(CIDRAP Source Weekly Briefing) – It's been a busy 10 days on the H5N1 front. Indonesia reported two new human cases and Egypt reported one new human case; there are new confirmed poultry outbreaks in South Korea, Pakistan, and Turkey; the Centers for Disease Control and Prevention issued its long-awaited community mitigation strategies document; the Occupational Safety and Health Administration introduced its first workplace guidelines for pandemic influenza; and CIDRAP hosted its second national summit on pandemic influenza and business preparedness in Orlando, FL.
But I believe that one particular H5N1 event during this time stands out as an important "teachable moment"—unfortunately, for all the wrong reasons. An H5N1 poultry outbreak in the United Kingdom (UK) raised many questions about how prepared governments and the private sector in developed countries are to respond to new and emerging influenza issues.
Here is what we know. H5N1-infected turkeys were documented in the Bernard Matthews Holdings Ltd. production facility outside of a Suffolk farm in England. On Feb 5, approximately 160,000 turkeys were culled from the operation. Bernard Matthews and the UK agency responsible for investigating and responding to H5N1 infections issued statements that the culling was complete and the situation posed no risk to humans. The agency—the Department of Environment, Food and Rural Affairs (DEFRA)—and Bernard Matthews also emphasized that biosecurity efforts on the farm would limit any other transmission of the virus, despite the fact that there was no explanation as to how the virus got to the birds.
This is where things get interesting. Government officials have determined that the H5N1 virus found in the Suffolk turkeys is virtually identical to the H5N1 strain that caused a poultry outbreak in January at a Hungarian farm about 30 miles from a slaughterhouse from which Bernard Matthews imported turkey meat. We have evidence that truckloads of poultry products from both the Hungarian and UK locations had been transported between countries after the outbreaks were identified. For several days, the UK media had a mild feeding frenzy on a series of confusing statements from DEFRA and Bernard Matthews about these events, the risk of H5N1 spreading to other poultry, and the risk posed to humans.
For example, The Times of London reported on Feb 12:
Despite the imposition of quarantine rules, six trucks of poultry products from the farm owned by Bernard Matthews were said to have arrived in Hungary on Thursday.
[DEFRA] launched an investigation into the claims made last night by Lajos Bognar, Hungary's Deputy Chief Vet.
The movement of meat from a site infected with the deadly H5N1 strain of avian flu was said by a DEFRA spokeswoman to be within the rules, but caused astonishment among opposition groups.
David Miliband, Secretary of State for the Environment, has already been forced to defend DEFRA's handling of the outbreak and will come under pressure to explain the latest revelation today. Peter Ainsworth, the Shadow Environment Secretary, said: "I'm increasingly bemused at the unfolding saga and finding it increasingly difficult to understand what's going on.
"It's exactly how you turn a drama into a crisis. I can't think of anything more calculated to damage public confidence."
Strict rules came into force 10 days ago at the farm and meat processing site in Holton to ensure that the virus was contained, but a loophole in the regulations allows limited exemptions. Live birds, eggs, and carcasses cannot be moved from infected sites, but processed meat in storage is exempt from the isolation rules.
Among the possibilities being examined by DEFRA is the suggestion that exported poultry products may have originally come from Hungary and been stored in a refrigeration unit in the same meat processing building that the infected turkeys were taken to in order to be gassed, before being returned to the Continent.
In short, this situation is still being sorted out. But there are some real lessons for government and private sector officials responsible for responding to such situations in the future.
First, the US and European poultry industries have maintained that current biosecurity efforts on their farms would greatly reduce the risk of similar situations happening. Based on this situation, do we need to reevaluate that premise and respond accordingly?
Second, this situation is a classic example of horrible risk communication. Assurances that the public not worry has reminded every British citizen of similar statements made more than a decade ago about cattle and mad cow disease (bovine spongiform encephalopathy, or BSE). Initial confident assurances that there was no "Hungarian connection" to the UK outbreak have been discredited.
And finally, the UK government missed a golden opportunity to emphasize the critical nature of pandemic preparedness while the public's attention was focused on the H5N1 issue. The turkey outbreak was a teachable moment, a chance to tell the UK population what they really needed to know to be prepared for the next influenza pandemic.
Unfortunately, UK government officials not only squandered that chance, they shot themselves in the foot. Businesses should take a closer look at this situation, even if their enterprises have nothing to do with turkeys. There are some real lessons to be learned about risk communication and outbreak investigations for a real crisis in the future.
