Press Centre 2006/02/02 (2): Health

Selami survives bird flu -- but the threat is not over yet

Bernard Kennedy

Şanlıurfa/Ankara, 2 February, 2005 -- Selami Baş sits cross-legged on the low cushion which constitutes the only furniture in the small main room of his home in Yakubiye, an impoverished neighbourhood of the historic city of Şanlıurfa in Southeast Turkey. A shy, brown-haired four year-old in a red pullover and denim jacket, he plays constantly with his fingers while a dozen other boys chase up and down the steep, stony alleyway outside. Selami is unique: the only person in fast-growing Şanlıurfa province to have contracted the avian influenza virus which has been sweeping the country. And he is lucky to be alive.

Selami developed a slight cough and a temperature on January 6 this year while he and his father were staying with his grandfather’s family in a village some 80 kilometres east of the city. He complained of a sore throat and stomach ache. His father Mehmet Baş, a construction worker, decided to take him directly to the state children’s hospital in the city.

It was about 9 in the evening when they arrived. Hospital staff knew that dozens of cases of bird flu had been reported among poultry across Turkey within the previous two weeks. They were also well aware of the growing number of reported cases among humans, mainly children. Within the previous two days, three children from Doğubeyazıt in the mountainous Northeast of the country had died of the disease.

Despite the religious holiday, doctors were working round the clock to evaluate a rising number of suspicious cases. It did not take them long to discover that Selami had been playing with the chickens kept by his grandfather’s family. They began administering the drug Tamiflu, and dispatched blood samples to a testing laboratory in the capital Ankara. Two days later, the samples tested positive.

Within two weeks, Selami had been discharged from hospital, fully recovered. Bird flu attacks the respiratory system in human beings and has generally proved fatal except when treated within the first 48 hours. Unlike some parents with children showing flu-like symptoms, Mehmet Baş took the matter seriously, knew where to get treatment, and trusted doctors’ advice to keep his child in hospital. Since he was eligible for social security, he did not worry about how much his son’s treatment might cost. In fact, treatment for suspected cases of bird flu is free in Turkish hospitals.

Lives still at risk

In the village where Selami’s grandfather lives with his family of fifteen, all the turkeys and chickens have been culled, like thousands of others in the province and around 1.6 million domestic birds in Turkey as a whole. Scared of the disease, children here say they would not want their chickens back, although their eggs provided a much-needed extra source of protein. The village population of 30-40 families has been kept under observation, but no other cases have been detected.

For the Şanlıurfa authorities, life is returning to normal. The number of people applying to hospitals out of concern about bird flu has slowed to a trickle. Likewise, fewer dead birds are being reported to the agriculture directorate or the municipality. Nationwide, the number of confirmed cases among human beings remains at 12. A total of four children, three of them from the same family, died from the disease in early January after direct contact with diseased poultry, but since then there have been no further fatalities.

Nevertheless, reports of further outbreaks of the disease among birds continue. In rural areas and back streets, millions of families continue to keep small numbers of chickens, turkeys, ducks or geese. The poultry are often free to mingle with other birds and animals. Typically, they are fed and watered by children who also play with and around them. In most parts of the country, the cull has been selective, notwithstanding the rapidity with which bird flu can spread. In provinces like Şanlıurfa, hygiene is not good, and even some schools may lack soap and water. Unlabelled, unpackaged chicken meat is still being sold in the bazaar, with no guarantee that the source is safe. Moreover, the migratory birds, believed to have introduced the virus in the first place, will be crossing Turkey again by March, this time on their way north.

A global dimension

Members of the Baş family complain that their neighbours are shunning them, and telling their children to keep away from theirs, on the grounds that they have bird flu. This is not only unpleasant; it also points to low levels of awareness about the disease in birds and humans. Similarly, there is concern along the Mediterranean coast that foreign tourists will stay away from Turkey this summer, hitting employment and the economy. Modern poultry plants have already suffered badly as the general public has dramatically reduced its consumption of chicken and eggs.

The greatest threat of all, in Turkey as elsewhere, is the possibility that a strain of avian influenza will emerge which is capable of being transmitted from human to human as easily as the seasonal flu. Some scientists believe that this would cause pandemic flu, which could affect up to a quarter of the global population.

For more information

Angela Hawke, UNICEF CEE/CIS, Tel: +41 (0)22 909 5433

Sema Hosta, Communications Officer, UNICEF Turkey, Tel: +90 (0)312 454 1010

Canan Sargın, Health Programme Officer, UNICEF Turkey, Tel: +90 (0)312 454 1006

Find out more about avian influenza or bird flu from the WHO international web site.

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