By Michael Kahn

LONDON, Nov 15 (Reuters) - Quick government action and clear communication with the public are needed to contain bird flu cases in humans, Turkish researchers said on Thursday.

The researchers were reviewing how Turkey handled an outbreak that killed four people in 2006 -- the first human victims reported outside China and Southeast Asia after the H5N1 bird flu strain reemerged in 2003.

The rapid response overcame the impact of nervous health-care workers who felt ill-prepared to deal with the outbreak and poor coordination between human and animal health services, the researchers reported in the journal BioMed Central Public Health.

It also highlights strategies that could be key for other countries in controlling a future bird flu pandemic, wrote Ozlem Sarikaya of the University of Marmara, Istanbul, and Tugrul Erbaydar of the University of Yuzuncu Yil in the city of Van.

"Lessons learned from this outbreak should provide an opportunity for integrating the preparation plans of the health and agricultural organisations and for revising the surveillance system and enhancing the role of the primary health care services in controlling epidemic disease," they wrote.

Humans rarely contract H5N1, but the virus has killed 206 out of 335 people infected since 2003, according to the World Health Organisation. Experts fear the strain could spark the next global pandemic.

Researchers blamed the outbreak in Turkey on poultry rearing practices in which families shared their homes with birds, poor access to healthcare and poverty.

In their study, the researchers interviewed health workers -- including doctors, nurses and officials -- who were actively involved in dealing with the outbreak.

They concluded that poor organisation concerning emergency disease plans in the event of a bird flu outbreak and a lack of training left health workers unprepared.

Fears about their own and their families' health also affected how workers responded, underscoring the need to communicate risks to front-line workers, the researchers said.

Another major problem was poor coordination between animal and health services that hindered the initial detection of a human bird flu case and stymied the search for the original infection, they said.

Despite these shortcomings, the rapid response from central and regional health authorities and the performance of health workers helped prevent more deaths and contained the outbreak.

"...the rapid response and performance of the health workers played an important role in controlling the epidemic," the researchers wrote. (Editing by Maggie Fox and Keith Weir)

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