibility of this ocurring. The most important objective, IMHO, should be to eliminate this outbreak before a more normal human flu strain arrives, since this would provide the ideal host for the kind of mutation that none of us want to see happen.