Images reminiscent of SARS, Ebola and Chernobyl
Since the first reported case of the deadly H5N1 avian flu virus in Germany on the Baltic Sea island of Rügen nearly two weeks ago, images of the outbreak have filled television newscasts, newspapers, Web sites and magazines. The most common pictures are those of the Bundeswehr decontamination center on the Rügendamm causeway that leads from the mainland to the island. The dead swans and the slaughtering of chickens wouldn't be all that hard to take if it weren't for that massive "epidemic mat" on the road to Rügen, with images of masked German soldiers in protective gear disinfecting their trucks with formic acid.
The images remind the public of SARS, Ebola and Chernobyl. And they're so powerful that the assembled members of Rügen's tourism community know full well that no matter how many experts claim that bird flu is an epidemic that affects animals and currently carries virtually no risk for humans, that isn't what the public believes.
At a meeting in the city fire house in Sellin -- a seaside resort on Rügen where everyone from the mayor and city council members to the 30 hotel and restaurant owners have come together to talk about bird flu and its consequences -- everyone agrees on one thing. "Without the television images of the Rügendamm, the media wouldn't be half as vocal about the whole thing," complains Raymond Kiesbye, director of the local tourist office. "We're not experiencing a catastrophe on Rügen; the real catastrophe is taking place on TV."
"There is only one word to sum up our problem: cancellation, cancellation, cancellation," says Mayor Reinhard Liedtke. Unlike poultry farmers, who receive government compensation for culled birds, no one is likely to compensate the resort community's hotel and restaurant owners for their losses. "We're talking about people, not chickens," says Hans-Joachim Kress of the Wald Hotel Sellin. "We haven't had any calls for rates or brochures for days."
This is Germany in the age of bird flu. As military aircraft search for the telltale corpses of swans and hawks, state and federal governments are quarreling over who should be responsible for crisis management in the future. Meanwhile, German Chancellor Angela Merkel, wearing a green parka, visits her ailing constituency on the island of Rügen.
The tabloid publication Bild is worried about bird droppings on windshields and pigeon feathers in sandboxes. A trade association is busy testing breathing masks. And suddenly mobile poultry enclosures and electronic scarecrows are all the rage on Ebay.
Overzealous flu experts and politicians on agricultural committees are warning that even the soccer World Cup could be jeopardized if a pandemic breaks out. The Institute of Economic Research in the state of Rhineland-Palatinate has issued dire predictions of German GDP plunging by 2 percent once -- and if -- the virus mutates to the point of human-to-human transmission. On the bright side, analysts are already talking up all the "beta opportunities" that will be available when the world economy begins recovering from a brief period of uncertainty sparked by the virus.
All predictions aside, helplessness seems to be the one sentiment that prevails in places where the feared H5N1 flu virus is currently rampant. The country was caught off guard when the first cases of the deadly virus were discovered on German soil two weeks ago, despite the fact that it's a scenario that's been expected for months. Experts began issuing warnings last spring when the virus first appeared at China's Qinghai Lake, an important gathering spot for migratory birds, a sure sign that the global spread of the virus was now virtually unstoppable. Since then, Germany has clung to the naïve hope that the H5N1 would somehow bypass its territory.
It wasn't as if German politicians were ignoring the threat. On the contrary, they have hotly debated the risks of a pandemic and concerns over the stockpiling of antiviral agents. But amid all the commotion, no one seems to have hit upon the idea that the H5N1 virus could one day turn up on German soil in the form of a dead bird.
"No one in the county or state government has ever spoken to us about these kinds of things," complains Karl-Heinz Walter. As the administrative director of the North Rügen municipality, Walter is responsible for the Wittower Ferry district, where all the commotion -- officially dubbed a catastrophe last week -- began.
Suddenly, he grumbles, "the political stars and disaster tourists" descended upon the island and accused him of failure. "First there was China and Vietnam, and then Romania and Turkey -- it was obvious that it would hit us at some point."
Despite warnings, no one made any preparations for what ultimately happened. "There was no plan for day X at the official level." Just as Walter is finishing the sentence, three firefighters storm into his office, searching for plastic bags for animal corpses. "That's all we have left," says Walter, pointing to a roll of blue trash bags on an otherwise empty shelf.
"What about gloves?" they ask.
"All gone. But they're on order. We expect them any day." A box of disinfectant bottles for the workers stands on the safe in his office. Walter picked up the box himself from the local pharmacy.
Workers lack suitable measuring cups for the formic acid that's mixed with water to make a solution used to soak the protective mats distributed to area poultry farmers. Someone suggests checking the chemistry lab at a local school, but it turns out to be locked.
Gloves, plastic bags and measuring cups aren't the only things that are missing here. The inflatable rafts used by local fire departments have turned out to be unsuitable for use in still-frozen lagoons. "The government in Schwerin (the capital of the German state of Mecklenburg-West Pomerania) instructed us to recover all dead animals," says Jens Steinfurth of the Breege Volunteer Fire Department. But when officials in police helicopters spotted scores of dead swans near the reed belt on the island's lagoon side, the lack of suitable craft turned out to be a problem. "We can't even reach the area without ice sleds," says Steinfurth.
More than 2,200 dead birds
And even when workers do manage to recover the dead birds, many never make it into the official body count. The official number -- 107 infected animals -- is a vast understatement, because it applies only to those 825 samples that have been sent to labs for analysis since the epidemic first began. In reality, volunteers have already recovered more than 2,200 dead animals in the shallow waters surrounding Rügen. Most of the birds -- song birds and mute swans -- were sent directly to a special facility in Malchin, a town near the city of Neubrandenburg, where they were destroyed without first being tested for H5N1. "We left them outside -- for capacity reasons," explains official veterinarian Bernd Nostitz, who believes that it's "quite likely" that most of the birds that were not tested were in fact infected.
While local veterinarians, fire departments and disaster relief volunteers searched for a strategy to control the epidemic, the Bundeswehr, or German military, apparently felt that it was its duty to provide images that seemed tailor-made for the media. Instead of creating the impression of poorly equipped volunteers, the soldiers deployed to the area ended up looking like aliens.
Despite its powerful impact on public perception of the disaster, the Rügendamm disinfection program's ability to actually prevent infection was doubtful from the start. And when infected animals were also found in a nearby region of northern West Pomerania early last week, it became clear that attempting to stop the virus from spreading to other areas was pointless.
The German public is gradually becoming accustomed to the idea that the epidemic will likely be around for a while. But what hasn't penetrated into the public consciousness is that the H5N1 subtype of the avian influenza virus is an epidemic for animals, not humans. And although the virus has claimed 92 lives in Asia and Turkey, those cases were caused by people living in close proximity to infected poultry. "A few thousand copies of the virus are enough to make animals sick," says Klaus Stöhr, Director of the Influenza Program at the World Health Organization (WHO). But the virus must be present in much higher concentrations in the lungs before it can be contracted by human beings.
Nevertheless, the epidemic will keep authorities busy for a long time, even without any human victims because it will continue to rage in animals. "We firmly expect to see infected wild birds sooner or later," says Eckhard Uhlenberg, a Christian Democrat (CDU) and the agriculture minister of the state of North Rhine-Westphalia. Officials in neighboring Lower Saxony are already preparing for the arrival of the virus. "Our goal is to find, test and destroy every dead bird in the state," says Friedrich-Otto Ripke, a senior official at the Ministry of Agriculture in Hanover, the state capital of Lower Saxony.
Fears for a €2 billion poultry industry
But Ripke is more worried about a large-scale outbreak of the virus on poultry farms than among a few buzzards and song thrushes. The German poultry industry is a €2 billion a year business, and H5N1 poses a potential threat to the country's 120 million chickens, turkeys and ducks, as well as to an egg industry with an annual production volume of 13 billion. "Once the virus gets inside all those indoor stalls, it'll be fatal," says Ripke.
Lower Saxony would be especially hard-hit by such an outbreak. "It would be a blow to the entire region," says Ripke, if the bird flu were to break out among the 20 million chickens on poultry farms in the region between the Weser and Ems rivers.
If that happens, Ripke will be required to implement a draconian emergency plan. A single case of bird flu would spell a death sentence -- to be executed within 48 hours -- for all poultry within one square kilometer. In addition, the site would be quarantined immediately and everything within a 10-kilometer perimeter would be declared off-limits to anyone even remotely linked to poultry production.
The emergency plan is based on experiences made during the breakout of another strain of the avian flu virus in the Netherlands three years ago. "At the beginning of that outbreak, officials were not successful at completely sealing off the affected farms right away," says Ripke.
At the time, veterinarians took too few precautions while walking around affected farms, and feed suppliers carried the virus to neighboring farms on the tires of their trucks. In addition, the containers used to store the corpses of infected birds were not always airtight, allowing the virus to escape to "the farms along the route to the animal destruction facilities," says Ripke.
To prevent even a single microgram of the virus from surviving, Dutch authorities were forced to kill 30 million chickens, a Herculean task that ended up stretching their equipment to capacity. To avoid similar bottlenecks, Germany's Emsland county already has a killing machine at its disposal that, according to county spokesman Dieter Sturm, can handle 250,000 animals a day.
Those who find themselves having to kill thousands of chickens during an epidemic will have the choice between gassing and electrocuting the birds. On the island of Rügen, where officials have already begun preventive culling at farms considered to be especially at risk, veterinarians are using a brand-new container system operated by the state of Mecklenburg West-Pomerania. In the system, carbon dioxide is pumped into a steel container. Once the CO2 concentration reaches 80 percent, workers toss live birds into the container through one of two hatches in the lid. Within seconds, the animals fall asleep for lack of oxygen and eventually suffocate.
Depending on the birds' weight, workers can destroy 5,000-7,000 chickens a day, or between 300-500 turkeys per hour. But the system doesn't work with ducks because waterfowl are capable of holding their breath for too long.
In electrical killing machines, animals are suspended upside-down from a conveyor belt that pulls the animals through a water bath. When the heads are submerged, a live current anesthetizes the birds' brains and paralyzes their muscles. "Atrial fibrillation kills the birds within 10 seconds or less," says Martin Boosen of Lower Saxony's state consumer protection agency. The method can be used to "humanely kill" 4,000-7,000 animals an hour.
Just how quickly officials find themselves flicking the switches on the killing machines became evident in Austria, where the H5N1 killer virus was discovered in a farm animal last Wednesday, the first such discovery in the European Union. The first suspected case appeared in Germany a short time later, when the virus struck a domestic duck in a town on the island of Rügen. The animal was quickly taken to the Friedrich-Loeffler Institute on the island of Riems, where researchers analyzed its tissue for presence of the deadly virus.
The end of free-range farming?
Hardly any experts are willing to predict what will happen next. "The course of the epidemic is very difficult to assess," says Erhard Kaleta, Director of the Institute for Poultry Diseases at the University of Giessen. Although he has seen many epidemics come and go, the 66-year-old scientist says he has never witnessed a virus spread so rapidly by migratory birds.
When an infected tufted duck was found on the tiny Baltic Sea island of Walfisch, researchers knew right away that Germany would be just as unsuccessful as other countries in stopping the virus. And if there is an outbreak, the country could very well see its poultry farms kept under tight quarantines for years.
It wouldn't pose much of a problem for Germany's more technologically advanced poultry and egg production facilities, which have already managed to institute highly effective isolation mechanisms. Workers are required to remove all clothing, except undergarments, and disinfect themselves when entering or leaving the facilities where birds are housed. The air is filtered and mats coated with disinfectant are placed at all entrances -- even without evidence of bird flu.
But it's a different story for the roughly 250 free-range poultry farms in Germany. Under current emergency regulations issued by consumer protection authorities, free-range poultry must be kept indoors until the end of April.
But now that the H5N1 virus has arrived, free-range birds could very well be staying indoors much longer. "We believe that this spells an end to free-range poultry farming, at least for the next few years," says Emsland veterinary spokesman Dieter Sturm. In his county, the area's 24 free-range farmers have long been thorns in the side of the operators of large, factory farms. The free-range ban, says Sturm, will only be lifted when infected animals are no longer found among wild birds after extensive testing.
But the free-range farmers' birds can't be kept indoors for too long. When birds are housed under too-crowded conditions, their droppings heat up, producing and releasing ammonia. The chickens develop eye inflammations and become apathetic, and eventually stop laying eggs. Cramped indoor conditions also cause pecking order problems. "They start pecking at each others' feathers and tearing them out, to the point where they can even bleed to death," says Kaleta, who favors free-range poultry farming.
Environmentally friendly farmers are desperately trying to save their free-range farming practices. Some suspend carrots in cages so that the animals can peck away their frustrations, while others are developing special stalls where the chickens live in several different rooms. "It allows them to avoid each other," explains Thomas Dosch, director of organic farmers association Bioland. Free-range farmers are also trying to alleviate officials' concerns by building special enclosures and aviaries covered with nets to protect against contact with wild birds.
Vaccine tests
A vaccination program could also reduce the risk of infection by wild birds. The Netherlands received special authorization from the European Commission in Brussels last week to immunize 5.5 million birds in a pilot campaign. But Germans have been averse to the practice.
Bioland director Dosch sees German attitudes about vaccination as little more than a cynical calculation on the part of the poultry industry. According to Dosch, killing birds is cheaper than vaccination, because farmers are compensated for each chicken they kill, whereas they receive nothing for vaccination. Dosch, who wants to see vaccination in Germany's poultry industry, has recently gained the support of some virologists. Hans-Dieter Klenk, head of the Institute of Virology at the University of Marburg, has called for Germans to seriously consider launching a preventive vaccination program, noting that large-scale slaughtering alone has failed to stop the epidemic in Asia.
But what if neither vaccination nor animal destruction works and the virus jumps to humans? The biggest concern among influenza experts is that the virus could quickly mutate. The more it spreads among birds, leading to billions upon billions of cell divisions, the greater the likelihood of a fatal mutation occurring in the genetic material of the H5N1 virus -- a mutation that would allow the virus to jump from human to human.
Scientists studying the virus in high-security laboratories in Europe and the United States are trying to determine the point in its gene sequence where this disastrous mutation is most likely to occur. Researchers at Rotterdam's Erasmus Medical Center are even trying to artificially assemble their own version of a pandemic virus. "But we still know far too little about the characteristics of the influenza virus to be able to recognize the critical mutation in the genetic material," concedes WHO expert Stöhr.
One thing is certain: If and when D-Day occurs, it will be the epidemiologists, not the geneticists, who will be the first to know. "One of the telltale signs is when you start seeing deaths among family members or neighbors of a flu patient, or among doctors and nurses who treated that patient," Stöhr explains. He already has teams stationed all over the world, on the lookout for that ominous patient zero.
Researchers were almost convinced that this was exactly what happened in Indonesia last summer. On June 28, 2005, an eight-year-old girl with a high fever was admitted to a hospital in the Indonesian capital Jakarta. The girl's doctor, believing it to be a routine case of the flu, prescribed antibiotics. But the girl's father and one-year-old sister were admitted to the hospital a week later with the same symptoms. All three died, and the cause was found to be H5N1.
But where did the three Indonesians contract the virus? The father was a well-to-do government auditor, not exactly someone with chickens running around in his back yard. Although the reasons behind the chain of infection were never cleared up, medical experts' fears were allayed by the fact that no one else in the family's immediate environment was infected.
Someday, experts fear, there will be another case in Vietnam, Nigeria or Turkey, but it won't end as harmlessly.
On the other hand, the H5N1 killer virus could take a completely different course -- at least if the number of wild birds that have grown immune to the disease continues to rise. "Those birds then have the antibodies that protect them against renewed infection," says Kaleta. In that case the epidemic, he says, would inevitably come to a standstill. That's because H5N1 is doomed to a rapid demise, at least when it isn't living in swans, chickens and ducks. "The virus," says Kaleta, "is highly sensitive to sunlight and heat."
MARKUS DEGGERICH, ULRIKE DEMMER, STEFFEN KRAFT, GUNTHER LATSCH, GERALD TRAUFETTER
Translated from the German by Christopher Sultan
© DER SPIEGEL 9/2006
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Reproduction only allowed with the permission of SPIEGELnet GmbH
