PAULA BRONSTEIN/GETTY IMAGES

DIRTY WORK: Thai soldiers carry chickens that will be buried alive

Is A Human Pandemic Next?
	Bird flu is erupting across Asia, devastating the region's poultry population. And this could be just the beginning
	By Simon Elegant

Posted Monday, February 2, 2004; 21:00 HKT
Before he slipped into unconsciousness, six-year-old Kaptan Boonmanuj told his mother, "Mum, my chest feels like it's going to explode." On Jan. 26, after two weeks in a coma, Kaptan died in Bangkok's Siriraj Hospital, becoming Thailand's first victim of avian flu. His parents returned home to the hamlet of Ben Ya Pad, deep in the country's rural western province of Kanchanaburi. Two days had passed since their son's death, and rice farmer Chamnan Boonmanuj and his wife Chongrak sat receiving friends and relatives, the smell of burning incense heavy in the front room of their concrete house. Behind them, Kaptan's body lay in a white coffin. Propped against it was his bicycle, along with a picture of Kaptan wearing his school uniform. Outside, a row of ornate wreaths was placed beside the wall of the house. One was from the Ministry of Public Health.

The gesture brought little consolation to Kaptan's parents. Though Kaptan had been hospitalized since Jan. 9, ministry officials only confirmed on Jan. 23 that Kaptan was suffering from avian flu—the same day the government finally reversed weeks of denials and admitted that the disease that had raced through Asia's chicken populations was also present in Thailand. Chamnan and Chongrak believe their son's death was the direct result of the authorities' deceit. "The government is to blame," says Kaptan's father, who describes how his son liked to spend hours each day at his uncle's nearby fighting-cock farm. "If we'd been told earlier about the bird flu, we wouldn't have let our son go near the birds."

There are still many mysteries about the eruption of bird flu that has swept across Asia in recent weeks—where and when the epidemic originated, how it spread so swiftly to so many countries. But one fact is undisputed: this is not a fight that Asia can afford to lose. The economic and social fallout will be bad enough, starting with the deaths of millions of chickens and the resulting loss of countless jobs and tens of millions of dollars in revenues. But a far more dangerous threat exists: the possibility that this particularly deadly strain of the avian-flu virus—often described using a shorthand for its genetic makeup, H5N1—could mutate and mix with human-flu viruses, and suddenly start spreading as swiftly and devastatingly among people as it has among chickens.

So far, there has been no evidence of the disease being passed from one person to another. By the end of last week there were still just 10 confirmed human deaths from this outbreak, most of them children like Kaptan who spent time in close contact with chickens. Although scientists say it is impossible to predict the odds that the virus will alter its genetic form radically enough to start leaping from human to human, there is no argument that the longer H5N1 is out there killing chickens, the more opportunities the virus will have to mutate. "The real risk [of a lethal mutation] does exist," says Professor Paul K.S.

Chan, a microbiologist at the Chinese University of Hong Kong. "The concern is that we don't know how much time it will take for the virus to gain the ability to transmit from human to human." The task at hand is clear and could hardly be more urgent, says Chan: "We have to destroy the source of the infection."

How to do that is no great mystery, especially in Hong Kong, where in 1997 bird flu first demonstrated an unprecedented ability to infect humans. On the advice of influenza specialists from around the globe, the government ordered all 1.4 million of the territory's chickens and ducks to be slaughtered. Although 18 Hong Kongers were infected, of whom six died, the swift culling headed off a potentially much greater disaster. "We believe we averted an incipient pandemic," says Kennedy Shortridge, the flu specialist who was at the core of the 1997 effort to prevent h5n1 jumping into the human population. "We need to eliminate the virus again. But this time it could take years."

The sheer geographical scale of the current outbreak is, of course, one critical reason why eradicating it this time will be so much harder than in 1997. Already, there have been confirmed flare-ups of bird flu in 10 Asian countries and territories: mainland China, Japan, South Korea, Taiwan, Thailand, Vietnam, Indonesia, Cambodia, Laos and Pakistan. Many scientists believe that migratory wildfowl, which can carry numerous viruses without being infected, were most likely to blame for the initial spreading of the disease. Then other factors—the transport of infected chickens across borders, both legally and illegally, as well as months of government inactivity despite mounting evidence of avian-flu outbreaks—came into play, combining to produce the current nightmare.

But geography is by no means the only enemy. There are other equally formidable forces arrayed against Asia's drive to avert a devastating pandemic: ignorance about the disease and its transmission, official stonewalling and reluctance to acknowledge mistakes, insufficient money and manpower to implement preventive measures, and simple incompetence. Taken together, says World Health Organization (WHO) director general Lee Jong-wook, they will make the task of crushing h5n1 "hard, costly work."

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	Playing Chicken [January 26, 2004] Thaksin Shinawatra's government comes clean on the extent of avian flu in Thailand On High Alert [January 19, 2004] From Japan to Vietnam, Asian countries are culling millions of chickens infected with a strain of bird flu that can also prove deadly to humans. Can they prevent a pandemic? The Cycle of Death [April 7, 2003] SARS is only the latest in a string of epidemics to emerge from southern China Hong Kong's Fowl Problem [February 15, 2002] Hong Kong's latest bird flu scare points to a lack of Chinese cooperation More Related Items | Search all issues of TIME Magazine