bird flu Viral respiratory disease affecting poultry and other birds. The disease is caused by the type A influenza virus. The H5N1 strain of the type A influenza virus has been known to affect humans and is the most deadly. In 1997 in Hong Kong, of the 18 people seriously infected with the H5N1 strain, six died.

A bird flu outbreak began in January 2004 in Vietnam and Thailand. The spread of the H5N1 strain devastated poultry farms in many Southeast Asian countries. By the end of 2005, millions of birds had been culled in an effort to limit the spread of the virus and to prevent the onset of a pandemic. According to the World Health Organization (WHO), by July 2006 there had been 231 human cases worldwide with 130 deaths since the outbreak— an alarmingly high rate of mortality. Most of the people infected were in close contact with diseased birds. Person- to- person transmission is limited, though researchers believe that the H5N1 strain virus may mutate and make this kind of transmission possible. It is believed that the 1918 ‘Spanish Flu’ pandemic that caused up to 40 million deaths worldwide, started out as a form of bird flu.

According to the WHO, a bird flu pandemic is imminent. The Ministry of Health (MOH) has outlined a national strategy to deal with bird flu. The strategy comprises three main areas: establish a surveillance system to detect the import of the virus, limit the damage when the first pandemic wave hits, and immunization when a vaccine becomes available.

The surveillance strategy formulated by the MOH is designed to detect the first cases or clusters of influenza in humans and animals, and to detect new strains of viruses. It involves community surveillance (compiling reports from polyclinics and hospitals), laboratory surveillance, hospital surveillance, veterinary surveillance through the Agri- Food and Veterinary Authority (AVA), and external surveillance (monitoring outbreaks regionally and internationally).

The AVA has taken precautions to prevent the disease from entering Singapore, one of which is the suspending of the import of live birds from countries affected by bird flu. Imported eggs and poultry consignments are routinely sampled and tested for the virus. As a further precaution, the AVA has intensified surveillance of poultry slaughterhouses, where workers are required to protect themselves with masks and adhere strictly to hygiene practices.

In August 2004, when the bird flu virus was detected on a poultry farm in Kelantan, Malaysia, the AVA banned all imports of poultry (including eggs) from the country. The ban was lifted after six weeks.

The MOH has implemented the Disease Outbreak Response System. It serves as a frame of reference for responses of increasing intensity according to pre- defined alert levels. For example, Alert Green means that the threat to public health is low and there are no new viral outbreaks in the world. Alert Orange means that the pandemic is underway and the infection has become a human disease with widespread person- to- person transmission.

Antiviral medication, as shown in research, is effective in the early treatment of influenza. The MOH is maintaining a stockpile of antiviral medication to be used in an outbreak. The use of antiviral medication is also expected to reduce flu- related complications that would otherwise require hospitalization. It is thus seen as an important strategy to prevent medical services from being overwhelmed.