Saturday, January 14, 2006

News - Turkey epicentre of war on avian flu

Three children are dead, and this snowbound mountain town high in eastern Turkey has suddenly become the new epicentre for international concern about a disease called avian flu.
"We are the experts now," says Dr. Ahmet Faik Oner, chief of pediatric hematology at the Hascanesu Hospital, a rambling complex of four-storey, rose-coloured blocks on Maras St. in downtown Van.
For the past fortnight, the 47-year-old, Turkish-trained medical specialist has been in charge of caring for most of the patients in these rugged highlands who have been stricken by a bird-borne disease.
Previously, the H5N1 strain of avian flu had passed from birds to humans only in China and in several parts of Southeast Asia, infecting more than 140 people since late 2003. Seventy-six of them have died.
Now the same virus has come to Turkey, presumably borne by wild birds that passed the deadly micro-organism to domestic fowl, which then infected humans — 18 of them so far.
"Most of the patients are children," says Oner. "We think they all had close contact with chickens."
Despite the global attention now focused on this mountainous region of eastern Turkey, and despite the avian flu cases being treated here, there is still no sign of the kind of communal alarm that seized Toronto during the 2003 SARS outbreak.
Among the throngs of pedestrians enjoying the winter sunshine on Cumhiriyet St. yesterday, nobody was wearing a surgical mask to guard against air-borne infection.
The main hospital here seems to be going about its business normally, with no shortage of visitors crowding through the steel gates at the dank, ill-lit entrance. But SARS was a disease that could be passed between humans, and that is not true — or not true yet — of this bird-borne virus now apparently winging its way westward from Asia toward Europe.
Currently, few people know more about the malady in its human form than does Oner, a slender, soft-spoken Turkish doctor.
Wearing a white lab coat over a dress shirt and a striped red tie, the physician perches on the edge of his chair in a downtown clinic and peers out through a pair of silver-framed eyeglasses, as he proceeds to outline the local dimensions of what many experts fear could soon become a global scourge.
So far at the hospital in Van, three youngsters are dead of avian flu; a child and a young adult have recovered from the disease and have gone home; three more infected children remain in hospital; two others are in intensive care and seem about to join the list of confirmed human cases.
Oner expects to know the official status of these last two in a couple of days, when the test results come back from a laboratory in Ankara, 1,200 kilometres to the west.
That makes eight confirmed cases so far — with two more on the cusp — representing nearly half of the 18 confirmed human infections that have turned up in Turkey in recent days.
So far, the only Turkish fatalities from the disease are the three children who died in the Van hospital early this month, all siblings from the mountain town of Dogubayazit, 185 kilometres to the northeast.
Health officials here stress that all human cases in this country to date have resulted from direct physical contact with dead or sickly domestic fowl.
But many fear that the virus may yet mutate into a form that could be passed directly between humans, producing a disease that could kill millions.
Here in this ramshackle but bustling town on the frigid shores of Lake Van, Oner is chiefly concerned with the fate of 32 patients at the hospital here, including 25 children and seven adults, who either are being treated for avian flu or are under observation for signs of the disease.
The sick are being treated with a combination of antibiotics, intravenous fluids, and Tamiflu, one of the few drugs that seems to be effective against the virus. Some patients also require cardiac-management medication.
With a population of about 450,000, Van is a bustling but less than beautiful modern city set beside a volcanic lake and surrounded by a stunning landscape of cathedral mountains and barren plateaus, all blanketed now in snow.
Previously, the city was probably best known abroad for a strange breed of felines called Van cats — fluffy white creatures each with one blue eye and one yellow. But notoriety has come now in the form of a lethal disease, one that may prove to be merely a harbinger of an even more deadly plague to come.
Turkish authorities are taking few chances and have ordered that all backyard poultry in the land be culled — an aggressive tactic that people here seem to be accepting with stoic resignation. - Turkey epicentre of war on avian flu


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