AlaskaDenise
In Memoriam
A string of avian influenza outbreaks in Indonesia has brought the country's death toll from the disease to a global high of 103, as scientists here deal with a lack of infrastructure and funding to fight the virus. Udayana University-based virologist and microbiologist I Gusti Ngurah Mahardika spoke to The Jakarta Post's Emmy Fitri about the necessary steps to spare the country from a pandemic.
Question: H5N1 mutated from a flu initially confined to birds, but can now infect humans. Is it possible to roughly predict how long it would take for this virus to mutate into a "pandemic" strain?
Answer: H5N1 itself is a product of natural evolution; an assortment of viruses from quails, geese, teal birds and wild birds found in Hong Kong. They meet at bird markets -- the perfect place for avian viruses to meet and mingle.
What we know is that it's still not easy for the virus to be transmitted from human-to-human, although it has proven that it can.
At present, human-to-human infections remain unusual, meaning that the flu has yet to acquire the full ability to be transmitted in this way. Perhaps it is still in the "trial and error" phase.
Are you saying there have been cases of human-to-human transmission of bird flu?
Yes, there have, but only a limited number of cases, like in early cases in Hong Kong (in 1997). What has made the avian influenza able to infect humans was mainly the presence of a genetic susceptibility in the human recipient.
We never can tell how long it will take for a virus to mutate into a pandemic strain, able to be passed from human-to-human. It could take a very long time or could come sooner than we thought.
We are also in the dark on whether the current H5N1 will be able to trigger a pandemic, or if it could happen with a mixture of H5N1 and other viruses -- we just don't know.
At least we can still hope, and buy time, while we brace ourselves for a pandemic.
What I see nowadays while we're buying time, instead of preparing ourselves for a worst-case scenario, people are making much ado about a (bird flu) vaccine (for humans) and a material transfer agreement for virus sharing.
These are really not necessary and ill-timed. We are wasting time over unimportant issues.
If bird flu is to be considered a natural disaster, perhaps it will be the only natural disaster humans have had time to prepare themselves for.
Could the virus become more virulent in a re-emerging outbreak?
Yes and no -- because it too could also become less virulent. It takes a genetic change for that to happen -- not necessarily a mutation.
Who is responsible for the close monitoring of the virus dynamics?
Virologists should do -- I should also but we don't have the facilities. We have the brains, knowledge and know-how -- all the things we need for that job, but again the limited funding and infrastructure hampers our work.
Actually we don't need a high-end laboratory with state-of-the-art equipment. What we have here (at Udayana University) is humble. Thank God there have been no infections so far, since I regularly check my staff and students who use the laboratory.
Of course, it would be great to have a bio-safety level 3 (bsl-3) laboratory to do all the research. With our limited facilities, we can't even do genetic sequencing for the avian virus, which is imperative for us to check if there is a cross-generation process going on or not.
For a virologist ... there is nothing new in this world, only change is eternal.
If there is an agent, it doesn't have to be a new form. It could be a combination of two agents that already exist. So-called "new viruses" or "new diseases" are born from two things; a variation of the old virus in which there are genetically mutated strains, or a habitat change of the virus host.
The classic example for the second cause is AIDS. The habitat of the original host of HIV (the chimpanzee) was damaged and found humans were susceptible to infection.
SARS (Severely Acute Respiratory Syndrome) was originally found in civet cats and did not make the animal sick until people disrupted its ecological habitat. Viruses want to survive on this planet. They have a biological task to accomplish.
As you once said, weather plays an important role in the emergence and re-emergence of outbreaks. Do we have weather-related studies to support prevention measures enforced here?
There are no studies specifically targeting bird flu but general knowledge is applicable not only for the bird flu virus but also other zoonotic viruses which thrive in highly humid conditions.
I don't think we need to put too much emphasis on this to justify what we already know -- I also believe that officials here, both at the agriculture and health ministries, must realize this also; they have data on the increase of outbreaks around this time. But unfortunately, we are not accustomed to being prepared, before trouble hits home.
We don't need rocket science for that. We need innovations and investment. Public campaigns must be intensified with the same warnings, and let people know what will happen if they don't heed the warnings.
Agricultural lifestyles, seen in densely populated urban settings like Tangerang, have a high risk of harboring diseases transmitted by animals. What is your comment?
I believe people know about bird flu -- at least they've heard of it. But we're talking about the Kampung Tengah livelihood. Why would people dare to sell a sick chicken or eat a sick chicken?
Our poverty and backwardness get in the way of us seeing better managed poultry and a clean and healthy environment.
It should be easier done than said, now, with more and more fatalities.
The government must be ready, at all cost, to remove poultry from housing areas, especially in crowded cities like Tangerang and Jakarta. At all cost -- otherwise it will be too late.
http://www.thejakartapost.com/detailnational.asp?fileid=20080218.H05&irec=4
Question: H5N1 mutated from a flu initially confined to birds, but can now infect humans. Is it possible to roughly predict how long it would take for this virus to mutate into a "pandemic" strain?
Answer: H5N1 itself is a product of natural evolution; an assortment of viruses from quails, geese, teal birds and wild birds found in Hong Kong. They meet at bird markets -- the perfect place for avian viruses to meet and mingle.
What we know is that it's still not easy for the virus to be transmitted from human-to-human, although it has proven that it can.
At present, human-to-human infections remain unusual, meaning that the flu has yet to acquire the full ability to be transmitted in this way. Perhaps it is still in the "trial and error" phase.
Are you saying there have been cases of human-to-human transmission of bird flu?
Yes, there have, but only a limited number of cases, like in early cases in Hong Kong (in 1997). What has made the avian influenza able to infect humans was mainly the presence of a genetic susceptibility in the human recipient.
We never can tell how long it will take for a virus to mutate into a pandemic strain, able to be passed from human-to-human. It could take a very long time or could come sooner than we thought.
We are also in the dark on whether the current H5N1 will be able to trigger a pandemic, or if it could happen with a mixture of H5N1 and other viruses -- we just don't know.
At least we can still hope, and buy time, while we brace ourselves for a pandemic.
What I see nowadays while we're buying time, instead of preparing ourselves for a worst-case scenario, people are making much ado about a (bird flu) vaccine (for humans) and a material transfer agreement for virus sharing.
These are really not necessary and ill-timed. We are wasting time over unimportant issues.
If bird flu is to be considered a natural disaster, perhaps it will be the only natural disaster humans have had time to prepare themselves for.
Could the virus become more virulent in a re-emerging outbreak?
Yes and no -- because it too could also become less virulent. It takes a genetic change for that to happen -- not necessarily a mutation.
Who is responsible for the close monitoring of the virus dynamics?
Virologists should do -- I should also but we don't have the facilities. We have the brains, knowledge and know-how -- all the things we need for that job, but again the limited funding and infrastructure hampers our work.
Actually we don't need a high-end laboratory with state-of-the-art equipment. What we have here (at Udayana University) is humble. Thank God there have been no infections so far, since I regularly check my staff and students who use the laboratory.
Of course, it would be great to have a bio-safety level 3 (bsl-3) laboratory to do all the research. With our limited facilities, we can't even do genetic sequencing for the avian virus, which is imperative for us to check if there is a cross-generation process going on or not.
For a virologist ... there is nothing new in this world, only change is eternal.
If there is an agent, it doesn't have to be a new form. It could be a combination of two agents that already exist. So-called "new viruses" or "new diseases" are born from two things; a variation of the old virus in which there are genetically mutated strains, or a habitat change of the virus host.
The classic example for the second cause is AIDS. The habitat of the original host of HIV (the chimpanzee) was damaged and found humans were susceptible to infection.
SARS (Severely Acute Respiratory Syndrome) was originally found in civet cats and did not make the animal sick until people disrupted its ecological habitat. Viruses want to survive on this planet. They have a biological task to accomplish.
As you once said, weather plays an important role in the emergence and re-emergence of outbreaks. Do we have weather-related studies to support prevention measures enforced here?
There are no studies specifically targeting bird flu but general knowledge is applicable not only for the bird flu virus but also other zoonotic viruses which thrive in highly humid conditions.
I don't think we need to put too much emphasis on this to justify what we already know -- I also believe that officials here, both at the agriculture and health ministries, must realize this also; they have data on the increase of outbreaks around this time. But unfortunately, we are not accustomed to being prepared, before trouble hits home.
We don't need rocket science for that. We need innovations and investment. Public campaigns must be intensified with the same warnings, and let people know what will happen if they don't heed the warnings.
Agricultural lifestyles, seen in densely populated urban settings like Tangerang, have a high risk of harboring diseases transmitted by animals. What is your comment?
I believe people know about bird flu -- at least they've heard of it. But we're talking about the Kampung Tengah livelihood. Why would people dare to sell a sick chicken or eat a sick chicken?
Our poverty and backwardness get in the way of us seeing better managed poultry and a clean and healthy environment.
It should be easier done than said, now, with more and more fatalities.
The government must be ready, at all cost, to remove poultry from housing areas, especially in crowded cities like Tangerang and Jakarta. At all cost -- otherwise it will be too late.
http://www.thejakartapost.com/detailnational.asp?fileid=20080218.H05&irec=4