One method of feathering chickens is to put the bird in a tall container and then pluck and shake until the feathers are gone. It is a quick and bloody process that can observed in backstreets across China, often behind wet markets were live chickens are on sale.
The wet markets are an integral part of day-to-day life across many parts of Southeast Asia but they are also a public health nightmare. Poultry, swine and people all interact in a small area – for a virus like the one that drives avian influenza, it is a veritable amusement park.
"It’s nice to see a healthy chicken jumping up and down but it is not good from a public health point of view," said Dr Henk Bekedam, of the World Health Organization (WHO). "When we start separating animals and humans, we are protecting humans."
An outbreak of avian influenza driven by a virus that can be transmitted from person to person is likely to emerge from one of these wet markets.
It will probably also be a market where pigs are for sale, as pigs can act as a melting pot for viruses that affect both poultry and people and – since their immune system is similar to that of humans – give the virus a testing ground for its next mutation.
The best case scenario for health workers would be for the virus to appear in a relatively isolated rural area.
Ideally, this area would have strong monitoring and limited contact with neighbors. Even better, the virus would first hit poultry or wild water fowl, giving the authorities a couple of weeks head start in which to cull animals in the region and start working on a vaccine.
With luck, only a minimum number of people would be infected. And, if movements are limited and the area is quarantined, a worldwide pandemic may be prevented.
But this is an outside chance at best.
In all likelihood, the virus would enjoy a period without detection. A infected person, not recognizing the symptoms, would travel to an urban hospital for treatment, making contact with people along the way and giving the virus a chance to spread.
"Then it becomes more difficult to cordon off," Bekedam said. "If it happens in country X, it is important to limit movement from there as much as possible. [If the virus breaks out ] in a big city like Jakarta, or Manila or Beijing it becomes almost impossible to stop it."
The problems in China are not with the central government, rather they can be found further down the food chain, with local authorities that don’t want to be saddled with the responsibility of a pandemic.
It is down to officials at this level to gather what resources and political will they have, and take a hit for the rest of the country by announcing the outbreak and implementing measures to contain it regardless of local economic impact.
Dr Jacques Jeugmans, principal health specialist at the Asian Development Bank, is skeptical about anyone actually doing this. "Is China clearly transparent? My answer would be no."
SARS is a good example of how easily things can go wrong.
The disease was all but localized until a doctor traveled from the mainland to Hong Kong and took the virus with him. It then spread as far as Canada and the US.
Nearly 10 years since H5N1 first showed up in Hong Kong, during which time it has spread to several other continents, the goal for epidemiologists remains the same: eradicate the virus in poultry.
As Margaret Chan pointed out after winning the election to lead the WHO last year: "As long as the virus continues to circulate in birds, the threat of pandemic will persist. The world is years away from control in the agriculture sector."
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