12/23 H5N1 Deaths Rising/Tamiflu Not Working/ Bird Flu Continues to Spread

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<B><font size=+1 color=red><center>Vietnamese teacher dies suspectedly of bird flu</font>

<A href="http://news.xinhuanet.com/english/2005-12/23/content_3959665.htm">www.chinaview.cn</a>
2005-12-23 10:34:37 </center>


¡¡HANOI, Dec. 23 (Xinhuanet) -- A 36-year-old school teacher from Vietnam's southern Soc Trang province died after showing bird flu symptoms, local newspaper Labor reported Friday. </b>

The teacher named Ha Thanh Ut from Thanh Tri district died fivehours after being admitted to the Bac Lieu General Hospital in southern Bac Lieu province on Dec. 21. According to the hospital'sdoctors, he might have been infected with bird flu virus strain H5N1.

The man's family is raising some fighting cocks, the report said.

Vietnam's Health Ministry on Thursday confirmed 66 human cases of H5N1 infections, including 22 fatalities, in 25 cities and provinces since December 2004, bringing the total respective numbers in the country since December 2003 to 93 and 42.

To date, H5N1 found in three Vietnamese patients, all dead, has become resistant to bird flu medicine branded Tamiflu, local newspaper Youth on Friday quoted Peter Hobby, an expert of the World Health Organization, as saying.

Vietnam should research and then apply on a pilot basis a new bird flu treatment procedure: let patients take Tamiflu at a higher dose and in a longer time, he said, noting that the organization and Vietnam would conduct the trial early next year. Enditem

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<B><font size=+1 color=brown><center>Latest bird flu death prompts fears in poultry industry</font>

Friday, 23/12/2005
<A href="http://www.abc.net.au/rural/content/2005/s1537211.htm">www.abc.net</a></center>

There is fresh concern in the poultry industry that bird flu could be becoming resistant to anti-viral drugs.</b>

The reported death of a young Vietnamese girl, despite her receiving the correct treatment, has the industry worried that chicken consumption will fall.

But Dr Peter Scott from the Australian Veterinary Poultry Alliance, says the disease needs to be kept in perspective.

"People forget the reality of the situation here, that there's been something like just in excess of 70 humans that have died of bird flu in Asia and these people had very, very unusual contact with the consumption of things like blood and other body fluids and it's forgotten that normal human influenza kills worldwide well over half a million per year,' he said.

"So we certainly need to keep these things in perspective."

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<B><center>23 December 2005 0149 hrs
<A href=" http://www.channelnewsasia.com/stories/afp_asiapacific/view/185006/1/.html">Channelnewsasia.com</a>

<font size=+1 color=green>Roche mulls increasing Tamiflu dose to treat bird flu</font> </center>

GENEVA : The Swiss pharmaceutical group Roche has said that increased doses of Tamiflu may be needed to treat human cases of virulent bird flu, after a study indicated that the H5N1 virus had developed resistance to its flagship anti-influenza drug. </b>

It may also be necessary to combine the drug, which public health authorities consider to be a frontline defence against a flu pandemic deriving from bird flu, with other antiviral agents to treat H5N1, the company said in a statement Thursday.

"Roche agrees that other treatment regimens for the H5N1 virus need to be explored, including higher dose and/or longer duration of treatment with Tamiflu, or a combination of antiviral agents."

Roche said that safety data supported the use of higher doses.

Clinical research was already under way with the World Health Organisation (WHO) and the US National Institutes of Health to assess the effectiveness of a higher dose, before the study on drug resistance was published, Roche spokeswoman Martina Rupp said.

The pharmaceutical giant is also ready to explore "potential combinations" of Tamiflu with "additional therapies" to treat H5N1.

The study, published in the New England Journal of Medicine, highlighted the deaths of two Vietnamese girls who had become resistant to Tamiflu despite getting the current full dose of treatment.

It suggested that use of higher doses of Tamiflu or longer therapy may be need to tackle human cases of the virulent form of bird flu.

The outcome prompted concern by one of the researchers in the study that the strategy of stockpiling the drug to guard against a possible flu pandemic could lead to insufficient dosage or inadequate therapy.

Roche said concerns about resistance should not dissuade countries from establishing stockpiles of antivirals. About 50 countries, and the WHO, are currently doing so.

But it also added a note of caution about the potential for new flu viruses that were less sensitive to "any antiviral treatment".

"The currently approved dose and duration of Tamiflu therefore remains the minimum required for the treatment of pandemic influenza," the pharmaceutical giant said.

"However when a pandemic strain emerges, it will be vital to test the susceptibility of the pandemic strain to Tamiflu to determine the optimal dose and duration for the treatment," it added.

Although inhibitor drugs like Tamiflu "should be effective", Roche also acknowledged that "the clinical and epidemiological implications of possible antiviral resistance in future pandemic influenza viruses are incompletely understood".

Rupp underlined that the H5N1 strain for bird flu was a particularly virulent form of influenza, causing severe infection and death rate of about 50 percent.

The study also found a rapid and consistent drop in the amount of the H5N1 virus circulating in the body -- the main aim of antivirals, which reduce the severity of the symptoms -- in survivors who had been treated with Tamiflu, according to Roche.

Any future pandemic strain that emerges is likely to become less virulent as a result of gaining the capacity to be easily transmitted from human to human, researchers have suggested.

The "vast majority" of data from permanent monitoring of thousands of patients worldwide showed that the incidence of influenza viruses that are resistant to Tamiflu is rare, Roche said.

Roche's share price on the Zurich stock exchange dipped slightly after the news, down by 0.96 percent in early afternoon trading to 196.8 Swiss francs.

Brokers said that the number of adverse reactions to Tamiflu were extremely small and pointed out that any increase in treatment length and dosage could boost demand for the drug, one of Roche's top sales generators.

About 139 people have been infected with the H5N1 virus in Asia, and more than 70 have died since 2003, according to the WHO. Vietnam has been hardest hit by the human form of virulent bird flu. - AFP /dt

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<B><font size=+1 color=blue><center>Tamiflu as good as useless against bird flu </font>

Disease/Infection News
Published: Thursday, 22-Dec-2005
<A href="http://www.news-medical.net/?id=15102">www.news.medical.net</a></center>
The stockpiles of bird flu drug Tamiflu, accumulated by governments around the world as the first line of defense against a flu pandemic, may prove to be useless.
At present Tamiflu appears to be the only drug available against the H5N1 avian flu virus, but now some experts are questioning the drugs' use for many of those infected and believe it may even worsen a pandemic.</b>

According to a study by Dr. Menno de Jong and colleagues of the Oxford University Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City, four of eight patients treated in Vietnam for bird flu infections died despite the use of Tamiflu.

Of the 13 Vietnamese patients infected with avian flu who were treated with the antiviral drug, Tamiflu, tests showed that in two of the patients, the virus had become resistant to Tamiflu, and in one of those patients the drug was used very early on, as recommended.

Some experts have described the findings as frightening and researchers are warning against an indiscriminate use of the drug in the event of a pandemic.

They say that could very well fuel the growth of a resistant virus strain, and trigger a second wave of infection against which there would be no defense.

According to Professor Anne Moscona of Cornell University, it is becoming clear that to treat avian flu with neuraminidase inhibitors such as Tamiflu, higher doses and a longer course of treatment is needed for them to work.

She and other experts agree that such drugs must be preserved carefully and used properly.

They do say however that the report concerned only a few people and stressed that more study is needed.

To date the H5N1 virus has infected a total of 138 people in Asia and killed 71 people in Indonesia, Thailand, Vietnam, China and Cambodia since 2003.

It is feared the virus could mutate and be transmitted amongst humans.

At present bird flu is difficult to catch and usually results from direct contact with sick birds.

Professor Moscona says the Vietnamese cases raise the worrying prospect that even with therapeutic doses, a resistance to Tamiflu may emerge.

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<B><font size=+1 color=purple><center>WHO cautions China about possible bird flu attack</font>

<A href="http://news.xinhuanet.com/english/2005-12/22/content_3958277.htm">www.chinaview.cn </a>
2005-12-22 23:37:51 </center>
CHANGSHA, Dec. 22 (Xinhuanet) -- The World Health Organization (WTO) warned Thursday that it is too early to tell if the avian influenza in China is under control, adding that prevention and detection measures should be stepped up.</b>

Dr. Shigeru Omi, WHO's Western Pacific regional director, made the remark during a visit to the home of a nine-year-old boy in central China's Hunan Province who survived a bout of the flu. He was China's first human case of H5N1.

"It is too early to say if it is under control," said Dr. Omi. "I will not be surprised if we have more human cases during the winter months."

He said bird flu outbreaks in December, January and February, can be much more serious.

So far, China has reported two deaths among six human cases of bird flu in Hunan, Anhui, Guangxi, Liaoning and Jiangxi provinces.

"Based on the experiences from other countries, the number of cases will drop and then rise again," said Dr. Omi.

"A temporary reduction in the number of cases doesn't mean the circulation of the virus has been halted. We have to assume that the virus is still circulating. That the virus is still there in the environment at least among chickens and ducks," he said.

He warned that the highly pathogenic avian influenza virus is very unpredictable and unstable and could mutate into a form that can pass easily between people, leading to a human pandemic.

"We have to assume that it is impossible for this virus to become so infectious that a global pandemic might happen," he said. "We are very concerned about the possibility this virus can efficiently transmit human to human."

"We don't know when it will happen," he said. "But we have to prepare for the worst situation, and the international community has to do its utmost to try to avert or prevent it."

Vietnam, Thailand and Indonesia have also reported human cases of bird flu in the past few months.

"Fortunately, so far all the reported human patients were infected by sick poultry and where not acquired from human transmission," Dr. Omi said. It is crucial to detect the occurrence of human cases of bird flu.

"Each human case is very important," he said.

The WHO delegation including Henk Bekedam, WHO's representative in China, Lee Chin-Kei, project officer of WHO in China and Roy Wadia, Who's information officer in China congratulated Hunan for successfully treating the nine-year-old boy.

The WHO delegation met with local health officials in Hunan and called for the prompt and quick detection of human cases of bird flu and enhancement of the reporting of animal outbreaks. Enditem

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<B><center>FEATURE
<font size=+1 color=purple>Pigs Also at Risk if Deadly Bird Flu Reaches US </font>

by Christopher Doering
USA: December 23, 2005
<A href="http://www.planetark.com/dailynewsstory.cfm/newsid/34207/story.htm">Planet Ark</a> </center>

WASHINGTON - If deadly bird flu spreads to the United States, the disease could have a sweeping impact on pig production because the animals are susceptible to the H5N1 disease, according to industry and veterinary experts. </b>

The H5N1 strain of avian influenza is known to have killed more than 70 people. To stop the spread of the disease, some 150 million birds have been destroyed worldwide, mostly in Asia, The virus also has been found in Europe.
No cases of H5N1 have been discovered in humans, chickens, turkeys or migratory birds in the United States.

"Not only do poultry people need to look into increasing their biosecurity, so do the swine (farmers)," said John El-Attrache, a veterinary pathologist with Texas A&M University. "Bird flu can readily infect a swine species and for the most part, go from swine on into humans," he added.

Experts do not believe pigs played a role in spreading H5N1 throughout Asia and eastern Europe. But pigs do have receptors for both avian and mammalian viruses. Some fear pigs could act as a "mixing bowl" - especially on farms where they coexist with humans and poultry - creating a new virus that spreads from person to person.

Biosecurity efforts at most US farms already include keeping pigs confined and separate from other animals. Human contact is limited and farm employees are encouraged to get annual flu shots.

A spokeswoman for Hormel Foods Corp., which buys hogs from some 1,500 farmers in the Midwest to make Spam and other meat products, said it has safeguards in place for many diseases including bird flu.

Hormel updated its business and crisis plans for all animal diseases after mad cow was found in the United States in December 2003.

Bird flu is "one of many things we're watching," said Julie Craven, a Hormel spokeswoman. "There is a lot of what could best be described as speculation between how the (H5N1) virus might travel, in between what species and what kind of timeline it's on."

The National Pork Board, which represents the industry and is responsible for the "Pork, the other white meat" slogan, said the bird flu situation in Asia and eastern Europe has sparked discussion among members.

"We have to make sure we're doing everything we can to keep it out of our herds and keep it from spreading to protect our species," said Liz Wagstrom, a veterinarian with the National Pork Board.

In addition to surveillance and routine swine vaccinations, Wagstrom said the industry must be prepared to alert farmers swiftly to impose stricter precautions, if needed.

Hogs and pigs have an annual flu season just like humans, poultry and other species.

The United States is the third largest pork producer in the world behind China and the European Union, according to U.S Agriculture Department figures. In its September hogs and pigs report, USDA said hog and pig inventory in the United States was 61.5 million head, up slightly from a year ago.

The USDA said it is not planning to require any new safety measures among pig farmers due to bird flu.

"We're aware that people worry about H5N1 in hogs... but any safeguarding now would be from the bird standpoint," said Jim Rogers, a spokesman with USDA's Animal and Plant Health Inspection Service.

The Bush administration asked Congress in November for $91 million for the USDA as part of a broader request for $7.1 billion in emergency funding to prepare for a possible bird flu pandemic.

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<B><font size=+1 color=red><center>Romania Confirms Bird Flu Outbreak East of Capital</font>

ROMANIA: December 23, 2005
<A href="http://www.planetark.com/dailynewsstory.cfm/newsid/34191/story.htm">Planet Ark</a></center>

BUCHAREST - Romania said on Thursday suspected bird flu cases found earlier in a village 100 km (60 miles) east of Bucharest were of the H5 type, and ordered more tests to see if it is the deadly version of the H5N1 strain.</b>

The Agriculture Ministry said in a statement culling of about 1,100 domestic birds in the village of Traian had started.

Since October, Romania has found avian flu in 23 villages in or near the Danube Delta on the Black Sea where the deadly strain was first discovered, some 300 km from Bucharest.

Nine cases have been confirmed as the highly pathogenic H5N1 strain, and the ministry said it will send another seven samples from the east of the country to a British laboratory for tests.

H5N1 is endemic in poultry in parts of Asia where it has killed more than 70 people since late 2003.

Experts say a flu pandemic among humans could kill millions around the globe.

Last week Romania, which has not registered any cases of bird flu in humans, warned that migratory birds possibly carrying the virus were heading south towards Bulgaria.

The virus remains hard for people to catch, but there are fears it could mutate into a form easily transmissible among humans. There have been no cases in humans outside of Asia.

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<B><font size=+1 color=brown><center>CDC Confirms Two More Bird Flu Deaths in Indonesia </font>

INDONESIA: December 23, 2005
<A href="http://www.planetark.com/dailynewsstory.cfm/newsid/34192/story.htm">Planet Ark</a></center>
JAKARTA - Two more human deaths from bird flu in Indonesia have been confirmed by the US Centers for Disease Control and Prevention (CDC), a Health Ministry official said on Thursday, bringing total known Indonesian deaths to 11. </b>


"... we have received confirmation from CDC Atlanta that the two, N and M, are positive," Hariadi Wibisono, director of the department charged with control of animal-borne diseases, told Reuters.
He was referring to the cases of a 39-year-old man and an eight-year-old boy who had previously tested positive locally for the deadly H5N1 strain of avian influenza.

Local tests are not considered definitive. The CDC laboratory tests are among those recognised by the World Health Organisation, Wibisono said.

Both victims died earlier this month. In addition to the 11 deaths, five individuals in Indonesia have been confirmed as having the disease but are still alive. Wibisono had said earlier it was unclear if the boy had contact with infected chickens. In the case of the 39-year-old, a WHO official has said there were reports of sick and dying poultry in the neighbourhood.

Experts fear the virus will mutate into one that can be passed from human to human, rather than from fowl to people, and that such a mutation might spark a pandemic killing millions.

The latest Indonesian deaths would take the known global total to 73, while cases including survivors would rise to 141. All the deaths so far have been in Asia.

Indonesia will launch house-to-house surveillance of poultry in Jakarta in a bid to halt the spread of the flu, a minister said earlier this week.

Local communities, student volunteers and military forces will be deployed to inspect poultry across the sprawling capital of some 12 million people. Several of the victims so far have come from the Jakarta area.

Since August 2003, 10 million poultry have died from the disease in Indonesia or been killed to prevent its spread.

Indonesia, with 220 million people, has millions of chickens and ducks, the majority in the yards of rural or urban homes, including many in Jakarta.

Such a close relationship between people and livestock has helped spread the disease in humans and the virus has been found in poultry in two-thirds of the nation's 33 provinces.

The Food and Agriculture Organisation has launched its own grass roots scheme covering Java Island. The UN agency says Indonesian efforts to control bird flu should be stepped up and the government needs to draft an effective national strategy.

Indonesia is also preparing an early bird flu warning system that will involve local governments setting up health posts in all villages, where doctors and nurses would be on the lookout for flu cases in birds and humans.

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<B><font size=+1 color=green><center>Bird flu deaths: 'no alarm'</font>

December 23 2005
<A href="http://news.scotsman.com/index.cfm?id=2450822005">Scotsman.com</a></center>
SIGNS that the H5N1 bird flu virus may be developing resistance to frontline drug Tamiflu are not necessarily alarming, a senior World Health Organisation official said yesterday. </b>

Keiji Fukuda, a scientist at the WHO's global influenza programme, said some resistance was inevitable.

"Whenever you use any kind of drugs, antivirals or antibiotics, you expect to see resistance develop in organs," he said. "Finding some resistance in and of itself is not surprising and is not necessarily alarming."

But reports that four bird-flu patients in Vietnam had died despite use of Tamiflu indicated more research was needed on its use, he added.

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<B><center>Americas News

<font size=+1 color=blue>Goats mysteriously dying on Canadian farm</font>

Dec 21, 2005, 19:05 GMT
<A href="http://news.monstersandcritics.com/southamerica/article_1070677.php/Goats_mysteriously_dying_on_Canadian_farm">Monsteraandcritics.com</a></center>
CHOICELAND, SK, Canada (UPI) -- Canadian veterinarians in Saskatchewan are trying to determine what has mysteriously killed at least 900 goats on one farm since last May.</B>

While Canadian beef farmers took massive losses because of mad cow disease export bans and poultry farmers are nervously guarding against avian flu, goat farmer Dave Smith told the Canadian Broadcasting Corp., he`s also facing financial ruin from the rash of deaths.

He has operated his farm near Choiceville, in central Saskatchewan, for 13 years, and has had to rent out nearby land to dump the carcasses, almost on a daily basis.

Smith said he`s gone to veterinarians, who couldn`t help him. But last week, he managed to arrange autopsies for some of his animals at the provincial veterinary college in Saskatoon.

While results aren`t expected for some time, Smith said he`s in bad financial straits.

'We`re done. We`ve probably lost $90,000 between what we owe and the income we`re not going to have,' he said.

Copyright 2005 by United Press International

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This article might bre reading - twice....


<B><font size=+1 color=purple><center>Bird flu study shows virus evolution in action</font>

Wed Dec 21, 2005 10:13 PM GMT
By Maggie Fox, Health and Science Correspondent
<A href="http://investing.reuters.co.uk/news/newsArticle.aspx?type=healthNews&storyID=2005-12-21T221327Z_01_KRA179937_RTRIDST_0_HEALTH-BIRDFLU-TAMIFLU-RESISTANCE-DC.XML">Reuters Healt News</a></center>
WASHINGTON (Reuters) - At first it looked like the 13-year-old girl was lucky. She only had a little pneumonia in one lung and doctors had treated her early with Tamiflu, a drug known to be effective against avian influenza.</b>

She "presented to a hospital in Dong Thap Province on January 22, 2005, with a one-day history of fever and cough," wrote Dr. Menno de Jong of the Hospital for Tropical Diseases in Ho Chi Minh city and colleagues.

And for several days, the drug seemed to be working. But then the girl began struggling to breathe and needed more and more oxygen.

The pneumonia worsened and she died six days after being admitted.

Tests done in Hong Kong showed the virus infecting her had mutated in a way known to make it immune to Tamiflu. She had a "H274Y substitution in the neuraminidase gene, which confers high-level resistance to oseltamivir (Tamiflu)," the researchers wrote in a report published in the New England Journal of Medicine.

The same thing happened with another patient treated by the same group. And four of eight patients they treated with Tamiflu, made by Roche AG under the generic name oseltamivir, died despite treatment with the drug.

No one is surprised -- viruses often develop resistance to drugs. For this reason, AIDS infections are treated with a cocktail of drugs.

"The best prevention of resistance is to suppress replication as completely and as early in the infection as possible. The paradigm 'Hit hard and Hit early' which has been used in the past for HIV/AIDS therapy is most likely true for influenza and undoubtedly many other viral infections," De Jong said in a statement.

NATURAL SELECTION IN ACTION

"Anything that you throw at a virus, a virus can evolve to evade it," said Dr. Anne Moscona, an expert in pediatric viral diseases at Weill Medical College of Cornell University, New York, in a telephone interview. "You can't attack a virus with just one compound."

Tamiflu is one of two influenza drugs in a class called neuraminidase inhibitors. These drugs target a protein on the surface of cells called sialic acid. Influenza viruses use an enzyme called neuraminidase -- the "N" in H5N1 -- to attach to the cells it infects.

Tamiflu and the other neuraminidase inhibitor, Relenza, block the neuraminidase enzyme used by the virus and keep the virus from hooking onto the sialic acid "doorway" on the cell.

But influenza viruses are mistake-prone -- they constantly evolve and change, and the neuraminidase structure can change, too.

Tamiflu does not block neuraminidase perfectly and has to make it stretch a little, Moscona said. "The structure of Tamiflu is such that several mutations are possible that allow for the neuraminidase molecule to still work and the virus to remain viable," Moscona said.

"The structure of Relenza is somewhat different, so that it seems to be somewhat less likely to allow for the development of resistance."

But Relenza, known generically as zanamivir, has its own drawbacks -- it must be inhaled, making it inappropriate for some patients, and it may only treat the lungs, while H5N1 attacks other organs, too. Maker GlaxoSmithKline is working on an injectable version.

Moscona said the report clearly illustrates why governments but not individuals should stockpile Tamiflu.

"One thing about stockpiling -- people are going to tend to share. They'll try to make a small amount go farther because there is a shortage," she said.

That will make resistance evolve even more quickly.

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<B><center>Two more bird flu fatalities in Jakarta

<font size=+0 color=red>An Indonesian man and child died this month of bird flu, the health minister said, after receiving confirmation from a World Health Organization-affiliated laboratory in Hong Kong.</font>

Friday, December 23, 2005
<A href="http://www.thestandard.com.hk/news_detail.asp?we_cat=6&art_id=8486&sid=6015717&con_type=1&d_str=20051223">The Standard</a></center>

An Indonesian man and child died this month of bird flu, the health minister said, after receiving confirmation from a World Health Organization-affiliated laboratory in Hong Kong.</b>

Siti Fadila Supari said the deaths of the security guard, 39, and the boy, eight, raised Indonesia's human toll from the H5N1 virus to 11.

The virus has killed hundreds of millions of chickens and ducks since it started ravaging poultry stocks across Asia in 2003, and has jumped to humans, killing at least 71. Most human cases of bird flu have been traced back to contact with sick birds. But experts fear the virus could mutate into a form that is easily spread among people, possibly triggering a pandemic.

The man and child who died were both from Jakarta. Health officials were not sure how they contracted the disease but birds in their neighborhoods tested positive for H5N1. ASSOCIATED PRESS

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<B><font size=+1 color=brown><center>Bird Flu Expands Worldwide in 2005</font>

By David McAlary
Washington
22 December 2005
<A href="http://www.voanews.com/english/2005-12-22-voa59.cfm">VOA News.com</a></center>
Fears of a long-predicted global influenza pandemic grew stronger in 2005 as a deadly form of the virus spread among birds worldwide and killed 36 more people in the disease's Southeast Asian epicenter. Governments and international organizations stepped up cooperative measures to isolate the disease and to deal with a possible pandemic.</b>

The number of human deaths from bird flu more than doubled in 2005 to over 70, according to World Health Organization numbers. So far, bird flu deaths are limited to East Asia, mainly the Southeast, with Vietnam the hardest hit. The death toll accounts for half of all human cases, an alarming death rate in the view of physician Gregory Poland of the Mayo Clinic College of Medicine in Minnesota.

"If that virus gains the ability to easily transmit from human-to-human, it will be a disaster of unprecedented proportion," he said.

Fueling this fear was the global spread of infected birds from Asia, thanks to seasonal migrations. By year's end, birds with the deadly H5N1 form of avian flu had been detected in Europe and Canada. In countries where it was found, tens of thousands of poultry were slaughtered.

The first sign of this spread came in late April at central China's Lake Qinghai, a migratory fowl congregation point where more than 6,300 birds of different species perished within weeks. Until then, the disease had been seen only in domestic poultry, thought to be its source. World Health Organization (WHO) spokesman Dick Thompson said migrating birds must be tracked.

"There's an urgent need to sample and tag and track as many of these species as feasible, especially considering the narrow time frame that we've got available to do it. We need more information on the migratory routes regarding these birds," said Mr. Thompson.

To confront its outbreaks, China embarked on an ambitious effort to vaccinate all of its many billions of chickens, ducks, and geese – 20 percent of the global total. Vietnam, Indonesia, and Pakistan also inoculated birds against the flu.

The European Union, meanwhile, temporarily banned live bird imports.

The ongoing outbreaks raised concern about the ability of public health systems to respond to an expected influenza pandemic. About three pandemics occur per century and it has been 37 years since the last one. U.S. Health and Human Services Secretary Michael Leavitt said if it comes, it could kill up to 7.5 million people around the world.

"Pandemics happen. It is a fact of biology. When it comes to a pandemic, we are overdue and underprepared," he said.

To overcome the preparation deficit, international conferences were held in Ottawa, Canada and Geneva, Switzerland in October and November to coordinate the responses of governments and global agencies.

Together, the meetings identified five major goals -- reduce human exposure to sick animals, strengthen surveillance and reporting of disease, develop national preparedness plans, intensify rapid containment operations, and accelerate global research to overcome the shortage of vaccines, antiviral medicines, and production capacity.

Canadian Prime Minister Paul Martin emphasized the importance of global teamwork.

"Within our countries and among our countries, each of these efforts will require cooperation and coordination on a scale that is virtually unprecedented," said Mr. Martin. "The consequences of a world that is unprepared are simply unacceptable."

The global standards were in line with President Bush's September announcement at the United Nations of the International Partnership on Avian and Pandemic Influenza. Its aim is to bring key nations together to improve global readiness by elevating the issue on their national agendas and coordinating efforts among donor and affected nations.

Within his own government, Mr. Bush asked Congress for $7 billion for flu pandemic preparations, a large portion of which would go toward new vaccine research. Other money would help other nations train personnel to expand detection and testing.


George Bush
"Together, we're working to control and monitor avian flu in Asia, and to ensure that all nations have structures in place to recognize and report outbreaks before they spread beyond human control," said Mr. Bush.

The lack of medical defenses against bird flu clouds the future. A study from the U.S. government's Centers for Disease Control (CDC) showed that worldwide resistance to influenza drugs increased by 12 percent in the last decade. H5N1 is resistant to one of the two major classes of flu drugs, amantadine, and scientists reported signs in Asia it is learning to defy the other one, which includes Tamiflu, the major drug nations are stockpiling against the disease.

Moreover, no one knows if existing flu vaccines will work against H5N1, and a vaccine specific to it is only in the testing stage.

So University of Maryland flu researcher Daniel Perez said the slaughter of infected birds will a crucial protective measure for the time being.

"Right now, that is the only tool that is effective in controlling avian influenza," said Mr. Perez.

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<B><font size=+1 color=green><center>Bird flu may have killed Vietnamese man</font>
(Reuters)

23 December 2005
<A href="http://www.khaleejtimes.com/DisplayArticle.asp?xfile=data/theworld/2005/December/theworld_December653.xml&section=theworld">Khaleej Times Online</a></center>
HANOI - Bird flu may have killed a 36-year-old man in the south of Vietnam, where the deadly virus remains in 10 of the country’s 64 provinces, doctors said on Friday.</b>

The man, who was a teacher in Soc Trang province, died on Wednesday of severe lung infection just five hours after being admitted to the Bac Lieu General Hospital in the nearby province of Bac Lieu, doctors at the hospital told Reuters.

They said samples had been sent to the Pasteur Institute in Ho Chi Minh City for laboratory bird flu testing. Results are expected by late next week.

The teacher’s family raised fighting cocks but all of the birds were healthy, the doctors said. Soc Trang has had no recent bird flu outbreaks.

The H5N1 virus has killed 73 people in Asia including 42 in Vietnam, the country worst affected, since it swept through late 2003.

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<B><font size=+1 color=blue><center>Insurers Warned about Bird Flu "Species Jump"</font>

December 22, 2005
<A href="http://www.insurancejournal.com/news/international/2005/12/22/63392.htm">insurancejournal.com</a/></center>
Even as new reports of deaths caused by the bird flu virus are coming in from Indonesia and Vietnam, the insurance industry received an additional warning about its potential exposures.</b>

An article on the Lloyd's Website [www.lloyd's.com] reports that the impact of avian flu may not be confined to the virus turning into a human pandemic. "Cara New, resident expert in chemical, biological, radiological and nuclear technology for intelligence company Exclusive Analysis said that insurers could be faced with further problems if the virus leaps from fowl to pigs or horses," the bulletin indicated.

Scientists, political and business leaders have focused their main concerns on the virus being transmitted to humans from infected birds, and then mutating into a form that could spread between infected individuals. The result could be a worldwide pandemic causing the loss of millions of lives.

So far the disease has been found responsible for 70 deaths – all of them in Southeast Asia – and all as a result of contact with infected birds. Two new deaths were recently reported from Indonesia, and two from Vietnam, where the infected individuals failed to respond to anti-viral drug treatments.

New pointed out that avian flu affected horses in an outbreak in Jilin, China in 1989, and warned that any infection of pigs or equine stocks would hit breeders and farmers hard.

"The 1989 outbreak, which involved a different strain of avian flu from the H5N1 strain currently causing concern, left as many as 20 percent of the infected horses dead," said the article. "Equine flu is currently the most common respiratory tract infection of stabled horses."

New also noted that pigs, which can be infected by both avian and human flu viruses, can serve as a "mixing vessel" for the two strains, which could produce a virus capable of jumping between humans. Traces of the current strain of avian flu have already been found in at least one pig in Vietnam and two in China.

The article explained that "scientists suspect that bird flu strains travelling through infected pigs were involved in the flu pandemics of 1918, 1957 and 1968, which killed millions." New said that given flu pandemics have occurred at relatively regular intervals in recent history, it may well be a case of "when, not if" the next flu pandemic strikes.

She also indicated that an H5N1 pandemic or other flu pandemic would most likely start in Asia, but could be expected to spread globally within a week. "People forget that the flu already kills as many as one million people each year, and conservative estimates are that an avian flu pandemic could possibly kill between five and 20 million," she warned.

Tamiflu, accumulated by governments around the world as the first line of defense against a flu pandemic, may prove to be useless.

Ok now, how about the Turmeric 95% CURCUMIN still the best bet?

Timber

Timber said:

Tamiflu, accumulated by governments around the world as the first line of defense against a flu pandemic, may prove to be useless.

Ok now, how about the Turmeric 95% CURCUMIN still the best bet?

Timber

Click to expand...

FWIW Timber.

An over the counter cold/flu med (Cold-Eeze) has been tested (in Jakarta) and proven to help lessen the H5N1 victums' symptoms. And it's active ingredient hinders the H5N1 viron from *sticking* to the soft tissue at the back of the throat.
[cost for Cold-Eeze is $5.00 per bag of 40 - how much is Tamiflu now?]

This means - that it hinders the H5N1 viron from being able to multiply as fast as it ordinaryly would. Which in turns means that the victum had a longer time for their body to build up anti-bodies against this bug..

The make of Cold_Eeze anounced about two weeks back that they had developed a mask which is 99% effective of killing H5N1 when the mask's surface encounter it.

They are working on a spray which can be sprayed on an ordinary surgical - or the lesser masks (such as N-95) which when caoted with the active ingredient. Will bring that face mask up to the 99% effect level...

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<B><font size=+1 color=red><center>Precautionary measures taken to check bird flu</font>

Friday December 23 2005 10:31 IST
<A href="http://www.newindpress.com/NewsItems.asp?ID=IEK20051223001017&Page=K&Title=Southern+News+%2D+Karnataka&Topic=0&">www.newindpress.com</a></center>
BELGAUM: Though no cases of bird flu have been reported in the district, the district administration has taken precautionary measures to check the disease in a big way.</b>

Deputy Commissioner, Dr Shalini Rajaneesh told a Health Committee Meeting held here on Thursday, to keep a watch on the birds migrating from other countries during the winter to the bird sanctuary near Ghataprabha.

She said that neither the Centre nor the State had registered any cases of bird flu. Precautionary measures should be taken to prevent the disease from entering the country and the district.

She said that there was a necessity to build new slaughterhouses in the jurisdiction of the city Corporation. She suggested the Corporation officials to prepare a plan of construction of new slaughterhouses around Belgaum city and to submit the same to her immediately.

She said that the slaughterhouses should maintain cleanliness to prevent any type of diseases. She said the bird flu was reported in Japan, Indonesia and Vietnam. The Centre had asked all the states to take precautionary measures against the spread of bird flu, she said.

The Deputy Commissioner told the officials to give details about the diseases to all the chicken farm owners. The chicken farm owners also should maintain cleanliness around their farms, she added.

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<B><font size=+1 color=brown><center>Bird flu seen as 'real problem' in RI </font>

<A href="http://www.asianewsnet.net/level3_template1.php?l3sec=8&news_id=50141">The Jakarta Post</a>
Publication Date : 2005-12-23</center>
With bird flu already claiming at least 11 lives in Indonesia, Jakartans are aware that the lethal virus is a problem, however they do not appear to be overly worried compared to other Asia-Pacific countries, a survey shows.</b>

Conducted in Jakarta early this month by Taylor Nelson Sofres (TNS) -- a leading London-based market research company, the survey found that 77 percent of 300 respondents aged from 17 to 65 have chosen to eat less poultry, indicating that some precautions are being taken.

On the other hand, the research released on Thursday (Dec 22) shows a lack of knowledge among people, as cooking chickens generally kills the virus provided the meat is heated to 70øC or higher.

Almost 40 percent of respondents expect avian flu to become a serious problem within six months, while 48 percent said it would be longer than six months.

"Indonesians, at least in Jakarta, recognize that bird flu is a 'real' problem. At the moment they eat less poultry, but what they want is more security through a vaccination program," TNS Indonesia managing director Hans Lang said.

The Indonesian government confirmed on Thursday that a man and a boy died of bird flu, bringing the country's fatalities from the virus to 11, and the total number of confirmed bird flu cases to 16.

Scientists fear that the avian flu virus will mutate to be able to be transmitted from human to human, creating a possible pandemic. The evidence so far, however, shows that the virus can only be transmitted from infected animals to humans.

The TNS survey showed that 52 percent of Indonesians have the same fear as the scientists, and in Korea, Hong Kong, Singapore and Taiwan, 55 percent to 76 percent also concur with the scientists, while in China, 47 percent thought that the virus could already be transmitted between humans.

There is a level of dissatisfaction towards the Indonesian government in its handling of the bird flu outbreaks, with 30 percent of people criticizing its performance on the issue as poor, while 10 percent consider it inadequate.

Singaporeans appear to be satisfied, with 62 percent of respondents saying their government had done sufficient to curb any bird flu outbreak, while 24 percent thought it had done very well.

In Hong Kong, 44 percent thought the government had done an adequate job, and three percent thought the government had handled the issue very well.

Koreans, meanwhile, said that their government had dealt inadequately with the outbreak (49 percent), and another 21 percent said it had handled the issue poorly.

As for the ban on poultry imports, only 3 percent of Indonesians agreed, compared to 82 percent in Taiwan, 69 percent in Korea, 58 percent in Hong Kong and 50 percent in Singapore.

The majority of people in those countries, however, agreed that their governments should vaccinate all the population as a precaution measure against the spread of bird flu, ranging from 59 percent in Korea, to 81 percent of Indonesians.

thanks dutch...your information is always appreciated.

Its learned to protect itself from tamiflu. Thats interesting. Just wondering what else we're teaching it. How to get around vaccines.

If that's true, North Runner, than this is very possibly the living, breathing entity they predict to become a pandemic.

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Just stopped in (busy house cleaning - with my pretty lady) Christmas you know... Of Bump!

Thanks for the reminder on Cold-Eze. The stuff works pretty well if you follow the directions. I'm gonna pick up a couple of boxes today, before it flies off of the shelves and the price goes through the roof. I'll pass on the Tamiflu......

heard them talk about Donald Rumsfeld owns tamiflu last night
and he's trying to cash out his tf stock his advisers told him not to
he may get into trouble
i hear it does not work from many different sources do they know this

I havent read the NEJM article, but I am still not buying the Tamiflu resistance message.

Of the two VietNamese that died:

The 13 yo was given Tamiflu within 24 hrs of couighing, fever and other symtoms. One could assume that the other was started on Tamiflu later, too late, in the disease cycle.

So the one that had Tamiflu early appears to be a prime candidate for ARDs - Acute Respiratory Distress Syndrome. ARDS is described as the cytokine storm that results when one's immune system fires all of its defenses at once against a new and previoulsy unecountered antigen. ARDS is said to hit teens and 20-somethings the hardest because they mount the stroingest immune response.

So, if this young person died of ARDs, it in no way speaks to Tamiflu resistance.

The part about doubling the Tamiflu dosage for HPAI H5N1 has been recommended for quite some time.

Tumeric w/curcuminoids is said to reduce the cytokine storm and MAY be a benefit to reduce the ffects of ARDS.

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http://www.stuff.co.nz/stuff/0,2106,3521167a10,00.html

An international bird flu expert says despite two Vietnamese patients dying after developing a tamiflu resistant strain of bird flu, most patients respond to the drug.


Professor Arnold Monto, from the University of Michigan, said it was expected that the bird flu virus H5N1 would evolve into resistant forms.

The deaths were reported this week in the New England Journal of Medicine.

But Prof Monto said the fact the two Vietnamese patients had developed the resistant strain may not have caused their deaths, in itself.

"I think that really has very little to do with the outcome, namely that both of them died, especially since one of them was actually treated six days into the illness," Prof Monto told National Radio.

"The virus has developed resistance. We knew that this was going to happen.

"But we also know, for example, that a girl treated with tamiflu some months ago (had) resistant virus but yet recovered," he said.

"So I don't know if the resistance is what is producing the bad effect in both of these cases, or the fact that treatment didn't start early enough in most cases, and if it was started early perhaps the disease was too far gone in order for the drug to work."

Prof Monto said while it was expected that the virus would develop some resistance, it was not expected to develop to a level where when a patient became infected with the virus they would be resistant from the start.

Countries around the world have scrambled to stockpile tamiflu to counter a global-pandemic.

New Zealand's Health Ministry has spent $26 million storing 850,000 doses of Tamiflu, which is roughly enough to treat 21 per cent of the population.

Prof Monto said tamiflu had been selected over the alternative anti-viral drug relenza.

"We have selected tamiflu because it is absorbed and disseminated in the body. Relenza is an alternative, and there is an IV or intravenous preparation that might be used if resistance is encountered," he said.

Dr Mark Jacobs, director of public health, said it could not be known for sure whether tamiflu would cure people sick with the bird flu virus.

But New Zealand had followed the advice of the WHO (World Health Organisation) to stockpile anti-viral medicines to prepare for a pandemic, he said.

The ministry would continue to monitor international developments, including whether there may be a need in the future to add to the anti-viral stockpile, he said.

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The 24th's H5H1 is posted. I guess It is about time to retire this on to the infectious disease forum...