12/14 H5N1 | US- Feds.State & Local Govts Ramp up Plans for a Pandemic

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<B><font size=+1 color=red><center>Federal, State Governments Plan for Bird Flu Pandemic</font>

Dec 13, 2005, 09:58 PM CST
<A href="http://www.klas-tv.com/Global/story.asp?S=4241309&nav=menu102_2">klastv.com </a></center>

Some medical experts say it is not a matter of if a flu pandemic -- such as the bird flu -- will reach Las Vegas; it is a matter of when. Eyewitness News has learned what the federal government is doing to help our state. State lawmakers sat down Tuesday morning to talk about what they need to do to prepare for a possible flu pandemic. They found out the federal government is sending experts to Nevada to help us prepare. </b>

Clark County Assemblyman Joe Hardy said, "We know there will be a pandemic flu problem. It is going to happen." As a doctor, Assemblyman Hardy says Clark County must be ready. He added, "We know we have to gear up as people and government bodies." State Senator Steven Horsford said, "This is everyone's problem and we need to be prepared."

Washoe County Assemblywoman Sheila Leslie said, "The upside is that it appears our health department is taking the possibility of a pandemic very seriously." Assemblyman Hardy said, "This is something we need to be geared up individually about. The federal government is not going to come in and kill all of the viruses in the world."

The federal government is providing ammunition in the fight against a possible pandemic. Assemblywoman Leslie added, "It appears the feds are going to each state to hold a summit on this topic which will be a first in my experience."

Senator Horsford said, "Unfortunately a lot of people have lost confidence in the federal government's ability to respond. Hurricane Katrina was a good example of that." That is why this panel says the planning begins here in Clark County.

Assemblywoman Leslie said, "I am not sure we can ever be completely prepared for an emergency, but it is something our health department will have to monitor as the months go by."

The Legislative Committee on Healthcare agreed Tuesday the most important steps are to plan and practice those plans so that Clark County is prepared in the case of a flu pandemic. The federal summit will be held in Las Vegas. The public and first responders will be given the chance to ask questions about the bird flu. The date for the summit has not been set.

The federal government has a broad plan for action against a possible avian flu pandemic. The government has appropriated $7.1 million over the next five years to fight a pandemic. Local government checklists have been designed to help local governments buy supplies and recruit workers before a possible outbreak.

There is also a guide to distribute 50 million doses of anti-viral medication. The medication will be purchased by the federal government and given to state governments.

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<B><font size=+1 color=brown><center>Federal experts swing by Tampa with bird flu update </font>

<A href="http://www.abcactionnews.com/stories/2005/12/051213birdflu.shtml">ABC Action News report</a>
12/13/05 </center>

TAMPA - Representatives from the Centers for Disease Control were in Tampa on Tuesday to talk bird flu with state Health Department employees. </b>

They say it's not a matter of if, but when the bird flu virus arrives, so we need to be prepared, especially since Florida sees so many tourists and business travelers.

CDC officials talked about what they are doing to contain the virus and prevent the spread, including surveillance at ports, monitoring birds that come into the country, and monitoring our own flocks.

"We all get to talk about our different plans for our different counties, how those plans work in conjunction with the CDC and our national plans and our national strategies. What we are able to do is take the strategies and information that we learn in this sort of setting back to our counties and apply it to our local plans," explained Steve Huard of the Hillsborough County Health Department.

The state of Florida already has an incident command team set up and ready to go if and when the virus does arrive in the state.

To keep tabs on the government's preparations for a possible bird flu outbreak, click on over to pandemicflu.gov.

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<B><font size=+1 color=green><center>Flu risk: city plots possible effect on services</font>

December 13 2005
<A href="http://www.thisisgwent.co.uk/gwent/news/NEWS2.html">This Is Gwent</a></center>

NEWPORT residents may have to put up with uncollected rubbish, untended parks and even the temporary suspension of emergency council services if a flu pandemic strikes.</b>

That is the scenario the city could face if hundreds of council staff at a time fall ill, according to a report being considered by councillors tomorrow.

Council services are set to be rated high, medium or low, depending on how essential they are considered.

But even some emergency contact services might have to be shut down if a pandemic is particularly acute, though interruption of only minutes or hours would be tolerated.

Details of the council's preparations to respond to a potential flu pandemic will be discussed by cabinet members.

Pandemic flu, usually linked to a higher severity of illness and a consequent higher risk of death, occurs roughly every 30 years and, as the last outbreak was in late 1960s, one is overdue.

The council report, by civil contingencies manager Alan Young, says that planning for absenteeism in the event of a pandemic should assume a peak level of 10 per cent of the workforce being absent at any one time.

For Newport council that would be some 750 of its 7,500 employees.

Lower levels of staff would likely to be absent ill during the early and later stages.

But over the course of a three-month pandemic up to a quarter of the council's workforce might become ill, each taking five to eight days off.

The report states the council must be particularly aware of government recommendations to control or delay the spread of infection.

These could include school closures or cancellation of public events, as local decisions must be made on these based on health experts' advice.

If council services are stretched due to staff being sick, "it will be essential to take account of level of disruption to the service that can be tolerated before reinstatement is essential", says Mr Young's report.

Rubbish collection could be suspended for a week or two, while grounds maintenance, including upkeep of parkland, might be stopped for up to a month.

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<B><font size=+1 color=blue><center>Georgia hospitals' staffing remains a challenge</font>

December 13 2005
MIKE STOBBE
<A href="http://www.ledger-enquirer.com/mld/ledgerenquirer/news/politics/13399351.htm">Associated Press Ledger-Enquirer.com</a></center>

ATLANTA - Georgia recently purchased 2,000 ventilators and has taken other steps to medically prepare for a bird flu pandemic, but hospital staffing remains a concern, the state's public health director said Tuesday.</b>

"At the moment, they don't have in place sufficient staff," said Dr. Stuart Brown, who heads the Georgia Department of Human Resources' Division of Public Health.

State and hospital officials have worked out plans to increase the state's hospital bed availability by more than 75 percent, if necessary, using existing beds and buildings, Brown said. But it's not clear where hospitals would get the nurses and other health-care workers needed to attend to patients in those beds, Brown said at an Atlanta Press Club luncheon Tuesday.

The state spent $600,000 for the new emergency ventilators. If there is a major influenza outbreak, it's likely some victims may develop pneumonia and the devices will be needed to aid their breathing.

The ventilators are not as expensive or sophisticated as those typically used in hospitals. However, they should do the job, and will increase the state's supply from 1,500 to 3,500 ventilators, state health officials said.

"But where are all the respiratory therapists and people you need to run those machines?" Brown said, adding that the new ventilators are in storage in an undisclosed location.

Georgia Hospital Association officials acknowledged the staffing concern, and said they're developing a volunteer registry of doctors, nurses and other health-care professionals.

It's not simply a matter of building a call-list, because security credentials will have to be set up for each health professional who might be asked to enter a disaster or outbreak site, noted Karen Waters, an association vice president involved in the planning.

Meanwhile, the hospital association announced Tuesday it had signed a $3.4 million contract to pay a New Jersey company, LiveProcess, to provide a Web-based service to all Georgia hospitals that will offer a disaster-planning template and a repository for all the state's hospitals' disaster plans.

A state grant is paying for the site, association officials said Tuesday.

At the luncheon, Brown and two other speakers discussed H5N1, a deadly type of influenza that has been spreading among birds, primarily in Asia.

It has infected nearly 140 people and killed 70 around the world, said Alex Azar, the No. 2 administrator at the U.S. Department of Health and Human Services, the parent organization of the Atlanta-based Centers for Disease Control and Prevention.

The flu does not easily spread from human to human, but health officials worry it will mutate to become more contagious. If that happens, it could trigger an epidemic of the disease around the world - what is known as a pandemic.

President Bush last month asked Congress for more than $7.1 billion to improve national preparedness against a pandemic flu. The money mostly would be used for vaccines and antiviral medications, said Azar, one of the luncheon speakers.

It's not known whether the current bird flu will mutate into a strain that's both highly lethal and contagious, but federal officials say they are taking the threat seriously.

"It may be one of the most terrible threats to life that the world has faced," Azar said.

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<B><font size=+1 color=purple><center>FDA Warns of Phony Bird Flu Drugs </font>

December 14, 2005
<A href="http://www.consumeraffairs.com/news04/2005/fda_bird_flu_drugs.html">consumeraffairs.com</a></center>

The Food and Drug Administration has issued warning letters to nine companies marketing bogus flu products behind claims that their products could be effective against preventing the avian flu or other forms of influenza.</b>

FDA said it is not aware of any scientific evidence that demonstrates the safety or effectiveness of these products for treating or preventing avian flu and the agency is concerned that the use of these products could harm consumers or interfere with conventional treatments.

"There are initiatives in place to deter counterfeiters and those who sell fraudulent or phony products to prevent or treat avian flu," said Andrew von Eschenbach, MD, Acting FDA Commissioner.

"The use of unproven flu cures and treatments increases the risk of catching and spreading the flu rather than lessening it because people assume they are protected and safe and they aren't. I consider it a public health hazard when people are lured into using bogus treatments based on deceptive or fraudulent medical claims."

FDA issued warning letters to nine firms marketing products making unproven claims that they treat or prevent avian flu or other forms of influenza.

Eight of the products purported to be dietary supplements. Examples of the unproven claims cited in the warning letters include: "prevents avian flu," "a natural virus shield," "kills the virus," and "treats the avian flu."

These alternative therapies are promoted as "natural" or "safer" treatments that can be used in place of an approved treatment or preventative medical product.

In the warning letters, the FDA advises the firms that it considers their products to be drugs because they claim to treat or prevent disease. The warning letters further state that FDA considers these products to be "new drugs" that require FDA approval before marketing.

The letters also note that the claims regarding avian flu are false and misleading because there is no scientific basis for concluding that the products are effective to treat or prevent avian flu. The companies have 15 days to respond to FDA.

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<B><font size=+1 color=red><center>Six-month bird flu lockdown possible</font>

14 December 2005
By LEE MATTHEWS
<A href="http://www.stuff.co.nz/stuff/0,2106,3511762a10,00.html">www.stuff.co.nz</a></center>

Emergency managers are warning that a bird flu pandemic could last up to six months and people should be prepared to stay indoors that long.

Ministry of Civil Defence and Emergency Management readiness manager Mike O'Leary said a bird flu pandemic could strike in multiple waves, lasting up to six months.</b>

"Three waves of approximately eight weeks each is what we are planning for," Mr O'Leary told Human Resources magazine.

Local Government Online chief executive Jim Higgins said it is rubbish to think a pandemic would last a few days.

". . .I've heard people on television speaking of a pandemic lasting a week or two, and I think, 'That's complete rubbish.' More likely a pandemic is going to last for three to six months, with two or three waves of infection."

Local Government Online would be key to providing information during an pandemic.

New Zealand's existing emergency response planning is for short, sharp disasters, such as earthquakes or floods, with mop-up afterward.

"When you think about all the (emergency response) planning that's been done to date, none of it includes anything about not being able to go outside for an extended period of perhaps three to six months. This threat is unique," Mr Higgins said.

Mr O'Leary also warned New Zealand would large
ly have to manage alone: "Public expectations will be high that relief will come to them, but there will be no cavalry coming over the horizon."

Bird flu is now only a threat, but health experts are worried that a small mutation of the H5N1 virus could let it transmit between humans, and humans have no natural immunity to it.

Health Ministry senior clinical adviser Andrea Forde said the key to surviving any pandemic will be in how well prepared people are, how quickly people can respond and how soon recovery happens.

A pandemic outbreak would see quarantine measures imposed, closing schools and workplaces to prevent infection from spreading. International borders would also be closed, affecting exports and imports. The experts say it could take months to get business functioning again. Getting back to normal would take longer.

Mr Higgins said businesses had to accept the pandemic is going to happen and to start planning.

"It's not a Y2K scenario. If businesses fail to heed this and do not have contingency plans in place, they will most likely grind to a halt."

Ministry of Economic Development resources and networks director Tony Fenwick said a pandemic would see businesses close either because they had to or through reduced demand.

Key industries must plan now for a pandemic, Mr Fenwick said.

"Undisrupted provision of key infrastructure services, the food-supply chain, the capacity of the health sector, the continued operation of banking-payments systems and the legal system are areas we must focus on," he said.

Mr Higgins said the chance of containing bird flu, as Sars was contained, may be remote because of the more infectious nature of influenza.

". . .so we have to look at ways to ride a pandemic out. One of the best ways to do that will be to limit personal contact," he said.

That means businesses have to immediately start looking at ways staff can work from home. Email and telecommunications will be the top tools to keep functioning.

"This really is the sort of line we have to follow to avoid unnecessary infection."

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<B><font size=+1 color=brown><center>Grandmother Helping U.S. Government to Spread Bird Flu Preparedness News </font>

December 13 2005
<A href="http://www.prweb.com/releases/2005/12/prweb321326.htm">www.prweb.com/releases</a></center>

Grandmother fed up with lack of U.S. government communication about bird flu preparation creates her own presentation, "Straight Talk About Bird Flu Preparation."</b>

(PRWEB) December 13, 2005 -- ”Ma Bailey” (a.k.a Lorilyn Bailey) says the government isn’t communicating well enough about how to prepare for a possible bird flu pandemic. So she decided to do something about it.

The result is "Straight Talk About Bird Flu Preparation," a 112-slide presentation that is hosted on her site, http://www.BirdFluPreparation.com. The URL of the slide presentation is: http://www.birdflupreparation.com/presentation.html

Bailey, mother of two, grandmother of one, says she was tired of listening to government advice to “start preparing for the bird flu” and finding little information to describe exactly what that meant.

So she read the government sites, made her own assumptions, and created a slide presentation. “The presentation presents the most vital information from the government sites as well as information from scientific and news sources,” she says.

The result, she says, is an easy-to-read presentation that she believes “everyone on Planet Earth” needs to read, because the entire planet is vulnerable if the virus mutates, as many scientists predict it will.

Bailey's intent, she says, is not to alarm people but to make sure they read and understand what the government is trying to tell them. "No one these days has time to read government documents, and government documents often leave much to be desired. My slide presentation makes a difficult pill easier to swallow."

“Ma Bailey” says that we have much to learn from the 1918 bird flu epidemic. “There are many similarities. As in 1918, the U.S. is involved in an expensive war; the government isn’t spending enough on health care; there is a large immigrant population that may not get the information it needs; and everyone will most likely resist necessary quarantines. In 1918, there were no drugs or vaccine, and if the pandemic strikes the U.S. in the next few years, manufacturers will not be able to provide enough drugs or vaccine for everyone.”

Bailey has a background in writing and instructional technology and felt she could put her skills to use helping out the U.S. government when they needed it.

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<B><font size=+1 color=purple><center>Pandemic or pandemonium? Drawing on crisis management best practice to prepare for the worst</font>

By Chris Woodcock, managing director, at UK-based pan-European crisis and risk management consultancy, Razor
<A href="http://www.continuitycentral.com/feature0277.htm">www.continuitycentral.com</a></center>

<font size=+0 color=red>The theory’s good but the practice is not so easy</font>

“Tell it all and tell it fast”: this has been the mantra of crisis communications specialists for well over a decade. And, what’s more, it’s not only easy to remember but it’s usually right. And it’s never more applicable than when dealing with highly emotive health scares, especially where thousands or millions of people might be affected - or believe or fear they might be affected.</b>

The good news in dealing with pandemics, mass food scares, or the fear of them is that people crave information; the bad news is that information is often confused or sparse and that people may not be predisposed to hear, believe or act on it.

As we shiver our way into the heart of this winter, the fears of Avian ‘Flu and virulent influenza epidemics are rising as the temperature falls. The UK media are reporting that over-zealous GPs and over-anxious consumers have already used up our stocks of flu jabs – and there are no signs of an avian flu diagnosis or cure being anywhere on the horizon, even though the race is well and truly on to find a vaccine.

How did we get here?
So, we have a demand from the public for communication to allay fears and provide accurate information. But this can often be a set of demands that are emanating in an all-pervasive atmosphere of distrust, misinformation - and very few absolute facts that we can rely on no matter what.

The government has a duty to inform, advise and reassure but very shaky ground on which to act. What should they do? What should any self-respecting public health education or advisory body do? They need to `tell it all’ but where are the accurate facts and how much are people ready to believe?

Back in March 2005, the UK government told us it was stockpiling enough anti-viral drugs to treat one in four people in the country for ‘flu. And, the BBC reported, the Government might also announce pandemic-containment plans to close large venues such as schools and cinemas, in the event of a major outbreak, to prevent the disease spreading. The move followed a spring warning from the World Health Organization that a new strain of Avian ‘Flu could develop, which would allow the virus to spread from human to human.

Professor Pat Troop, of the Health Protection Agency, told worried punters watching BBC Breakfast as they downed their cereal:

"The general consensus is that it's not if but ‘when’ we have a pandemic. We don't know when. It could be this year, next year or beyond that. What's most important is that we have good plans in place and we are all prepared. We won't be able to stop it or completely control it but we can mitigate its effect."

Brave words as an attempt to get things in a reasonable perspective – to imply authority and calm but to be telling us quite clearly, at the same time, that we have no plan (yet) and that there will always be an out-of-control aspect to the problem. No wonder our media and our minds have had a field day ever since…

Perception of risk is a tricky phenomenon
Much of what we know about risk perception and communication in both the world of health education and protection and in the food industry (witness the recent huge food scares and recalls) is from observing and experiencing risk behaviour. In this process, three components of taking risks play a decisive role:

* The complexity of the issue at hand

* The uncertainty about the actual occurrence of the presumed positive or negative effects, and

* The ambiguity when these effects are assessed by oneself and others.

All three components – complexity, uncertainty and ambiguity – must be applied in parallel to all four stages of the risk regulation process and the risk-benefit balancing process. The key questions to ask, in planning how and what to communicate with regard to the risk, cover four areas for action. They are:

* How high is the risk? This is an issue concerning scientific risk assessment.

* How acceptable is the assessed risk? Is it tolerable or not? This concerns risk evaluation. This process includes a comparison between benefits and risks; without such a balancing act risk tolerability cannot be determined.

* What possibilities are there to further reduce a risk rated as being unacceptable and, if possible, to avoid or minimise risk? This concerns risk management.

* How are transparency, understanding, and if at all possible, agreement to the planned risk management achieved? This concerns risk communication.

Similarly, experience makes it possible to categorise four functions of risk-benefit communication that are very relevant to the steps required in preparing for a pandemic or the threat of one:

* Enlightenment: Making people able to understand risks and benefits (and their interactions)

* Behavioural changes: Making people aware of potential risks and benefits helps them to make the right choices

* Trust building: Assisting health education bodies to generate and sustain trust

* Conflict resolution: Assisting health education bodies to involve major stakeholders and affected parties to take part in the risk-benefit evaluation

Professor Pat Troop, of the Health Protection Agency, had little choice but to embark, in her BBC interview, on the first tentative steps of this process. Unfortunately for her, there is a well-documented ‘trust deficit’ backdrop where she, or anyone else, has to fight back against huge apathy and mistrust before clawing their way back to the level playing field on which to convey sound information and simple, clear advice.

Stepping stones towards a communications plan
Insight from various respected research can be distilled into a few good principles of risk communication that our government – and all others – would be well advised to take on board in the case of health or food scares and crises:

* Risk-benefit communication starts with an excellent record of management

* Communicators need to specify in advance:

- Purpose of communication (orientation, behavioural advice, involvement)
- Aspects of risk-benefit debate (risk challenges, benefit problems)
- Types of audiences to be approached
- Available risk communication resources and channels
- Follow-up after the risk communication programme is completed
- Design for evaluation
- Risk-benefit communication needs to address:
- Difference between risk and hazard
- The process of risk management decision making
- The trade-offs and value conflicts when making management decisions (risk-benefit-balancing) – this is the unavoidable nub of the problem in the case of pandemics

* Trust and credibility cannot be “produced” or “manufactured” but only earned in terms of performance and effective communication.

So what can be done – what would ‘success’ look like?
Health education policy makers cannot produce certainty but can help people to develop coping mechanisms to deal prudently with the necessary uncertainty that is required for organisations and business plans to progress.

So is there anyone out there who is managing to get some straightforward coping mechanisms in place? Well, our health education counterparts in New Zealand have made a decent start. Their Ministry of Health website outlines their national pandemic plan which is continually being updated in line with WHO recommendations. District Health Boards have local plans too.

All other government agencies are also planning for a pandemic. An inter-sectoral group is considering non-health issues that are directly affected by a pandemic, such as school closures, border management and the maintenance of critical infrastructure, including supply of food and water and law and order resources and plans.

The New Zealand Government, following the advice of the WHO, has been stockpiling anti-viral medicine (Tamiflu) suitable for use against influenza viruses. By the end of 2005, they claim, there will be enough anti-viral medicine to treat about 21 percent of the population. (Compare that with the UK aims and the current reality.)

The New Zealand Ministry of Health has also set up a Pandemic Influenza Technical Advisory Group (PITAG), which advises the Ministry on the international situation and provides recommendations on the appropriate nature of New Zealand's responses. There is also a Pandemic Influenza Reference Committee (PIRC), with members from across the health sector.

They are also conscious too of the essential importance of the front-line, consumer-facing advisors who will bear the brunt of communicating and caring. They rightly say: “Primary health care is a fundamental component of pandemic planning at a District Health Board (DHB) level, and DHBs are working in their communities to make sure this is achieved through their emergency plans. Many DHBs employ general practitioners to liaise with other GPs on primary care issues.

“Nationally the Ministry of Health is working on pandemic planning with primary care leaders, such as the Royal New Zealand College of General Practitioners and the College of Practice Nurses.

“National GP organisations have met and identified how they are will continue to contribute to the ongoing pandemic planning processes, and the College of GPs has been nominated as the lead agency for this. There are GPs and nurses on various pandemic influenza advisory groups to the Ministry.”

And this still leaves the basic communication job to be done: simple messages and practical advice. In New Zealand, they are answering this need by producing information packs advising on infection control measures to minimise the spread of ‘flu among health workers and the public. These are being distributed to primary care practitioners. Of course, there is a much wider industry and business distribution that would also be necessary, but their website doesn’t tell us this is planned.

Risk is a fact of life
Pandemic and health scares test our ability to predict, manage and communicate risk to the limit. Too many scares have come and gone for the average punter to worry unduly but, at the same time, there is a need to prevent and protect and to allay deep-seated fears. A process of careful planning and assessment and the establishment of expert figures who can, gradually, command a high degree of trust are essential to creating a system that is controllable and thorough. In the UK, ahead of possible ‘flu and Avian ‘Flu pandemics, there still seems to be a lack of linkage between top policy makers and front-line health advisors. Perhaps it’s time for someone in the DoH to stand well back and review the progress and challenge the mechanisms.

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<B><center>Dec. 14, 2005
<A href="http://www.the-scientist.com/news/20051214/01">DAILY NEWS - The Scientist</a>
<font size=+0 color=red>U.S. zoos prepare for avian flu</font>

New guidelines focus on biocontainment, recommend vaccination in case of disease threat
By Graciela Flores </center>

The organization representing U.S. zoos and aquariums recently released a set of guidelines for monitoring and preventing avian influenza within their walls. As part of the measure, American Zoo and Aquarium Association (AZA) officials suggest isolating and decontaminating areas if they become affected by the flu, and eventually closing certain facilities.</b>

"Even if we never see avian influenza in this country, this is a good thing to be doing," Donald Janssen, associate director of veterinary services at the San Diego Wild Animal Park, who helped draft the recommendations, told The Scientist. "But in all likelihood, in some form or another, we will see the high pathogen strain of avian influenza H5N1."

Robert Cook, chief veterinarian and vice president of the Wildlife Conservation Society -- which operates five parks in New York City -- noted that avian flu could hit U.S. zoos though birds or people, although the latter possibility was much less likely. Cook also urged calm. "It's very possible that avian flu won't come," he said.

Even if avian flu hits zoo birds, "it is very unlikely, almost impossible, that a visitor will get infected in a zoo," Mike Cranfield, director of animal health, research, and conservation at the Maryland Zoo in Baltimore, told The Scientist. He noted that the risk of infection was higher in zoo workers, but even they are relatively safe because of the low density of zoo birds -- relative to chicken farms, for instance.

The proposed measures include education programs for employees at the 210 AZA-accredited zoos and aquariums, along with instructions for wearing appropriate equipment and employing proper cleaning and disinfecting protocols. In the event of an outbreak, the AZA suggests developing protocols for short-term treatment of affected native birds and moving indoors collection of birds that co-mingle with free-ranging waterfowl. The organization also recommends that zoos consider vaccination of birds if there is a threat of an outbreak.

The guidelines emphasize biological containment, which Cranfield said is an "excellent" approach. "If the flu comes, it is going to take citywide, statewide, and countrywide efforts to fight it. We will have to develop our own little in-house plan and that will have to fit into a much bigger plan," he said.

Cook, who sits on the animal health committee of the AZA, noted that the guidelines were written with the input of zoo veterinarians in the U.S. who had years of experience in dealing with preventing disease in zoo collections and protecting visitors' health. He added that guideline writers had experience with other outbreaks, such as West Nile virus in the U.S., and also studied the experience of places like the Jurong Birdpark in Singapore, which had to confront a threat of avian influenza last year.

Jonathan Sleeman of the Virginia Department of Game and Inland Fisheries told The Scientist he is "very impressed" with the recommendations, and praises the AZA for being so proactive on this issue. Still, he said he wonders how well member institutions will be able to comply with the guidelines, given that they are recommendations, not regulations. For instance, Sleeman noted that the AZA recommended that institutions develop a protocol for proper footbath preparation, maintenance, and disposal -- but don't specify a disinfectant to use, how often to change it, and where to dispose of the materials.

Jane Ballantine, AZA spokesperson, told The Scientist that the guidelines were left open-ended to give facilities with different species the chance to personalize them. "We have to make certain that the information and materials we issue can be adapted by our members to fit their particular situations."

"If things change, we'll surely need to update these guidelines, said San Diego's Janssen. "For now, they provide another standard for the protection of our bird collections from a variety of infectious diseases."

Another round, please!

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http://www.wired.com/news/technology/0,1282,69580,00.html</B>

Don't worry about bird flu -- video games will come to the rescue.

The Centers for Disease Control and Prevention is funding a series of computer games to help prepare health workers and other first responders facing bioterror attacks, nuclear accidents and pandemics.


Backed also by Chicago's Department of Public Health, a University of Illinois at Chicago research team is developing a series of games that simulate health-related emergencies as well as biological, chemical, radiological and natural disasters.

The new approach is expected to save money -- but it can also prepare many professionals and volunteers quickly in the event of a health emergency, like the potential bird-flu pandemic.

"These games let people train on their own schedules," said Eric Holdeman, an expert in disaster relief and director of Washington state's King County Office of Emergency Management. "And it gets us away from death by PowerPoint in the typical classroom environment. It's also cost-effective."

The first game, which took three months to develop, trains health workers to respond to an anthrax outbreak. A massive flu pandemic simulation is in the works.

Players learn how to set up MASH sites, evaluate patients and dispense drugs. They also are trained to distribute medications to health-care sites and notify the public, instructing people on what to do -- without instilling panic.

Throughout the game, trainees' responses are scored for speed and appropriateness.

The game also helps health workers and volunteers cross-train for more than one job. Crisis teams are typically understaffed. The scoring helps players determine what they are good at and what skills they need to sharpen.

A multiplayer prototype is being developed to train teams of health specialists to work together.

There are about 23 different roles for each crisis, and each scenario requires different training, explained Dr. Colleen Monahan, an epidemiologist and the simulations' lead programmer.

"Avian flu is a real challenge, because people will be really scared," she said. "Fifty percent of people who get avian flu die, regardless of age. Quarantines, keeping people away from each other, will be difficult. Our approach helps people train for multiple tasks and role-play with each other without the cost and on their own schedules."

Traditionally, health-care workers are trained by role-playing or watching videos. The simulations won't entirely replace conventional approaches, Monahan said, but they will shorten and focus the face-to-face training.

The game was originally developed for the Chicago Public Health Department, but the CDC and other agencies, embarrassed by the response to Hurricane Katrina and other recent disasters, are keen to adopt new tools that will help them be more prepared when the next crisis hits.

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