Never use police, army, US pandemic expert says

[Guest guest]

http://news./s/nm/20060523/us_nm/birdflu_advice_dc_2

 

 

Never use police, army, US pandemic expert says

 

By Maggie Fox, Health and Science CorrespondentTue May 23, 2:05 PM ET

 

Dr. D.A. Henderson, who helped wipe out smallpox around the world, has

a little piece of advice for governments fighting bird flu -- don't

use the military or police to enforce public health.

 

Henderson, who likes to describe how he was vaccinated thousands of

times against smallpox to demonstrate the immunization's safety to

wary villagers, says it is much easier to halt epidemics by winning

the trust of community leaders and making use of gossipy schoolchildren.

 

He is critical of parts of the U.S. national pandemic plan that call

for the use of quarantine and other imposed types of enforcement

should influenza or any other infectious disease bring on a pandemic.

 

" Never use the police or the military, " Henderson told a meeting

organized by the University of Pittsburgh Medical Center's Center for

Biosecurity, where he works.

 

" Once we brought military or police in, we found many citizens retired

to the woods, " Henderson told the meeting on Tuesday.

 

And when the health teams tried to quarantine families, they found a

similar response. " People hid, " he said. " They didn't want to be

quarantined so they hid cases. "

 

As H5N1 avian influenza spreads in birds across Asia, Europe and into

Africa, global health officials are trying to switch into high gear to

control it. But they are running into problems with local residents in

many places, including most recently the village of Kubu Simbelang on

the Indonesian island of Sumatra, where six people died from H5N1

infection.

 

" They are not angry, just unfriendly. They are unfriendly to the

people from the central government, the provincial government, " said

Sidharta Pinem, head of animal husbandry in the region.

 

WINNING TRUST

 

Henderson said the drive to eradicate smallpox, which was eliminated

in 1979, relied heavily on winning the trust of just such people.

 

" What was the most effective was the support from religious leaders

and village leaders, " he said.

 

For instance, they found they could train villagers to administer the

vaccine, which is given using a fork-like needle that scratches the

vaccine fluid into the skin.

 

" How responsive and enthusiastic and reliable these people were, "

Henderson said. " The only thing we could pay these people with was a

thank you. "

 

And an unexpected resource came from the youngest citizens.

 

" For detection of cases we relied on schoolchildren, " Henderson said.

" What is remarkable is how much 9- to 12-year-olds know about what is

going on in their communities, and how willing they are to tell you. "

 

Henderson said his team showed the children pictures of what a person

looked like with the distinctive smallpox pustules and asked them if

anyone in their communities seemed infected. Sometimes their

information was more reliable than word from official sources, he said.

 

Henderson said he was concerned that the U.S. national pandemic plan

includes mentions of possible forced quarantine of travelers and

perhaps of affected areas. Henderson does not believe quarantine works.

 

When Severe Acute Respiratory Syndrome, or SARS, hit Canada in 2003,

quarantine and isolation were used to try to control the vicious

respiratory infection. Some people who worked in hospitals developed

fevers and respiratory symptoms.

 

" But they made the decision that they were so key to what was going on

in the hospital that they came in to work, " Henderson said.

 

Hospitals ended up being a source of SARS infection for many of the

nearly 800 people who died from the virus before it was brought under

control.

 

" So many people in so many professions feel they are key, " Henderson

added.

 

Any flu plan, Henderson feels, should do more to incorporate community

organizations. He cited Rotary International, which has raised

hundreds of millions of dollars for global polio vaccination

campaigns, and Brazil, which eradicated polio by holding an annual

Carnival-like mass vaccination festival.