It's winter in the northern hemisphere — flu season for people and birds. Sure enough, bird flu has recently flared up in eight countries in Asia and the Middle East.
The World Health Organization fears that with a few mutations, the bird-flu virus H5N1, could touch off the next global flu pandemic. But WHO Director General Margaret Chan says the world is years away from controlling it.
"Countries have made heroic efforts," Chan told WHO's executive board this week. "Yet the virus stays put or comes back, again and again."
No country has done more to control bird flu than Vietnam. Mass vaccination of poultry — often door-to-door — and educational programs down to the commune and village level have paid off. Vietnam had no reports of bird flu in 2006.
At the Viet Doan Commune, not far from Hanoi, several hundred farmers and their families crowded into a community hall to hear about preventive measures. Singers entertained them with traditional music, and the farmers watched skits that showed the importance of washing hands and cleaning poultry cages. Posters and banners drove the messages home. For instance, one sign advised farmers to inform the local authority if their flocks have bird-flu symptoms.
Still, the battle isn't won, especially this time of year.
"This is the season that everybody's concerned about," says Don Douglas, a consultant with Abt Associates, based in Hanoi. "Everybody holds their breath in the avian-flu community with each passing flu season."
And this month, bird flu did come back in Vietnam. So far in January, there have been at least eight large outbreaks, all in the Mekong Delta in the south.
The nation's 40 million ducks are mostly to blame. Ducks can spread the virus without showing symptoms. And a moratorium on duck-hatchings didn't work. Neither did orders to keep ducks penned up and out of rice paddies, where traditionally the birds are used to fertilize the rice, and to clean up leftover grain after harvests.
"Rice production and duck raising have gone hand-in-hand for hundreds of years," says Dr. Juan Lubroth, the lead bird-flu expert of the United Nations' Food and Agriculture Organization.
These ancient practices are hard to change, especially when they run counter to farmers' economic interests. Lubroth says the ban on duck-roaming made some farmers cover up the fact that their flocks were on the loose. Because the ducks weren't registered, they didn't get vaccinated against bird flu.
"What has happened with the ban," Lubroth says, "is those ducks are, let's say, 'underground,' are not vaccinated and thus are not protected. And that's where we have seen the outbreaks of late."
But a much bigger problem is growing in Indonesia. Last year, Indonesia surpassed Vietnam in the number of humans who have died from bird flu: 62.
Many bird-flu authorities say Indonesia has been slow to respond to bird flu. But after five new human cases, and four deaths this month, Indonesia authorities say they'll ban the raising of backyard poultry in Jakarta, the capital, and eight provinces.
But Lubroth predicts Indonesia won't be able to stop people from keeping backyard poultry.
"It will still continue to occur, even though there is a ban," he says. "So it's better for it in some ways to be out in the open and have positive measures, such as improving hygiene, awareness, veterinary inspection at the markets, vaccines delivered to the villages or urban areas where these backyard chickens are being raised."
Implementing such measures is a daunting task – especially in a country like Indonesia that is sprawled among 13,000 islands and three time zones.
So Keiji Fukuda, the WHO's global flu coordinator, says there may be one useful aspect of continuing outbreaks of bird flu, at least among poultry. They keep people motivated when prevention measures become an endless daily grind.
"I think that the presence of avian influenza outbreaks has been an important spur," Fukuda says. "If there's a silver lining, that's it, I guess."
The Vietnamese don't need a spur.
"Avian influenza is a very big concern of my family," says Nguyen Van Tikh, who has a prosperous farm with more than 1,000 chickens and ducks in Bac Ninh Province in northern Vietnam. "We invest quite a lot of capital in our poultry. And avian influenza is happening every year in the world."P>
It's also a big concern for Bui Quang Anh, the chief animal-health officer in Vietnam's Ministry of Agriculture and Rural Development.
Even before the latest outbreaks, Anh was worried about prevention fatigue. His concern is peaking right now, in the weeks leading up to the lunar new-year celebrations called Tet in mid-February. That's when many Vietnamese travel to ancestral villages, often carrying cages of live chickens to prepare the traditional Tet banquets; it's a good way to spread bird flu.
"In the Tet holidays, it's not so easy to control the live chickens," Bui says. "There's a lot of transportation of chickens. Before the Tet holiday, we implement very serious vaccination programs."
But as the recent outbreaks show, there are still plenty of unvaccinated birds out there.
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