Be steadfast in protection against viruses from afar

THE ISSUE Asian countries are battling the spread of avian flu and dengue fever, posing a potential threat to Hawaii.

Infectious diseases that have swept through Asia in recent years remain a threat to Hawaii despite commendable efforts to prevent medical disasters. The best strategy is to contain and eliminate the diseases in the countries where they are born, a daunting task.

Problems are nearly insurmountable in the spread of avian flu, which finds its way from chickens and ducks to the lower lungs of people who fall victim, and dengue fever, the lethal bug transmitted by mosquitoes that surpasses what seems at first to be a bad case of flu.

Asian health officials say avian flu remains a threat because of the region's chicken-related culture and economics, lack of resources and what seem to be more pressing health crises. Prevention is the primary defense against dengue, for which there is no antidote.

"We take action before an outbreak," Vu Sinh Nam of the Vietnam Administration of Preventive Medicine told a group of Asian and U.S. health writers, including the Star-Bulletin's Helen Altonn, in their visit to Hong Kong, Vietnam and Indonesia. Nam said volunteers go house to house to urge people to eliminate mosquitoes' watery breeding areas.

Most dengue cases in the United States have involved people who had traveled to infectious areas. A 2001-2002 outbreak in Hawaii, resulting in 122 people who tested positive, was traced to a resident who had visited French Polynesia during a dengue epidemic.

The avian flu virus would have to make a few genetic mutations before becoming contagious among humans. At that point it could result in a pandemic such as the 1918 Spanish flu epidemic, which killed 50 million people worldwide and 500,000 in the United States. A vaccine is available for poultry but not for humans.

Vietnam and Indonesia are among 15 countries that experienced avian flu outbreaks in the past month, according to a United Nations report. Indonesia is one of the world's worst-affected countries, with all but two of its 33 provinces infected with avian flu since 2004. The U.S. Agency for International Development is working with the Indonesian Red Cross to advise farmers to wash their hands after contact with poultry, avoid touching dead chickens and keep ducks away from chickens.

The Trust for America's Health research group ranks Hawaii among the top states in preparedness for public health emergencies, but state health officials cannot be complacent.

"Pathogens are becoming more mobile as a result of increases in international travel and trade as well as changes in ecosystems," said David Nabarro, the United Nations' senior influenza coordinator. That reality makes Hawaii a prime target for deadly viruses on the move.