Keeping avian flu from taking flight

Turkish rescue workers remove a chicken contaminated with avian flu. (Photo: AP)Experts say that it’s only a matter of time before the deadly avian flu, which has already hit Europe, Asia, and Africa arrives on the shores of North America. …

Turkish rescue workers remove a chicken contaminated with avian flu. (Photo: AP)Experts say that it’s only a matter of time before the deadly avian flu, which has already hit Europe, Asia, and Africa arrives on the shores of North America. But not if Dr. Bina Rubinovitch has anything to do with it.

The Israeli expert in infectious diseases from the Rabin Medical Center recently returned from Turkey – after being recruited by the World Health Organization to be a team member of professionals sent to assist Turkish officials with combating the avian flu crisis in that country.

A WHO laboratory in the United Kingdom has confirmed 12 of the 21 cases of H5N1 avian influenza previously announced by the Turkish Ministry of Health. Four fatalities were among the 12 confirmed cases.

Human beings thus far, are only able to contract avian flu through direct contact with infected or sick poultry. The bird flu has killed more than 80 people, mostly in Asia, since it reemerged in late 2003. There is substantial fear in the medical community that the virus could mutate into a form that passes easily from person to person, sparking a pandemic in which millions could die.

“The Israel Medical Association approached me after they had been asked by the World Health Organization to provide a specialist in infection control to join a delegation going to Turkey,” Rubinovitch told ISRAEL21c.

The delegation was part of the Global Outbreak Alert and Response Network (GOARN), a technical collaboration of existing institutions and networks who pool human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance. The Network provides an operational framework to link this expertise and skill to keep the international community constantly alert to the threat of outbreaks and ready to respond.

“I’ve been involved in the specific field of infection control at the Rabin Medical Center for two years, so I was recommended. And in mid-January I flew with a team of doctors to eastern Turkey to provide training to Turkish officials in preparedness for avian flu control. Our team of six doctors from various countries provided training and implemented programs in Turkish hospitals that were aimed at preventing infectious diseases from spreading,” said Rubinovitch, who serves as head of the infection prevention and control department at Rabin.

A senior WHO official praised the Turkish government’s response to the latest bird flu crisis. WHO European Regional Director Marc Danson told reporters in Ankara that “for our part … the reaction in (Turkey) has been appropriate and the management of this health crisis is at the level it should be. We are satisfied.”

“The worse situation is a panic situation … there is no reason to panic when you are doing the right things,” Danson said.

According to Rubinovitch, while cases of the flu have been contained until now, it doesn’t mean that the situation couldn’t deteriorate without notice.

“It’s clear that avian flu is spreading. Cases have been discovered in Asia, parts of Europe and in Africa. It’s absolutely plausible that it could show up in the United States.

“What we have to watch out for that would increase the chances of an epidemic is changes in how the flu is transmitted – is if it becomes easier for a human to catch it from a bird, or if people start transmitting it to other people. So far that’s not the case, but it could change.”

Israel Health Minister Yaacov Edri has approached the WHO about organizing a meeting of representatives of Middle East countries to discuss the ongoing spread of avian flu in the region. Health and Agriculture ministry officials are monitoring the spread of the disease among poultry within Egypt, and wants to improve regional cooperation and coordination.

“Israel is well-equipped and prepared to handle any case of avian flu. And through the WHO, there’s a certain level of regional cooperation, that at least provides a concentration of information for specialists in the area,” said Rubinovitch.

According to Rubinovitch, the Turkish officials were very grateful for the WHO delegation’s recommendations and contributions.

“The Turkish government was very appreciative of the help provided by the delegation. They fully cooperated and there was a sincere desire to implement our recommendations,” she said.

Danson said the main way to control the outbreak and hopefully to stop any further outbreaks was through information campaigns ensuring that everyone knew the risks, in particular, sending the message that children should not handle sick or dead birds.

The fact that the WHO approached Israel about sending an expert to join the delegation speaks volumes about the esteem in which the level of the country’s research is held, said Dr. Inon Schenker, the Israel Medical Association’s head of international programs. It was Schenker who recommended Rubinovitch for the task.

“Before a team is sent, first and foremost, you must assess the situation in the country before you bombard them with specialists. Rather than remedying the situation, it’s possible to create hysteria. You need to match the real needs of the country with the skills of the people you choose to go.

Bina’s a great physician, and very experienced. She was able to be matched very quickly to a team of international experts. She was able to deliver what was expected and she got complimented for her work,” Schenker told ISRAEL21c.

“It just opens more doors for other Israelis to follow. There’s a potential for further involvement of Israeli researchers and expertise on this issue – due to new cases reported in Sicily and Nigeria.”

According to Schenker, Israel’s geography also gives it a big advantage when choosing specialists for international delegations.

“The location of Israel is important – it’s the crossroads between Europe and Asia, and for anybody wanting to engage medical professionals, it’s cost efficient.”

“The fact is that Israeli physicians are ready – more than ever before – to be engaged in international efforts. In emergency situations involving rescue units, we’re already proven and known, and proper use is made of Israel’s excellence,” he said.

Rubinovitch said that the fact she was Israeli proved to be irrelevant to both her colleagues in the delegation and the Turkish officials.

“To my colleagues and to the Turkish officials, it was totally irrelevant that I was Israeli. People that work in this field are professionals and it just doesn’t enter into play. Communication is the most important aspect, and we worked well together,” she said.

After her experience, Rubinovitch added that she’s ready to pack her bags again, whenever needed.

“There’s a permanent WHO office in Ankara, and if they need more help, then we’d be notified. I’d be happy to go back.”