Bird flu: Don’t panic, be ready
By Kumudini Hettiarachchi
Turkey has it now. So does Indonesia. Sri Lanka seems to be getting hemmed in.

Will we or won’t we be hit by bird (avian) flu? If it does invade our country are we ready? Like in other countries if the H5N1 virus jumps from birds to humans how will we tackle it?

These are the crucial issues being tackledby both the Epidemiology Unit of the Health Ministry and the Department of Animal Production and Health.
“Sooner or later we will get it. How soon is the issue,” warns Epidemiologist Dr. Nihal Abeysinghe.

Stressing that there is no cause for panic, Dr. Abeysinghe however strongly urges that Sri Lanka should be ready to face such an eventuality. In the latest outbreak of the H5N1 virus in 2005/2006 January, of the 164 people who contracted the disease in 12 countries, 81 have died.

“The avian flu surfacing in Turkey and Indonesia has caused considerable concern to us,” he says, explaining that the Epidemiology Unit which has taken on the responsibility of managing the human side of the problem is attempting not to take any chances.

Two consignments of protective gear, 100,000 kits in all, have been brought down. The kits each comprising a pair of goggles, a mask, an apron and a pair of gloves are being distributed to hospitals around the country. “The Infectious Diseases Hospital (IDH) has already been given protective gear and we are distributing the others to 20 ‘sentinel sites’,” says Dr. Abeysinghe pointing out that these sites which will double up as surveillance units include all the Colombo group of hospitals such as the National Hospital, Kalubowila, Ragama and one each from different geographical regions such as Jaffna, Karapitiya, Vavuniya, Nuwara Eliya and Polonnaruwa.

“We have had bad experiences before. When we wanted stocks at the height of some crisis we have not been able to get them, so we are getting ready now,” he says. According to him some private sector organizations including a well-known global bank and international agencies have already got down protective gear for their personnel.

All hospital directors and Deputy Provincial Directors of Health have also been sent a checklist and requested to prepare contingency plans. “We will be reviewing these plans by end January,” he says.

The contingency plan would deal with such vital aspects as accepting at OPD level patients suspected to have contracted the H5N1 virus, detecting whether they are having the disease, isolation and management, and thereafter restriction of hospital use and transfer of critically ill patients.

The Regional Epidemiologists have also been sensitized to pass on the message not only to their health staff but also to institutions in their area and the public.

The IDH, however, will have a separate emergency plan. “We have equipped them and trained the staff. The World Bank has agreed to support the development of this emergency plan and we will coordinate with the hospital staff, the running of the emergency room, intensive care and isolation room,” says Dr. Abeysinghe.

Anti-viral drugs have been ordered initially for 1,000 patients. Stocks are being awaited in two months as only one company in the world is producing them. The Epidemiology Unit, having secured funding from the World Health Organization, has also requested the Medical Supplies Division to order laboratory reagents needed for testing the human virus at the Medical Research Institute.

“The virologist at the MRI who does the testing and one technician worked with Prof. Malik Sriyal Peiris — who was part of the team that identified the SARS virus — in December for one week when he was here on holiday. In February they will undergo more training in Hong Kong,” he says.

Some final advice from Sri Lanka’s Chief Epidemiologist is not to panic. “Don’t fear to eat chicken and egg because egg is the cheapest way of getting the body’s protein requirement.” The moment we identify the avian flu virus in the country, we will inform the people, Dr. Abeysinghe assures.

Keeping a close tab on the region
A sub-regional conference on the avian flu is due to be held in New Delhi, India on February 7 and 8, with Health Minister Nimal Siripala de Silva, Livestock Minister C.B. Ratnayake, Epidemiologist Dr. Nihal Abeysinghe and Director General of the Department of Animal Production and Health Dr. S.K.R. Amerasekera attending.

“We want to keep a close tab on what is happening in neighbouring countries,” says Dr. Amerasekera. In Sri Lanka, he says, normal surveillance is being carried out for the bird flu virus among animals.

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