Turkey Copes With Bird Flu

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GET A JUMP ON THE VIRUS At least scientists and doctors can profit from Turkey's troubles. "There will be huge lessons to come out of these outbreaks," says John Oxford, a professor of virology at London's Queen Mary's School of Medicine. "Even the dad whose children died can reassure himself of that." The most crucial item of scientific information: who officials say they have so far seen nothing to indicate that the Turkish victims contracted bird flu from other people, the potential nightmare that could lead to a pandemic.

Virologists at the National Institute for Medical Research (nimr) in London, which is home to the World Influenza Centre, analyzed the sequence of genes in the h5n1 virus that killed the Kocyigits. They found the structure of those genes was very similar to that found in the avian version. But nimr director and influenza expert John Skehel says he has also found a worrisome protein change in one of the human genetic sequences. "That mutation makes the virus prefer human cells," Skehel told Time. He cautioned that there are other factors — some still unknown — that will determine whether people eventually transmit bird flu to one another. But, he says, the protein mutation is "one of the things" that is required.

Scientists are intrigued, however, by the cases of two young brothers hospitalized at the Kecioren Hospital in Ankara. They tested positive for the h5n1 virus after exposure to sick chickens, but have not shown symptoms of the disease. Nevertheless, they are now being treated with Tamiflu, one of the antiviral drugs with some capacity to fight avian flu. The who's Rodier thinks that the boys' parents probably became suspicious about possible exposure to the virus before the disease could take hold, and whisked the boys to hospital. Such vigilance may hold the key to survival. Swedish researchers reported in the American Medical Association journal Archives of Internal Medicine that 650-750 people in northwest Vietnam admitted suffering flu-like illnesses after handling sick or dead chickens. While virologists say the study did not use blood tests to confirm the presence of h5n1, they think it could mean that some people may carry bird flu without getting sick. "It suggests more cases are not being picked up, and that the mortality rate is lower than the 50%" recorded by the who, says Oxford. That is not necessarily good news; he points out that a virus that kills at a lower rate but spreads quickly is more dangerous than one that kills at a higher rate but spreads more slowly.

GLOBAL THREAT, GLOBAL RESPONSE Fending off a potential pandemic is not just the job of infected countries. Last week, the U.N. warned that Turkey's neighbors were at risk from avian flu unless they also took immediate steps to protect themselves. Some tightened border controls and increased surveillance. But it is unclear whether next-door states like Azerbaijan, Georgia, Iran and Iraq have the knowledge or resources to do enough. It is far easier for the wealthy nations of the E.U. to mount a strong defense. Bans on Turkish poultry products remained in place throughout the E.U., and member nations pledged to spend $100 million to fight off the global spread of bird flu, focusing on the most needy countries. In the U.K., businesses have been urged by the government to develop contingency plans against a pandemic: the giant global bank HSBC estimates human-to-human transmission could make ill half its worldwide staff. The World Bank is calling for rich nations to donate millions — to pay for mass culling, compensation and animal vaccination — to the places where the disease has lodged, and wants the West to invest in research to speed up the development of effective antiviral treatments before human-to-human transmission takes off.

In Turkey, meanwhile, the virus may already be endemic: a permanent presence that would constantly threaten to invade Europe in the future. Even if everyone has learned the lessons of previous health and food-safety crises such as mad-cow disease and foot-and-mouth disease, avian flu defies traditional responses. Wild birds don't stop for quarantine controls, and they don't recognize borders.