With avian flu, an Asian tragedy

Thailand: A rooster given to a family inadvertently produces a worldwide health alert.

February 05, 2004|By Athima Chansanchai | Athima Chansanchai,SUN STAFF

PANG THRUK, Thailand - In a village where generations of farmers have raised chickens, people ordinarily might scoff at the idea of remembering one particular rooster.

But they are unlikely to forget the rooster that a 6-year-old boy, Captan Boonmanut, received last month as a gift from a favorite aunt, a bird that contributed to the boy's death and a new, worldwide health alert.

Captan had cradled the rooster in his arms. The boy's uncle had culled it from a brood of fighting cocks because the bird seemed too big for anything other than a hungry household's next meal, and it also seemed too sick. Pakkanan Boontong, the favorite aunt, remembered that the bird trembled, coughed and wheezed.

The boy loved farm animals. His parents remember him holding the bird tight and kissing it. A few minutes later, they killed the rooster, and it became the main ingredient that night for everyone's meal of chicken curry.

That was Jan. 5.

Within 24 hours, Captan developed a fever.

His parents took him to a local clinic. He was sent home after being diagnosed as probably having a cold. Three days later, his fever no better, his parents drove him to the nearest public hospital. After X-raying his lungs, doctors diagnosed pneumonia and decided to keep him under observation.

His fever continued to rise. His parents remember that he shook as he spoke.

No one brought up the child's contact with the rooster.

On Jan. 13, an ambulance took Captan 80 miles to Bangkok, to the infectious diseases department of Siriraj Hospital. He arrived with a fever, shortness of breath and other flu-like symptoms. A new series of X-rays showed that the pneumonia was affecting both lungs. On Jan. 16, doctors moved him to the pediatric intensive care unit. When his breathing became more labored, he was placed on a ventilator.

In children, pneumonia is often caused by bacteria, but as the boy's condition deteriorated, doctors suspected a virus was at work.

For the doctors, the most important clue came not from the X-rays or blood tests but from newspaper and television stories reporting an outbreak of avian flu that was killing chickens in at least three Thai provinces, including Captan's.

Avian flu, the doctors knew, had a history of jumping from birds to people, as happened seven years ago in Hong Kong when at least 18 people were infected and six died.

Doctors at the hospital asked the boy's parents if they had chickens. When the parents described the rooster, the doctors tested the boy's mucous.

On Jan. 23, the results came back positive for the H5N1 virus, which is associated with a strain of avian flu.

On Jan. 26, Captan died.

Thai authorities knew by then that they were facing a health crisis. Captan was the country's first confirmed human casualty of avian flu, and his death occurred two days after the Thai government first acknowledged that the disease was present in the country, after weeks of public denials.

Since then, about 27 million chickens on more than 39,000 farms have been slaughtered in an attempt to stop the virus. It has claimed five lives in Thailand and 10 in Vietnam; one of the latest victims here was a 6-year-old neighbor of the Boonmanuts. The virus has also appeared in China, Cambodia, Laos, Indonesia, Japan, Pakistan, South Korea and Taiwan.

Praise for the meal

Pang Thruk is a community of 3,000 people where the concrete of the capital gives way to sugar cane and rice fields and tin-roofed shacks. Motorcycles and mopeds race by on dirt roads.

Chamnan and Jongrak Boonmanut have known each other most of their lives. They married about a dozen years ago, and Captan was their second child.

Chamnan, 30, worked as a driver when he wasn't farming his five acres of rice. Jongrak, also 30, worked alongside her husband in the fields.

Pakkanan Boontong is Chamnan Boonmanut's sister. She glanced down as she recalled the day she gave Captan the rooster that she had chosen for its plumpness.

She and her husband went to her brother's house to eat the curry served over rice. Everyone complimented Captan's mother for the meal. No one guessed that the rooster had probably been infected with avian flu by migratory birds.

The fighting cocks on the Boontong farm were regularly released to exercise in rice fields in the back. Public health officials believe the flu virus could have been passed to the chickens by birds that landed in the fields.

Thailand, the world's fourth-largest chicken exporter, last year sold $1.3 billion worth of chickens abroad. In recent days, Prime Minister Thaksin Shinawatra has let himself be photographed eating fried chicken at KFC. But the industry is in trouble.

Ampawn Limprahpunsin, 51, and her husband own Uthong Farm in Supanburi province. Their livelihood depends on their making the most of their limited resources. She sells chicken eggs and live birds at local markets and uses chicken droppings to feed schools of fish that are sold in turn.

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