The report says that poverty and families sharing their homes with poultry were the major factors that saw the virus transfer from birds to humans.

During early 2006, 12 avian influenza cases were confirmed in Turkey. Of these eight cases occurred in the Dogubeyazit-Van region. Ozlem Sarikaya of the University of Marmara, Istanbul and Tugrul Erbaydar of the University of Yuzuncu Yil, Van, conducted in-depth interviews with senior health professionals to evaluate attempts to control the outbreak.

The authors of the report found that, although a crisis committee was created quickly, healthcare workers felt anxious and ill-prepared due to a lack of clarity about their responsibilities in emergency disease plans, and delays in receiving protective clothing.

The researchers also found that the coordination between the human and animal health services was not sufficient. Despite these difficulties, open communication between the government and the public, as well as the health authorities' and health workers' efforts, helped control the epidemic. Poultry rearing practices, coupled with poverty and poor access to healthcare, were the primary risk factors for infection.

"Lessons learned from this outbreak should provide an opportunity for integrating the preparation plans of the health and agricultural organisations," said Sarikaya and Erbaydar.

"For revising the surveillance system and enhancing the role of the primary health care services in controlling epidemic disease." They add that informed response strategies will play an invaluable role in the control of a future avian influenza pandemic.