Bird flu Remains Potent Threat

Bird flu virus 'still smoldering,' U.S. expert says

Dr. Robert Webster, whose vaccine the U.S. government plans to use in case of an outbreak, told CNN (last year), "If this virus learns to transmit human to human and maintains that level of killing, we've got a global catastrophe." ...That worldwide pandemic hasn't yet materialized, and bird flu has been out of the headlines for a while. But we may be in for another round of news. ...Last week South Korea announced two new outbreaks in poultry. And Dr. Timothy Uyeki of the U.S. Centers for Disease Control and Prevention said he's bracing for another surge in human infections. "When the temperature drops and the humidity drops, that's when you start seeing more poultry outbreaks. And when you see poultry outbreaks, that's when you see human cases." ..."It's still smoldering," said Dr. Anthony Fauci, who heads U.S. scientific efforts to combat bird flu.

Three recent papers in the New England Journal of Medicine illustrate serious roadblocks to understanding and controlling the virus. The first describes three clusters of cases within families in Indonesia, eight patients in all. In two of the clusters, the authors said it's quite possible one person caught the disease, then passed it to family members. ...Worldwide, about a third of all cases involve family clusters and there are a handful of cases where the virus likely passed from person to person, he said.

...Webster and another prominent flu expert said efforts to eradicate the virus, through killing infected chicken flocks or by vaccinating poultry, have largely failed. Worse, they said, many vaccines used in Asia are of poor quality and are pushing the virus to mutate faster, in potentially more dangerous directions. ..."It's been a really rare human disease to date," Uyeki cautions, but "who can predict what's going to happen? We better continue to monitor and plan. To ignore this would be insane."

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Bird flu remains potent threat with possibility of human pandemic

The bird flu virus, with its possible mutation into a deadly human pandemic, remains a potent threat around the world, with greater transparency and sharing of information critical to meet the challenge, and Africa emerging as a top priority for resources and technical aid, according to the latest United Nations update released today. ...FAO said several parts of the world remain particularly vulnerable because of a shortfall in donor funding, including Africa, eastern Europe and the Caucasus, and Indonesia where just this year there have been 55 human cases, 45 of them fatal. ...well over 200 million birds have died worldwide from either the H5N1 flu virus or preventive culling...

“The possibility of a human pandemic hangs over us,” FAO warned ...H5N1 remains a “potent threat around the world, both to animals and humans,” it said, noting that with the arrival of the virus this year in Africa there is much cause for concern. ...“Africa must now be a top priority for resources and technical assistance in the battle against avian influenza,” it added, also calling for continued commitment to unaffected parts of the world like Latin America and the Caribbean, “where FAO’s investment in national and regional preparedness planning is paying off.”

Winning the battle against the virus demands a long-term vision, with more surveillance, rapid response to outbreaks and greater transparency and sharing of information essential. “Scientific breakthroughs on improved diagnostics, vaccines and treatments can only emerge if virus information is shared widely and willingly, for the greater good,” FAO said. ...Senior UN System Coordinator for Avian and Human Influenza David Nabarro said last month $1.5 billion is needed worldwide over the next two to three years for preventive measures. So far, FAO has received $76 million for its, and agreements have been signed for $25 million more, with a further $60 million in the pipeline.

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U.N.: bird flu virus still a powerful threat, vulnerable regions include Africa and eastern Europe

The H5N1 bird flu virus remains a powerful threat to animals and humans, and the most vulnerable regions include southeast Asia, Africa, eastern Europe and the Caucasus, the U.N. food agency said Wednesday.

"The possibility of a human pandemic hangs over us," the U.N. Food and Agriculture Organization warned...

"Failure by any one country to contain the disease could lead to rapid re-infection in many more countries," said Alexander Muller, assistant director-general at FAO. "One weak link can lead to a domino effect, undoing all the good that we have achieved so far. Now is no time for complacency."

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Bird flu Experts

The outbreak of highly pathogenic H5N1 avian influenza began in Asia in 2003 and spread rapidly in early 2006. ...It has now been detected in more than 50 countries around the world, including eight in Africa, where experts fear veterinary and human health systems are inadequate to contain outbreaks.

...(RE) the devastating effects on vital poultry industries in poor and densely populated countries ..."The potential costs of an influenza pandemic would be of the order of $1-2 trillion ... and the actual cost of avian influenza thus far has been in the multiple billions of dollars," Nabarro said.

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US CDC contracts for new, faster bird flu tests

The U.S. Centers for Disease Control and Prevention said on Monday it had awarded $11.4 million for developing new, quick tests for influenza to four U.S. companies. ...The idea is to come up with reliable, on-the-spot tests for H5N1 avian influenza, the CDC said in a statement.

Current quick tests can tell if a person is infected with influenza A or B, but they do not identify the strain and reports suggest the tests miss influenza in patients infected with H5N1.

"We have seen avian influenza infections since 1997 but we unfortunately still do not have a good way to quickly and easily distinguish at a patient's bedside whether they suffer from H5N1 or a more common type of influenza," said CDC Director Dr. Julie Gerberding. ..."These contracts will support development of promising technology that could help doctors treat their patients faster and help public health authorities track influenza viruses that could spur a pandemic." ...Currently, to test for H5N1, samples from the patient must be sent a specialized testing lab, which can sometimes take more than a week. This would be too slow to stop the spread of a pandemic, experts say.

Scientists Criticize U.S. Bird Flu Search

Birds from Latin America - not from the north - are most likely to bring deadly bird flu to the main U.S., researchers said Monday, suggesting the government might miss the H5N1 virus because biologists have been looking in the wrong direction. ...The United States' $29 million bird flu surveillance program has focused heavily on migratory birds flying from Asia to Alaska, where researchers this year collected tens of thousands of samples from wild birds nesting on frozen tundra before making their way south. ...Those birds present a much lower risk than migratory birds that make their way north from South America through Central America and Mexico, where controls on imported poultry are not as tough as in the U.S. and Canada, according to findings in the latest Proceedings of the National Academy of Sciences.

"The risk is actually higher from the poultry trade to the Americas than from migratory birds," said Kilpatrick, of the Consortium for Conservation Medicine in New York. Other researchers on the study came from the Smithsonian Institution. ...If bird flu arrives in Mexico or somewhere farther south, it could be a matter of time before a migratory bird carries the virus to the United States, Kilpatrick said. ..."It's not just a matter of worrying about who you trade with, but it's a matter of thinking about who do your neighbors trade with, and who do your trading partners trade with," Kilpatrick said. "We need to be looking both south and north." ...The study concluded that "current American surveillance plans that focus primarily on the Alaskan migratory bird pathway may fail to detect the introduction of H5N1 into the United States in time to prevent its spread into domestic poultry."

The report is the first to combine the DNA fingerprint of the H5N1 virus in different countries with data on the movement of migratory birds and commercial poultry in those countries. ...The study found that:
* Bird flu was spread through Asia by the poultry trade.
* Most of the spread throughout Europe was from migratory birds.
* Bird flu spread into Africa from migratory birds as well as poultry trade.

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U.S. Bird Flu Detection Plan Is Wild Goose Chase

Officials are looking in the wrong place to stop the spread of bird flu to the U.S., a new study suggests. ...The report predicts that bird flu will likely spread to the Americas through infected poultry. This poultry may then infect local wild birds...

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Poultry trade likely route for bird flu to Americas, experts say

The H5N1 strain of bird flu is most likely to enter North America through infected poultry trade, researchers say. ...British and American researchers studied how H5N1 moved out of China, across Asia and Europe and into the Middle East and Africa. The poultry trade was often the source, with migrating fowl then spreading it, they concluded.

"We conclude that the most effective strategy to prevent H5N1 from being introduced into the Western Hemisphere would be strict controls or a ban on the importation of poultry and wild birds into the Americas and stronger enforcement to curb illegal trade," they wrote in this week's online issue of the Proceedings of the National Academy of Sciences.

About three-quarters of new diseases originate in animals, the researchers noted. ...Genetic testing allowed most of the H5N1 outbreaks to be traced to the poultry trade, migratory birds or wild birds, but some outbreaks remained, such as those in South Korea, Russia, India, Pakistan and Cameroon, the researchers said. ...Illegal trade in chicken feces for fertilizer and fish food could be a culprit.

Pandemic Preparedness: Information Systems and Health Services Capacity-Building

Within the last year, avian influenza in poultry has spread from 14 countries to 55. For the first time, highly pathogenic avian influenza was found on the continent of Africa. More humans have become infected, and over half of those infected have died. The global situation for avian influenza is not improving.

We do not know if the highly pathogenic H5N1 virus will someday mutate or re-assort to the point of sustained and efficient human-to-human transmission. But we do know that influenza viruses have threatened animal and human populations for centuries. The three human influenza pandemics that occurred in the 20th century each resulted in illness in approximately 30 percent of the world population and death in 0.2 percent to 2 percent of those infected. Our Implementation Plan and our cooperative international efforts focus on an outbreak of influenza with pandemic potential, not just on the H5N1 virus.

Our Implementation Plan envisages the following policies and actions for U.S. public diplomacy and public-health specialists to explain and advocate:
* Emphasizing the importance of international cooperation and efforts complementary to those of multilateral organizations to contain the spread of the virus;
* Elevating pandemic influenza on national agendas, stressing the role of committed high-level political leadership in containment efforts;
* Advocating transparency in surveillance and reporting of suspected animal and human cases;
* Encouraging the sharing of epidemiological data and samples with WHO, FAO, OIE, and the world community to detect and track outbreaks;
* Assisting others to develop pandemic preparedness plans, build public and animal health capacity, strengthen communications infrastructures, increase logistical capability, and prepare to take effective countermeasures;
* Mobilizing and coordinating global resources; and
* Enhancing public awareness and knowledge of protective measures.

Here's how to survive a severe pandemic: Prepare to become self-sufficient for several months; stockpile nonperishable food, water, disinfectants, prescription medication, office supplies, batteries and generators, air-filter masks, cash (small bills), portable gas cookware, entertainment for the kids, and so on. If you happen to be shopping for an air purifier anyway, make sure it has a UV component like these - that's the only type that will actually kill a virus. Consider having to take care of a sick family member if a hospital is out of the question; this would require the antivirals Tamiflu or Relenza (Relenza is likely to be more effective, since Tamiflu more quickly provokes resistance), as well as drugs for nausea, fever, pain, and muscle aches; basic medical supplies like gloves, masks, and a blood pressure monitor would also be prudent.

How To Survive the Avian Flu, Smallpox, or Plague

NEW BIRD FLU PERIL ON WAY

Top virologist John Oxford said that Britain was being "too complacent".

In a new warning last month, the Royal Society and Academy of Medical Sciences urged the Government to act fast.

The Academy's Sir John Skehel said: "The decision to continue to stockpile just one antiviral drug is a major concern." He called on Tony Blair to appoint a "flu tsar". ...Shadow Health Secretary Andrew Lansley said: "I believe there's a major risk of a flu pandemic. We should think about stockpiling more antiviral drugs and facemasks."

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Haj pilgrims warned of flu attack

People intending to perform Haj this year have been cautioned against a flu pandemic. They have been advised to take an additional flu shot, since Haj is falling in winter. ...“People planning to make the Haj pilgrimage should get flu shots beforehand to reduce the risk of a flu pandemic,” said doctors in the recent issue of British Medical Journal (BMJ).

Respiratory problems are already common during the Haj congregation. ...Aziz Sheikh, an epidemiologist at the University of Edinburgh, has issued a warning that such a gathering makes a possibility of a global flu pandemic much more likely. ...Shaikh said that overcrowding was common during Haj and epidemiologists think at least one in three pilgrims would develop respiratory symptoms during the stay.

Such a large gathering represents a major public health risk, according to the editorial in the BMJ, particularly at a time when the risk of a pandemic is thought to be high.

As Bird Flu Panic Subsides, Experts Wonder What Comes Next

Earlier this year, bird flu panic was in full swing: The French feared for their foie gras, the Swiss locked their chickens indoors, and Americans enlisted prison inmates in Alaska to help spot infected wild birds. ...With the feared H5N1 virus - previously confined to Southeast Asia - striking birds in places as diverse as Germany, Egypt, and Nigeria, it seemed inevitable that a flu pandemic would erupt. ...Then the virus went quiet. Except for a steady stream of human cases from Indonesia, the current bird flu epicenter, the past year’s worries about a catastrophic global flu outbreak largely disappeared from the radar screen.

What happened? ...Part of the explanation may be seasonal. Bird flu tends to be most active in the colder months, as the virus survives longer at low temperatures. "Many of us are holding our breaths to see what happens in the winter," said Dr. Malik Peiris, a microbiology professor at Hong Kong University. ...Some experts suspect poultry vaccination has, paradoxically, complicated detection. Vaccination reduces the amount of virus circulating, but low levels of the virus may still be causing outbreaks - without the obvious signs of dying birds. ..."It’s now harder to spot what’s happening with the flu in animals and humans," said Dr. Angus Nicoll, influenza director at the European Centres for Disease Control and Prevention. ...Though human-to-human transmission occurred - ...the virus did not adapt enough to become easily infectious. ...This pandemic near-miss highlighted many of the problems that continue to plague public health officials, namely, patchy surveillance systems and limited virus information.

While the pandemic hasn’t materialized, experts say it’s too early to relax. ...“We have a visible risk in front of us,“ said Dr. Keiji Fukuda, coordinator of the World Health Organization’s global influenza program. ...Having H5N1 lurking in the environment, ...is essentially like having an unexploded bomb in your garden as the virus spreads even further more people are around to kick the bomb. “It may be a live bomb and actually have pandemic potential,“ Nicoll says. “But it might also simply be a dud.“

HANOI, Vietnam -- Thousands of poultry died of bird flu in the past two weeks in southern Vietnam, the government said Wednesday, in the country's first reported outbreak in a year.

Tests showed that some 5,500 month-old ducks and 500 chickens died of the virulent H5N1 bird flu strain in the southern Mekong Delta provinces of Ca Mau and Bac Lieu, said Hoang Van Nam, deputy director of the Department of Animal Health.

Bet on it: Pandemic flu looms

Let's think, for a while, about the unthinkable:
* America's modern medical system grinds into gridlock as victims of a pandemic influenza overflow hospitals and crowd into makeshift wards in school gyms and church halls.
* Schools close because they are "virus factories,'' as Dr. Tom Locke puts it, and crowds aren't allowed to gather at events like basketball games.
* Between sick days and family leave, from a third to half of most businesses' employees are absent -- including those who provide such vital goods as food and fuel, or services like police protection and fire fighting.
* The first wave of illness lasts one month, two, three. Not until four to five months after the outbreak is a vaccine available.

Some of these thoughts are from a worst-case scenario, admits Locke, health officer for Clallam and Jefferson counties. But you can bet the farm that a pandemic of avian influenza will occur in the foreseeable future, he told a recent public forum on pandemic flu and preparations to avoid it.

'Panflu' preparations
Other strategies against a pandemic -- also dubbed "panflu" -- include:
* Gathering patients in places like gymnasiums -- called "cohorting" -- while the disease runs its one- to two-week course through victims
* Educating people to provide home-based care
* Urging people to get seasonal flu vaccinations, which at least will help health authorities deal with H5N1 cases instead of bouts of seasonal flu
* Limiting travel
* "Social distancing": forbidding people to gather in large numbers at athletic contests or concerts
* Encouraging people to prepare for panflu like they would for earthquakes or windstorms -- only in terms of weeks, perhaps months, instead of the rule-of-thumb 72-hour supply of food, water and medicines.