In its current form, the disease kills about three-quarters of the people who catch it from birds. Twelve Vietnamese have died this year. The disease was the suspected cause of one death in Cambodia.
Public-health experts say it is only a matter of time before the flu strain remakes itself, unleashing a disease that is both highly lethal and as easy to catch as an ordinary flu bug.
If this occurs, World Health Organization officials predict that, in the most optimistic scenario, 2 million to 7 million people would die worldwide and that the toll could potentially reach 100 million. Health experts say the virus has already exhibited traits similar to those that caused the Spanish flu pandemic of 1918, which is estimated to have killed 40 million people.
Tommy Thompson, former U.S. secretary of heath and human services, told reporters at his farewell news conference in December that avian flu was his greatest health fear. He called it a "really huge bomb" that concerned him even more than bioterrorism.
A year ago, as Thailand became the epicenter of an avian-influenza outbreak, local officials descended on Prathum's farm and put his chickens to death along with tens of millions in the rest of the country. The campaign was meant to stem the spread of a disease that has struck nine Asian countries.
The mass culling, however, did not stop the virus. And now, many poultry farmers are back in business, again raising their birds in unsanitary conditions that health experts say pose a threat unprecedented in modern agriculture.
Prathum, 54, has restocked his farm in central Thailand, rebuilding his flock, though not his confidence. His brown eyes have grown heavy. Bags hang low on sunbaked cheeks, and a deep furrow cuts across his broad forehead.
"Even if we're afraid of the disease returning, what can we do? Nothing," he said. "We can't run away."
U.N. agriculture officials say farmers can take simple steps to prevent the disease from spreading. They can require that workers disinfect their shoes, change clothing and spray their vehicles before entering a poultry farm. They can ban outsiders from chicken sheds, keep other animals away and keep egg trays and cages clean.
But farmers resist such measures, health and agriculture experts say. And governments in the region lack the money, staffing and, at times, political will to enforce these requirements on an industry that has become a vital component of economic growth.
Taking the lead from a neighbor, Prathum started in 1991 with 300 hens and began selling eggs. His flock grew steadily until it reached 15,000. He bought about 20 acres, more than tripling the size of his farm, and ultimately erected seven open-sided poultry sheds suspended above artificial ponds, which he stocked with fish to supplement his income. Each shed stretches about 40 yards under a pitched metal roof. Wood planks splattered with droppings run between the cages.
He bought a pair of Ford pickups, replaced his leaky clapboard hovel with a home three times as large and outfitted it with a color television, refrigerator and air conditioning. He gave each of his three children a computer and sent two sons to college, one of whom is studying veterinary science.
"I feel grateful to the chickens," Prathum said. "Chickens are like human beings. You take care of them well and they'll take care of you."
So when livestock officials came to the farm in December 2003, the order to kill the chickens was a great shock.
"They came by the hundreds in trucks, bringing soldiers and prisoners to kill the chickens," said Prathum's wife, Samrouy, 47, her leathery hands raised in exasperation. Avian flu had been discovered in a poultry shed down the road.
Thai officials were demanding that all poultry in the area be culled as a precaution. Workers dug a mass grave at the end of the property with a backhoe and buried the birds alive.
"It broke my heart," Samrouy recounted between rounds of collecting eggs. She wiped her brown eyes with a red-and-green checked scarf. "I felt that the chickens were like my children."
After nine months, weary of sitting idle, Prathum decided to restock his farm. He draped fishing nets over his sheds, as required under new government regulations, to keep out wild birds that local officials said might carry the disease.
But Prathum adopted none of the other safeguards that veterinary officials recommended, such as barring visitors and other animals from the farm. He continued to raise fish in the ponds, which attract waterfowl that could spread the virus. Neighboring farmers in filthy work clothes visit with Prathum inside the sheds as he feeds the flock and collects the eggs. Even his black dachshund follows him on his rounds.
It will take more for avian flu to spread rapidly among people. The current H5N1 strain would have to acquire genetic material from a human-flu bug in a process called re-assortment. The worst fears of public-health experts could come true if a person caught both flu strains at the same time.
Scientists, however, have demonstrated that this mixing of strains could also occur in other mammals, notably pigs. Ominously, the Asian swine population has also increased significantly.
It could be the gathering of a perfect storm: dense concentrations of chickens, pigs, aquatic birds and people.
"It's clear that Southeast Asia poses the greatest risk today of a new virus unfolding and coming forward as a pandemic strain," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "Darwin could not have created a more efficient re-assortment laboratory if he tried."
Prathum admitted he was counting on good fortune to avoid a bird-flu outbreak among his flock. "I'm still scared, but what can I do?" he said. "We'd never had bird flu before. It just came."
He acknowledged that his sons had been encouraging him to adopt modern safeguards. His older son, the student of veterinary science, had been particularly outspoken.
"I may not be able to learn about these as fast as young people," Prathum said. "I'll retire after a while and pass the farm on to my son. Then he can do what he wants."
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