Thailand in January 2004, officials adapted the country’s established emergency response plan, which specifies chains of command and communications, to address the threat (see Buranathai in Chapter 2; Buranathai, 2004).

Approximately 75,000 cloacal samples from poultry in every village in the country were tested for the virus within a 2-week period, followed by culling and disinfection of the 160 premises found to be infected. In addition, all poultry within 5 kilometers of each of the infected farms were preemptively culled, and the movement of all poultry within a 50 to 60 kilometer radius was controlled. A second round of active surveillance and culling was performed from mid-February through early March, when the epidemic was deemed to be under control. The country then reverted to passive agricultural surveillance while maintaining active clinical surveillance for human cases. Thailand is currently investigating the possibility of using vaccination against future avian flu outbreaks. The country has the necessary manufacturing capacity, but at present prohibits livestock vaccination due to the aforementioned risks.

Thailand’s generous emergency compensation policy, also in place prior to the recent epidemic, became even more generous in response to farmers’ losses (Buranathai, 2004). Rather than the standard 75 percent of market price, farmers whose infected flocks were culled received their full market value. This strategy backfired, however, when struggling farmers infected their flocks so as to recoup losses sustained as a result of decreased demand for poultry products. While many workshop participants identified compensation for farmers’ losses as a key strategy in the control of avian influenza, this example highlights the difficulty of designing a compensation policy that truly supports the goal of infection control.

The Puzzling Present and Worrisome Future of Avian Flu

In addition to the Asian epidemic, unprecedented numbers of outbreaks of diverse subtypes of avian influenza arose during the 2003–2004 flu season in locations including British Columbia and three separate regions of the United States (Figure S-3) (Webster, 2004a). In several of these instances, a few nonfatal cases of human infection were also identified (ProMED-mail, 2004n). Meanwhile, the Asian H5N1 epidemic continued to smolder. In July 2004 it reignited, resulting in multiple outbreaks in Vietnam and Thailand and a single outbreak in China; hundreds of thousands of birds were culled in both Vietnam and Thailand in an attempt to contain the epidemic (ProMED-mail, 2004o). Since July, Vietnam has confirmed that six more people have died from H5N1 influenza (ProMED-mail, 2004b,c), and Thailand has confirmed four more deaths (ProMED-mail, 2004d,v), with one case possibly having been transmitted from human to human (ProMED-mail, 2004e).

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