01:00 AM EST on Sunday, January 22, 2006

WASHINGTON

FATMA OZCAN surely deserved better. Hastily wrapped in a body bag and buried by torchlight, 12-year-old Fatma recently became the fourth Turkish child to die of the deadly H5N1 strain of avian influenza, or "bird flu." Without a miracle, she will not be the last.

Authorities in Turkey now say that the disease has spread to neighboring countries, despite attempts to stem the outbreak by slaughtering nearly 1 million chickens and other domesticated birds.

Bird flu has become a perplexing -- and deadly -- problem. It's time to admit that our current response, which mixes denial with a naive faith in anti-viral medications and sporadic culls of infected flocks, is not working. That approach did not save Fatma. And it won't protect the rest of us if the H5N1 virus begins to spread easily among humans, which could result in a pandemic that kills millions around the world.

In the United States, the poultry industry likes to assert that bird flu does not pose a risk because our factory farms supposedly have better sanitation and containment procedures than farms in Asia.

But bird flu has already struck in this country. In February 2004, an outbreak of H5N2, another strain of the disease, was detected in a flock of 7,000 chickens in south Texas. In fact, more than 16 outbreaks of H5 and H7 influenza have occurred among poultry in the United States since 1997, according to the Centers for Disease Control and Prevention. So far, the H5N1 strain has not arrived, but it easily could.

These outbreaks were entirely predictable. Collectively, Americans now eat 1 million chickens an hour. That means that about 9 billion chickens a year are raised for food in the United States. Most live in overcrowded and unsanitary conditions, with as many as 20,000 birds packed into a single shed. So when one chicken gets sick, disease spreads quickly, making these huge poultry operations the perfect "flu factories."

These conditions explain why salmonella and campylobacter are commonly found on chicken products sold in stores. It's also why flocks are often dosed with massive quantities of antimicrobials. But such measures will not stop avian flu.

Scientists predict that, sooner or later, H5N1 will mutate and gain the ability to spread easily among humans. That's especially alarming because this strain of avian flu is very aggressive, often causing pneumonia, multiple organ failure and death. At an October 2005 briefing on bird flu, infectious-disease experts told congressional staffers that, in a worst-case scenario, an avian-flu pandemic could kill 40 million Americans.

To avert the predicted pandemic, the United States and other nations recently pledged $1.9 billion for a variety of stopgap measures, from better surveillance to changes in food-handling practices.

But the threat of bird flu will remain high as long as chickens, ducks and turkeys are raised in dirty, overcrowded conditions. Like mad-cow disease, bird flu is the result of profoundly irresponsible agricultural practices. And consumers shouldn't wait for industry or the government to take action.

The obvious solution is to dry up the reservoir -- the chicken flocks where bird flu breeds. If, for a six-month period, a moratorium were placed on raising new chickens, existing flocks would soon be gone, and bird flu would exist only in the occasional migratory bird, posing essentially no risk to humans.

Of course, doctors have been encouraging people to cut chicken fat out of their diets for many years for entirely different reasons. A shift to a healthy plant-based diet can eliminate the intake of animal fat and cholesterol, a shift that dramatically lowers the risk of heart disease and some cancers.

If there were no animal agriculture, there would be no mad-cow disease, essentially no salmonella or campylobacter, and virtually no risk of bird flu. This is an easy nutrition prescription, but a difficult one politically, of course. However, it is the sure way to prevent what could become one of the deadliest diseases the world has ever known.

Neal Barnard, M.D., is a nutrition researcher and the president of the Physicians Committee for Responsible Medicine.