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Mass Inoculations for Bird Flu Challenge China's Capabilities

Posted on: Thursday, 1 December 2005, 18:00 CST

By Howard W. French

Five men on battered motorcycles pulled up at this roadside village from a nearby town and summoned the local headman.

Wearing ordinary clothes and bearing boxes of vaccine from two separate manufacturers, they worked their way from house to house, about 300 dwellings in all, to vaccinate every chicken, duck and goose in the hamlet.

For the rest of the afternoon, the members of the small team took turns, some briefly explaining the process to the villagers whose courtyards and homes they entered, others rounding up the fowl and still others working their syringes, sticking the birds one by one. For the most part, they did not take the most basic hygienic precautions, like wearing surgical gloves or masks.

"We set out each morning at daylight, and we stop when we can't see any more," said Shen Dianchun, a livestock extension worker whose work over the previous 10 days had taken him up and down the tree-lined two-lane road that cuts through prime farmland in Anhui Province. Shen estimated that his team, one of thousands like it, handles about 600 birds on a typical day.

Their task, part of a crash effort to inoculate nearly all of the country's domesticated birds against avian flu, is daunting, given that China claims a domesticated population of about 14.2 billion birds, according to Agriculture Ministry statistics. The mass vaccinations illustrate both the high priority China has placed on preventing the disease from leaping from birds to humans and the immense challenges involved, including the possibility that the rural health workers themselves might spread the virus.

China is also worried about its credibility, which was badly tarnished in the outbreaks of severe acute respiratory syndrome, or SARS, in 2003, which the authorities initially tried to cover up.

International experts say Beijing's official figure of only two human deaths from bird flu is suspiciously low: Some speculate that dozens or even hundreds may have died already.

Since September, when the recent outbreak of avian flu was first acknowledged, the Chinese authorities have increased production of bird flu vaccines at nine plants around the country, which are operating around the clock. Agriculture Ministry officials estimate that more than 100 million doses are being produced daily, and teams like the one in this village are busy throughout the country. According to Chinese news reports and interviews, the vaccination drive is proceeding relatively well in places with large poultry industries. In the countryside, however, among China's peasantry, the vaccine is reportedly in short supply, despite the huge production.

Typically, workers on the vaccination campaign have little epidemiological training and, like the ones in this village, take virtually no precautions, even to protect themselves against the disease.

Toward the end of the afternoon, when the presence of foreigners in the village drew the attention of local officials, the vaccination team donned white smocks for the first time but continued to handle the birds barehanded and without masks. After inoculating the geese in one dusty courtyard, the team discarded its used needle on the ground and walked away.

China is estimated to have 640,000 to one million villages where birds are raised in close proximity with humans, making any effort to sustain a twice-yearly vaccination campaign something akin to fielding an army of extension workers, veterinarians, doctors and other public health experts.

Source: International Herald Tribune

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