04/02 | Bird Flu Vaccine: Echo of (1976) Swine Flu Vaccine?

Link to yesterday's thread: http://www.timebomb2000.com/vb/showthread.php?t=191891

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 Azerbaijan
(see update)
o Turkey

* Near East:
o Iraq

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

Updated March 21, 2006

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

* Africa:
o Cameroon
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 Myanmar (Burma)
o Thailand
o Vietnam

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

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

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


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

Updated March 29, 2006

http://www.cdc.gov/flu/avian/outbreaks/current.htm

WHO, Avian Flu Timeline in .pdf: http://www.who.int/csr/disease/avian_influenza/timeline.pdf

In Bird Flu Vaccine Hunt, 1976 Tragedy Looms
Scientists Are Working Toward an Effective Bird Flu Vaccine, but Want to Avoid Harm of Swine Flu Shots​

April 1, 2006 — - For nearly nine years, infectious disease specialists at Rochester University Medical Center in Rochester, N.Y., have been conducting tests as part of a broad national effort to develop a bird flu vaccine.

Beginning in late 1997, the human trials have tested 30 different vaccines, all pegged to the H5N1 virus. The testing is funded by National Institute of Allergy and Infectious Diseases at Rochester and six other centers around the country.

Volunteers like Jamal Khal are acutely aware of the growing talk that avian flu may be the next pandemic. As he received an injection at Strong Memorial Hospital, Khal said, "I just wanted to be prepared in case it comes to this country."

As infected birds are found closer and closer to the United States, moving from Asia through the Middle East to Europe, scientists also are feeling a sense of urgency.

"When you are trying to be ready for a disaster, you have to be prepared for the worst-case scenario," said Dr. John Treanor who heads the Rochester program.

Vaccine Would Require Two Shots

So far, there has been limited success. The latest vaccines have been effective when given in large doses -- four to 12 times normal. And two shots would be required, straining the ability of pharmaceutical companies to produce enough to protect the U.S. population.

Since the bird flu virus has yet to mutate so that the illness can be transmitted from person to person, instead of bird to person, Treanor and other specialists do not believe that a pandemic is inevitable. But they are preparing, nevertheless.

"The goal would be to have a vaccine that's safe, first of all -- that would be effective, at least preventing the most severe manifestations of bird flu," Treanor said, "and that could be made widely available."

He also sees part of the scientist's job to gather enough information to guide those in Washington who would decide whether to stockpile a vaccine and when to order inoculations.

Avoiding a Repeat of Harmful 'Swine Flu' Vaccine

What's happening in Rochester and elsewhere is a reminder of another pandemic scare 30 years ago.

The pandemic never occurred, but the vaccine produced to protect Americans had tragic consequences.

In 1976, three American soldiers at Ft. Dix, N.J., died from swine flu, raising fears of a pandemic. Unlike bird flu, the swine flu virus was transmitted person to person.

The administration of President Gerald R. Ford mounted a national campaign urging Americans to get swine flu shots. In a famous photo opportunity that year, Ford himself rolled up his sleeve and was inoculated.

But the vaccine was unsafe. Thirty-two people died and hundreds of other developed paralysis from Guillain-Barre syndrome.

Patty Tipton was 32 in 1976, when she was inoculated.

"I didn't know anything about the side effects," she says today at her home in Owensboro, Ky. "It has been such a life-changing event."

After being inoculated with the swine flu vaccine, she developed Guillain-Barre and is confined to a wheel chair. She has lost her fine motor skills and can no longer sew or embroider, things that once gave her pleasure -- let alone play softball or ride a horse, her main outdoor pursuits in 1976.

Her constant thought is what might have been had she not had the vaccine.

"I could have survived the swine flu," she says. "I was young, I was healthy."

What would she recommend about the bird flu vaccine? Find out first if there are side effects.

The decision to inoculate is still defended by Dr. David Sencer, director of the Centers for Disease Control in 1976.

"If there was a pandemic and we hadn't done anything," he says today, "there would have been a lot more deaths than we saw."

Sencer says the big mistake in 1976 was ceding the decision making to politicians, a mistake he hopes is not repeated.

"The more it's recognized as a health problem and decisions are made by health personnel," he adds, "the better of we'll be."

Which Bird Flu Strain Will It Be?

Today in Rochester and at the other centers, there is confidence the mistakes of 1976 won't be repeated with bird flu.

"We have demonstrated that the vaccine is safe," says Treanor, "the name of the game now is finding a vaccine that is equally effective."

Treanor says scientists have had time they did not have in 1976 to follow the development of the bird flu. But underscoring the difficulty is the notorious ability of a flu virus to change its characteristics rapidly.

"If a pandemic were to arise," he says, "it's very possible that the pandemic strain would not be exactly the strain as the one in the vaccine we're testing."

In that case, Treanor says it might take four to six months to develop the proper vaccine.

But unlike 1976, he says, nothing in 2006 will be done in panic.

"I think the commitment right now is not to immunize until there is clear evidence of person to person to person transmission," he says. "And that, I think, would be a singal suggesting that pandemic is inevitable. And would probably be a good time to start vaccinating people."

http://abcnews.go.com/WNT/AvianFlu/story?id=1794656&page=1&CMP=OTC-RSSFeeds0312

Disaster strikes: We're not prepared​

Despite polls, officials say public, government not ready for next big one

http://www.insidebayarea.com/trivalleyherald/localnews/ci_3665342

By Steve Geissinger, SACRAMENTO BUREAU

SACRAMENTO — Top government officials and independent experts are warning the cavalry won't necessarily be able to ride immediately to the rescue when the next major disaster hits, contrary to what two new polls show many unprepared Californians believe.

And the surveys show the Bay Area — despite a century of disaster experience dating from the "Great Quake of 1906" — is among the most lax regions for household preparation.

"I think people's faith in government is somewhat wishful thinking," said Phil Trounstine, director of the Survey and Policy Research Institute at San Jose State University.

At a Thursday summit in Los Angeles on one potential disaster, a deadly flu pandemic, Gov. Arnold Schwarzenegger said, "The bird flu is sending a clear message to all of us — get ready, be prepared."

"The responsibility (for disaster preparation generally) does not stop with government. We want every business, every school, every family to have their own disaster or emergency plan and an emergency kit with essential items in it," he said.

At the same time, administration officials said the governor's No. 1 priority is public safety and that government is investing hundreds of millions to brace for everything from the flu to terrorist attacks.

But U.S. Health and Human Services Secretary Mike Leavitt said that "when it comes to pandemics, we are overdue and underprepared."

Polls by the San Jose institute and the Public Policy Institute of California indicate many Californians believe a major disaster will occur in the state soon and are worried about it, but have notprepared supplies or made family plans.

Seven in 10 Californians believe a big earthquake will strike the state and affect them, but only 20 percent consider themselves well prepared, according to the San Jose institute survey released Friday.

Despite the cautionary example of the government response to Hurricane Katrina in New Orleans, about half of those surveyed said they view local, state and federal government as well prepared or somewhat prepared to provide disaster assistance after a significant earthquake in California.

The poll found broad confidence in the government's efforts to shore up buildings, bridges, levees and other structures against earthquakes. Eight

in 10 respondents characterized those efforts as excellent, good or fair.

"In the aftermath of Hurricane Katrina, it's surprising to find that nearly half of Californians believe that state, local and federal government are prepared for a major disaster," Trounstine said.

Respondents in Los Angeles were almost twice as likely to describe themselves as well prepared than those in the Bay area. Almost a third of respondents on California's Central Coast said they were well prepared, the highest proportion in the survey. The lowest rates of preparation were in the Bay Area and Central Valley.

Overall, about six in 10 Californians surveyed said they were well prepared or somewhat prepared for a big earthquake. The figure was about the same for respondents who said they believe a large quake is likely.

Four in 10 described themselves as not very well prepared or not prepared at all.

The results of the San Francisco-based Public Policy Institute of California poll released Thursday roughly match those of the San Jose State University survey.

Results for the Bay Area showed:

-34 percent believe it is very likely and 46 percent think it's somewhat likely that a disaster will occur in the region in the next 10 years.

-17 percent are very worried and 40 percent are somewhat worried that a disaster will disrupt their lives.

-30 percent are very knowledgeable and 55 percent somewhat knowledgeable about how to prepare for a disaster.

-58 percent have a disaster kit equipped with food, water and other essential supplies.

-44 percent have a household plan in case of disaster.

"Even though the American public, and especially Californians, are very well aware of the potential for a major earthquake, most people have not taken seriously enough the need to get prepared," said Bruce Burtch, spokesman for the American Red Cross Bay Area Chapter.

The Associated Press contributed to this report.

H5N1 Bird Flu in Penguins in Antarctica?​

http://www.recombinomics.com/News/04010601/H5N1_Penguin.html

Recombinomics Commentary
April 1, 2006

The discovery of two corpses of penguins at the beginning of the week on l’île of the Possession threw the disorder in the scientific community of the base Alfred-Faure. The first analyses carried out on the spot reveal a strong suspicion of aviary influenza.

The last rotation of Marion-Dufresne which had left the Meeting on last 19 March to supply the southern Lands and the Antarctic Frenchwoman (TAAF), complete equipment of molecular biology had been delivered to l'équipe of Professor Chauron who undertakes research on the penguins of the sub-antarctic French islands for the account of l'OMS... The results of the first analyses are relatively worrying. Traces of virus H5N1 were insulated in the low part of l'appareil digestive of these marine birds.

The above comments suggest penguins in Antarctica are fatally infected with H5N1. Confirmation of these results would be cause for concern. Antarctica is relatively close to South America, Africa, and Australia, offering easy access for worldwide spread of H5N1 as the host range and geographical reach continue to expand.

More details on the initial results would be useful. If H5N1 is isolated, sequence data would be revealing.

H5n1 moves toward U.S.: Wild birds mingle at 'stopover points'​

http://news.google.com/news/url?sa=...80&path=!health!healthology&cid=0Surveillance

Surveillance for infected fowl to include areas such as bay, mid-Atlantic coast

BY A.J. HOSTETLER
TIMES-DISPATCH STAFF WRITER
Apr 2, 2006


For ornithologist Dan Cristol, "migration seems to be the key" to avian flu's arrival on U.S. shores and in the skies.


As migratory birds fly north this month to breeding grounds in Alaska and northeastern Canada, their return by fall could bring avian flu to the East Coast. That could threaten residential wild birds, the $29 billion U.S. poultry industry and, potentially, human health.

Federal wildlife and public-health officials have created sampling protocols to spot infected birds migrating to Alaska from Asia beginning this month.

The federal surveillance already under way expanded as experts reached a growing consensus that migrating birds played a significant role in spreading avian flu from Asia to Europe, the Middle East and Africa.

"The migratory pathway, I think it's pretty clear from what's happening in the Old World, is pretty potent" in dispersing the virus, said Cristol, a College of William and Mary scientist who specializes in migration issues.

The H5N1 flu has killed more than 60 species of wild birds, including swans, robins and starlings, as well as several species of domestic poultry. Which of the 700 North American species could become victims is unknown.

"I do not think that U.S. domestic birds are so genetically distinct from any non-U.S. birds that they would be any more resistant," said Thomas Toth, an avian virologist at the Virginia-Maryland Regional College of Veterinary Medicine at Virginia Tech. "The news is not good for other bird species."

To prepare, the Atlantic Flyway Council plans to finish drafting a surveillance program for the East Coast by mid-July. Diane Eggeman, president of the Florida Fish and Wildlife Conservation Commission, said early efforts are likely to focus on avian "stopover points," such as the Chesapeake Bay and the mid-Atlantic coast, and then the Carolinas and Florida.

The first infected birds, probably migratory waterfowl such as mallards or shorebirds, could show up along the East Coast as soon as late August or September.

Once here, the virus will probably circulate for several months among res- idential birds such as chickadees, titmice or the yellow-rumped warbler. It may be next spring before people see signs of sickened birds in more suburban and urban areas, Cristol said.

Predators, such as peregrine falcons, crows and hawks, that eat other birds also could become infected, Cristol said. Even the bald eagle, with its appetite for dying waterfowl, could be at risk.

Birds could bring the virus to the East Coast via two migratory routes.

The likeliest is the East Asian/Australian Flyway, which brings birds to Alaska. These birds could infect other birds that traveled from the East Coast and across Canada. In mid-August, they will return to the East Coast.

Among their numbers is the blackpoll warbler, a songbird that stops in Virginia before heading to northern South America. Or the gray-cheeked thrush, which also flies along the East Coast for its return south.

Another route is the East Atlantic Flyway, which brings birds from western Africa to Europe, across the North Atlantic through Greenland to northeastern Canada, said avian infectious-disease specialist Bill Pierson of the Virginia-Maryland Regional College of Veterinary Medicine.

Tom DeLiberto, national wildlife-disease coordinator for the federal Animal and Plant Health Inspection Service, said one species of concern is a small population of Canada geese that, unlike most Canada geese that migrate along the Atlantic Flyway, nests in Greenland. Another species of concern is the Eurasian wigeon, a duck that migrates from Europe into the Chesapeake Bay area.

What happens next, no one knows.

"The entire issue of mutations in influenza viruses and consequential changes in their behavior . . . is extremely mysterious and unpredictable," Toth said. "After all, this is why we are waiting with such tension for the inevitable pandemic."

Bird flu plan for 'mass graves'

http://news.bbc.co.uk/2/hi/uk_news/4869224.stm

=-=
Last Updated: Sunday, 2 April 2006, 04:21 GMT 05:21 UK
Bird flu plan for 'mass graves'

Plans for mass burials are being considered as part of Home Office preparations for a possible bird flu pandemic, reports the Sunday Times.

It cites a confidential report that says a "prudent worst case" assessment suggested 320,000 could die if the H5N1 virus mutated into a human form.

The document warns "there are likely to be substantially more deaths than can be managed within current timescales".

The Home Office said it did not respond to leaks but is making preparations.

A spokesman said: "Prudent precautionary planning is under way across all elements of the response, including the health service, other essential services and local authorities."

The H5N1 virus, which causes bird flu, does not pose a large-scale threat to humans, as it cannot pass easily from one person to another.


'Common burial'

Experts, however, fear the virus could mutate at some point in the future, and in its new form trigger a flu pandemic, potentially putting millions of human lives at risk. Any such mutation and subsequent pandemic would lead to delays of up to 17 weeks in burying or cremating victims, the document - said to have been discussed by a cabinet committee - states.

And the document warns the prospect of "common burial" would stir up images of the mass pits used to bury victims of the Great Plague in 1665.

However, it "might involve a large number of coffins buried in the same place at the same time, in such a way that allowed for individual graves to be marked".

The report suggests town halls could deal with what it refers to as a "base case" of 48,000 deaths in England and Wales in a 15-week pandemic.


'Strong plans'

Titled Managing Excess Deaths in an Influenza Pandemic and dated 22 March, according to the Sunday Times the document says vaccines would not be available at least for "the first wave" of a pandemic and would not be a "silver bullet".

The newspaper claimed ministers discussed the issue last week and, although they were alarmed at the prospect of such delays to burials, accepted there might be no option in the event of a mass outbreak.

Bird flu has already prompted the slaughter of millions of birds across three continents since the H5N1 strain emerged three years ago.

And it has claimed the lives of more than 100 humans - all of whom had been in close contact with infected birds.

Chief Medical Officer Sir Liam Donaldson has said preparing for a pandemic was "a top priority" and "strong plans" were in place to respond.

These plans include building a stockpile of 14.6 million doses of anti-viral drugs to treat those who fall ill during a pandemic.
=-=

www.chron.com

April 1, 2006, 7:00PM
WINGING IT
While bird flu news evolves, government gives good tips on preparing for disaster — any disaster

Copyright 2006 Houston Chronicle

It had to be expected after the absurdity of the color-coded terror alerts. But judging from late-night TV and reported grocery store sales, recent pandemic advice from the Health and Human Services Department is prompting mainly skepticism or apathy. In fact, U.S. Health and Human Services Secretary Michael Leavitt offered individuals just the right approach as avian flu sails inexorably westward.

In an unusually pointed recommendation this month, Leavitt offered citizens a sort of pandemic shopping list. "When you go to the store and buy three cans of tuna fish, buy a fourth and put it under the bed," he advised the March 13 Wyoming Pandemic Flu Summit. "When you go to the store to buy some milk, pick up a box of powdered milk. Put it under the bed. When you do that for a period of four to six months, you are going to have a couple of weeks of food. And that's what we're talking about."

With its practicality and embrace of routine, Leavitt's advice underlines two truths about avian flu. One: If it does turn pandemic, citizens have the responsibility to feed themselves and minimize contagion by temporarily staying home. Two: Avian flu may never pose a threat in this community. But some micro-organism, madman or weather system probably will.

By now, it's clear that international monitoring of the H5N1 strain is well justified. Though it has killed only 106 humans worldwide, the strain already has two of the three necessary weapons for a pandemic: the ability to jump from birds to humans and the power to cause fatal illness.

Though its presence has been traced in animals for about nine years, H5N1 hasn't mutated into a form transmissible between humans. It would take a major change to move from person to person. The virus resides, though, in millions of birds, and each new infection represents another chance for lethal mutation. If it did mutate, and no matching vaccine were available, some projections suggest half of all Americans could contract the potentially deadly flu in three months.

A few developments are starting to mitigate this frightening scenario. This week, researchers showed that a bird flu vaccine works on about half of those who are infected. But the dosage would be 12 times greater than a normal flu shot, and current manufacturing abilities couldn't create the needed amount of vaccine.

In any case, even a perfect, abundant vaccine warding off bird flu right now might be useless on a pandemic mutation. Meanwhile, Houston — with nationally recognized communication and disaster protocols — still lacks emergency room beds and equipment for nonpandemic medical needs.

The migration of bird flu should drive correction of these hospital infrastructure weaknesses, both at state and national levels. Similarly, this is the time for the federal government to pour grant money into research on new vaccine technologies that can fight a whole spectrum of flu strains. Congress can also encourage more vaccine makers with tax breaks.

But, as Secretary Leavitt implied in his shopping list, citizens must accept that pandemic avian flu will in any scenario demand individual resourcefulness. It may be bird flu that shutters our stores, causes utilities to be shut down and hampers access to potable water. It might be another disaster. One week's worth of food, drinking water and first-aid supplies is a good minimum precaution for all households that can afford it. It's the equivalent of a full gas tank on a long, unknown highway.

Bump

Egypt reports two more human bird flu infections​

http://www.alertnet.org/thenews/newsdesk/L02753152.htm

CAIRO, April 2 (Reuters) - Two more Egyptians have been infected with the bird flu virus, Egyptian Health Minister Hatem el-Gabali said on Sunday, taking to eight the number of reported human cases in the country.

The two were sisters, one aged 18 months and the other six years, from Kafr el-Sheikh province north of Cairo. The pair, who had handled dead birds, were in a stable condition. Blood tests on their immediate family were negative for the virus.

An Egyptian labourer working in Jordan was diagnosed with the disease on Friday.

A World Health Organisation spokesman said only five cases had been confirmed by the organisation. Of the five, two have died, two have recovered and one is still in hospital. Bird flu has killed at least 105 people worldwide.

The disease was first detected in Egypt in February and has since devastated its poultry industry. Efforts to combat the disease have been hampered by poor Egyptians breeding poultry in backyards or in homes to supplement their income, despite a ban.

The avian flu virus has so far not been transmitted from human to human, but can be caught from infected birds.

Although difficult for humans to catch, scientists fear bird flu could mutate into a form that can pass easily between humans, causing a pandemic.

Suspected birdflu patient dies in Madiun, E Java​

http://news.antara.co.id/en/seenws/index.php?id=10661

Surabaya (ANTARA News) - An under-five-year-old infant who was admitted to the Dr Soedono General Hospital in Madiun, East Java with bird-flu-like symptoms died on Tuesday after being treated for around three hours, a hospital spokesman said.

"The patient was accepted at the hospital at around 10.55 pm on Monday and died at 1.55 am on Tuesday. The patient was referred to us by the Magetan General Hospital," the spokesman, Sugeng Haryanto, said.

He said the patient known by its initial as AG (4) was weak, in a coma, convulsive and having breathing difficulty. The Magetan hospital suspected the child was suffering from birdflu and therefore needed further treatment.

"We contacted the Dr Soetomo hospital in Surbaya and a team from that hospital was expected to arrive Tuesday morning to take blood samples of the child but the patient died before the team arrived. We have tried hard to improve the condition of the patient but the reality was not as expected." he said.

The Dr Soedono hospital has so far treated three suspected birdflu patients and two of them were eventually declared negative of the virus and recovered.

The hospital has formed a special team to deal with birdflu cases. "The team was the one that treated the child last night. The team is always ready any time it is needed," he said.

400 Chinese Students Hospitalized With Unknown Flu​

http://www.forbes.com/markets/feeds/afx/2006/04/02/afx2640033.html

BEIJING, Apr 2

BEIJING (AFX) - Over 400 students at a university in central China's Henan province were hospitalized with high fevers linked to an unknown flu virus, state press and a school official said.

The outbreak began on March 26 when 22 students were hospitalized with high fevers, Xinhua news agency said.

The next day the number of sick students at the Henan University of Science and Technology in Luoyang city rose to 88, and on March 28 there were 208 sick students in the university's infirmary, it said.

'There were over 400 students that became feverish with the flu,' a university official who declined to be named told Agence France-Presse when contacted by phone.

He refused to detail what type of flu it was or how the outbreak had succeeded in infecting so many students.

Local health officials were currently trying to identify the flu strain, Xinhua said.

The temperatures of some of the students reached 39.6 degrees celsius, it said.

The sick students were quarantined while school officials, under directions from provincial health authorities, cancelled classes and began disinfecting the university's 2,000 dormitory rooms, dining halls and classrooms, it said.

Most students were only hospitalized for about three days and released, the report said, adding that only several dozen students remained hospitalized as of today.

Bird flu: the secret Cabinet document​

http://news.scotsman.com/health.cfm?id=508792006

JAMES KIRKUP
POLITICAL EDITOR

More than 700,000 could die in worst-case bird flu scenario
The figures were disclosed in a Cabinet Office briefing paper
Army could be "too stretched to help" due to international commitments

Key quote "Scientific modelling suggests that it may only take 2-3 weeks from the virus first entering the UK to its being widespread," - Cabinet Office paper

Story in full THE death toll from a bird flu pandemic in Britain could be more than 700,000, according to a confidential government report seen by The Scotsman.



The figure - far higher than previously stated - is contained in a Cabinet Office briefing paper prepared for emergency planning officials, which warns that the virus could strike the country in multiple "waves".

It also says the armed forces may not be available to help in an emergency because of Britain's extensive international military deployments.

Although ministers promised to order enough vaccine for the entire UK population, the document says that effective drugs "would not be available until at least four to six months after a pandemic had struck, which could be well after the first wave of illness in the UK".

Key health workers would be guaranteed the vaccine, but "other sectors should not assume priority access to pandemic vaccine", it warns.

The Cabinet Office paper has been circulated only to "Category 1 responders" - emergency services chiefs, local authorities, NHS officials and others responsible for drawing up contingency plans. It details the preparations under way for a flu pandemic arising in a number of ways, including the mutation of the H5N1 virus among birds.

The document warns that, once such an infection arrives in Britain, it could take only two weeks to become widespread. Issued in late February, it contains the latest updated projections for the spread of a "novel" form of the common flu virus to which people would have no immunity.

One of its central themes is the possibility that the virus could mutate again after an initial widespread infection, producing further pandemic waves. Those projections include a "reasonable worst-case scenario" in which multiple waves of the virus infect a total of 50 per cent of the population. At worst, the disease would be as powerful as the strain that caused the 1918 global pandemic, killing 2.5 per cent of those infected.

"This combination would give rise to an estimated 709,300 excess deaths in the UK across the whole period of the pandemic, spread across one or more waves," the Cabinet Office paper concludes.

However, that death toll is at the extreme of the scenarios considered by government scientists. The "base case", which experts believe most likely, is for an estimated 53,700 excess deaths from a multi-wave pandemic.

According to the Cabinet Office's civil contingencies secretariat, a flu pandemic is one of the greatest current threats to the UK. A mutated strain of the H5N1 avian flu virus is one possible source of such an infection, but however the new strain arises, it is projected to spread rapidly.

"Scientific modelling suggests that it may only take 2-3 weeks from the virus first entering the UK to its being widespread," the Cabinet Office paper states.

Some disaster scenarios constructed by independent experts foresee troops being called in to help manage a mass flu infection. But the Cabinet Office warns there can be no guarantee that the armed forces will be able to help.

"Planning for an influenza pandemic should take into account that military support may not be available if local units are deployed on operations," the paper says. "Nor should it be assumed that local units have personnel available with either the skill or equipment to undertake specialist tasks."

That could leave local councils having to cope with problems such as disposing of thousands of extra corpses that would overwhelm normal mortuary capacity and result in bodies being stockpiled before mass burials.

"A key point for local planning is likely to be the identification of potential sites for the location of facilities for the temporary storage of bodies, prior to funerals taking place," the document says.

The possibility of responding with mass burials is raised in a second leaked document, this one prepared by the Home Office.

It uses a "prudent worst-case" death toll of 320,000.

In such an event, Home Office planners estimate that bodies could be stored for up to 18 weeks before being buried.

The paper accepts that the prospect of mass burial may cause public anxiety and says: "Common burial stirs up images of the burial pits used in the great plague of 1665 - where in London 70,000 people died."

In fact, the mass burials envisaged would more closely resemble temporary sites used after major wars. The dead would be consigned to individual coffins and buried in discreet graves, with names clearly marked, in unconsecrated fields.

After the pandemic had passed, the coffins could then be disinterred and reburied in formal ceremonies elsewhere.

Government departments yesterday declined to comment on the leaked documents, but the Home Office issued a statement about emergency planning.

"The government is taking seriously the possible threat of an influenza pandemic in the light of the global situation and the possibility that a novel strain of the influenza virus could emerge," it said.

"Prudent precautionary planning is under way across all elements of the response, including the health service, other essential services and local authorities."
The key points

• The "reasonable worst-case scenario" of repeated "waves" of infection would mean 709,300 deaths from flu. The "base case" would mean 53,700 deaths.

• Planners must not rely on the armed forces being able to help with emergency management.

• Once the flu virus mutates into a "novel" strain, widespread infection could be reached in two weeks.

• An effective vaccine would not be available until at least four-to-six months after a pandemic. Only health service staff can be sure of priority access.

• The huge death toll could swamp mortuaries. Authorities should plan to stockpile bodies then bury them en masse.

Link to tomorrows (4/3) Bird Flu thread: http://www.timebomb2000.com/vb/showthread.php?t=192099