Media criticism is creating tension between the WHO and Asian governments.

Fowl play: Asian governments may not be sharing their bird flu samples with the WHO. Credit: Reuters/Stringer

Sampath Krishnan mumbled unintelligibly, decried news that avian influenza had been found in India as “malicious rumors,” and then hung up the phone, all without letting a word in edgewise.

Krishnan, who is the World Health Organization (WHO)'s communicable disease surveillance officer for India, declined to discuss reports that surfaced on 11 May that three Indians from a poultry farm near the southern coastal city of Chennai had antibodies to the H5N1 avian influenza virus.

The episode is one of many across Asia that reflect the pressure on surveillance systems charged with tracking the spread of the flu virus. As policymakers in the region balance a desire to prop up tourism and trade with the need to be diligent and transparent in reporting potential cases, the press has reported that in Vietnam, Thailand, China and now India, surveillance is not up to snuff. Frustrated public health officials and scientists are starting to react to the criticism with silence or anger.

There is a lot of tension within the WHO and between WHO and its member countries. , Dick Thompson, WHO

On 11 May, an article on the Indian website Webindia123.com—later posted on ProMED, an online infectious disease news source—said that Nirmal K. Ganguly, director of the Indian Council of Medical Research, admitted to being “in a moment of total darkness” concerning the findings. The cases had been confirmed by the US Centers for Disease Control and Prevention (CDC) in 2004. The article also said the WHO was surprised that the findings escaped the weekly reports it receives from the government.

The H5N1-positive samples were taken in 2002, two from a test group of 120 poultry workers and another from the control group. But it is unclear when these three were infected and whether they are infected with the highly pathogenic strain used for testing, says Jacqueline Katz, who led the CDC team that analyzed the samples. Still, the report should not spread fear of an outbreak in India, she says.

The incident comes as the WHO is trying to alleviate concerns that international health agencies are not sharing information and samples with each other and with regional governments ( Nature 435, 131; 2005 ). “There is no refusal to share human samples by Vietnam or any country with avian influenza cases,” the organization says.

Still, says Dick Thompson, WHO spokesperson in Geneva, “there is a lot of tension within the WHO and between WHO and its member countries” on how and when to release information to the press.

Despite what the WHO says, there are signs that the tension could take a toll on collaborations. On 17 March, a researcher at the Institut Pasteur in Ho Chi Minh City wrote to WHO officials saying Vietnam's “Ministry of Health may not allow [my institute] to send any specimens to foreign countries in the future.” His email statement followed reports of false negatives at the institute.

With so much pressure on international health organizations and the countries under their charge, officials on both sides tend to be careful with the press. But the WHO says governments should be the first to announce any problems—before journalists get ahold of it. “This is the time to be as open as possible,” Thompson says. “Making the announcement first is the only way to maintain trust.”