03/11 | Daily Bird Flu Thread: Pandemic Fears Focus on Swine

Link to yesterday's thread: http://www.timebomb2000.com/vb/showthread.php?t=189128

Since January, 2004 WHO has reported human cases of avian influenza A (H5N1) in the following countries:

* East Asia and the Pacific:
o Cambodia
o China
o Indonesia
o Thailand
o Vietnam

* Europe & Eurasia:
o Turkey

* Near East:
o Iraq
(see preliminary report)

Since December 2003, avian influenza A (H5N1) infections in poultry or wild birds have been reported in the following countries:

* Africa:
o Niger
o Nigeria

* East Asia & the Pacific:
o Cambodia
o China
o Hong Kong (SARPRC)
o Indonesia
o Japan
o Laos
o Malaysia
o Mongolia
o Thailand
o Vietnam

* Europe & Eurasia:
o Albania
o Austria
o Azerbaijan
o Bosnia & Herzegovina (H5)
o Bulgaria
o Croatia
o France
o Georgia (H5)
o Germany
o Greece
o Hungary
o Italy
o Poland
o Romania
o Russia
o Serbia and Montenegro (H5)
o Slovak Republic
o Slovenia
o Switzerland
o Turkey
o Ukraine

* Near East:
o Egypt
o Iraq (H5)
o Iran

* South Asia:
o India
o Kazakhstan
o Pakistan (H5)


For additional information about these reports, visit the
World Organization for Animal Health Web Site.

Updated March 10, 2006
http://www.cdc.gov/flu/avian/outbreaks/current.htm#animals

Flu pandemic fears focus on swine​

The world will move closer to an avian flu pandemic once pigs carry the H5N1 virus, a Guangdong health official has warned.

Winnie Chong

Saturday, March 11, 2006

The world will move closer to an avian flu pandemic once pigs carry the H5N1 virus, a Guangdong health official has warned.

However, Guangzhou Institute of Respiratory Diseases director Zhong Nanshan still insisted Friday that with adequate precautionary measures such as early discovery, diagnosis, quarantine and medication, a disaster can be averted.

He said that with cats and beech martens being infected in Germany, the alarm bells over a possible human pandemic have begun sounding.

"We are one step closer to human beings contracting bird flu as mammals are now being infected, and humans are, after all, mammals," Zhong said.

He fears that once pigs started to carry the virus, the risk to humans will grow accordingly.

Hong Kong epidemiologist Lo Wing-lok said that among mammals, pigs are capable of playing host to a number of viruses such as swine flu, bird flu and even human influenza.

Should pigs contract the H5N1 virus, which happened in 1976 in the United States and in 2004 in Indonesia, they will become the mixing pots for the recombination of viruses.

"The reassortment of a new virus among pigs could likely spread among humans," he said.

But Lo said since pig farms in Hong Kong are licensed and no one has backyard pig farms, the risk of bird flu virus transmission through pigs is not high.

He urged people to pay attention to their personal hygiene and to avoid contact with poultry and pigs.

Zhong issued a reassuring message: "If people have prepared well, I don't think that there will be a great outbreak [of bird flu among humans]."

Hong Kong University microbiologist Ho Pak-leung said several overseas studies had revealed that many types of mammals could contract the H5N1 virus, especially rats and those from the feline family such as tigers, leopards and cats. He urged people not to allow their children to handle dead birds and to keep their cats, dogs and other pets away from wild birds.

In a related development, Zhong said that bird flu victims in the mainland were found to have weaker immune systems. He said mainland experts have not come to any conclusion and are still studying the relationship between the physical condition of the victims and their susceptibility to bird flu. Two Indonesian children have died of bird flu, bringing the country's toll to 22. A 12-year-old girl died on March 1 in Solo, a city in Central Java province and a boy, 3, died last week in the city of Semarang, also in Central Java.

Both appeared to have had contact with infected chickens.

http://www.thestandard.com.hk/news_print.asp?art_id=13958&sid=7008024

Airports

Airports not ready for large-scale bird flu quarantine​

By John Ritter, USA TODAY

The nation's major airports aren't prepared to quarantine a planeload of international passengers if someone is suspected of carrying bird flu, airport and government officials say.

Eighteen airports with heavy international traffic have small federal quarantine stations. They must rely on airlines and state and local authorities to help identify sick travelers and, if needed, quarantine other passengers.

"Do we have enough people? No," says Robert Tapia, chief of Honolulu's five-person quarantine station. "If we have 25 international flights a day here and get a surge of four or five airlines reporting illness, how do we get to them all?" (Related: Honolulu has aggressive plan)

Bird flu response plans are still being developed at many airports, where the first human case could show up. Few airports have practiced quarantine scenarios. It has been more than 40 years since a U.S. airport quarantined a passenger, for smallpox. (Graphic: Migratory path of birds)

The deadly H5N1 strain of the bird flu virus can't be passed yet from person to person. Until it can, the risk is slight except to those in contact with infected wild birds and poultry. Bird flu has been found in animals in 39 countries. It has infected 175 people and killed 96 since December 2003. (Related: U.S. to expand its testing)

If human-to-human transmission evolves, the stakes rise because airline passengers could be infectious and able to spread bird flu without showing symptoms themselves.

Most major airports — Logan in Boston, Dulles outside Washington, Seattle's SeaTac, Miami and New York's JFK among them — haven't found facilities they can seal off to house a large number of potentially exposed passengers for several days.

Los Angeles International plans to use a vacant maintenance hangar, but it has no plumbing or other amenities to meet passenger needs. Honolulu is outfitting two remote gates and has found two nearby warehouses that could serve as quarantine sites.

If passengers on a jumbo jet needed to be quarantined, "I don't know what we would do except leave them on the plane while we scramble, and that's not a good answer," says Jeff Fitch, SeaTac's public safety director.

Marty Cetron, head of the federal Centers for Disease Control and Prevention's quarantine division, says, "There's a great deal of variability in operational readiness. Where we're not seeing the rubber hit the road is actual tactical planning at specific airports."

The CDC and the airlines haven't resolved how to improve in-flight reporting of sick passengers to destination airports, a legal requirement that has had spotty compliance. The CDC wants the airlines to add passenger home addresses and emergency contacts to flight manifests. Airlines oppose the changes. "The rule needs significant work," says Katherine Andrus of the Air Transport Association, the airlines' trade group. She says airlines have been working to improve in-flight illness reporting.

"It can be a challenge for (flight crews) who aren't medical professionals," Andrus says. "Outwardly, a respiratory infection can look like a common cold."

http://www.usatoday.com/travel/flights/2006-03-09-airports-bird-flu_x.htm

USGS

The Department of the Interior - H5N1 National Surveillance Efforts​

The global spread of H5N1 increases the likelihood that it will eventually be detected in North America. There are a number of pathways through which the virus could be brought to this continent; introduction by wild migratory birds is one possible pathway that the U.S. Department of Agriculture and the Department of the Interior are working together to address.

The Department of the Interior is responsible for managing wildlife, including migratory birds, under various laws and treaties, and for ensuring public health on more than 500 million acres of land across the country. To carry out these responsibilities, the Department and its partners are investigating highly pathogenic avian influenza (HPAI) in migratory birds and making plans to protect the health of employees and the 450 million people who visit Department-managed lands each year.

Three organizations have roles in the Department’s efforts related to HPAI: the U.S. Geological Survey, the U.S. Fish and Wildlife Service and the National Park Service. The U.S. Geological Survey (USGS) is the scientific arm of the Department, with a long history of responding to wildlife disease emergencies and conducting wildlife disease investigations. USGS is also supporting international HPAI research efforts by contributing information and world-class expertise about migratory birds and bird movements.

USGS scientists from the National Wildlife Health Center and the Alaska Science Center, in conjunction with the U.S. Fish and Wildlife Service and the State of Alaska, have been strategically sampling migrating birds for H5N1 in the Pacific Flyway. USGS is also monitoring reported migratory waterfowl and shorebird mortality events for presence of H5N1.

The USGS, U.S. Fish and Wildlife Service, and U.S. Department of Agriculture are already planning a coordinated, more comprehensive surveillance and detection program for 2006. This program is being designed to provide an early warning to the agriculture, public health, and wildlife communities should migratory birds be found to carry the virus.

The U.S. Fish and Wildlife Service (FWS) is the federal wildlife management agency within the Department. FWS administers the National Wildlife Refuge System; many of its 545 refuges provide critical nesting, migration, and wintering habitat for waterfowl and other migratory birds. FWS also carries out permitting and enforcement responsibilities under federal laws governing trade in wildlife species and products, and works with the U.S. Department of Agriculture to regulate the importation of wild birds for the pet trade, research, and other purposes.

With 384 areas in the National Park System, the National Park Service (NPS) has a key role in protecting the health of its visitors. The National Park Service hosts 32 commissioned officers of the U.S. Public Health Service to meet this important responsibility.

http://www.nwhc.usgs.gov/disease_in...a/department_of_the_interior_-_H5N1_brief.jsp

Air Sahara is still chicken​

By: Shramana Ganguly
March 11, 2006

While the bird flu scare seems to have passed, Air Sahara is playing it extra cautious. It is the only airline has hasn’t resumed serving chicken dishes.

Chicken will remain off he menu until March 16 at least, says the management, which is still worried about the avian bird flu. Mutton is available for hardcore non-vegetarians, but only on request.

“We have to keep serving mutton till headquarters okays chicken dishes,” explained an official from the airline’s catering department.

A company spokesperson told MiD DAY from New Delhi, “We are still concerned about the quality of chicken in the market and will stick to mutton for the time being. We will study the official reports on the spread of avian flu on March 16 and take a call then.”

Meanwhile, Jet Airways resumed serving chicken and eggs in-flight on March 8. Air India and Indian Airlines have also followed suit. In-flight director Amod Sharma said, “Our poultry suppliers are getting us certificates declaring that the chicken they supply is virus free.”

http://web.mid-day.com/news/city/2006/march/132762.htm

Bird flu targeting the young​

http://www.thestar.com/NASApp/cs/Co...ageid=968332188492&col=968793972154&t=TS_Home

As death toll nears 100, scientists scramble to explain why H5N1 virus is killing healthy people under 40
Mar. 11, 2006. 07:57 AM
RITA DALY
STAFF REPORTER

With the World Health Organization set to announce the 100th death from bird flu any day now, data compiled by the Toronto Star lead to one particularly compelling question: Why does the H5N1 virus attack the young?

The Star's analysis shows that all but six of the 97 people who have died globally so far from bird flu were under 40.

People, in other words, with the strongest immune systems and not, as one might expect, the elderly and those already sick. The median age was 19, and a quarter of them were under age 12.

Children, teenagers and young adults are the unfortunate victims of the deadly H5N1 bird flu sweeping through poultry farms in Asia, Africa and now Europe.

Hooked up to breathing tubes and dialysis machines in local hospital beds, bodies soaked in sweat, and blood oozing from their nostrils and mouth, they have a mere 50 per cent chance of pulling through. The rest die in a matter of days.

Any day now the World Health Organization will announce the 100th death from the bird flu that re-emerged in late 2003.

Yesterday, health officials confirmed a 4-year-old Indonesian boy died last month, bringing the number of confirmed cases to 176 and the world death toll to 97. Another three deaths in Azerbaijan are under investigation.

Although human cases are uncommon, it is now apparent the H5N1 will eventually reach North American shores, possibly via migratory birds in Alaska within six to 12 months. So what health experts know about how and whom it strikes is crucial.

So far, they know nearly everyone who died of the respiratory disease was in close contact with infected domestic birds, and most were young and previously healthy. Yet scientists still aren't sure why they fell ill, while others equally exposed to H5N1-infected chickens and ducks were spared.

"There are still a lot of unanswered questions and that's one of them," Sonja Olsen, an epidemiologist for the Atlanta-based U.S. Centers for Disease Control, said in an interview from Thailand where she is studying human cases of the H5N1.

There are other unanswered questions, like why is it some family members become infected and others not? Why aren't health-care workers in hospitals or unprotected agricultural workers slaughtering chickens also getting sick?

Originally surfacing in Hong Kong in 1997, killing six, then again in early 2003, killing one, the bird flu re-emerged later with a vengeance, decimating poultry stocks and infecting more people in areas of Southeast Asia.

The 97 deaths in the third wave are now spread across seven countries ? Vietnam, Cambodia, Indonesia, China, Thailand, Turkey and Iraq. The infection rate is already double this year over last, with more than three human cases a week as infected birds spread the virus further afield.

"A lot of the human cases of bird flu have occurred in people under 25 and we're still not exactly sure why that is," said the WHO's Maria Cheng.

"They may have different behaviour patterns, they may be exposed to the virus in closer ways, they may be more susceptible to it. But there's such a small number of cases that it's difficult to draw any conclusions about how it's transmitted in target populations."

WHO officials stress the number of deaths from H5N1 bird flu is extremely low compared to the 250,000 to 500,000 who die annually from seasonal human flu, or the nearly 800 people who died during the SARS epidemic in 2003, 44 of them in Toronto. But health experts also warn no bird flu has ever sickened and killed so many people as H5N1.

The virus has only a limited ability to infect people, but experts fear it could mutate and spread easily among humans, sparking a pandemic that could kill millions within months.

Canadian officials have devised an emergency plan in the event of a pandemic, but say as long as H5N1 remains bird flu there is little cause for alarm in a country where people and poultry live separate lives.

In the past century we've had three human flu pandemics: in 1918, 1957 and 1968. The most lethal ? the 1918 Spanish flu ? also targeted the young and healthy, killing 20 million to 50 million worldwide.

In a study published in the online medical journal Respiratory Research in November, Hong Kong scientists noted the H5N1 was creating what's called a "cytokine storm" in its healthy victims, causing their immune system to overreact to the virus, flood the lungs with an overabundance of antibodies and cause extensive lung damage, eventually shutting them down. It's the same response scientists believe caused so many deaths during the Spanish flu.

The H5N1 virus has already earned the notorious reputation of being the worst flu in birds. An unprecedented 200 million have died or been slaughtered. It is so highly pathogenic, infected chickens drop dead in 48 hours. This month, the virus showed up in several domestic cats and a weasel-like animal called a stone marten in Germany and Austria, creating fear in the European Union that it might easily be infecting other species.

Earl Brown, an avian flu expert and professor of immunology and virology at the University of Ottawa, said the behaviour of small children playing among infected fowl could logically account for the high infection rate among the young.

A recent news report saw 15 Iraqi children running through an area where thousands of culled chickens were dumped, tying them to sticks and waving them in the air.

A 14-year-old Turkish boy and his two sisters, 15 and 11, died in January after playing with the head of an infected chicken the family slaughtered and ate. And an 8-year-old Turkish girl died after kissing and hugging her dying pet chicken.

But each person's immunity, even genetic factors, may also play a part in determining who falls ill and dies, Brown said.

"On average, you'll get influenza once every five or 10 years, so kids are less likely to have antibodies from prior exposure," he said. "Adults will have had experiences with different influenza viruses."

It still doesn't explain the disproportionate number of people in their 20s and 30s who have succumbed to the disease. One theory is that some people have immunity to the N1 antigen of the bird flu virus developed from the H1N1 Spanish flu. That virus was still circulating in a milder form until 1957 and also re-emerged as a milder strain in 1977.

Each time there is a suspected case, WHO officials quickly send a team of field experts to investigate.

Swab samples are sent to the organization's reference labs for further tests and to determine whether the virus has changed genetically in a way that might allow it to transmit more easily between people.

So far, they have found most confirmed cases involve people with backyard poultry farms who had close contact with infected or dying birds ? in some cases slaughtering, defeathering and preparing them for dinner.

"When the chickens get sick and die, they get plucked, eviscerated and put into a pot, so maybe it's the mother and kids that are exposed at this point," Brown said.

Virologists know infection occurs through contact with blood, feces and other body fluids, and WHO officials recently reiterated the flu virus is also airborne, posing even a greater threat than AIDS.

If the virus were to start spreading easily among people, the first warning signal of a possible pandemic will be more and more clusters of people getting sick.

The CDC's Olsen and a team of researchers looked for this while examining 15 family clusters of infected cases in Vietnam, Thailand, Cambodia and Indonesia between Jan. 2004 and July 2005 ? a mother and child; siblings; cousins; a niece and aunt; a teenager, her older brother and grandfather.

They found no increase over time.

But Olsen said most had not been investigated thoroughly enough to say for certain there was no person-to-person transmission.

"There was only one where you could clearly say there was person-to-person transmission and the others left you sort of wondering," she said.

WHO officials said this week there are three confirmed cases of suspected person-to-person transmission:

In January 2004, Ngo Le Hung, a 31-year-old Vietnamese schoolteacher, became infected and died from a chicken he bought for his wedding, and his two sisters also died.

In September 2004 a dying 11-year-old Sakuntala Premphasri infected her mother Pranee, 26, in Thailand and both died. And in July 2005 a 38-year-old father is believed to have infected his two daughters, aged one and eight ? all three died.

Cheng said there may be other cases in which people became infected through human-to-human transmission, but there isn't enough evidence to prove it. There may also be many less severely ill people going unnoticed.

"But we haven't seen any substantial change in the virus and that is really the trigger we're watching for."

Poland confirms second bird-flu outbreak​

http://news.monstersandcritics.com/....php/Poland_confirms_second_bird-flu_outbreak

Warsaw - Poland on Saturday confirmed its second outbreak of the H5 type of bird flu in a dead wild swan found in the Ujscie Warty national park bordering Germany, Poland's chief State Veterinarian Krzsztof Jazdzewski was quoted by Polish Radio as saying.

Jazdzewski said further testing was needed to determine whether the H5N1 virus sub-type, which poses a threat to humans, was present in the infected bird. The results were expected Sunday noon, he said.

The dead swan was found in the village of Warniki, close to the Polish city of Kostrzyn bordering the Oder river and Germany. Jazdzewski said a no-go zone surrounding had been set up around the area where the diseased bird was discovered.

Poland had informed Germany and the European Union of the discovery, he said.

On Monday Poland was the tenth European Union member to confirm the H5N1 strain of the bird-flu virus. The virus was confirmed in three dead wild swans collected from the banks of the Vistula river running through the central Polish city of Torun, several hundred kilometres east of the Ujscie Warty national park.

The Torun case is among the first in Europe where the disease has cropped-up in an urban rather than a rural area.

Torun city authorities responded swiftly to the threat, setting up a 3-kilometre no-go zone around the area the dead birds were found, urging drivers to avoid the city and setting up special disinfectant stations for cars and pedestrians around the city.

Public reaction to the discovery of the disease in Poland has been muted.

© 2006 dpa - Deutsche Presse-Agentur

Bird Flu Detected in 11 Nigerian States​

http://allafrica.com/stories/200603110061.html

United States Department of State (Washington, DC)

March 10, 2006
Posted to the web March 11, 2006

Charlene Porter
Washington, DC

One month after the first official confirmation of a dangerous form of highly pathogenic avian influenza in Nigeria, the disease now has been detected in flocks in 11 of the West African nation's 37 states.

About 450,000 birds have been destroyed or died from disease as poultry producers and health officials work together to contain the damage and prevent further spread of the disease, the World Health Organization (WHO) reported March 9.

Nigerian agriculture officials earlier acknowledged that lax regulatory control of the movement of poultry across borders is one likely way the virus entered Nigeria. That also may explain the appearance of the H5N1 strain of bird flu in late February In Niger, which shares a border with Nigeria's Kano state.

"It will be vitally important to have disease containment plans in place," said WHO Director-General Lee Jong-wook in Nairobi, Kenya, March 9 as he urged African nations to limit the spread of bird flu.

This dangerous form of avian influenza has been confirmed in 33 nations so far, with tests still under way in several other countries where bird deaths are suspect. Since this form of the virus first appeared in Southeast Asia in 2003, an estimated 200 million birds have died or been destroyed in attempts to contain the disease.

Border controls and poultry import bans are among the strategies nations are using to protect their flocks from migrating H5N1. The United States first imposed an embargo on birds and bird products from nations affected by this highly pathogenic form of avian influenza in February 2004. On March 6, the Department of Health and Human Services amended the embargo to forbid such imports from Nigeria and Egypt. On March 9, the list of nations under embargo was expanded to include India and Niger.

The European Union has imposed import bans on potentially risky poultry products and adopted tighter bio-security measures. Theses measures require imposition of protection zones 3 kilometers around the site where infected birds are found, and a broader 10 kilometer surveillance zone in which the movement of poultry and hatching eggs must be controlled strictly. Fairs, markets, shows or any other gathering of poultry are prohibited in these zones.

This form of bird flu has leapt the species barrier and infected humans in 176 cases, resulting in 97 deaths, the latest confirmed March 10 by WHO. The Indonesian government has attributed the death of a 4-year-old boy to H5N1, the latest of 21 deaths in the Southeast Asian nation.

Azerbaijan is investigating disease in 10 people with respiratory illness to determine if H5N1 is the cause. The first disease in animals was detected there in February.

Other mammals are also at risk of exposure to this strain of influenza. German health officials March 9 confirmed the appearance of the disease in the stone marten, a nocturnal mammal that feeds on birds. It is presumed that this creature -- found alive, but severely ill - was infected by eating an H5N1-infected bird. Three infected cats also have been found in Germany, but the WHO announcement on these discoveries describes infections of nonbird species as rare events.

U.S. government and academic organizations have been conducting an ongoing testing program to look for bird flu viruses in migratory flocks. Flyways crossing Alaska are considered the most likely place for a highly pathogenic influenza strain to enter North America, according to the U.S. Geological Survey, because of the intermingling of native and Asian flocks that occurs there.

H5N1 has not been detected in North America so far, although more common, less dangerous bird flu viruses have been detected. The U.S. agencies will be conducting tests on up to 100,000 migratory birds in 2006 in an expanding federal, state and regional disease surveillance effort.

The U.N. senior coordinator for avian and human influenza, David Nabarro, said March 8 that migratory patterns likely will carry avian influenza into the Americas within six months to 12 months.

Birdflu virus reaches Batam​

http://www.antara.co.id/en/seenws/?id=10001

Batam (ANTARA News) - Laboratory tests on blood samples from four dead chickens and one ailing chicken in Batam have shown that they carried the bird-flu virus, a local government official said here Saturday.

Jusak, an official of the local marine resources, fisheries and agricultural service, said the discovery meant that the deadly disease had already reached Batam, the country`s oldest industrialized zone.

He said how the virus had come to Batam was still unknown but it was believed the source of the infection was wild birds.

The blood sample from a sick chicken in Kampung Tiban Koperasi in Sekupang had also tested positive for the H5N1 virus.

In view of the discoveries, Jusak said, his office had called on all parties particularly poultry farmers to increase cleanliness at their farms.

"Fortuntely, until now the virus has not claimed any human life here. But we have to be alert to the danger," he said.(*)

Youth Dies of Suspected Bird Flu in Baku​

http://www.panarmenian.net/news/eng/?nid=16810

/PanARMENIAN.Net/ On Friday 16-year-old Shahriyar Asgarov, a resident of the Daikand village, Salyan region, who has been hospitalized with the bird flu symptoms, died at the Scientific Research Institute of Lung Diseases, says a news release of the Azerbaijani Health Ministry. But the Ministry insists that the cause of the death was double pneumonia and lung deficiency. The final diagnosis of the patient will be determined by a test at a London laboratory.

Out of the four deceased residents of the region, analysis were negative in two cases: one died from pneumonia, and the other – from an oncological disease. The Azeri Health Ministry reports that no one from Salyan region is hospitalized at the moment. In spite there is no direct proof of death from bird flu, there is ground that the young man died from that disease exactly. It should be reminded that until lately Azeri Health Ministry representatives denied there are people in Azerbaijan infected with avian influenza, in spite of numerous alarming signals by the society and media, reports Day.az.

Fourth Fatal Suspect H5N1 Bird Flu Case in Azerbaijan​

http://www.recombinomics.com/News/03100601/H5N1_Azerbaijan_Clusters_4.html

Recombinomics Commentary
March 10, 2006

On Friday 16-year old Shahriyar Asgarov, the resident of the Daikand village, Salyan region, died of double pneumonia and lung deficiency

The above comments increase the number of suspect bird flu deaths in Azerbaijan to four. Media reports indicated the latest fatality had collected dead swans in the area. Moreover, the name similarity to Nabat Askerova (20F) who had died earlier suggest these two fatalities may be part of the 8 member familial cluster.

Samples from the deceased and hospitalized have been sent to Weybridge for testing. However, the descriptions sound like the large cluster in Turkey.

S227N was identified in the index case in that cluster. Although WHO has indicated that S227N has not become fixed in H5N1 in the region, none of the sequences from humans in Turkey or Iraq have been made available outside of the private database maintained by WHO.
'
These sequences should be released immediately.

Four More Bird Flu Cases in Greece​

http://www.allheadlinenews.com/articles/7002741891

March 11, 2006 12:00 p.m. EST

Denise Royal - All Headline News Staff Writer

Athens, Greece (AHN) - Greece confirms four more cases of the lethal H5N1 strain of bird flu in swans found dead near its northern borders, bringing to 30 its total number of wild fowl known to have been infected.

According to Reuters, there have been no cases of bird flu identified in Greek farm poultry, but sales have plummeted and the government has announced measures, including state-guaranteed loans, to help farmers. Wildlife experts say Greece had a high number of migratory birds this winter, forced south by an unusually severe winter in northern Europe.

Meanwhile, a new case of the H5N1 bird flu virus was found in a wild swan in Poland but it was not yet known if it was the deadly strain, which can be fatal to humans, the veterinary services have said.

Two swans found dead in Poland earlier this week were confirmed to have the strain. That highly virulent type of H5N1 bird flu has killed at least 96 people, mainly in Asia.

Ventilators in Short Supply in Event of Bird Flu Pandemic​

http://www.nytimes.com/2006/03/12/n...gin&adxnnlx=1142101672-JzAlawRztMu7KYHXg5CdJg

By DONALD G. McNEIL Jr.
Published: March 12, 2006

No one knows whether an avian flu virus that is racing around the world might mutate into a strain that could cause a human pandemic, or whether such a pandemic would cause widespread illness in the United States. But if it did, public health experts and officials agree on one thing: the nation's hospitals would not have enough ventilators, the machines that pump oxygen into sick patients' lungs.

Right now, there are 105,000 ventilators, and even during a regular flu season, about 100,000 are in use. In a worst-case human pandemic, according to the national preparedness plan issued by President Bush in November, the country would need as many as 742,500.

To some experts, the ventilator shortage is the most glaring example of the country's lack of readiness for a pandemic.

"This is a life-or-death issue, and it reflects everything else that's wrong about our pandemic planning," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University. "The government puts out a 400-page plan, but we don't have any ventilators and there isn't much chance we're going to get them."

A typical hospital ventilator costs $30,000, and hospitals, operating on thin profit margins, say they cannot afford to buy and store hundreds of units that may never be used. Cheaper alternatives can be deployed in a crisis, but doctors say they are grossly inadequate to deal with a flu pandemic.

Congress authorized only $3.8 billion of the $7.1 billion that Mr. Bush requested for flu preparedness, and nearly 90 percent of it is earmarked for vaccines and the antiviral drug Tamiflu. Buying enough ventilators for a flu outbreak like that of 1918 would cost $18 billion.

"We only have a certain amount of money to spend on preparedness," said Thomas W. Skinner, a spokesman for the federal Centers for Disease Control and Prevention in Atlanta. "We can't invest strictly in respirators."

The federal preparedness plan leaves preparations for medical care up to state and city health officials, but the only government agency that amasses ventilators is the Strategic National Stockpile, created in 1999 by the disease centers to store medicine and equipment for use in a terrorist attack or a disaster. But the agency has only 4,000 to 5,000 ventilators, according to a federal official who spoke on the condition of anonymity because of a dispute between government health and security agencies about whether the size of the stockpile ought to be kept secret.

There is also a shortage of trained personnel, said Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

"Ask any respiratory therapist — you have to adjust the gases, the pressures," he said. "We don't have enough trained people to maintain them."

In a recent emergency drill, said Dr. John L. Hick, a professor of emergency medicine at the Mayo Medical School in Minnesota, the 27 hospitals in his area could come up with only 16 extra ventilators when faced with a hypothetical outbreak of 400 cases of pneumonic plague.

"In a pinch," Dr. Hick said, "you can hand-bag people," a procedure in which a fat plastic bellows is squeezed to push air into the lungs. "But in a pandemic, you're stuck."

Dr. Hick wrote a recent paper for The Journal of Academic Emergency Medicine suggesting guidelines to determine in a crisis which patients should be taken off ventilators and allowed to die.

In a national emergency, he said, "it will come down to some really thin cuts on a scoring system."

"Families are going to be told, 'We have to take your loved one off the ventilator even though, if we could keep him on it for a week, he might be fine,' " he went on. "How do you think that's going to go over? It's going to be a nightmare."

Representatives of three of the country's largest hospital chains, HCA, Tenet Healthcare and Triad Hospitals, said they were aware of the potential shortage. "We're considering the feasibility of acquiring additional ventilators, but I can't say we're even close to making that decision," said Jeff Prescott, a spokesman for HCA.

Steven Campanini, a spokesman for Tenet, said the company had looked at seven models from $40 to $30,000, but had not made any extra purchases. "There are split camps about whether or not bird flu will mutate," Mr. Campanini said. "But we recognize the threat and, should the need arise, we'll work with state and local officials to meet it."

Dräger Medical, a German company that is the world's largest maker of hospital ventilators, can double its assembly line capacity in a week, said Mandy Hartman, a vice president for marketing. In a year, that would add "more than 10,000" ventilators to the world supply, said Ms. Hartman, who declined to be more specific.

In interviews, experts in respiratory medicine and emergency preparedness offered other suggestions for dealing with an emergency, including the use of hand bags by teams of volunteers or family members as was done in New Orleans hospitals during Hurricane Katrina. But hand-bagging is exhausting, and flu patients may need assistance for weeks.

"You can do it for maybe 10 minutes before your forearms turn to jelly," said Amy Nichols, an infection control specialist at the University of California at San Francisco. "Think of squeezing a mushy football — that's the kind of pressure you have to create to fill engorged lungs."

A few hospitals are stockpiling disposable emergency ventilators normally used by paramedics and powered by the pressure of the oxygen tank. Their plastic valves can be set to deliver oxygen at various pressures, and they cost $50 to $100 each. They can run for hours if attached to a large bedside tank, or indefinitely on a hospital's oxygen supply.

Mark Nunes, an emergency preparedness consultant to the Washington State Hospitals Association, said hospitals in the state had stockpiled about 1,500 of one brand, Vortran Automatic Resuscitators. But doctors said they required care to operate: too little pressure would not deliver enough oxygen to lungs made inflexible by fluid and mucus, while too much pressure could damage them, increasing the chances of fatal bacterial infections.

"They'll keep somebody alive," Mr. Nunes said. "But they need to be monitored. You can't just intubate somebody and walk away."

James Lee, a senior vice president of Vortran Medical Technology, said his company had sold thousands of disposable resuscitators to hospitals worried about blackouts, terrorist attacks, storms and other emergencies.

"In a $30,000 I.C.U. ventilator, you're paying for a computer with a lot of alarms," Mr. Lee said. "In a pinch, ours can do pretty much everything you need to do — but they have to be monitored."

Although they are meant to be used only for minutes or hours, he said, models have worked in tests for two months, "although, obviously, you wouldn't have someone on for that long," he added.

Another alternative, said Michael Olesen, an infection control specialist at Abbott Northwestern Hospital in Minneapolis, would be the thousands of home machines used by people with sleep apnea and severe snoring.

Those machines, which cost $300 to $600 and are known as C-PAP for continuous positive airway pressure, are not ideal, because they do not develop the pressures needed to inflate fluid-filled lungs, nor do they release the pressure to let the lungs empty. (They have been likened to breathing with one's head outside a speeding car.)

"It's not normal ventilation," he admitted. "But it helps get oxygen to the lungs."

Not everyone takes alternative plans very seriously.

Dr. Hick said he thought most ventilators that lacked alarms and fine-tuned pressure controls would be "worthless" for seriously ill patients, and Dr. Rex Archer, chief health officer for Kansas City, Mo., and president of the National Association of County and City Health Officials, laughed a bit contemptuously when told of the backup plans and said: "Yeah, and maybe we should pull out some of the old iron lungs sitting around in museums."

Here's the link for summits by state. My state, California, isn't even listed yet. Sigh.
http://www.pandemicflu.gov/

Article on Wyoming's summit yesterday:

http://www.wyomingnews.com/news/more.asp?StoryID=107257

Wyoming, be ready for the flu
Gov. Dave Freudenthal and Michael Leavitt, U.S. secretary of health and human services, urged preparation at the Wyoming Pandemic Flu Summit.

By Jennifer Frazer
rep8@wyomingnews.com
Published in the Wyoming Tribune-Eagle

CHEYENNE - The governor of Wyoming and the U.S. secretary of Health and Human Services shared a united message at the Wyoming Pandemic Flu Summit Friday: Be prepared.

They would like this motto to be impressed on every mind and reflected in the pantries, medicine chests and supply closets of every Wyomingite.

It doesn't matter whether it is pandemic influenza, a blizzard or a bioterrorist or nuclear attack, said Secretary of Health and Human Services Michael Leavitt.

"What we're talking about here is preparedness," he said, "and preparedness saves lives."

Don't expect the federal government to help, he added, because it is going to be busy trying to help everyone at once.

"It needs to begin to permeate the thought process of the state that the notion of a pandemic is very different from what we're used to," Gov. Dave Freudenthal said.

Unlike the tornado in Wright or even Hurricane Katrina, he said, which were discrete events in specific areas, a pandemic creates a very different environment - one where many states are threatened at once, and the state next door won't be able to come to the rescue.

"In this context, there's going to be a much greater role for the public in terms of understanding and helping," he said.

In demonstration of their united cooperative effort, Freudenthal and Leavitt signed a planning agreement as a gesture of cooperation between the state and the federal government.

Also set aside in this year's state budget reserve account is $5 million for future flu pandemic needs, for which the governor thanked the Legislature.

In addition, the federal government has set aside some $350 million to help reduce the time needed for a flu vaccine to be manufactured for 300 million Americans to just six months from the current three to five years.

But even with an efficient vaccine delivery method, Americans will have to hold out for about six months.

Freudenthal and Leavitt encouraged stockpiling over a period of time.

"When you go to the store and buy three cans of tuna fish, buy a fourth and put it under the bed," he said. "When you go to the store to buy milk, buy powdered milk and put that under the bed."

People should try to accumulate up to a six-week supply of food, water, medicine and other essential supplies, he said. Preparation should be no different than that for a two-week blizzard.

"It's just a good idea," Leavitt said. "It's called self-reliance."

Leavitt highlighted what the potential human cost of such an outbreak might be. If a pandemic equal in magnitude to the 1918 flu epidemic struck today, he said, some 90 million people worldwide would be sickened, 40 million would seek hospitalization and 2 million would die.

And there is a candidate for such a pandemic - an avian flu, so far acquired only from birds, is flirting with human infection. So far it cannot be transmitted between people. But it has very similar genetics and virtually the same symptoms in people as the pandemic of 1918.

Admiral John Agwunobi, assistant secretary for health at the Department of Health and Human Services, showed a slide of an avian flu victim's lungs filled with pus, blood and fluid.

"The last time we saw this kind of damage was in 1918," he said, emphasizing that the current flu, unlike the 1918 virus, has not yet been able to spread person-to-person.

But there are costs beyond the loss of life itself. Leavitt noted how the economy of China was paralyzed after the relatively small SARS outbreak in which 8,000 people fell ill and 800 died.

Anne Alexander, director of the Health Economics Policy Center at the University of Wyoming, estimated the cost to Wyoming of a flu pandemic in medical and productivity costs at anywhere from $17.66 billion to $142.2 billion, in the event of an epidemic where 50 percent of those who contract the disease die.

Wyoming's rural nature may not necessarily protect it, either.

Freudenthal noted that Wyoming, though sparsely populated compared to other states, is right in the path of many migratory bird flight paths.

"Wyoming has as much chance of getting this as anyone," he said.

Leavitt concurred.

"If a pandemic happens in the 21st century, it'll happen in Wyoming. You can count on it," Leavitt said.

Such a pandemic, Leavitt said, would likely last 12 to 18 months and come in several waves lasting six to eight weeks each.

Planning efforts for such eventualities began in Wyoming more than a year ago.

Wyoming completed the latest version of its flu plan in January, but is seeking local input. The state also has created some 21 local emergency health planning and response coordinators whose job is to train, equip and plan for local public health emergencies.

But that is not enough, speakers said.

Every city, county, state, business, church, school and utility needs to have a plan, Freudenthal said, because the best way to fight a pandemic is on a local level.

What happens if 40 percent of the workforce can't come to work for six to eight weeks because they are sick, scared or caring for someone who's sick?

The best thing that local communities can do, Leavitt said, is to make a plan, consult planning checklists the government has made and have exercises to test the plan.

"It's one thing to have (plans)," he said, "It's another to get pills into the palms of people at the right moment."

http://tinyurl.com/l5omx

10 March 2006

Health Services Could Be Overwhelmed in a Pandemic, Experts Say
Communities urged to plan for meeting populations' health care needs

This fact sheet was compiled from various Internet sources as well as from presentations made at a February conference, held in Minnesota, on business planning for a pandemic.

Following information applies to pandemic influenza generally:

(begin fact sheet)

U.S. Department of State
Bureau of International Information Programs
Washington, D.C.
March 9, 2006

PUBLIC HEALTH AND HEALTH CARE DELIVERY: PLANNING FOR A PANDEMIC

Health care services likely will be overburdened if confronted by a pandemic: Hospitals and clinics could be overwhelmed by thousands of seriously ill patients; health care workers might be in short supply because of their own illnesses.

Communities and health care providers should plan now for maintaining a workable health care system during a crisis that could last several months. Planning should include the delivery of triage care, self-care and telephone consultations.

HEALTH CARE CONCERNS

Health care planning for a potential pandemic should involve all levels of government, including specialists in policy development, legislative review and drafting, human and animal health, patient care, laboratory diagnosis and testing, disaster management and communications. Health professionals must learn how to communicate risk effectively and be able to provide the facts to a frightened population. Experts at the World Health Organization (WHO) and in academia say that communities must prepare for:

• Medical shortages of equipment and supplies such as ventilators, respirators, syringes, anti-bacterial soap, anti-virals, vaccines, clean water and waste management.

• Death management challenges: refrigerated trucks dedicated to transporting bodies, and crematory and funeral service facilities that may be in short supply.

Disruptions in routine health care services and the likely need for alternative sites, such as gymnasiums, nursing homes, daycare facilities and tents, to provide health care. Plans should also address who could be used as alternates in some positions.

For additional information, see Checklist for Influenza Pandemic Preparedness Planning (PDF, 39 pages) on the WHO Web site.

PUBLIC HEALTH INTERVENTIONS BEFORE AND DURING A PANDEMIC

According to WHO, community health care managers should make plans now to determine:

• Where patients will be treated;

• What will be the admission criteria for existing and newly created health care facilities;

• How specimens will be collected and transported to laboratories;

• Who will get priority if there are limited quantities of protective masks and gloves; and

• How large a supply of chlorine for water purification is sufficient if shipments are delayed or suspended. Many cities keep only enough chlorine on hand to last five days to seven days.

According to Michael Osterholm, director of the University of Minnestota’s Center for Infectious Disease Research Policy, normal, everyday surgical masks and pieces of cloth tied across the face will do little or nothing to stop the spread of virulent viral strains that can be airborne or transmitted on droplets expelled in a cough. Special masks with sealed sides to block out contaminated air can be purchased from medical product suppliers, but after one wear they must be disposed of properly to avoid contact with lingering germs, Osterholm said.

An improved vaccine production system with the capacity to meet surges in demand also is needed, according to experts. Under the 2005 Public Readiness and Preparedness Act, the secretary of health and human services, in the event of bioterrorism or pandemic, can allow companies to produce medical supplies under a streamlined process without incurring legal liability. Planning for a better vaccine production system is an element of the Bush administration's National Strategy rolled out late in 2005.

WHAT INDIVIDUALS CAN DO

To avoid contracting or passing flu viruses to others, individuals should wash hands after touching blood, body fluids, secretions, excretions and contaminated items; after removing gloves; and between physical contacts with other people. Wash with either plain or anti-microbial soap and water or use alcohol-based products (gels, rinses or foams) that contain an emollient and do not require the use of water.

They also should:

• Avoid touching eyes, nose, mouth, or exposed skin with contaminated hands. Avoid touching surfaces doorknobs, keys, light switches without clean gloves.

• Use gloves and eye protection if in contact with blood, body fluids, secretions or excretions.

• Contain and dispose of solid waste in accordance with community health guidelines.

• Make sure building ventilation systems are well maintained to protect people inside from airborne threats.

Families should stock cupboards with enough nonperishable and prepackaged food products to last four weeks to five weeks. Supplies should include bottled water, canned meats, fruits, vegetables, soups, protein or fruit bars, dry cereal, granola and fruit bars, crackers, peanut butter or nuts, canned juices, canned or jarred baby food and formula, and pet food.

To avoid opportunities for exposure, shoppers should consolidate trips to the grocery store by purchasing larger quantities than normally and avoid dining outside the home during the initial months of a pandemic.

Other important precautions include stockpiling prescription drugs, if possible, as well as medical supplies like insulin and blood-pressure monitoring equipment, soap and water or alcohol-based hand wash, anti-diarrheal medication and fluids with electrolytes and vitamins.

For additional information, see the “Pandemic Flu Planning Checklist for Individuals and Families” on the U.S. government pandemic flu Web site.

SURVEILLANCE

Surveillance is the ongoing collection, interpretation and dissemination of data to enable the development of evidence-based interventions during health crises. Community pandemic plans should include surveillance designed to detect unusual or unexplained clusters of cases of acute respiratory illness. Prompt and transparent reporting of cases and results of investigations are essential. Surveillance, which may help public health officials prevent or delay the spread of the disease, includes:

• Monitoring hospital admissions and deaths for suspected or confirmed cases of pandemic influenza

• Monitoring workforce absenteeism, especially in critical services.

• Monitoring sales of drugs used to treat acute respiratory infections or to relieve coughing.

For more information, see “Preparing for Pandemic Influenza: The Need for Enhanced Surveillance” in the periodical Emerging Infectious Diseases.

OTHER RESOURCES

Additional information on pandemic preparedness is available on the Web site of the Center for Infectious Disease Research Policy, Centers for Disease Control, Food Industry QRT Pandemic Analysis, PandemicFlu.gov, the U.S. Department of Health and Human Services and the World Health Organization.

(end fact sheet)

(Distributed by the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

Poland confirms four separate outbreaks of bird-flu​

http://news.monstersandcritics.com/..._confirms_four_separate_outbreaks_of_bird-flu

Warsaw - Poland on Saturday confirmed three separate outbreaks of the H5N1 type of bird flu in dead wild swans and a goose across Poland, bringing to four the total number of locations the disease has appeared, state veterinary officials announced.

A dead wild swan found in the Ujscie Warty national park near the Polish city of Kostrzyn on the Oder river bordering Germany tested positive for H5N1, Poland's chief State Veterinarian Krzsztof Jazdzewski confirmed.

Another dead wild swan tested positive for H5N1 in the north- western port city of Swinoujscie while a third bird tested positive in the western city of Bydgoszcz.

On Monday, Poland confirmed its first case of the H5N1 bird flu potentially fatal to humans in dead wild swans in the central Polish city of Torun, several hundred kilometres east of Kostrzyn, Szczecin and Bydgoszcz.

Jazdzewski said further testing was needed to determine whether the H5N1 virus sub-type, which poses a threat to humans, was present in the infected birds found in the three new locations. The results were expected in the coming days.

Three kilometre no-go zones have been set up around the areas where the diseased birds were discovered.

Poland had informed Germany and the European Union of the new cases.

So far, public reaction to the discovery of the disease in Poland has been muted.

Alaska villagers to help bird flu survey​

http://www.usatoday.com/news/health/2006-03-11-alaska-bird-flu-study_x.htm

UNEAU, Alaska (AP) — He lives in one of the most remote areas of North America, but that hasn't stopped James Active Jr. from worrying about bird flu on its march around the globe.

The federal government will determine if waterfowl and shorebirds that migrate through Alaska from Asia are carrying a deadly form of the flu virus.
U.S. Fish and Wildlife Service, AP

A Yupik Eskimo from Kipnuk, a native village of 600 people on the edge of the Bering Sea, he follows the news on satellite television: millions of chickens and ducks dead or slaughtered in Asia, a scattering of human deaths, fallen swans in France, a dead cat in Germany.

Thousands of miles from these outbreaks, Active sounds resigned to the eventual appearance of the disease on his turf.

"We hear about it being overseas in different countries but somewhere down the line, I'm sure it will end up this way too," he said.

A subsistence hunter, Active depends on birds to feed his family through the spring until salmon return to local rivers in June. Like many others, he shrugs off his nagging worries.

He can't afford to give up hunting birds, he said, even as a massive effort gears up to catch the disease if it enters North America through his vast backyard.

While no roads link Kipnuk and dozens of neighboring villages to the rest of the world, the skies are thoroughfares for migrating waterfowl and shorebirds. Come spring, they nest by the millions in the surrounding delta of the mighty Yukon and Kuskokwim rivers — a broad flat plain covering millions of acres that is crisscrossed by rivers and streams and dotted with countless lakes and sloughs and ponds.

It's considered the crossroads for birds migrating between Asia and North America.

So far, the deadly H5N1 strain of bird flu, found in migratory birds in other parts of the world, has not been detected in North America. In an effort to catch it when it does, the federal government plans to test 75,000 to 100,000 live or dead birds this year in Alaska and more than two dozen other states.

Deborah Rocque, avian influenza coordinator for the region's U.S. Fish and Wildlife Service, says her agency will work with others to test at least 15,000 birds in Alaska.

"We feel pretty confident that if it is here, our sampling plan will be able to detect it," she said.

While most birds will be tested live, several thousand hunter-killed birds also will be checked.

That will require the help of local subsistence hunters. They'll be asked to bring their catch to a check station where technicians will swab the birds for fecal matter.

Even though test results won't be available for two weeks to two months, Active is willing to help. He and other residents of the delta's cash-poor villages depend on the spring migration — birds like cackling geese, king eiders, sandhill cranes, green and blue-winged teal — to add a boost of protein to their diet.

"Without (subsistence) we'd have to depend on chicken and turkey. That's expensive," said Active. Food prices in remote villages are 2 ½ to three times what they are in urban areas.

"And wild bird is better than chicken and turkey," Active added.

Michael Rearden, manager of the Yukon-Delta National Wildlife Refuge, said the benefits of good fresh food far outweigh the more uncertain risks of bird flu.

"People need to be cautious and reasonable about (handling the birds) but this is an important food source out here and I'd hate to see people avoiding them," he said.

Still, the news from abroad is making some people nervous. Radio station KYUK in the hub village of Bethel recently broadcast a call-in show on bird flu. Some villagers wanted to know if boiling the birds would kill the virus, and if they should worry about bird droppings on the wild berries they pick.

Wildlife and health experts say they have little to fear. So far the only cases of human sickness have been among people in very close daily contact with infected poultry. Callers were told their chances of picking up the virus from contaminated berries are next to nil and their food is safe as long as it's well-cooked, even if the virus is present.

Yet the jitters are not surprising. Elders remember the stories of the flu pandemic of 1918 that wiped out entire households in some villages. That virus, believed to have been carried to Alaska by soldiers returning from World War I, was also a bird flu that mutated into one that spread easily among humans.

Swiss stock up for times of crisis​

http://www.swissinfo.org/sen/swissinfo.html?siteSect=107&sid=6531552&cKey=1141918518000

Switzerland has stockpiled enough of the drug Tamiflu to treat one quarter of the population should bird flu become a human pandemic.

The country has a longstanding disaster preparedness strategy, which includes stocking up on rice, sugar, petrol and medicines to ensure that its citizens never go short.


Stockpiling is the job of the Federal Office for National Economic Supply. Currently it has SFr6 billion ($4.6 billion) worth of goods in its warehouses.

The supplies are meant to tide the country over in times when political or economic crises, natural disasters or terrorist attacks disrupt the flow of goods into the country.

Switzerland relies heavily on imports, especially as it has virtually no raw materials of its own.

Peter Graf, an office official, explained that stockpiling was initially a response to difficulties experienced during the 20th century.

With the advent of the Cold War, Switzerland started to increase its reserves.

"Nowadays stocks are not piled because of wars directly affecting Switzerland but for other types of problems such as boycotts or natural catastrophes," Graf told swissinfo.



Nowadays stocks are not piled because of wars.

Peter Graf, head of obligatory stockpiles


Hurricane Katrina

The country was recently called upon to help in the aftermath of Hurricane Katrina, which devastated parts of the United States last August. The hurricane disrupted production in oil refineries, prompting fears of shortages.

To counter the supply disruption, the International Energy Agency called on its members, among them Switzerland, to make crude oil and products from their reserves available.

The global market has led to a wide distribution of products, but has also created strong interdependencies between countries.

"Everything works on the just-in-time principle and the logistics sector has become weaker," said Graf, adding that it only needs a small change in the situation for problems to become apparent.

In 2002, delivery problems experienced by a US company meant that a certain important type of antibiotic did not reach Switzerland. This was countered by the stockpiled supplies.

Three areas

The supply office concentrates on three main areas – food, energy and medicines.

Storerooms hold grains, rice, sugar and coffee. Among the medicines are antibiotics and Tamiflu.

The authorities decided back in 2004 to stockpile the anti-viral medication and they now have enough to treat 25 per cent of the population for six weeks.

But the most expensive items in the warehouses are energy products, such as petrol and heating oil.

"We review our strategy every five years," said Graf. "It is done in such a way as to have what we need but not more than that."

"At first, we had fuel reserves for 12 months, now it's for four and a half months."

This also makes it easier for the government to rein in costs, despite the fact that it does finance the stockpiles directly. The merchandise remains the property of the producers, distributors or importers, who fill up the stores on the government's orders.

They are, in turn, reimbursed via a special fund made up from levies on imported goods.



We... have what we need but not more than that.

Peter Graf, head of obligatory stockpiles


Effect on prices

This has an effect on prices, meaning that the costs of compulsory stockpiling are passed on to the consumer, explains Graf.

"Drivers, for example, contribute to the financing of petrol reserves through [an extra cost of] 0.3 centimes per litre of fuel they buy."

During non-crisis times, stockpiling, even at home, is not an issue for most people.

"People get very worried about supply questions but only when it is of topical interest," said Graf.

"On the other hand, we try to have a long-term policy. If we had only decided to stock up on Tamiflu when everyone was talking about it and was trying to get hold of it, we would be lagging behind."

they stockpile sugar?

What am I missing? Why sugar? Why not, say, peanuts?