Lessons From Turkey's Bird Flu Outbreak

Rapid responses by Turkey's health authorities and key health personnel were critical in bringing the 2006 bird flu outbreak under control, according to research published in the online open access journal, BMC Public Health. Those involved cite poverty and families sharing their homes with poultry as factors behind the virus' transfer to humans.

During early 2006, 12 avian influenza cases were confirmed in Turkey, of which eight cases occurred in the Dogubeyazit-Van region. Ozlem Sarikaya of the University of Marmara, Istanbul and Tugrul Erbaydar of the University of Yuzuncu Yil, Van, conducted in-depth interviews with senior health professionals to evaluate attempts to control the outbreak.

The authors found that, although a crisis committee was created quickly, healthcare workers felt anxious and ill-prepared due to a lack of clarity about their responsibilities in emergency disease plans, and delays in receiving protective clothing. The researchers also found that the coordination between the human and animal health services was not sufficient. Despite these difficulties, open communication between the government and the public, as well as the health authorities' and health workers' efforts, helped control the epidemic. Poultry rearing practices, coupled with poverty and poor access to healthcare, were the primary risk factors for infection.

"Lessons learned from this outbreak should provide an opportunity for integrating the
preparation plans of the health and agricultural organizations," say Sarikaya and Erbaydar, "and for revising the surveillance system and enhancing the role of the primary health care services in controlling epidemic disease." They add that informed response strategies will play an invaluable role in the control of a future avian influenza pandemic.

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