Say Yes, Spring 2006: A Natural Threat

Three young women listen to advice about bird flu

UNICEF Health Project Assistant, Sumru Kutlu talks to women in Şanlıurfa, Eastern Turkey about the hazards of bird flu.
Photograph by Oğuz Sağdıç © UNICEF Turkey 2006

Worldwide concern about a potential pandemic of avian influenza or bird flu grew when the H5N1 virus finally reached Turkey and the borders of neighbouring Europe during mid-winter.

A POTENTIAL PANDEMIC

The H5N1 strain causing the bird flu epidemic is a type A virus which occurs mainly in water fowl -- especially ducks. Being generally immune, ducks are ideal carriers as they infect other birds which in turn spread the disease through their natural migratory patterns. H5N1 has a mortality rate of between 90 and 100% amongst birds where symptoms appear within hours of infection, followed by death at any time during the subsequent two days.

Type A viruses are particularly dangerous to humans, causing regular epidemics of respiratory illnesses. Because type A viruses can easily mutate -- that is change their genetic code -- the World Health Organisation (WHO) has been concerned for some time that H5N1 could mutate suddenly and produce a strain to which humans might be prone, causing a pandemic with a potential loss of millions of lives worldwide.

Accordingly, WHO is coordinating a global epidemic and pandemic alert response on the premise that the feared mutation might just as well occur overnight as it might never happen.

The concern that the virus might present a significant global health issue has been growing since 2003 when the first cases of human infection were reported in Vietnam. Since then Vietnam has reported 93 cases to WHO -- 42 of which resulted in mortality. By November 2005, bird flu was known to have spread to domestic fowl in most of Asia with China reporting 8 deaths out of 12 cases of human infection, followed by 36 deaths around that time in Cambodia, Thailand and Indonesia where a total of 51 cases were reported.

Fortunately, the virus has as yet been unable to mutate and achieve sustained person to person transmission which would allow it to follow the seasonal pattern of ordinary human flu and threaten millions of lives -- especially children and elderly who are most susceptible, having less resistance to infection.

Nevertheless, UNICEF is concerned that children already account for roughly 50% of human cases and 30% of mortalities so far. A pandemic could result in massive child mortalities and the disruption of the daily routine of millions of others.

Poultry is also an important source of protein for families of low-income and the loss of this important nutritional element could have disastrous consequences for millions of children and their families the world over.

Four-year-old Selami Baş was fortunate to survive a bout of bird flu thanks to his quick thinking father, Mehmet, who sought medical attention at the first sign of symptoms
Photograph by Oğuz Sağdıç
© UNICEF Turkey 2006

BIRD FLU REACHES TURKEY

The virus was known to have reached Turkey in October 2005 when 1,870 birds were culled following an outbreak at a farm in the Province of Çanakkale.

It was not until January this year, however, that the first cases amongst humans were reported with four mortalities -- all of them children. Three of the children were from the same family in Doğubeyazıt in the Eastern Province of Ağrı. Mehmet Ali Koçyığıt, 14, and his older sister Fatma, 15, both died the week before the important public holiday of Kurban Bayram and their younger sister, 11-year-old Hulya, died a week later.

There was no evidence of person to person infection in the Koçyığıt household: the children are believed to have had prolonged contact with blood products whilst slaughtering chickens.

The initial Government response to the outbreak amongst humans was swift, involving a cull of poultry in four eastern provinces.

Risks to children were compounded by a lengthy three week school holiday that coincided with the outbreak. It was expected that many families would be keeping birds indoors at the time to protect them from the harsh winter snows and fears were high that prolonged exposure to infected birds would result in further cases of human infection -- especially amongst children.

An inter-sectoral communication task force was set up immediately between Government ministries, UN agencies including UNICEF and civil society organisations such as the Turkish Red Crescent in order to coordinate response to the outbreak.

One of the first duties of the task force was to launch a campaign providing clear messages on how to avoid contamination from potentially infected birds. The major points that the Task Force sought to get across to the families and children were illustrated on a simple public information poster:

Keep children away from poultry and other birds.
Report sick or dead birds to your local authorities immediately.
Seek immediate treatment if you fall sick after contact with sick or dead birds.
Avian flu treatment is free.
Soap kills germs -- wash your hands with soap and water frequently.
Cook eggs and chicken thoroughly at a high temperature.

The Ministry of Health circulated copies of this and other communication materials to health centres throughout the country.

Concern for the welfare of children has since remained high: children in rural areas of Turkey are often responsible for rearing birds, cleaning their pens and collecting eggs. Older boys are traditionally expected to slaughter the birds while their sisters pluck and prepare the carcasses for cooking. Younger children often treat poultry as pets and play with them.

UNICEF has since been working with the Government to develop the communication strategy in preparation for further potential outbreaks.

BIRD FLU CONTINUES TO SPREAD

Two cases of bird flu in neighbouring Iraq have been reported to WHO since January -- both mortalities. WHO also announced seven cases in Azerbaijan in March -- five of whom died. The virus has since spread to Europe although there have been no cases of human infection. The death of a domestic cat in Germany, however, has heightened fears that H5N1 might yet find a route to humans via species other than birds.

Africa’s first case was confirmed on a poultry farm in Nigeria on the 8th of February, followed by further outbreaks in Niger, Egypt -- where a woman died following infection in mid-March -- and Cameroon.

Read Selami’s story in our Press Centre.

This poster was produced by UNICEF, the MOH and other partners to promote the six easy steps that children and their families should take to protect themselves from bird flu. Print-optimised versions are available for download in the following standard formats [PDF 1.9MB approx.]:

Previous page |

Skip to the page footer menu or select an item from this list ▼

SAY YES, SPRING 2006

Download this issue in pdf format. [PDF 1.3MB]

* How to use RSS …