06/26-30 | Weekly BF: Counties reviewing quarantine rules in case of BF outbreak

Link to yesterday's thread: http://www.timebomb2000.com/vb/showthread.php?t=201818

Here is an important link...
Johns Hopkins on influenza: http://www.iom.edu/Object.File/Master/33/450/Rashid Chotani.pdf

Iowa

Post #21 from yesterday's thread... but in these days or stiffled BF news, this is a significant article for a thread starter...

Counties reviewing quarantine rules in case of avian flu outbreak​

Sunday, June 25, 2006 6:12 AM CDT

By TOM BARTON
Courier Staff Writer
INDEPENDENCE --- Public health officials will likely take a harder stance than your mother.

No chicken soup or spoonful of medicine. Instead, try a written quarantine or isolation order and the threat of simple misdemeanor charges.

As the recent mumps epidemic is contained, state and county officials are focusing more attention on another potential problem, an outbreak of avian influenza. And in an effort to assesses state preparedness, the Iowa Department of Public Health's Center for Disease Operation and Response is working with county and local governments to develop and review emergency response plans.

Part of the process is encouraging many entities to update quarantine and isolation ordinances.

Buchanan County supervisors are scheduled to vote on a third and final reading of a new ordinance Monday. The policy would give the board authority to segregate individuals with communicable diseases, such as avian flu, measles or smallpox.

Amy Marlow, community care manager at the Buchanan County Health Center, said generally most people cooperate voluntarily.

" ... But sometimes individuals do not comply, and in that situation, the county and local law enforcement need to be able to have the authority to step in and intervene," Marlow said.

If approved, county officials could file simple misdemeanor charges against those who refuse to play nice.

Marlow said as it stands, supervisors and the Buchanan County Board of Health would have to wait for an order from the Iowa Department of Public Health before isolating or quarantining residents. That, she said, presents problems in the county's ability to stop the spread of disease.

"The bottom line is to stop the spread of disease. This gives the county the authority to act immediately in its best interest to stop a pandemic from escalating," Marlow said.

She cautioned the ordinance is not meant to be confrontational.

"It's not to be a threatening situation, but a cooperative situation."

The county supervisors, along with the board of health, hospitals and law enforcement, would still coordinate efforts with the state and would follow similar procedures used by the Iowa Department of Public Health.

"Under Iowa law there's dual jurisdiction. Either the state or the local government can issue a quarantine. County governments have the authority to quarantine a person, but we need to make sure those ordinances are established and have enforcement provisions," said Heather Adams of the Iowa Attorney General's Office.

She represents the Iowa Department of Public Health.

"It's putting meat on the bones," Adams said.

Fayette and Black Hawk counties, along with 39 others, also are in the process of adopting similar ordinances. Forty-eight counties in Iowa have policies in place, including Butler, Bremer, Grundy and Benton.

The most recent example of using such an ordinance was in 2004. Johnson County quarantined eight individuals who contracted measles.

After Sept. 11, 2001, the Iowa Department of Public Health ordered a comprehensive review of its disaster preparedness, including quarantine policies, which Marlow maintains is a good idea.

"We feel we could handle what comes our way, should something happen, but the key is to have ongoing planning -- that these rules, ordinances and guidelines don't sit on the shelf and become outdated," she said.

The Buchanan County Health Department is revising its existing emergency response plan to include pandemic flu. Officials declined to release the plan's provisions, citing sensitive information they said is protected from disclosure under Iowa law.

In general terms, Marlow said the department is looking at policies and procedures for shutting down operations in the county in the event of a problem.

"That trucker bringing in supplies who isn't affected but maybe coming into an area that is affected -- do we let him in? How do we control movement in and out of the county?" she said.

Buchanan County received $8,000 from the Iowa Department of Public Health to develop an emergency response plan. Black Hawk County received $25,000 in federal funds to plan for pandemic flu and is in the initial stages of assembling its plan. Next year, Iowa will receive $1.2 million in federal funding for pandemic planning and operations, according to the governor's office.

Last Monday, two dozen scientists from around the world gathered in Ames to learn how to diagnose avian flu and control its spread. Ames is home to the National Veterinary Services Lab, which will determine whether H5N1, a highly pathogenic bird flu virus, has arrived in the United States.

The virus spread from Asia, where officials slaughtered 200 million birds, and moved on to Africa and Europe. The virus has killed at least 124 people. Scientists are concerned H5N1 could mutate into a form that can travel from human to human.

http://www.wcfcourier.com/articles/2006/06/25/news/regional/021e4bea54740fc886257197007f5f91.txt

Pillow Feathers

First cases found of avian flu caught from wild​

· Four Azeris died after plucking swan feathers
· Virus spread by humans in Indonesia, WHO confirms

David Adam and James Meikle
Monday June 26, 2006

Four people have died after catching avian flu from infected swans, in the first confirmed cases of the disease being passed from wild birds, scientists have revealed.

The victims, from a village in Azerbaijan, are believed to have caught the lethal H5N1 virus earlier this year when they plucked the feathers from dead birds to sell for pillows. Three other people were infected by the swans but survived.

Andreas Gilsdorf, an epidemiologist at the Robert Koch Institute in Berlin, who led the team that made the discovery, said: "As far as we know this is the first transmission from a wild bird, but it was a very intensive contact. We know that the virus is carried by swans and we know that you can catch the virus if you have close contact, so it doesn't change anything, it's just the first time it has been reported."

Some ornithologists and conservation experts have tried to play down the role that wild birds could play in spreading the disease. The UN's Convention on Migratory Species organised a "world migratory bird day" in April, which it said came "at a time when migratory birds are being unfairly portrayed solely as the harbingers of death and disease".

Almost all of the 220 other confirmed human cases of bird flu, including 130 deaths, have been linked to infected domestic poultry. A handful are believed to have caught the disease directly from infected humans.

The cluster of cases in the Salyan district of Azerbaijan, 90 miles south-east of Baku, was first reported in March. Six of the seven, all aged between 10 and 20, were from the same family. Relatives initially denied any contact - hunting and trading wild birds and their products there is illegal - but eventually admitted that the victims had plucked the feathers from dead swans among a huge number of the birds to have died in February.

Only one wild bird has been found with H5N1 in Britain in recent years, the dead swan floating off Fife in April. But surveillance of migratory birds returning this autumn is likely to be far greater and more targeted on specific species of ducks, geese and swans than it was this winter and spring. Checks are being carried out this summer on the black headed gull and lesser black back gull, which might have travelled from North Africa. Nigeria suffered a big outbreak in poultry this year.

Andy Evans, head of terrestrial research for the RSPB, said: "You have to get extremely close to an infected bird. Most cases are associated with poultry and preparing poultry for the pot. This is essentially the same process. If you have extremely close contact with an infected carcass, it is possibly to contract the disease, but it remains difficult."

The Health Protection Agency said: "Our advice remains the same, if you see a dead bird, don't pick it up." Defra said its scientific advisers regarded the risk of bird flu transmitting to humans from wild birds as small.

Separately, the World Health Organisation has confirmed fears that a cluster of cases in Indonesia was caused by the virus passing directly from person to person. Seven people died, but officials insisted there was no risk of wider transmission. Scientists found that the virus had mutated slightly, but not into a form that could be passed on easily.

http://www.guardian.co.uk/international/story/0,,1805813,00.html

Qinghai H5N1 Sequences in Karo Cluster in Sumatra Indonesia​

http://www.recombinomics.com/News/06260601/H5N1_Qinghai_Karo.html

Recombinomics Commentary
June 26, 2006

The recent workshop in Jakarta on human H5N1 in Indonesia provide additional detail on genetic changes associated with the Karo cluster. The father of the nephew of the index case had fourteen genetic changes not found in the consensus sequence H5N1 isolates from of the cluster. All other isolates had zero or one change. The high number of changes suggest the polymorphisms were acquired by recombination.

The past histories if polymorphisms can be identified in the flu database at Los Alamos. This approach has identified Qinghai bird flu sequences in recent isolates from Bali. Although Qinghai isolates in Indonesia have not been identified, the presence of Qinghai sequences on an Indonesian H5N1 genetic background points toward prior acquisitions via recombination.

The full sequences of the Karo H5N1 have not been released. However, phylogenetic trees of HA1 and M indicate that the closest public sequence to the Karo cluster isolates is A/chicken/Dairi/BPPVI/2005(H5N1). Like the Karo cluster, this isolate has an HA cleavage site of RERRRKKR and the amantadine resistance M2 change of S31N. Identities with the wild type positions were used to identify the number system used to represents the polymorphisms. For HA the chicken H5N1 sequence matched the consensus Kao cluster sequence for the first six polymorphism, but differed fro the last three indicating differences between the chicken and Karo sequences or a numbering error in the table, so these three positions were not evaluated.

Two of the matching eleven polymorphisms. HA A512G and M G651A were found in Qinghai isolates as listed below. The M polymorphism was defined with an 18 BP downstream probe, as well as a 23 BP upstream probe The downstream probe identified a large number of matching human isolates. H3N2 matches primarily limited to recent isolates from Indonesia and Canterbury, while a broader distribution was seen in H1N1 isolates. Several health care workers who cared for H5N1 patients in Karo and Bandung developed flu-like symptoms and was had been identified as being H1N1 positive. Although the healthcare workers tested negative for H5N1 virus, test results for H5N1 antibodies have not been disclosed. The M polymorphism is also in Canadian swine that have evidence of extensive recombination and have a human PB1 gene,

The profiling of these polymorphisms raises concerns that H5N1 in Indonesia is acquiring Qinghai sequences. Almost all Qinghai isolates have PB2 E627K. The only published exception is A/duck/Kurgan/08/2005(H5N1). Two of the human isolates in Indonesia, A/IDN/06/2005(H5N1) and A/IDN/321H/2006(H5N1) have E627K.

The rapid evolution of H5N1 in the Karo cluster and acquisition of Qinghai and human polymorphisms is cause fro concern.

HA A512G

DQ447199 A/chicken/Egypt/960N3-004/2006 2006 H5N1
DQ676834 A/chicken/Krasnodar/01/2006 2006 H5N1
DQ406728 A/chicken/Nigeria/641/2006 2006 H5N1
DQ515984 A/Cygnus olor/Czech Republic/5170/2006 2006 H5N1
DQ435200 A/domestic cat/Iraq/820/2006 2006 H5N1
DQ435201 A/domestic goose/Iraq/812/2006 2006 H5N1
DQ659113 A/duck/Niger/914/2006 2006 H5N1
DQ464377 A/Egypt/2782-NAMRU3/2006 2006 H5N1
DQ435202 A/Iraq/207-NAMRU3/2006 2006 H5N1
DQ458992 A/mallard/Bavaria/1/2006 2006 H5N1
DQ449031 A/mallard/Italy/332/2006 2006 H5N1
ISDN133105 A/Turkey/15/2006 2006 H5N1
ISDN133356 A/Turkey/651242/06 2006 H5N1
ISDN133364 A/Turkey/65596/06 2006 H5N1
AB233319 A/bar-headed goose/Mongolia/1/05 2005 H5N1
DQ320898 A/chicken/Guangxi/604/2005 2005 H5N1
DQ449632 A/chicken/Kurgan/05/2005 2005 H5N1
DQ323672 A/chicken/Kurgan/3/2005 2005 H5N1
DQ389158 A/Cygnus olor/Astrakhan/Ast05-2-1/2005 2005 H5N1
DQ434889 A/Cygnus olor/Astrakhan/Ast05-2-10/2005 2005 H5N1
DQ343502 A/Cygnus olor/Astrakhan/Ast05-2-2/2005 2005 H5N1
DQ358746 A/Cygnus olor/Astrakhan/Ast05-2-3/2005 2005 H5N1
DQ363918 A/Cygnus olor/Astrakhan/Ast05-2-4/2005 2005 H5N1
DQ365004 A/Cygnus olor/Astrakhan/Ast05-2-5/2005 2005 H5N1
DQ364996 A/Cygnus olor/Astrakhan/Ast05-2-6/2005 2005 H5N1
DQ363923 A/Cygnus olor/Astrakhan/Ast05-2-7/2005 2005 H5N1
DQ399540 A/Cygnus olor/Astrakhan/Ast05-2-8/2005 2005 H5N1
DQ399547 A/Cygnus olor/Astrakhan/Ast05-2-9/2005 2005 H5N1
DQ320899 A/duck/Guangxi/793/2005 2005 H5N1
DQ449640 A/duck/Kurgan/08/2005 2005 H5N1
DQ676840 A/goose/Krasnoozerka/627/2005 2005 H5N1
DQ320897 A/quail/Guangxi/575/2005 2005 H5N1
DQ320137 A/swan/Astrakhan/1/2005 2005 H5N1
ISDN129523 A/turkey/Turkey/1/05 2005 H5N1
DQ407519 A/turkey/Turkey/1/2005 2005 H5N1
AB233320 A/whooper swan/Mongolia/3/05 2005 H5N1
AB233321 A/whooper swan/Mongolia/4/05 2005 H5N1
AB233322 A/whooper swan/Mongolia/6/05 2005 H5N1
ISDN140936 A/Whooping swan/Mongolia/244/2005 2005 H5N1
DQ659326 A/Whooping swan/Mongolia/244/2005 2005 H5N1
AY651346 A/Ck/Hong Kong/31.2/2002 2002 H5N1
AY651350 A/Ck/Hong Kong/3176.3/2002 2002 H5N1
AY651347 A/Ck/Hong Kong/37.4/2002 2002 H5N1
AY651345 A/Gf/Hong Kong/38/2002 2002 H5N1
AY575880 A/pheasant/Hong Kong/675.14/02 2002 H5N1
AY651348 A/SCk/Hong Kong/YU100/2002 2002 H5N1
M18450 A/Duck/Ireland/113/83 1983 H5N8

M G651A downstream probe

DQ676835 A/chicken/Krasnodar/01/2006 2006 H5N1
DQ529297 A/chicken/Nigeria/641/2006 2006 H5N1
DQ533580 A/Cygnus olor/Italy/742/2006 2006 H5N1
ISDN136480 A/Turkey/12/2006 2006 H5N1
ISDN133372 A/Turkey/15/06 2006 H5N1
ISDN133357 A/Turkey/651242/06 2006 H5N1
ISDN133365 A/Turkey/65596/06 2006 H5N1
AB239305 A/bar-headed goose/Mongolia/1/05 2005 H5N1
DQ237951 A/bar-headed goose/Qinghai/0510/05 2005 H5N1
DQ095641 A/Bar-headed Goose/Qinghai/12/05 2005 H5N1
DQ095637 A/Bar-headed Goose/Qinghai/5/05 2005 H5N1
DQ095632 A/Bar-headed Goose/Qinghai/59/05 2005 H5N1
DQ095635 A/Bar-headed Goose/Qinghai/60/05 2005 H5N1
DQ095638 A/Bar-headed Goose/Qinghai/61/05 2005 H5N1
DQ095640 A/Bar-headed Goose/Qinghai/62/05 2005 H5N1
DQ095642 A/Bar-headed Goose/Qinghai/65/05 2005 H5N1
DQ095643 A/Bar-headed Goose/Qinghai/67/05 2005 H5N1
DQ095633 A/Bar-headed Goose/Qinghai/68/05 2005 H5N1
DQ095639 A/Bar-headed Goose/Qinghai/75/05 2005 H5N1
DQ100566 A/black-headed goose/Qinghai/1/2005 2005 H5N1
DQ100567 A/black-headed goose/Qinghai/2/2005 2005 H5N1
DQ100568 A/black-headed gull/Qinghai/1/2005 2005 H5N1
DQ095636 A/Brown-headed Gull/Qinghai/3/05 2005 H5N1
DQ676839 A/chicken/Dovolnoe/03/2005 2005 H5N1
DQ320942 A/chicken/Fujian/1042/2005 2005 H5N1
DQ320964 A/chicken/Guangxi/604/2005 2005 H5N1
DQ449633 A/chicken/Kurgan/05/2005 2005 H5N1
DQ323678 A/chicken/Kurgan/3/2005 2005 H5N1
DQ095646 A/Chicken/Shantou/810/05 2005 H5N1
DQ394576 A/Cygnus olor/Astrakhan/Ast05-2-1/2005 2005 H5N1
DQ434888 A/Cygnus olor/Astrakhan/Ast05-2-10/2005 2005 H5N1
DQ359692 A/Cygnus olor/Astrakhan/Ast05-2-2/2005 2005 H5N1
DQ358739 A/Cygnus olor/Astrakhan/Ast05-2-3/2005 2005 H5N1
DQ363925 A/Cygnus olor/Astrakhan/Ast05-2-4/2005 2005 H5N1
DQ365009 A/Cygnus olor/Astrakhan/Ast05-2-5/2005 2005 H5N1
DQ365002 A/Cygnus olor/Astrakhan/Ast05-2-6/2005 2005 H5N1
DQ363928 A/Cygnus olor/Astrakhan/Ast05-2-7/2005 2005 H5N1
DQ399542 A/Cygnus olor/Astrakhan/Ast05-2-8/2005 2005 H5N1
DQ400912 A/Cygnus olor/Astrakhan/Ast05-2-9/2005 2005 H5N1
DQ320941 A/duck/Fujian/897/2005 2005 H5N1
DQ320965 A/duck/Guangxi/793/2005 2005 H5N1
DQ320967 A/duck/Guangzhou/20/2005 2005 H5N1
DQ449641 A/duck/Kurgan/08/2005 2005 H5N1
DQ234078 A/duck/Novosibirsk/56/2005 2005 H5N1
DQ320988 A/Environment/Qinghai/31/2005 2005 H5N1
DQ095648 A/Goose/Shantou/1621/05 2005 H5N1
DQ320981 A/goose/Shantou/2216/2005 2005 H5N1
DQ100569 A/great black-headed gull/Qinghai/1/2005 2005 H5N1
DQ095634 A/Great Black-headed Gull/Qinghai/2/05 2005 H5N1
DQ234077 A/grebe/Novosibirsk/29/2005 2005 H5N1
DQ320982 A/migratory duck/Jiangxi/1653/2005 2005 H5N1
DQ320983 A/migratory duck/Jiangxi/1657/2005 2005 H5N1
DQ320984 A/migratory duck/Jiangxi/1701/2005 2005 H5N1
DQ095647 A/Quail/Shantou/911/05 2005 H5N1
ISDN129521 A/turkey/Turkey/1/05 2005 H5N1
AB239312 A/whooper swan/Mongolia/3/05 2005 H5N1
AB239319 A/whooper swan/Mongolia/4/05 2005 H5N1
AB239326 A/whooper swan/Mongolia/6/05 2005 H5N1
AB212651 A/blow fly/Kyoto/93/2004 2004 H5N1
AY950238 A/chicken/Henan/210/2004 2004 H5N1
AB189048 A/chicken/Kyoto/3/2004 2004 H5N1
AB188819 A/chicken/Oita/8/2004 2004 H5N1
ISDN49085 A/Chicken/Yamaguchi/7/2004 2004 H5N1
AB166865 A/chicken/Yamaguchi/7/2004 2004 H5N1
AB189056 A/crow/Kyoto/53/2004 2004 H5N1
AB189064 A/crow/Osaka/102/2004 2004 H5N1
AY651412 A/peregrine falcon/Hong Kong/D0028/2004 2004 H5N1
AY790306 A/swine/Korea/S452/2004 2004 H9N2
DQ280252 A/swine/Ontario/11112/04 2004 H1N1
DQ280244 A/swine/Ontario/23866/04 2004 H1N1
DQ280234 A/swine/Ontario/48235/04 2004 H1N2
DQ280210 A/swine/Ontario/55383/04 2004 H1N2
AY676047 A/chicken/Korea/ES/03 2003 H5N1
ISDN45748 A/Chicken/Korea/es/2003 2003 H5N1
AY800234 A/chicken/Korea/S1/2003 2003 H9N2
AY862622 A/chicken/Korea/S18/03 2003 H9N2
AY862615 A/chicken/Korea/S4/03 2003 H9N2
DQ107517 A/chicken/Korea/S4/2003 2003 H9N2
AY862616 A/chicken/Korea/S5/03 2003 H9N2
AY862623 A/chicken/Korea/S6/03 2003 H3N2
AY862628 A/dove/Korea/S11/03 2003 H3N2
AY862619 A/dove/Korea/S14/03 2003 H9N2
AY676048 A/duck/Korea/ESD1/03 2003 H5N1
AY862627 A/duck/Korea/S10/03 2003 H3N2
AY862618 A/duck/Korea/S13/03 2003 H9N2
AY862624 A/duck/Korea/S7/03 2003 H3N2
AY862625 A/duck/Korea/S8/03 2003 H3N2
AY862626 A/duck/Korea/S9/03 2003 H3N2
AY862614 A/silky chicken/Korea/S3/03 2003 H9N2
DQ280220 A/swine/Ontario/53518/03 2003 H1N1
AY363579 A/swine/Hong Kong/1144/02 2002 H3N2
AY363580 A/swine/Hong Kong/1197/02 2002 H3N2
AY585391 A/duck/Shanghai/08/2001 2001 H5N1
AY363578 A/swine/Hong Kong/9745/01 2001 H3N2
AY684906 A/black-headed gull/Netherlands/1/00 2000 H13N8
AF523499 A/Duck/Shantou/1588/00 2000 H9N1
AF523500 A/Duck/Shantou/2030/00 2000 H9N1
AY363576 A/swine/Hong Kong/7982/00 2000 H3N2
AY684907 A/black-headed gull/Sweden/1/99 1999 H13N6
AY684908 A/black-headed gull/Sweden/2/99 1999 H16N3
AY684909 A/black-headed gull/Sweden/5/99 1999 H16N3
AF508692 A/Chicken/Korea/99029/99 1999 H9N2
AJ293925 A/Hong Kong/1774/99 1999 H3N2
AJ316047 A/swine/Cotes d'Armor/1482/99 1999 H1N1
AJ316051 A/swine/Cotes d'Armor/604/99 1999 H1N2
AY363573 A/swine/Hong Kong/5190/99 1999 H3N2
AY363574 A/swine/Hong Kong/5200/99 1999 H3N2
AY363575 A/swine/Hong Kong/5212/99 1999 H3N2
AJ316053 A/swine/Italy/1654-1/99 1999 H1N2
AJ316052 A/swine/Italy/1521/98 1998 H1N2
AJ293938 A/swine/Italy/1553-2/98 1998 H3N2
AF250493 A/Duck/Hong Kong/P151/97 1997 H3N8
AF250487 A/Duck/Hong Kong/P169/97 1997 H3N8
AJ316049 A/swine/Cotes d'Armor/790/97 1997 H1N2
AF156468 A/Chicken/Korea/25232-96006/96 1996 H9N2
AF156467 A/Chicken/Korea/38349-p96323/96 1996 H9N2
AF203788 A/Chicken/Korea/MS96/96 1996 H9N2
DQ102483 A/swine/Bakum/5/95 1995 H1N1
AF213916 A/Swine/Italy/25823/94 1994 H3N2
AJ316060 A/swine/Scotland/410440/94 1994 H1N2
Z46439 A/swine/Schleswig-Holstein/1/93 1993 H1N1
AJ311509 A/Swine/Belgium/220/92 1992 H3N2
Z26861 A/Swine/Germany/8533/91 1991 H1N1
AF188004 A/Swine/Quebec/5393/91 1991 H1N1
Z26859 A/turkey/Germany/3/91 1991 H1N1
Z26860 A/oystercatcher/Germany/87 1987 H1N1
M63525 A/Swine/Netherlands/12/85 1985 H1N1
AJ311508 A/swine/Cotes d'Armor/3633/84 1984 H3N2
AJ316059 A/swine/Finistere/2899/82 1982 H1N1
M55478 A/Swine/Germany/2/81 1981 H1N1
Z26862 A/Swine/Netherlands/25/80 1980 H1N1


upstream probe

AB259772 A/Aichi/104/2006 2006 H3N2
AB259773 A/Aichi/108/2006 2006 H3N2
AB259745 A/Aichi/122/2006 2006 H3N2
AB259768 A/Aichi/14/2006 2006 H3N2
AB259769 A/Aichi/173/2006 2006 H3N2
AB259770 A/Aichi/19/2006 2006 H3N2
AB259743 A/Aichi/211/2006 2006 H3N2
AB259747 A/Aichi/7/2006 2006 H3N2
AB259771 A/Aichi/80/2006 2006 H3N2
AB259746 A/Aichi/9/2006 2006 H3N2
DQ676835 A/chicken/Krasnodar/01/2006 2006 H5N1
DQ676831 A/chicken/Mahachkala/05/2006 2006 H5N1
DQ529297 A/chicken/Nigeria/641/2006 2006 H5N1
DQ533580 A/Cygnus olor/Italy/742/2006 2006 H5N1
ISDN136480 A/Turkey/12/2006 2006 H5N1
ISDN133372 A/Turkey/15/06 2006 H5N1
ISDN133357 A/Turkey/651242/06 2006 H5N1
ISDN133365 A/Turkey/65596/06 2006 H5N1
AB259751 A/Aichi/165/2005 2005 H3N2
AB259750 A/Aichi/174/2005 2005 H3N2
AB259767 A/Aichi/185/2005 2005 H3N2
AB259749 A/Aichi/188/2005 2005 H3N2
AB259748 A/Aichi/197/2005 2005 H3N2
AB239305 A/bar-headed goose/Mongolia/1/05 2005 H5N1
DQ237951 A/bar-headed goose/Qinghai/0510/05 2005 H5N1
DQ095641 A/Bar-headed Goose/Qinghai/12/05 2005 H5N1
DQ095637 A/Bar-headed Goose/Qinghai/5/05 2005 H5N1
DQ095632 A/Bar-headed Goose/Qinghai/59/05 2005 H5N1
DQ095635 A/Bar-headed Goose/Qinghai/60/05 2005 H5N1
DQ095638 A/Bar-headed Goose/Qinghai/61/05 2005 H5N1
DQ095640 A/Bar-headed Goose/Qinghai/62/05 2005 H5N1
DQ095642 A/Bar-headed Goose/Qinghai/65/05 2005 H5N1
DQ095643 A/Bar-headed Goose/Qinghai/67/05 2005 H5N1
DQ095633 A/Bar-headed Goose/Qinghai/68/05 2005 H5N1
DQ095639 A/Bar-headed Goose/Qinghai/75/05 2005 H5N1
DQ100566 A/black-headed goose/Qinghai/1/2005 2005 H5N1
DQ100567 A/black-headed goose/Qinghai/2/2005 2005 H5N1
DQ100568 A/black-headed gull/Qinghai/1/2005 2005 H5N1
DQ095636 A/Brown-headed Gull/Qinghai/3/05 2005 H5N1
CY009933 A/Canterbury/125/2005 2005 H3N2
CY008076 A/Canterbury/129/2005 2005 H3N2
CY008084 A/Canterbury/166/2005 2005 H3N2
CY008341 A/Canterbury/20/2005 2005 H3N2
CY008565 A/Canterbury/205/2005 2005 H3N2
CY008092 A/Canterbury/206/2005 2005 H3N2
CY008381 A/Canterbury/220/2005 2005 H3N2
CY008581 A/Canterbury/233/2005 2005 H3N2
CY008389 A/Canterbury/234/2005 2005 H3N2
CY008405 A/Canterbury/236/2005 2005 H3N2
CY008413 A/Canterbury/237/2005 2005 H3N2
CY008421 A/Canterbury/238/2005 2005 H3N2
CY008044 A/Canterbury/24/2005 2005 H3N2
CY008429 A/Canterbury/242/2005 2005 H3N2
CY008637 A/Canterbury/258/2005 2005 H3N2
CY008108 A/Canterbury/259/2005 2005 H3N2
CY009029 A/Canterbury/26/2005 2005 H3N2
CY008052 A/Canterbury/29/2005 2005 H3N2
CY007964 A/Canterbury/33/2005 2005 H3N2
CY009037 A/Canterbury/34/2005 2005 H3N2
DQ676839 A/chicken/Dovolnoe/03/2005 2005 H5N1
DQ320942 A/chicken/Fujian/1042/2005 2005 H5N1
DQ320964 A/chicken/Guangxi/604/2005 2005 H5N1
DQ449633 A/chicken/Kurgan/05/2005 2005 H5N1
DQ323678 A/chicken/Kurgan/3/2005 2005 H5N1
DQ095646 A/Chicken/Shantou/810/05 2005 H5N1
DQ394576 A/Cygnus olor/Astrakhan/Ast05-2-1/2005 2005 H5N1
DQ434888 A/Cygnus olor/Astrakhan/Ast05-2-10/200 2005 H5N1
DQ359692 A/Cygnus olor/Astrakhan/Ast05-2-2/2005 2005 H5N1
DQ363925 A/Cygnus olor/Astrakhan/Ast05-2-4/2005 2005 H5N1
DQ365009 A/Cygnus olor/Astrakhan/Ast05-2-5/2005 2005 H5N1
DQ365002 A/Cygnus olor/Astrakhan/Ast05-2-6/2005 2005 H5N1
DQ363928 A/Cygnus olor/Astrakhan/Ast05-2-7/2005 2005 H5N1
DQ399542 A/Cygnus olor/Astrakhan/Ast05-2-8/2005 2005 H5N1
DQ400912 A/Cygnus olor/Astrakhan/Ast05-2-9/2005 2005 H5N1
DQ320941 A/duck/Fujian/897/2005 2005 H5N1
DQ320965 A/duck/Guangxi/793/2005 2005 H5N1
DQ320967 A/duck/Guangzhou/20/2005 2005 H5N1
DQ449641 A/duck/Kurgan/08/2005 2005 H5N1
DQ234078 A/duck/Novosibirsk/56/2005 2005 H5N1
DQ320988 A/Environment/Qinghai/31/2005 2005 H5N1
DQ095648 A/Goose/Shantou/1621/05 2005 H5N1
DQ320981 A/goose/Shantou/2216/2005 2005 H5N1
DQ100569 A/great black-headed gull/Qinghai/1/2005 2005 H5N1
DQ095634 A/Great Black-headed Gull/Qinghai/2/05 2005 H5N1
DQ234077 A/grebe/Novosibirsk/29/2005 2005 H5N1
DQ320982 A/migratory duck/Jiangxi/1653/2005 2005 H5N1
DQ320983 A/migratory duck/Jiangxi/1657/2005 2005 H5N1
DQ320984 A/migratory duck/Jiangxi/1701/2005 2005 H5N1
DQ095647 A/Quail/Shantou/911/05 2005 H5N1
ISDN141893 A/Taiwan/482/2005 2005 H3N2
ISDN141892 A/Taiwan/518/2005 2005 H3N2
ISDN129521 A/turkey/Turkey/1/05 2005 H5N1
AB239312 A/whooper swan/Mongolia/3/05 2005 H5N1
AB239319 A/whooper swan/Mongolia/4/05 2005 H5N1
AB239326 A/whooper swan/Mongolia/6/05 2005 H5N1
AB212651 A/blow fly/Kyoto/93/2004 2004 H5N1
CY007468 A/Canterbury/106/2004 2004 H1N1
AB189048 A/chicken/Kyoto/3/2004 2004 H5N1
AB188819 A/chicken/Oita/8/2004 2004 H5N1
ISDN49085 A/Chicken/Yamaguchi/7/2004 2004 H5N1
AB166865 A/chicken/Yamaguchi/7/2004 2004 H5N1
AB189056 A/crow/Kyoto/53/2004 2004 H5N1
AB189064 A/crow/Osaka/102/2004 2004 H5N1
AY651412 A/peregrine falcon/Hong Kong/D0028/20042004 H5N1
CY004444 A/shorebird/Delaware/68/2004 2004 H13N9
DQ280252 A/swine/Ontario/11112/04 2004 H1N1
AY676047 A/chicken/Korea/ES/03 2003 H5N1
ISDN45748 A/Chicken/Korea/es/2003 2003 H5N1
AY862622 A/chicken/Korea/S18/03 2003 H9N2
AY862615 A/chicken/Korea/S4/03 2003 H9N2
AY862623 A/chicken/Korea/S6/03 2003 H3N2
AY862628 A/dove/Korea/S11/03 2003 H3N2
AY676048 A/duck/Korea/ESD1/03 2003 H5N1
AY862627 A/duck/Korea/S10/03 2003 H3N2
AY862618 A/duck/Korea/S13/03 2003 H9N2
AY862624 A/duck/Korea/S7/03 2003 H3N2
AY862625 A/duck/Korea/S8/03 2003 H3N2
AY862626 A/duck/Korea/S9/03 2003 H3N2
CY002985 A/New York/221/2003 2003 H1N1
CY002681 A/New York/222/2003 2003 H1N1
CY002689 A/New York/223/2003 2003 H1N1
CY002537 A/New York/227/2003 2003 H1N1
CY003297 A/New York/228/2003 2003 H1N1
CY002625 A/New York/230/2003 2003 H1N1
CY003377 A/New York/292/2003 2003 H1N1
CY003385 A/New York/293/2003 2003 H1N1
CY002705 A/New York/348/2003 2003 H1N1
CY006428 A/New York/350/2003 2003 H1N1
CY002809 A/New York/399/2003 2003 H1N1
CY008525 A/New York/483/2003 2003 H1N1
CY008997 A/New York/484/2003 2003 H1N1
CY003689 A/New York/486/2003 2003 H1N1
CY006916 A/New York/488/2003 2003 H1N1
CY006668 A/New York/493/2003 2003 H1N1
CY003705 A/New York/496/2003 2003 H1N1
AY862614 A/silky chicken/Korea/S3/03 2003 H9N2
AY303652 A/chicken/Chile/176822/02 2002 H7N3
AY303653 A/chicken/Chile/4322/02 2002 H7N3
AY303654 A/chicken/Chile/4957/02 2002 H7N3
AY303655 A/chicken/Chile/4968/02 2002 H7N3
AY303656 A/chicken/Chile/4977/02 2002 H7N3
CY000418 A/New York/103/2002 2002 H3N2
CY000114 A/New York/110/2002 2002 H3N2
CY001334 A/New York/118/2002 2002 H3N2
CY001198 A/New York/122/2002 2002 H3N2
CY001945 A/New York/126/2002 2002 H3N2
CY000426 A/New York/128/2002 2002 H3N2
CY002529 A/New York/220/2002 2002 H1N1
CY003305 A/New York/291/2002 2002 H1N1
CY003105 A/New York/404/2002 2002 H3N2
CY003137 A/New York/409/2002 2002 H3N2
CY003161 A/New York/412/2002 2002 H3N2
CY003193 A/New York/416/2002 2002 H3N2
CY006676 A/New York/494/2002 2002 H1N1
CY001302 A/New York/75/2002 2002 H3N2
CY000402 A/New York/89/2002 2002 H3N2
CY000926 A/New York/93/2002 2002 H3N2
DQ249267 A/Taiwan/2984/2002 2002 H1N1
AY303657 A/turkey/Chile/4418/02 2002 H7N3
CY010397 A/Canterbury/01/2001 2001 H1N1
CY009861 A/Canterbury/08/2001 2001 H1N1
CY010477 A/Canterbury/106/2001 2001 H1N1
CY010309 A/Canterbury/119/2001 2001 H1N1
CY010317 A/Canterbury/125/2001 2001 H1N1
CY010325 A/Canterbury/126/2001 2001 H1N1
CY010333 A/Canterbury/139/2001 2001 H1N1
CY010341 A/Canterbury/144/2001 2001 H1N1
CY011089 A/Canterbury/152/2001 2001 H1N1
CY009981 A/Canterbury/153/2001 2001 H1N1
CY010349 A/Canterbury/155/2001 2001 H1N1
CY009877 A/Canterbury/16/2001 2001 H1N1
CY010149 A/Canterbury/17/2001 2001 H1N1
CY010157 A/Canterbury/19/2001 2001 H1N1
CY010765 A/Canterbury/20/2001 2001 H1N1
CY010165 A/Canterbury/21/2001 2001 H1N1
CY010773 A/Canterbury/22/2001 2001 H1N1
CY010173 A/Canterbury/23/2001 2001 H1N1
CY010181 A/Canterbury/24/2001 2001 H1N1
CY010189 A/Canterbury/25/2001 2001 H1N1
CY010197 A/Canterbury/27/2001 2001 H1N1
CY010205 A/Canterbury/29/2001 2001 H1N1
CY010213 A/Canterbury/30/2001 2001 H1N1
CY010221 A/Canterbury/34/2001 2001 H1N1
CY010229 A/Canterbury/35/2001 2001 H1N1
CY010237 A/Canterbury/40/2001 2001 H1N1
CY009885 A/Canterbury/41/2001 2001 H1N1
CY010781 A/Canterbury/42/2001 2001 H1N1
CY010245 A/Canterbury/45/2001 2001 H1N1
CY010253 A/Canterbury/47/2001 2001 H1N1
CY010261 A/Canterbury/48/2001 2001 H1N1
CY010413 A/Canterbury/51/2001 2001 H1N1
CY010269 A/Canterbury/53/2001 2001 H1N1
CY010557 A/Canterbury/54/2001 2001 H1N1
CY010277 A/Canterbury/58/2001 2001 H1N1
CY011081 A/Canterbury/60/2001 2001 H1N1
CY010421 A/Canterbury/63/2001 2001 H1N1
CY010285 A/Canterbury/64/2001 2001 H1N1
CY010429 A/Canterbury/65/2001 2001 H1N1
CY009957 A/Canterbury/66/2001 2001 H1N1
CY010437 A/Canterbury/68/2001 2001 H1N1
CY010445 A /Canterbury/69/2001 2001 H1N1
CY010453 A /Canterbury/70/2001 2001 H1N1
CY010461 A/ Canterbury/71/2001 2001 H1N1
CY010293 A/ Canterbury/72/2001 2001 H1N1
CY010301 A/ Canterbury/73/2001 2001 H1N1
CY009965 A/ Canterbury/74/2001 2001 H1N1
CY009973 A/ Canterbury/76/2001 2001 H1N1
CY010469 A/ Canterbury/79/2001 2001 H1N1
AY651428 A/Dk/ST/5048/2001 2001 H3N8
AY585391 A/ duck/Shanghai/08/2001 2001 H5N1
CY001953 A/New York/205/2001 2001 H1N1
CY002617 A/New York/208/2001 2001 H1N1
CY006420 A/New York/212/2001 2001 H1N1
CY010853 A/New York/235/2001 2001 H1N1
CY003001 A/New York/239/2001 2001 H1N1
CY003009 A/New York/241/2001 2001 H1N1
CY006356 A/New York/242/2001 2001 H1N1
CY003017 A/New York/246/2001 2001 H1N1
CY002569 A/New York/281/2001 2001 H1N1
CY003313 A/New York/302/2001 2001 H1N1
CY006364 A/New York/303/2001 2001 H1N1
CY003393 A/New York/305/2001 2001 H1N1
CY003401 A/New York/306/2001 2001 H1N1
CY002801 A/New York/308/2001 2001 H1N1
CY006876 A/New York/309/2001 2001 H1N1
CY002673 A/New York/310/2001 2001 H1N1
CY002697 A/New York/312/2001 2001 H1N1
CY003025 A/New York/341/2001 2001 H1N1
CY003321 A/New York/342/2001 2001 H1N1
CY002393 A/New York/343/2001 2001 H1N1
CY006780 A/New York/344/2001 2001 H1N1
CY002401 A/New York/345/2001 2001 H1N1
CY003329 A/New York/346/2001 2001 H1N1
CY003089 A/New York/402/2001 2001 H3N2
CY009237 A/New York/441/2001 2001 H1N1
CY003465 A/New York/442/2001 2001 H1N1
CY003473 A/New York/443/2001 2001 H1N1
CY003289 A/New York/444/2001 2001 H1N1
CY003834 A/New York/445/2001 2001 H1N1
CY003481 A/New York/446/2001 2001 H1N1
CY006172 A/New York/447/2001 2001 H1N1
CY009869 A/South Canterbury/15/2001 2001 H1N1
CY010357 A/South Canterbury/159/2001 2001 H1N1
CY011185 A/Waikato/10/2001 2001 H1N1
CY011193 A/Waikato/16/2001 2001 H1N1
CY011209 A/Waikato/18/2001 2001 H1N1
CY011201 A/Waikato/20/2001 2001 H1N1
CY011161 A/Waikato/4/2001 2001 H1N1
CY011233 A/Waikato/42/2001 2001 H1N1
CY011225 A/Waikato/51/2001 2001 H1N1
CY011169 A/Waikato/7/2001 2001 H1N1
CY011393 A/Waikato/80/2001 2001 H1N1
CY011153 A/Wellington/1/2001 2001 H1N1
CY011241 A/Wellington/28/2001 2001 H1N1
CY011177 A/Wellington/3/2001 2001 H1N1
CY011217 A/Wellington/9/2001 2001 H1N1
CY011073 A/West Coast/31/2001 2001 H1N1
CY010405 A/West Coast/33/2001 2001 H1N1
CY010133 A/Canterbury/100/2000 2000 H1N1
CY009757 A/Canterbury/23/2000 2000 H1N1
CY010101 A/Canterbury/27/2000 2000 H1N1
CY009189 A/Canterbury/28/2000 2000 H1N1
CY009181 A/Canterbury/30/2000 2000 H1N1
CY009221 A/Canterbury/32/2000 2000 H1N1
CY009213 A/Canterbury/33/2000 2000 H1N1
CY009229 A/Canterbury/34/2000 2000 H1N1
CY009197 A/Canterbury/36/2000 2000 H1N1
CY009533 A/Canterbury/37/2000 2000 H1N1
CY009829 A/Canterbury/41/2000 2000 H1N1
CY010093 A/Canterbury/43/2000 2000 H1N1
CY009541 A/Canterbury/5/2000 2000 H1N1
CY010109 A/Canterbury/51/2000 2000 H1N1
CY010125 A/Canterbury/54/2000 2000 H1N1
CY009845 A/Canterbury/57/2000 2000 H1N1
CY010117 A/Canterbury/58/2000 2000 H1N1
CY009821 A/Canterbury/60/2000 2000 H1N1
CY010389 A/Canterbury/63/2000 2000 H1N1
CY009549 A/Canterbury/65/2000 2000 H1N1
CY009765 A/Canterbury/7/2000 2000 H1N1
CY009789 A/Canterbury/76/2000 2000 H1N1
CY009813 A/Canterbury/78/2000 2000 H1N1
CY009797 A/Canterbury/79/2000 2000 H1N1
CY010381 A/Canterbury/8/2000 2000 H1N1
CY009805 A/Canterbury/87/2000 2000 H1N1
CY009941 A/Canterbury/9/2000 2000 H1N1
CY010141 A/Canterbury/95/2000 2000 H1N1
AF523499 A/Duck/Shantou/1588/00 2000 H9N1
AF523500 A/Duck/Shantou/2030/00 2000 H9N1
CY002641 A/New York/233/2000 2000 H1N1
CY002649 A/New York/234/2000 2000 H1N1
CY005428 A/Quail/Nanchang/12-340/2000 2000 H1N1
AJ458304 A/Saudi Arabia/7971/2000 2000 H1N1
DQ021740 A/semi-palmated sandpiper/DE/2109/00 2000 H11N6
CY009773 A/South Canterbury/31/2000 2000 H1N1
CY009205 A/South Canterbury/35/2000 2000 H1N1
CY009781 A/South Canterbury/40/2000 2000 H1N1
CY009173 A/South Canterbury/50/2000 2000 H1N1
CY009837 A/South Canterbury/59/2000 2000 H1N1
CY010997 A/Wellington/2/2000 2000 H1N1
CY011005 A/Wellington/3/2000 2000 H1N1
CY011013 A/Wellington/5/2000 2000 H1N1
AF508692 A/Chicken/Korea/99029/99 1999 H9N2
DQ508860 A/New Caledonia/20/1999 1999 H1N1
ISDN139828 A/New Caledonia/20/99 1999 H1N1
AJ458301 A/New Caledonia/20/99 1999 H1N1
AF250493 A/Duck/Hong Kong/P151/97 1997 H3N8
AF250487 A/Duck/Hong Kong/P169/97 1997 H3N8
AF250484 A/Duck/Hong Kong/P185/97 1997 H3N8
AF073201 A/Turkey/Utah/24721-10/95 1995 H7N3
AF073204 A/Emu/Texas/39924/93 1993 H5N2
AY664429 A/ruddy turnstone/Delaware/34/93 1993 H2N1
AY664465 A/ruddy turnstone/Delaware/81/93 1993 H2N1
AF001677 A/Equine/LaPlata/1/88 1988 H3N8
DQ021729 A/mottled duck/LA/32M/87 1987 H6N2
Z26860 A/oystercatcher/Germany/87 1987 H1N1
CY005421 A/sanderling/Delaware/1258/1986 1986 H6N6
AY664436 A/sanderling/Delaware/1258/86 1986 H6N6
CY004838 A/mallard duck/Alberta/25/1985 1985 H4N6
CY004831 A/mallard duck/Alberta/630/1984 1984 H4N2
CY010957 A/Memphis/15/1983 1983 H1N1
CY005896 A/duck/MN/1516/1981 1981 H5N2
M63528 A/turkey/Minnesota/166/81 1981 H1N1
M63538 A/Gull/Massachusetts/26/80 1980 H13N6
M63527 A/turkey/Minnesota/833/80 1980 H4N2
CY005907 A/turkey/MN/833/1980 1980 H4N2
CY004798 A/blue-winged teal/Alberta/580/1979 1979 H4N2
CY004631 A/mallard duck/Alberta/1012/1979 1979 H3N4
CY004626 A/mallard duck/Alberta/663/1979 1979 H3N5
CY004988 A/pintail duck/Alberta/114/1979 1979 H8N4
CY004012 A/blue-winged teal/Alberta/48/1978 1978 H6N5
CY004784 A/mallard duck/Alberta/354/1978 1978 H4N2
CY004600 A/mallard duck/Alberta/712/1978 1978 H3N3
DQ107490 A/turkey/MN/511/78 1978 H9N2
CY004743 A/blue-winged teal/Alberta/243/1977 1977 H4N6
CY005016 A/blue-winged teal/Alberta/295/1977 1977 H7N3
CY004722 A/canvasback duck/Alberta/274/1977 1977 H4N6
AF001686 A/Equine/Newmarket/1/77 1977 H7N7
CY005033 A/gadwall duck/Alberta/291/1977 1977 H7N3
CY004729 A/gadwall duck/Alberta/53/1977 1977 H4N6
CY004593 A/mallard duck/Alberta/127/1977 1977 H1N1
CY004961 A/mallard duck/Alberta/291/1977 977 H4N1
CY004459 A/mallard duck/Alberta/42/1977 1977 H1N6
AY664426 A/mallard duck/Alberta/42/1977 1977 H1N6
CY004750 A/mallard/Alberta/300/1977 1977 H4N3
AY664480 A/mallard/Alberta/300/1977 1977 H4N3
CY003848 A/mallard/Alberta/77/1977 1977 H2N3
AY664425 A/mallard/Alberta/77/1977 1977 H2N3
CY004736 A/redhead duck/Alberta/74/1977 1977 H4N6
CY005023 A/widgeon/Alberta/284/1977 1977 H7N3
CY004310 A/mallard duck/Alberta/20/1976 1976 H4N6
CY004710 A/mallard duck/Alberta/26/1976 1976 H3N1
CY004290 A/mallard duck/Alberta/65/1976 1976 H1N1
AF073197 A/Turkey/Oregon/71 1971 H7N3
AF001674 A/Equine/Miami/63 1963 H3N8

Phylogenetic Trees

Pandemic flu plan counts on care at home​

Monday, June 26, 2006
By TOM VOGT, Columbian staff writer

If a pandemic hits Clark County within the next few years, the flu patients could outnumber hospital beds.

But a local coalition is preparing for an overflow of uber-flu, and the response is based on what nurses like Layla Garrigues are providing now: home health care.

The federal pandemic flu plan calls for care in non-hospital settings, including patients who will need help at home. And help will be available.

"We want the community to know they won't be alone," nurse Ginny Lee said.

Care would be provided by Garrigues and her colleagues in the HomeCare Southwest system, as well as other local nurses who provide home care for more than 500 people right now. In a disaster, their caseload could climb to 1,400 home-bound patients.

It's a model that's worked before, in the aftermath of a 2001 disaster. Much of the care provided to those injured on Sept. 11 came from home health nurses, said Lee, a coordinator with HomeCare Southwest.

Representatives of Waterford Home Health, Community Home Health and Hospice, Gentiva Health Services, Clark County Public Health and HomeCare Southwest run by Southwest Washington Medical Center are building a plan around the concept.

The planning is motivated by the 20th century's pandemic flu cycle. The landmark outbreaks were the 1918 Spanish flu that killed more than 500,000 people in the U.S.; the 1957-58 Asian flu (70,000 U.S. deaths); and the 1968-69 Hong Kong flu (34,000 U.S. deaths).

"Every 40 or 50 years, another pandemic occurs," Lee said, adding that world and federal health officials see bird flu as the next pandemic.

Officials are game-planning the potential impact in Clark County. According to the most optimistic estimate, about 560 people would be hospitalized and 100 would die in the next flu pandemic; that's the most likely outcome of a 15 percent attack rate.

At the other end of the "what-if" chart is the maximum outcome of a 35 percent attack rate: Clark County could have more than 1,700 flu patients and almost 500 deaths over a 12-week period.

Meanwhile, the area's two hospitals are licensed for a total of 662 beds. Southwest Washington Medical Center has 442 beds, and Legacy Salmon Creek Hospital has 220.

At the low range of pandemic flu, the county would have about as many flu patients needing hospitalization as hospital beds. That's assuming, of course, that nobody gets injured, sick or pregnant.

If the county had to face a heavier dose of flu, the local home health system would have a "surge capacity" of about 1,400.

"That's the maximum number of patients we can handle in a disaster pandemic situation," Lee said, "providing all our staff is able to work."

Which is unlikely, based on recent outbreaks of norovirus. Several health care workers were infected by the people they were helping.

Mika Daly, clinical manager of HomeCare Southwest, said nurses would be able to administer IVs, monitor vital signs and serve as the eyes and ears of the doctor.

That was a big part of the visit recently when Garrigues dropped in to see Tiffany Sasaki, a Hazel Dell woman who has a congenital spinal problem. Garrigues pulled a stethoscope and a thermometer out of her bag, as well as a laptop computer she used to check Sasaki's medication schedule.

The home health coalition was assembled to prepare for a pandemic, but its value to the community won't be defined by avian flu. These discussions will set the stage for other collaborative programs, Daly said.

Planning sessions open the door to a lot of emergency response topics: anticipating communication problems, stockpiling supplies, establishing a command structure. Whatever the threat, talking about those issues now will pay off in unexpected ways, said Richard Konrad, emergency response coordinator for Clark County Public Health.

"All of this will be gold, no matter what happens," Konrad said.


Did you know?

* Pandemic flu and avian flu are not the same thing. Pandemic describes the way a disease is spread. Any disease can be a pandemic if it spreads rapidly among people all over the world.

http://www.columbian.com/news/localNews/06262006news38716.cfm

Posted on Mon, Jun. 26, 2006

Feds: Bird flu border closures unlikely​

BARRY SCHWEID
Associated Press

WASHINGTON - Closing U.S. borders would be the last option in combating the spread of bird flu, a senior State Department official said Monday.

It would not be likely to decrease the number of cases, would interrupt essential services and would disrupt lawful border crossings, said Paula J. Dobriansky, undersecretary of state for democracy and global affairs.

"Avian flu is not only a health issue. It has economic, social and security ramifications," Dobriansky said at a seminar at the Nixon Center, a private think tank.

Dobriansky outlined a U.S. government program in which information and other support is provided to 46 countries. Congress has provided $3.8 billion to finance this year's expenses.

The Agriculture Department's inspector general last week reported that the Bush administration lacked a comprehensive plan to test and monitor bird flu in commercial poultry.

Dobriansky declined to reply directly to the report, saying it was not issued by the State Department. However, she said "our efforts have been extremely well-coordinated" and include strong support for the World Health Organization and the U.N. Food Agency.

There have been outbreaks of the disease in 53 countries, leading to the deaths of 130 people, Dobriansky said.

If the disease escalates it could lead to civil unrest and instability, the State Department official said, and she likened the potential impact to the bubonic or Black Plague, which started in China and ravaged Europe in the 14th century.

Most human cases of bird flu have been traced to contact with sick birds. In Vietnam, 42 people have died, and in Indonesia, 39, since the virus began ravaging Asian poultry stocks in late 2003.

http://www.thestate.com/mld/thestate/news/nation/14907368.htm

Bird flu pandemic would shrink Asia economies
by up to 9 pct : study​

http://www.antara.co.id/en/seenws/?id=15241

Sydney (ANTARA News)- A bird flu pandemic would shrink Asian economies by 6-9 percent as strict quarantine measures impacted on global trade and sickness and death caused productivity to plummet, the Australian government's economic adviser has predicted.

The economies of developing countries would be worst hit due to higher
mortality rates from an outbreak of bird flu in humans, AFP reported citing the Australian Bureau of Agricultural and Resource Economics (ABARE).<br />

Gross domestic product in China would fall 8.7 percent, compared with 6.7
percent in South Korea, 6.1 percent in Japan, 7.1 percent in the Association of Southeast Asian Nations (ASEAN) and 6.8 percent in Australia.

Border closures disrupting the supply chain and affecting exports, lost labor productivity as workers became ill or died, and plummeting consumer and investor confidence would pose the biggest economic challenges, said the report released Monday.

ABARE based its predictions on a "medium scale" pandemic that would kill 80 million people worldwide.

It estimated that the outbreak would kill 0.2 percent of the population in developed countries and 1.39 percent in developing countries.

The organization also assumed that healthy adults aged 19-45 would be among the hardest hit, as was the case in the 1918-1919 Spanish influenza epidemic.

ABARE estimated that GDP in the United States would drop 3.5 percent, in
the European Union by 3.7 percent and Canada by 3.0 percent.

Tens of millions of birds have been infected with the deadly H5N1 virus.

According to the World Health Organization, around 200 people have caught
the virus from birds since 2003. Of those, around 120 have died, affecting several ASEAN countries.

ASEAN comprises Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the
Philippines, Singapore, Thailand and Vietnam.

Experts fear that if H5N1 mutates to become highly contagious among people, it could spark the first flu pandemic of the 21st century and kill millions.

"It is important to recognize that many countries, including Australia, are potentially vulnerable to a pandemic, regardless of where the initial outbreak occurs," ABARE said in its report.

"Hence it is more efficient for Australia and other countries to continue <br />
to be active in international efforts aimed at eradicating, preventing or <br />
containing the influenza virus at its source before it reaches international boundaries."

Experts call for computer imaging to halt outbreaks​

http://news.yahoo.com/s/nm/20060627...BZT.3QA;_ylu=X3oDMTA5aHJvMDdwBHNlYwN5bmNhdA--

HONG KONG (Reuters) - Experts called on Tuesday for the use of computer imaging to track the spread of disease, such as bird flu, saying it can be used to identify areas of outbreaks so they can be ringfenced.

The technology, geographic information system (GIS), can be used to chart detailed maps showing exact locations of residential and office buildings, produce markets, chicken farms and any other sites where infections might have occurred.

"Anytime there is a new disease, the important thing is to georeference that information ... where do the victims live, where might the exposure have taken place, did it take place at home, at work or recreationally?" said Charles Croner of the U.S. Centers for Disease Control and Prevention (
CDC).

"If flu cases continue to appear in the medical system, then we start to get a pattern of its existence."

"We must immediately put in resources to stop the flu. We must remediate it, we must give out vaccines to people who might have been exposed to these people. The geography is crucial," he told reporters on the sidelines of a conference on

GIS.

Although the H5N1 avian flu virus remains predominantly a disease among birds, the medical community has warned it can trigger a pandemic if it mutates to spread efficiently among people.

There have been a few cases of limited transmission among humans but genetic analyses of the virus by the
World Health Organization and the CDC has not shown any of the traits known to help the virus spread more easily among people.

Croner said GIS was badly needed in countries such as China, Vietnam and Indonesia where the virus is now endemic.

"The WHO is very concerned about the use of this technology so it can help improve disease detection," he said.

GIS is the science of capturing, managing, analysing and displaying all forms of geographically referenced information. The WHO has recommended that the technology be used to analyze epidemiological data and trends that would be more difficult to discover in tabular format.

GIS was used in Hong Kong in 2003, when it was struck by Severe Acute Respiratory Syndrome, or
SARS, which killed almost 300 people in the territory.

Lai Poh Chin, associate professor of geography at the University of Hong Kong, said the technology can be used to predict the spread of an epidemic.

"Based on the mean center, you can track its movement and see it going in a certain direction," Lai told Reuters.

"This technology (helps) ascertain where cases are and (allows for) fast intervention."

Doctor warns Britain unprepared for bird flu​

http://today.reuters.co.uk/news/new...1299_RTRUKOC_0_UK-BIRDFLU-BRITAIN.xml&src=rss

LONDON (Reuters) - A doctor warned on Tuesday that preparations for a possible bird flu pandemic in Britain were inadequate and could put more lives at risk.

Dr Steve Hajioff, a general practitioner from London, urged private companies such as utilities and service providers to ensure they were properly prepared.

"We will have an influenza pandemic sooner or later -- it's 37 years since the last pandemic, there tend to be three every century, and I think it is a matter of when rather than if," Hajioff told BBC radio.

Britain has been on high alert for bird flu since it discovered the lethal H5N1 virus in a wild swan in Scotland in April.

"It needs adequate preparation. If 25 percent of the population become infected -- which is the Department of Health estimate -- you could expect maybe 40 percent of people away form work," Hajioff said.

He said that with so many people affected, some workplaces may have to close, creating a dangerous knock-on effect.

"In my surgery I can make every preparation I like, but if the power company that supplies me hasn't made appropriate preparations then I'm not going to have any electricity, and if the phones are out, my patients can't call in, and if the transport system isn't working, how do people get to me?"

Bird flu remains essentially an animal disease, but it has taken 127 lives among 224 cases in 10 countries since 2003.

Scientists fear bird flu could become highly dangerous to humans if the virus mutates into a form easily passed on from one person to another.

New bird flu outbreak hits Siberia​

27/06/2006 17:00 NOVOSIBIRSK, June 27 (RIA Novosti) - A new outbreak of bird flu has hit the West Siberian region of Tomsk, the local administration said Tuesday.

A representative said a laboratory analysis of fancy pigeons that died in a village last week revealed the deadly virus.

"All the pigeons and chickens from the courtyard have been culled," the representative said. "The owner who had refused to vaccinate poultry will receive no compensation."

Governor Viktor Kress ordered vaccination as a preventive measure against an epidemic of the disease, which claimed over a million birds in Russia in February-April.

According to the Agriculture Ministry, bird flu was registered in 10 villages in three West Siberian regions in late May.

http://en.rian.ru/russia/20060627/50551090.html

It looks like damage estimates are increasing, but still low based on current mortality rates. Global damage est is now US$ 800 billion with a 2.5% mortality rate. Real H5N1 mortality is over currently 50%. It looks like managment is messaging the numbers...



Bird flu pandemic a 180-bln-euro risk to EU economy

Tue Jun 27, 2006 7:19 PM IST
By Brian Love, European Economics Correspondent

PARIS (Reuters) - A bird flu pandemic among humans could cost upwards of 180 billion euros in lost economic output in the European Union in the year that it strikes, according to a study for the European Commission.

The study, the first for the 25-country EU group, estimates that an avian influenza pandemic would reduce economic output by 1.6 percent because of a slump in overall hours worked as well as in travel and leisure activities.

"The macroeconomic effects of a future pandemic as estimated here are roughly of the same size as those of a major recession," concluded the study, conducted by Lars Jonung and Werner Roeger of the European Commision's economics department.

The authors, however, said that the economy would likely rebound after the worst of the pandemic peaked.

They used medical assumptions similar to those of a recent report by the U.S. Congressional Budget Office and then ran simulations based on a number-crunching model of their own.

That involved working on the basis that 30 percent of the EU population, or 150 million people, fall ill for about three weeks and that 2.5 percent of the sick die.

The "supply-side" damage, principally the cost in terms of work hours lost through death and sickness, accounts for about two-thirds of the total impact of a pandemic, says the study.

The rest would come from a drop in travel, tourism and the fact that people are likely to stay at home rather than go out to restaurants, pubs or cafes.

That, if it were to happen in 2006, would amount to around 180 billion euros, and it would be more in subsequent years.

Jonung and Roeger also ran a worse-case simulation where the psychological impact and damage to goods trade was far greater. The reduction in GDP would in that case be perhaps as high as 3 or 4 percent -- roughly double their preferred estimate.

"There'd be a rebound but even with a rebound you don't make up all the loss," Jonung told Reuters.

"There's an eternal, or long-lasting scar," he said, noting that this would not, however, be very significant.

The H5N1 virus has killed 130 people since 2003, according to the World Health Organisation, and most human cases can be traced to contact with infected birds. What experts fear is a mutation of the virus that would allow it to be easily transmitted from human to human.


GUESSING GAME

The World Bank said in November a pandemic could cost the global economy $800 billion over a year, or $200 billion per quarter. The Asian Development Bank said the cost to Asia alone could run as high as $283 billion over a year.

Jonung pointed out that the EU simulation gave a marginally lower hit than the one produced for the U.S. economy by the U.S. Congressional Budget Office, which ranged from a dent in GDP of 1.5 to 5.0 percent.

The European study said the impact would likely be larger in Mediterranean countries where tourism was more significant, and that the impact depended too on whether a pandemic struck at the height of the tourist season or not.

The authors said their study, like all others, amounted to a sophisticated "guesstimate". They said the economy would rebound after any disaster, as happened in the case of the deadly Spanish flu of 1918 or the Sept. 11 attacks on the United States in 2001.

The Spanish flu pandemic began in September 1918 and lasted until December that year. During that period, U.S. retail sales fell about 2 percent in November and 6 per cent in December, but after the pandemic was over in January 1919, retail sales jumped 8 per cent, the study noted.

The 1918 Spanish influenza pandemic killed 40-50 million people, according to the WHO, while the other big pandemics of the last 100 years were much smaller -- about 2 million died in the Asian flu pandemic of 1957 and 1 million in the Hong Kong one of 1968.

The study also assumes that the European Central Bank would chop interest rates by a percentage point to help boost economic activity if a pandemic struck.


http://in.today.reuters.com/news/ne...190616Z_01_NOOTR_RTRJONC_0_India-257062-1.xml

Commentary

Massive H5N1 Bird Flu Die-off in Tuva, Siberia

Recombinomics Commentary
June 27, 2006

The Siberian office of the Russian emergencies ministry Tuesday said the outbreak of the H5N1 strain of bird flu in the constituent Tuva Republic was intensifying.

The emergencies ministry first reported June 23 that 169 dead wild birds had been collected from the Ubsu-Nur Lake in the Ovyursky district of the Tuva Republic, and the presence of H5N1 in their blood samples had been confirmed by the Kemerovo veterinary laboratory.

Tuesday's statement said wild bird deaths were continuing, with 371 new deaths reported by Sunday afternoon. A total 1,622 birds have died since the first were found on the lake June 15.

The above report describes a massive number of H5N1 deaths in Tuva, which is in southern Russia, just to the north of Mongolia. Other reports indicate the number of dead birds is up to 3,339. The size of this outbreak is rivaling the deaths at Qinghai Lake in May, 2005 which topped 5000 dead birds primarily bar head geese. This year there is another outbreak somewhat south of Qinghai Lake near the southern border of Qinghai Province and northern border of Tibet. Over 1000 birds have died including ba headed geese and a number of other species. The recent wild bird meeting in Italy included phylogenetic trees of H5N1 from bar headed geese in China this year, indicating the isolates were most closely related to a crested Grebe from Novosibirsk or whooper swans from Mongolia.

This latest outbreak in Siberia suggests more H5N1 may be spreading worldwide this year. In 2005, there were no H5N1 reported until mid-July. The H5N1 this season may be more complex genetically because the H5N1 from Qinghai Lake on Novosibirsk evolved considerably in Europe as seen by the phylogenetic tree of over 70 isolates.

Thus, 2006 will likely see new sequences and new problems.

http://www.recombinomics.com/News/06270601/H5N1_Tuva.html

That involved working on the basis that 30 percent of the EU population, or 150 million people, fall ill for about three weeks and that 2.5 percent of the sick die.

Click to expand...

Why are they only suggesting that 2.5 percent of the sick will die? I think the current rate is more than 50%.
Do they really believe that after three weeks it's all going to be over?
This doesn't seem like a very realistic study.

H5N1 Bird Flu Spreads to Tomsk Siberia

Recombinomics Commentary
June 27, 2006

A new outbreak of bird flu has hit the West Siberian region of Tomsk, the local administration said Tuesday.

A representative said a laboratory analysis of fancy pigeons that died in a village last week revealed the deadly virus.

"All the pigeons and chickens from the courtyard have been culled,"

The above description of confirmed H5N1 bird flu in Tomsk provides additional evidence of earlier and more widespread outbreaks in Russia. Last year the first reports of H5N1 in the Novosibirsk region were in mid-July. Those reports were followed by H5N1 infections along the southern border with Kazakhstan. In August there were reports of H5 antibodies in birds in Tomsk.

The finding in Tomsk comes on the heals of a massive outbreak in Tuva, which also failed to report H5N1 last year. Earlier there were reports of H5N1 in northwestern Russia last month. These reports suggest H5N1 in Russia is more widespread and will increase in the upcoming months. Last year the reported cases were in southern Siberia in a region that links flyways to the Indian subcontinent, eastern Europe, the Middle East, and Africa. Less frequent outbreaks were reported in western Europe and there were no reports in the Americas.

Flyways in northern Russia link to western Europe and North America via the East Atlantic fly way. There are also links to Alaska via the East Asia / Australia flyway. The H5N1 reported in India over the winter may feed into north eastern Russia, which would link to the outbreak in Tuva.

These early reports of H5N1 in new areas in Russia may be signaling a significant increase in the H5N1 geographical reach and lead to additional expansion in H5N1 bird flu range in the upcoming months

http://www.recombinomics.com/News/06270602/H5N1_Tomsk_Spread.html

Tuesday 27 June 2006
28/06/2006
By CHANTAL HARRIS

TWO workers from the Veterinary Laboratory Agency (VLA) near Weybridge were sent home in the same week amid fears that they may have contracted bird flu.

The two technicians, who were testing infected Avian Flu samples, were sent home after they were grazed by needles potentially contaminated with the deadly H5N1 strain of bird flu.

The two members of staff were immediately given preventative treatment and sent home for seven days isolation.

In the first incident, on June 14, a technician was working with dead duck samples infected with the avian influenza virus when the needle got caught in her protective clothing and grazed her skin.

A second similar incident took place just six days later last Tuesday, when another technician grazed herself with a potentially infected needle while inoculating chick embryos with sample material from Israel with suspected H5N1.

Spokesman Matt Conway from the Department for the Environment, Food and Rural Affairs (DEFRA) said the workers did not appear to have suffered any illness.

He said: “Both were sent home as a precaution. They now appear to be well and await the results of their blood samples. Neither has shown any ill effects.”

The first employee returned to work seven days later on June 22, which, according to DEFRA, is the normal procedure.

Mr Conway said: “Swabs were taken on day two, three, four and seven and, provided the results are negative, the officer is able to return to work.”

The EU’s VLA headquarters in Woodham Lane are where all cases of bird flu in the EU are tested.

Britain’s first case of bird flu was confirmed there after a dead swan discovered floating on a Scottish lake in March was found to have the deadly H5N1 virus.

The H5N1 virus does not currently pose a large-scale threat to humans as it cannot easily pass between people, but scientists fear the virus could mutate, triggering a flu pandemic of catastrophic consequences.

Despite the infection risks surrounding virus testing, staff at the VLA are only given five days training on what to do if an incident of this kind happens.
Helen Petrou, a resident of Common Lane, has lived opposite the Weybridge Veterinary Labs all her life.

Although she is concerned about the latest news, she has never experienced any problems living close to the labs.

She said: “To be honest, I don’t even think about it, but it is quite worrying that it is so near to our house.

“They have been testing things there for years now but, obviously, I do not think they would do it if it were not safe for the people living near by.”

A spokesperson for the Health Protection Agency Centre said: “We try to minimise incidents. When you’re dealing with deadly pathogens, you have to wear protective clothing.

“It can happen and there are protocols to minimise the risk. There are plans in place.”

Although the second incident occurred just six days after the first scare, the VLA is confident in its procedures.

Mr Conway said: “VLA has a comprehensive health surveillance protocol for Influenza A viruses, which has been in place for two years.

“It has been agreed by the VLA occupational health physician, the VLA safety manager and the head of Avian Influenza Unit.

“It is reviewed and updated annually, or more frequently as appropriate. The VLA occupational health advisor has been closely involved in both of the recent cases.”

http://www.waltononline.co.uk/news/article/article_id=7622.html

Nice catches all.


Bill,

Hey there! A quick point on that 50%+ mortality rate. Another person on another board pointed this out, but I can't remember the name to give proper credit:

That 50%+ mortality rate is based upon the patients receiving extensive medical care. In a pandemic situation, where the medicines and machinery may not be available, the mortality rate may be MUCH higher.

Of course, that all depends on if H5N1 retains its current virulence. If it loses strength, then we may luck out. Otherwise, it's got the potential to be a real fire storm.

Fwiw...

PanAfrica: Africa Action Statement on Avian Influenza
and Africa - Looking Ahead to the Annual G8 Meeting​

http://allafrica.com/stories/200606270920.html

Africa Action (Washington, DC)

DOCUMENT
June 27, 2006
Posted to the web June 27, 2006

The subject of infectious disease, prominent on the agenda of next month's Group of 8 wealthy nations (G8) meetings in St. Petersburg, Russia, cannot be addressed without special attention to Africa. In this continent where HIV/AIDS has already taken millions of lives, the same social and economic conditions that underpin that pandemic threaten to spread another: avian influenza.

Africa Action urges the international community to comprehensively address the threat of avian flu and the particular challenges facing public health systems in Africa and other developing regions. As they confront a possible future avian flu pandemic, the U.S. and other G8 countries must recognize the common vulnerability of all humanity and must help to prevent, monitor, and control outbreaks in developing countries. The leaders of the G8 must make new commitments to develop health care systems in Africa and to support African efforts to respond to deadly public health crises, from the current HIV/AIDS pandemic to the emerging challenge of the avian flu. A failure to mount a serious response towards such international health threats will have serious global consequences in the future.

The Origins of Avian Flu

Avian flu surged to the forefront of the mainstream media in 2003, when outbreaks of the potent H5N1 strain began to have destructive effects on poultry in Southeast Asia. In late 2003, bird-to-human transmissions of avian flu highlighted the increasing danger posed by the disease. As of June 20, 2006, over 200 confirmed human cases of avian flu H5N1 had been reported to the World Health Organization (WHO). Of these cases, found in Asia, Europe, and Africa, more than half have been fatal, demonstrating avian flu's high mortality in humans. Recent evidence from Indonesia shows that, in at least one instance, the rapidly evolving virus has developed the capacity to pass from human to human. Many researchers express grave concerns that, if this ability becomes stronger and more consistent, the world will face a major pandemic.

Africa's Vulnerabilities

Africa faces particular vulnerabilities, which make the continent more susceptible and less capable to respond to a major avian flu outbreak. These weaknesses include inadequate and overburdened health care systems and economic under-development. In many areas of Africa, where frequent contact between humans and birds is common, families often own and rely heavily on small backyard poultry flocks. Furthermore, the migratory patterns of wild birds moving southward from Europe, as well as growing levels of international travel, carry the added danger of introducing and spreading the virus. These factors create ideal conditions for the silent and extensive spread of the virus. Africa also has a limited capacity to mount a comprehensive response in the case of an avian flu pandemic, due to the scarcity of vaccines and other treatment options.

The HIV/AIDS pandemic in Africa has been fueled by many of these same social and economic factors. HIV/AIDS has further weakened health care networks, drained resources from governments, and sapped the productivity of populations. The ability of African governments to respond has been worn thin, and it is unclear how robustly the continent could react to another significant health threat. Medical facilities experiencing shortages in trained medical workers, space and medical resources - familiar obstacles in the fight against HIV/AIDS - would quickly become overwhelmed by an avian flu pandemic. In addition, HIV-positive individuals with already compromised immune systems would be acutely susceptible to avian flu with its high mortality rate.

Health officials admit that it is hard to gauge the current extent of avian flu outbreaks in African countries. Many places lack the resources needed to consistently monitor the disease in birds. Poor communication between government officials, poultry farms, and the general population complicate efforts to spread information about prevention and surveillance tactics.

To date in Africa, avian flu outbreaks have emerged in domestic birds in Nigeria, Egypt, Niger, Cameroon, Burkina Faso, Sudan, and the Ivory Coast. The WHO has confirmed fifteen human cases of the avian flu H5N1 in Djibouti and Egypt, six of which were fatal.

The effects of inadequate access to education, economic resources, and health care have caused the devastating HIV/AIDS pandemic to overrun the African continent. These same inequities may now allow the avian flu virus, a potentially much faster killer, to spread unchecked through the continent and beyond its boundaries.

The last major global flu pandemic occurred in 1918. Conservative official estimates stated the death toll in that pandemic at 40 to 50 million, however it may have been as high as 100 million people globally.

The world remains unprepared for a major human pandemic of avian flu. The international community has already devoted insufficient attention and resources to containing outbreaks in Africa and Asia. By the time the virus begins to affect the U.S. and other G8 nations, the scale of the crisis will have swollen beyond the capacity of the international community to respond.

The WHO has issued an advisory for countries to begin stockpiling vaccines and antiviral drugs. But African and other developing countries do not have such a capacity, and even industrialized nations are likely to face shortages. The victims of a pandemic will be mainly those without access to treatment.

The 2004 outbreak of the relatively less dangerous H5N2 avian flu strain that infected South African ostriches strongly illustrates the potential negative economic impact of a flu pandemic in Africa, even if confined to poultry. This outbreak led to the deaths of more than 26,000 birds through culling. Reports suggest that the culling alone resulted in an estimated $100 million setback to farmers and a loss of 4,000 jobs. Additional losses incurred by the suspension of poultry exports further demonstrate the significant financial consequences of even a relatively limited avian flu outbreak.

Recommendations

Representatives of the health ministries of the G8 nations met on April 28, 2006 and issued a statement outlining their priorities concerning the prevention and control of infectious diseases. This statement acknowledged the imperative of advancing the health of populations in order to meet the Millennium Development Goals, and, importantly, the need for internationally coordinated efforts to counter major health threats. These priorities are likely to figure prominently on the G8 meeting agenda in July.

The G8 nations must commit to a comprehensive and globally integrated response to public health threats, and to investing in drastic improvements in global health systems. The U.S. must recognize the moral and practical necessity in dedicating the required funding, resources, and expertise to address Africa's public health challenges. Additionally, the U.S. must increase its support for programs seeking to promote a comprehensive response to health crises and to strengthen health systems in developing countries, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Recognizing the obstacles Africa faces in confronting the avian flu, in 2005 the WHO advised that certain precautions be taken. It stated that various health service sectors should seek to build stronger connections with each other, and that this coordinating effort should be supported by national governments. The WHO further recommended that countries improve their capacity to detect and respond to emerging cases of avian flu, and that this information be rapidly and widely communicated.

However, these important national efforts must be supported by the G8 on an international level, and new funding must be committed to this endeavor. In January 2006, a gathering of nations and organizations committed to spend $1.9 billion on avian flu measures. However, a recent World Bank report shows that only $286 million has actually been delivered so far. The U.S. was specifically implicated in the report for providing only $71 million of its previously pledged $334 million for avian flu efforts.

The G8 must take seriously the global threat posed by infectious disease, and must comprehend their own obligations in this regard. For it is clear that, aside from the very real considerations concerning a possible outbreak of the avian flu, the pandemic predictions made by world health officials have revealed a much broader reality. No longer can the U.S. and other G8 nations pretend to ignore the vulnerabilities in African health systems and the health crises faced in Africa in favor of strictly national concerns. As the spread of HIV/AIDS has shown, the boundaries of national and global health concerns no longer exist.

Africa Action emphasizes that the international community cannot afford to disregard the lessons learned from HIV/AIDS or the ongoing devastation wrought by this current pandemic, even as it seeks to avoid a possible avian flu catastrophe. The G8 meetings in July provide the opportunity for economically powerful nations to show responsible global leadership in the face of urgent public health threats, and they must seize this opportunity or pay a high price in the future.

http://www.jsonline.com/story/index.aspx?id=442572


Zoo on forefront of avian flu fight
Officials develop four-level protocol to combat outbreaks
By KATHARINE OTT

Posted: June 26, 2006

While researchers in Alaska continue to monitor migratory bird flocks for evidence of avian flu, the Milwaukee County Zoo is one of the first zoos in the nation to develop its own response system to the virus.

Rhinoceros hornbills are among the 80-plus species of birds at the Milwaukee County Zoo considered equally susceptible to avian flu. If the flu enters Wisconsin or neighboring states, all birds would be quarantined.

The zoo's protocol for handling avian flu includes several procedures aimed at protecting the animal collection from an emerging disease. The protocol, in practice since April, consists of four response levels depending on the proximity of avian flu to the Milwaukee area.

The zoo is operating at Level 1 - or normal - and that won't change unless a highly pathogenic influenza enters North America.

Zoo officials acted early because of their experience with the West Nile virus in 2002, when 12 penguins died, said Kim Smith, bird curator and one of the primary authors of the response plan.

They learned that after an initial outbreak, there is absolutely no immunity against an emerging disease. "We will take no chances," Smith said.

She has been at the forefront of the national effort to prepare zoos for avian flu. She serves as the chairwoman of the Avian Scientific Advisory Group for the American Zoo and Aquarium Association, which advises bird curators on issues of bird management in zoos.

Nationwide, zoos will act as surveillance and monitoring tools for avian flu.

"Zoos are a perfect sentinel," said Robyn Barbiers, vice president of collections at the Lincoln Park Zoo in Chicago and chairwoman of the Animal Health Committee for the zoo association. "We are here 365 days a year with trained staff and veterinary care. If there is a disease with the potential to affect zoos, we will notice it."

Not a worry for humans

Authorities at the Milwaukee zoo worked with the Wisconsin Department of Agriculture, Trade and Consumer Protection, the zoo association and local public health officials to develop the procedures, which focus on the health and safety of the bird collection. If avian flu were to develop into a human disease, the federal Centers for Disease Control and Prevention would take over.

Zoo Director Charles Wikenhauser said he believes the zoo is well-equipped in the event of an outbreak. The aviary and Animal Health Center, built in 2003, provide holding areas large enough to accommodate the birds, including the penguins, if quarantine is necessary.

People should not be worried about visiting the zoo even if avian flu gets closer, said Donald Janssen, associate director of veterinary services at the San Diego Wild Animal Park.

People have become sick with the H5N1 virus strain of avian flu , but it is very difficult for humans to become infected.

"The virus would need a major change (to easily infect humans), and it has remained the same for roughly the past 10 years," Janssen said. "H5N1 is very bad news for birds, not people."

No cases of avian flu have been found in North America. The World Health Organization reports 228 human cases and 130 human deaths from avian flu.

Although threats of avian flu prompted the zoo to create a plan, the protocol applies to any emerging disease that could endanger the animals. Smith stressed that zoos in general have biosecurity measures already in place.

An important part of the policy is ongoing communication between the zoo and local and federal authorities. "Most importantly," Smith said, "we want to avoid euthanization of the collection over a scare."
Managing infection

Each of the more than 80 species of birds at the zoo is considered equally susceptible to avian flu and would be treated the same under the plan. If avian flu entered the vicinity, the zoo would work with regulatory officials to possibly quarantine cats and primates. These are the remaining three levels in the protocol:

• Level 2 corresponds to an incident of the H5N1 strain in North America and would require cautionary measures, such as posting a sign at the aviary to keep out those people who have visited an outbreak area. Uncooked poultry and raw eggs would be removed from any animal diets.

• Level 3 corresponds to an incident of avian flu in neighboring states or Ontario. The aviary and the Family Farm and Animal Encounter buildings would be closed. All birds on the premises would be quarantined. Working with the CDC, the zoo would decide whether to vaccinate employees.

• Level 4 corresponds to avian flu entering Wisconsin or northern Illinois. All birds would remain quarantined, and outdoor ponds would be drained.

http://news.yahoo.com/s/nm/20060627...A0wpT.3QA;_ylu=X3oDMTA5aHJvMDdwBHNlYwN5bmNhdA


Experts call for computer imaging to halt outbreaks


HONG KONG (Reuters) - Experts called on Tuesday for the use of computer imaging to track the spread of disease, such as bird flu, saying it can be used to identify areas of outbreaks so they can be ringfenced.


The technology, geographic information system (GIS), can be used to chart detailed maps showing exact locations of residential and office buildings, produce markets, chicken farms and any other sites where infections might have occurred.

"Anytime there is a new disease, the important thing is to georeference that information ... where do the victims live, where might the exposure have taken place, did it take place at home, at work or recreationally?" said Charles Croner of the U.S. Centers for Disease Control and Prevention (CDC).

"If flu cases continue to appear in the medical system, then we start to get a pattern of its existence."

"We must immediately put in resources to stop the flu. We must remediate it, we must give out vaccines to people who might have been exposed to these people. The geography is crucial," he told reporters on the sidelines of a conference on

GIS.

Although the H5N1 avian flu virus remains predominantly a disease among birds, the medical community has warned it can trigger a pandemic if it mutates to spread efficiently among people.

There have been a few cases of limited transmission among humans but genetic analyses of the virus by the
World Health Organization and the CDC has not shown any of the traits known to help the virus spread more easily among people.

Croner said GIS was badly needed in countries such as China, Vietnam and Indonesia where the virus is now endemic.

"The WHO is very concerned about the use of this technology so it can help improve disease detection," he said.

GIS is the science of capturing, managing, analyzing and displaying all forms of geographically referenced information. The WHO has recommended that the technology be used to analyze epidemiological data and trends that would be more difficult to discover in tabular format.

GIS was used in Hong Kong in 2003, when it was struck by Severe Acute Respiratory Syndrome, or
SARS, which killed almost 300 people in the territory.

Lai Poh Chin, associate professor of geography at the University of Hong Kong, said the technology can be used to predict the spread of an epidemic.

"Based on the mean center, you can track its movement and see it going in a certain direction," Lai told Reuters.

"This technology (helps) ascertain where cases are and (allows for) fast intervention."

http://www.wired.com/news/technology/medtech/0,71199-0.html?tw=wn_culture_1


When Fluffy Catches the Bird Flu





By Randy Dotinga| Also by this reporter
02:00 AM Jun, 26, 2006

As medical research links house pets to SARS and bird flu, public health officials have something new to worry about: the risk that poodles and parakeets will need to be quarantined during an outbreak. The worst-case scenario? A runaway epidemic that can only be stopped by dispatching pets to that big animal shelter in the sky.

During Toronto's SARS outbreak in 2003, cats were ignored because health officials "had bigger things on their minds," said Dr. Scott Weese, a veterinarian and associate professor at the University of Guelph in Ontario. "But we need to think about it. What if someone had SARS in their household and infected their cat, and their cat went outside and infected feral cats? SARS would still be in Toronto, or there would be no cats in Toronto."

Weese and a colleague argue in the June issue of Emerging Infectious Diseases that health officials and veterinarians need to develop quarantine protocols for house pets in case of an epidemic.

Among household pets, cats and birds seem to pose the most danger as potential transmitters of epidemic disease. In Germany, a cat's death from avian flu earlier this year sparked the government to warn people to keep their cats inside and not to sleep with them.

Research does suggest that cats get avian flu from eating infected birds and can spread it to each other, said Dr. Michael Greger, who oversees public health for The Humane Society of the United States.

This is surprising because until now, "no flu virus in recorded history (has) been able to make cats sick," he said. Still, no cat-to-human cases have been reported. Cats and ferrets can also become infected with SARS and spread it to each other.

Dogs seem to be in the clear, at least so far. While they share a wide variety of diseases with humans and can spread some to people, there haven't been any reports of dogs coming down with avian flu, Greger said. Even so, dogs have shown signs of avian flu antibodies, suggesting they were exposed but didn't get visibly sick.

If a pet species was connected to avian flu, "the knee-jerk reaction with this virus is mass culling within (the habitat) of a susceptible species," Greger said. "That's what they do with birds."

But in Thailand, the mandatory killing of valuable fighting cocks led people to flee with their birds and spread the disease, he said. In the United States, if authorities even thought about killing cats, "people would run and stay with their cat at their aunt's house five states away."

In the wake of Hurricane Katrina, public health officials have been paying more attention to pets and people's reluctance to abandon them in times of crisis, said Dr. Clete DiGiovanni, a public health adviser with the Defense Threat Reduction Agency.

"When push comes to shove, a lot of people are not going to abandon their pets and may put their own lives at risk because of that," DiGiovanni said.

Indeed, a Zogby International poll released last October found that 61 percent of pet owners surveyed would refuse to evacuate before a disaster if they couldn't take their animals.

However, DiGiovanni added that he's attended meetings where public health officials have argued that it's "ludicrous" to worry about pets when human lives are at stake. According to him, the officials say something along the lines of, "We'll have a difficult enough time managing people; let's not worry about pets."

There are signs that the North American authorities aren't ready to handle simple human quarantines, let alone those complicated by potentially infectious pets.

During the 2003 SARS outbreak in Toronto, officials had trouble getting food to people who quarantined themselves at home at the request of the government, DiGiovanni said. And some of those who were self-quarantined left their homes to walk their dogs.

"We don't really have well-established quarantine protocols in place," said Dr. David Katz, director of the Yale-Griffin Prevention Research Center at Yale University. "It's a system we've neglected, and you can't fix that in a sprint. We need to be running a marathon."

Bird Flu Fatalities Almost Triple, Spurring Need for Treatments

(It's getting very, very mainstream now, especially when Bloomberg puts it on their front page....)

Bird Flu Fatalities Almost Triple, Spurring Need for Treatments

June 28 (Bloomberg) -- Bird flu fatalities have almost tripled this year as the lethal virus spread across Asia, Europe and Africa, prompting calls for increased supplies of medicines to fight the virus and any pandemic it might spawn.

Since January, at least 54 people have died from the H5N1 avian influenza strain in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq and Turkey, according to the World Health Organization. That compares with 19 fatalities in Vietnam and Cambodia in the first six months of 2005. Human cases create opportunity for the virus to mutate into a lethal pandemic form.

``The situation worldwide remains as serious as ever,'' said Ian Jones, a professor of virology at the University of Reading in the U.K. ``Screening and preventative measures are as appropriate as ever.''

Pharmaceutical companies, including Sanofi-Aventis SA, GlaxoSmithKline Plc, MedImmune Inc., Vical Inc., Acambis Plc and CSL Ltd. are racing to produce pandemic flu treatments amid concern over H5N1, which was found for the first time in wild birds and domestic poultry in 38 countries since February.

``We have seen three major pandemics in the last century,'' Albert Osterhaus, the head of the Department of Virology at the Erasmus Medical Center in Rotterdam, Netherlands, said in a June 22 phone interview. One in 1918 known as Spanish flu ``killed 1-2 percent of the world population. If the threat is there, we should be prepared,'' he said.

Flu Conference

Tomorrow Osterhaus, whose laboratory was the first to identify human infection from the H5N1 strain, will co-chair the opening session of the First International Conference on Avian Influenza in Humans in Paris.

The two-day conference at the Institut Pasteur will bring together more than 200 health experts, policy makers, researchers and drugmakers to discuss the latest advances in therapies aimed at treating and preventing avian flu and averting a pandemic.

``Our aim is to launch the discussion between the different actors involved in the fight against avian influenza starting from medical and scientific specialists to government crisis management specialists,'' said Marvin Edeas, chairman of a committee organizing the meeting. ``We will try to answer many questions: is the medical profession ready to fight against a pandemic? Is the world ready to face a human avian flu pandemic?''

The rate of new infections has almost doubled to one every two days this year, from almost two a week in 2005. Since late 2003, at least 130 of the 228 people known to have been infected with H5N1 have died, according to the Geneva-based WHO.

`Virus Pressure'

The rising human tally ``continues to reflect the underlying virus pressure in both domestic and, to some degree, wild birds,'' Michael Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy, said in a June 22 interview from Minnesota.

``We're in what is an unfolding experiment of Mother Nature,'' Osterholm said. ``We're trying to explain it as if we've already done the bench work and can tell you what's going to happen. That's just not the case.''

Before 1997, when the first known human H5N1 case occurred, scientists didn't believe an H5 subtype of the flu virus could infect people. Pandemics last century were caused by viruses of the H1, H2 and H3 subtype.

More than 209 million poultry have died or been culled worldwide in the past 30 months because of outbreaks of the H5N1 virus, the Food and Agriculture Organization of the United Nations said last week.

Severe Winter

A severe winter in Russia and the Caucasus area at the end of last year pushed migratory birds south and westward, the FAO said. By February, initial outbreaks in wild birds and poultry were reported in Iraq, Nigeria, Bulgaria, Slovenia, Greece, Italy, Azerbaijan, Iran, Germany, India, Egypt, Austria, Bosnia-Herzegovina, France, Slovakia, Switzerland and Niger.

The following month, Hungary, Serbia and Montenegro, Pakistan, Albania, Poland, Georgia, Cameroon, Myanmar, Denmark, Sweden, Israel, Afghanistan, Jordan and the Czech Republic reported initial outbreaks. They were joined by Burkina Faso, Palestine Authority, U.K., Sudan and Ivory Coast in April and Djibouti in May.

In contrast, no initial outbreaks were reported in the first half of last year. In the first half of 2004, Vietnam, Japan, Thailand, Cambodia, Hong Kong, Laos, Indonesia and China reported H5N1 for the first time.

Probe continues into 'first bird flu death'​

http://english.people.com.cn/200606/28/eng20060628_277992.html

Chinese scientists are continuing investigations into what is believed to be the world's first bird flu fatality.

In a letter in the New England Journal of Medicine last Thursday, eight Chinese scientists claimed a 24-year-old Beijing man who died in late 2003 had contracted H5N1 avian influenza.

The experts, including Cao Wuchun from the State Key Laboratory of Pathogens and Biosecurity, said the virus was isolated in a sample taken from the man.

"The Ministry of Health heard about the new findings through the media, and got in touch with the scientists this week," said ministry spokesman Mao Qun'an.

The ministry is now organizing a retrospective investigation into the death, including further laboratory tests, epidemiology research and clinical treatment, said Mao.

The investigation's results will be released when it is complete, but Mao could not say when that will be.

The dead man, who served in the army, fell ill on November 25, 2003, the year China experienced the severe acute respiratory syndrome (SARS) outbreak.

He was rushed to the No 309 Hospital of the PLA, but died of pneumonia without clear cause on December 3, 2003, said Roy Wadia, spokesman for the Beijing Office of the World Health Organization (WHO).

Tests at that time showed he had not died of SARS, said Wadia.

At that time no human cases of avian influenza, or bird flu, had been reported by health authorities on the Chinese mainland. The first case was reported two years later, in November 2005.

According to WHO sources, current outbreaks of the H5N1 virus were first recognized in early 2004 in Viet Nam.

A report given by the Ministry of Health to the WHO said that the scientists have done a lot research on the dead man in the past two years and have finally resolved that he had the H5N1 virus, said Wadia.

He added that more investigation is needed.

"For example, we need to know the source of the man's infection, and we need to learn the situation of his family members or people who he had close contact with.

Up to now China has reported 19 human cases of bird flu, with 12 fatalities. Globally, 225 human infections have been recorded by the WHO, with 128 deaths.

Source: China Daily

21 Active Bird Flu Foci Remain in Romania​

http://www.focus-fen.net/index.php?catid=126&newsid=91211&ch=0&datte=2006-06-28

28 June 2006 | 14:29 | FOCUS News Agency

Bucharest. Presently the bird flu foci in Romania are 21, the National Veterinary Sanitary Service announced on its Internet site. Eight bird flu foci have been liquidated in the last 24 hours.
FOCUS News Agency reminds that a total of 127 bird flu foci were registered in Romania in May and early June.

Flu Among the Felines
Avian influenza can infect cats, and cats might then help spread the disease. By Elizabeth Katt-Reinders


Scientists say we need to pay attention to the role that cats might play in spreading the bird flu virus. The virus has killed domestic cats in parts of Asia and Europe, but experts say the cats are not just victims of the disease; they are potential carriers of it.
Albert Osterhaus specializes in the study of viruses at the Erasmus Medical Center in the Netherlands. He and his colleagues studied the role of cats in the spread of bird flu, and they published their findings in April in the journal Nature. Osterhaus says cats can pick up bird flu when they catch wild birds that are infected or when they eat carcasses of infected poultry. Osterhaus says the virus can make cats very ill and even kill them.


"Cats that are free roaming, when they catch birds that are infected and they eat them, then indeed they can develop very serious infections and die from it."
Osterhaus says the risk of exposure to avian influenza is greatest for cats that are free roaming or kept outdoors if they live in places where birds or other cats are infected. He says cats that contract avian influenza can then spread the virus to other cats, and there is a risk they could infect humans.

Osterhaus says there are simple precautions that people can take to avoid these risks.


"Our advice would be in those areas where, indeed, infected birds and domestic poultry are found, to keep the cats indoors. And if they are outdoors, if they're free roaming cats, don't bring them indoors."
Osterhaus says cat owners should call a veterinarian promptly if they see their pets showing signs of flu, including symptoms such as vomiting or diarrhea.


Script for Wednesday, June 28, 2006


http://ewradio.org/program.aspx?ProgramID=4289

Economic impact of bird flu hinges on panic - experts​

http://in.today.reuters.com/news/ne...023700Z_01_NOOTR_RTRJONC_0_India-257319-1.xml

By Gilbert Le Gras

WASHINGTON (Reuters) - The severity of a global economic slowdown caused by a bird flu pandemic, estimated to slash 1 to 12 percent off world output, largely depends on how people and governments react, economists said on Wednesday.

Initial confirmation of a bird flu strain that easily transmits between people would have an immediate shock effect on the world economy both in supply -- absenteeism and reduced productivity -- and demand -- a drop in activity -- but the depth and duration of the shock depends on people's reaction.

"Behavior, behavior, behavior is everything," International Monetary Fund capital markets expert Charles Blitzer said.

"We see a sharp down, followed by a recovery. Governments need to ensure the collateral damage from the sharp down be minimized so we bounce back," he told a think-tank discussion.

The H5N1 avian influenza virus has picked up speed as it has spread out of Asia and into flocks in Europe and Africa, and experts agree a human pandemic is a question of time.

The virus does not yet easily infect humans, having killed 130 people in nine countries since 2003, but scientists fear it could mutate into a pandemic that could kill millions.

"The (economic) effects tend to be lower than you'd expect because people are good at adjusting," said Donald Marron, acting director of the U.S. Congressional Budget Office, citing the U.S. economy's resiliency after the Sept. 11, 2001, attacks and last year's Hurricane Katrina.

"A lot depends on the public reaction, which is difficult to predict," Marron added.

Public reaction is already being felt by poultry producers, World Bank economist Andrew Burns said.

The Food and Agriculture Organization expects an 8 percent fall in world demand in 2006, despite no risk of contracting the virus from cooked meat, and he said demand in France -- with two isolated cases of infected flocks -- fell 40 percent.

Air travel could drop as much as 20 percent once a human pandemic occurs with passenger numbers dwindling by 40 to 50 percent on flights to the hardest-hit countries, Burns said.

Pharmaceutical companies could see their stock prices jump while some commodity prices may fall, the IMF's Blitzer said.

Economies should weather the pandemic better than the last severe pandemic of 1918 thanks to better social safety nets and technology that allows people to work from home, he added.

"The IT backbone is really going to get stretched and it seems little attention has been paid to this," Blitzer said. "Countries with weak fiscal positions, dependent on commodity exports are most exposed to a reversal in capital flows."

Insurance companies and investment funds could come under pressure during the initial economic shock but market price effects should be temporary. Another concern due to absenteeism is disrupted bank payments, accounting and market settlements.

Central banks should expect a jump in demand for cash and they will have to meet that demand before worrying about mopping up extra liquidity or inflation, Blitzer said.

Citigroup's global head of emerging markets economic and market analysis, Don Hanna, added that investors are likely to put their money in safe-haven U.S. dollars and securities.

"Long-term interest rates would adjust less in the U.S. probably because of a better health response (than most of the world) and more money would come into the U.S. economy so there would be no unwinding of global imbalances," Hanna added.

Massive U.S. fiscal and trade deficits and corresponding hoarding of foreign reserves by Asian central banks are growing concerns for policy-makers who fear a disruptive correction.

NZ needs to be ready for 'smart' flu virus ​

29 June 2006
By ALICE COWDREY

The deadly H5N1 bird flu virus is volatile and evolving, and New Zealanders need to prepare for the possibility it might strike, a leading virologist says.

People need to learn from history that an influenza pandemic is on the cards, and they need to be ready for it, Canterbury District Health Board clinical virologist Lance Jennings said yesterday.

Jennings talked on developments in knowledge of influenza and how to plan for a pandemic as part of a series of lectures called Our City O-Tautahi.

Jennings said his lecture was a timely reminder about the possibility of an influenza pandemic because bird flu had recently swept through Indonesia, killing seven people.

Because past influenza pandemics had emerged from avian influenza (three in the past 100 years), it was more than likely that another would hit, whether it was the H5N1 virus or a different one, Jennings said.

"I think in terms of whether bird flu is hype, we can safely say we will have another human influenza pandemic," he said.
Although there were still no "sustained chains of transmission" between humans for the virus, Jennings said, the complexities of the virus could not be underestimated and there were many aspects of the "smart virus" no-one understood yet.

"This virus is not just a single entity; it is volatile and continues to evolve."

New Zealand had been innovative with its pandemic planning, being one of few countries to recognise that a pandemic the size of the 1918-19 flu would put extreme stress on the health system, he said.

The Canterbury District Health Board planned to separate services in the health sector during the next pandemic.

Jennings said services would be divided into two streams: a green stream, which would deal with core primary care, and a red influenza stream, where influenza would be dealt with.

http://www.stuff.co.nz/stuff/0,2106,3716030a7144,00.html

Would the bird flu kill the Internet, too?​

Lamont Wood

29/06/2006 16:12:12

If a bird flu pandemic sweeps the nation, we could avoid infection by working from home via the Internet.

Or, hammered by overuse, the Internet could shut down within two to four days of an outbreak, eliminating telecommuting as a viable option.

Disturbingly, that was one finding of a simulation, or war game, held in January in Davos, Switzerland, by the World Economic Forum and management consulting firm Booz Allen Hamilton. More than 30 senior industry and governmental executives played out the arrival of the flu in Germany from Eastern Europe -- and the results weren't pretty.

"We assumed total absentees of 30 percent to 60 percent trying to work from home, which would have overwhelmed the Internet," said participant Bill Thoet, vice president of Booz Allen Hamilton. "We did not assume that the backbone would be gone, but that the edge of the network, where everyone was trying to access their office from home, would be overwhelmed. The absence of maintenance was also a factor. The person who brought up the problem was himself a CEO of an Internet service provider.

"The conclusion [of imminent collapse] was not absolute, and the situation was not digitally simulated, but the idea of everyone working from home appears untenable," Thoet said.

On this side of the Atlantic, predictions about how the Internet would fare in the face of a pandemic are less dire.

"We don't believe that the Internet will be compromised within a matter of hours or days," said Brent Woodworth, worldwide manager for IBM's Crisis Response Team, which does consulting on disaster preparedness. "Most Internet traffic is reroutable, and as different areas are affected at different rates by a pandemic, the networks could anticipate increased traffic and adjust accordingly -- with the caveat that critical components will be maintained."

Besides, mass telecommuting in the face of a pandemic would just accelerate a trend that has been under way for a decade, said Verizon Communications Inc. spokesman Mark Marchand in Basking Ridge, N.J. Voice and data traffic have both been shifting to the suburbs, and the carriers have been re-engineering their networks to follow it, he said. Marchand referred to the strike of the New York City transit workers just before Christmas last year (see "IT aids New Yorkers during transit strike") . "A lot of people worked from home and the network handled it," he recalled.

"If we were having this conversation 10 years ago, I would have had to say that mass telecommuting was not an option," he added. "But remember, we just handle access -- after you get on the Internet, that's another question."

Within the Internet, there could indeed be problems, agreed Paul Froutan, vice president of research and development at Rackspace Managed Hosting Ltd., a large Web-hosting company in San Antonio. "A large company has large amounts of data traffic that never leaves the office," he noted. "If you send people home to do the same work remotely, that could cause a problem."

But he doesn't foresee the Internet collapsing from overuse, if only because frustrated users won't bother pushing it to the brink.

"You can see the Internet as a self-regulating supply-and-demand mechanism," Froutan said. "The more people use it, the slower it gets, so the less people use it. If 10,000 people go to a site that normally supports 100 users, 9,000 will give up, while the other thousand will get very slow connectivity but will keep going until they get the job done."

At some point, people who need the Internet will start working after midnight, when there's less traffic, he predicted, and corporations will start paying premiums to the carriers to make sure their traffic gets through.

"If the problem persists long term, the carriers may drop some customers in order to service the ones that pay extra, and we will be left with a patchwork of private Internets," Froutan added.

"A pandemic will not bring down the Internet the least little bit, but there will be local problems," said Eric Paulak, an analyst at Gartner Corporations that plan to rely on telecommuting should act now, before an emergency, to reserve sufficient inbound bandwidth, he said.

"If you have a third of your people working from home, you will see your bandwidth requirements tripling," Paulak said, noting that a virtual private network will take about 250Kbit/sec. per user. Rather than pay upfront for the tripling, he suggested getting "shadow service," with reserved bandwidth that costs about 25 percent of a live connection. There are also burstable connections, where the rated connection speed represents the maximum or burst speed and the user pays only for what is actually used.

Taking an inventory of what Internet connections are available to potential telecommuters would also be a good idea now, he advised.

Dire predictions about the Internet's fate did not surface during a U.S. version of the Davos simulation that was held in March in Washington under the auspices of Booz Allen Hamilton and the Center for Health Transformation, a group founded by former House speaker Newt Gingrich that supports using IT to improve health care and reduce costs.

Robert Egge, project manager at the center, said there were telecommunications industry participants in the exercise, but the question of Internet survivability was not addressed in detail and no specific predictions were made. However, "the exercise was less about making predictions than about talking to each other about the different challenges that a pandemic would present," he explained.

Actually, if any of the other predictions that arose from the Davos simulation bear out, the fate of the Internet may be the least of anyone's worries. The war game indicated that by the 28th day of a pandemic, the social infrastructure would have disappeared and governments would have to declare martial law to maintain basic services. To that end, they would probably end up conscripting those who had caught the flu and survived, since those people would continue to be around.

Hopefully, you'll read about it on the Internet.

http://www.computerworld.com.au/index.php/id;1330379098;fp;16;fpid;0

Severe Flu Pandemic May Cost World Up to $2 Trillion​

http://www.bloomberg.com/apps/news?pid=20601100&sid=axCIX7K2789I&refer=germany

(Update1)

June 29 (Bloomberg) -- A flu outbreak killing 70 million people worldwide may cause global economic losses of as much as $2 trillion, a World Bank official said.

A slump in tourism, transportation and retail sales, as well as workplace absenteeism and lower productivity, may cause the world economy to shrink by 3.1 percent, said Milan Brahmbhatt, a lead adviser in the East Asia region, citing a study by the Washington-based World Bank. The study predicted a surge in corporate bankruptcies in companies with a high level of debt to equity, such as airlines.

``It goes almost without saying that these broad scenarios are not meant to be forecasts,'' Brahmbhatt told the First International Conference on Avian Influenza in Humans, which started today in Paris. ``They are only exercises to help think through the various channels of impact and possible orders of magnitude.''

The Bank, which funds projects to alleviate poverty, is working with developing countries to improve hospitals and laboratories to bolster disease surveillance and management of bird flu. Human fatalities from the H5N1 avian influenza strain have almost tripled this year, providing more chances for the virus to mutate into a lethal pandemic form.

Since January at least 54 people have died from H5N1 as the virus spread in wild birds and domestic poultry across Asia, Europe and Africa. That compares with 19 fatalities in the first six months of 2005. In the past three years, at least 130 of the 228 people known to have been infected with H5N1 have died, according to the World Health Organization.

Panic Effect

``As these outbreaks continue and spread to new regions, they also increase the probability of a second stage, with human-to-human transmission and a global influenza pandemic, with enormously greater costs on a world scale,'' Brahmbhatt said.

A pandemic can start when a novel influenza A-type virus, to which almost no one has natural immunity, emerges and begins spreading. Experts believe that a pandemic in 1918, which may have killed as many as 50 million people, began when an avian flu virus jumped to people from birds.

The most immediate and largest economic impact of a pandemic might arise from the uncoordinated efforts of people to avoid becoming infected, not from actual death or sickness, according to Brahmbhatt.

Looking at SARS

During an outbreak of severe acute respiratory syndrome, or SARS, three years ago, people tried to avoid infection by minimizing face-to-face interactions, causing a slump in demand for services such as tourism, mass transportation, hotels and restaurants. SARS infected more than 8,000 people between 2002 and 2003, killing 774.

The World Bank study assumes 20 percent declines in demand for tourism, transportation and other key services, which reduce global GDP by about 2 percent. The economic losses could range from $1.25 trillion to $2 trillion, according to the report.

Jim Rogers, who joined George Soros to start the Quantum hedge fund in the 1970s, said commodity prices would fall less and recover faster than other assets if there were a pandemic. Rogers correctly predicted a bull market in commodities that began in 1999 and helped to send oil to a record and gold to a 26-year high this year.

``Oil can go down to $35 a barrel if something like'' a pandemic occurs, Rogers said in an interview today in Singapore. ``Stocks will go down a lot but commodities will go down less. Commodities will be the first to go back up.''

Business Survival

Besides the immediate costs of disruption, a severe global flu pandemic could slash the size and productivity of the world labor force because of illness and death. The effect of the disease on the labor force would depend on factors including the virulence and spread of the disease and its impact on different age groups, Brahmbhatt said.

The Bank's scenario of a severe pandemic assumes about 35 percent of people worldwide would be infected. Of those, 3 percent, or about 70 million people, may die.

``There are economic losses due to the enormous morbidity typically associated with influenza, leading to absenteeism, school closing, declining productivity and crowded hospital emergency rooms,'' Brahmbhatt said.

Businesses that are the most resilient to volatility are the ones likely to suffer the least financial damage, he added. ``It would be firms with strong balance sheets and capitalization that are more likely to survive steep downturns in demand and cash flow that could last from 6 months up to 2 years,'' Brahmbhatt said.

$2.8 billion spent already on bird flu preparations, per a report to Congress. The US Treasury is also literally printing up spare money and coins to be positioned in the event of an emergency:

Let me now turn specifically to today's topic. Pandemic influenza is a serious threat. Moreover, although the narrow specifics of an influenza pandemic threat are unique, elements contained within the planning for pandemic countermeasures are relevant to preparedness for radiological, nuclear, biological and chemical threats. The United States experienced three major pandemics in the twentieth century. The influenza pandemic of 1918 killed tens of millions of people worldwide, and estimates are that between 500,000 and 800,000 people in the United States lost their lives. Milder outbreaks of influenza in 1957 and 1968 killed tens of thousands of Americans, and perhaps millions more across the world.

Most disasters are confined to a limited geographic area, usually measured by the number of cities and States that are impacted. Pandemic influenza is unique in that it has the potential to affect our entire country very quickly, from Wall Street securities firms to Midwestern credit unions, to back-office operations centers in the Arizona desert that serve them both and many others.

This type of potential disruption forces us to think differently about how we prepare for something as widespread as a pandemic. For example, we must change the way businesses within the financial services sector think about business continuity. A firm cannot simply move to out of region back-up facilities and restore operations because it is likely those facilities are also experiencing challenges associated with the pandemic. Without proper planning, a pandemic could disrupt the ability of a financial institution to operate.

For example, contingency planning, in both the public and private sector, must now take into consideration efforts to mitigate the spread of influenza within the firm or a department. Among the key issues for consideration are the stockpiling of masks, gloves and anti-viral agents, additional hand washing stations for employees, and identifying and isolating employees who may be sick.

There are many possible impacts of a pandemic on firms' abilities to operate. One of the most likely is a sharp increase in employee absenteeism. It is important that we begin to consider now how best to cope with high absenteeism rates. Here, too, there are many considerations, including making provisions to provide parking for employees who may not want to take public transportation, childcare for workers if schools are closed, cross training so that workers can do multiple jobs, and identifying work streams that can be performed at home, and ensuring that internal information technology is prepared to support that work from home.

Finally, as we consider all of these issues, we must also recall that for unbanked Americans, the ability to access financial services is generally based on person-to-person interactions, such as cashing a check or purchasing a money order, and we must take into consideration the unbanked and consider whether there are unique or specific concerns that affect them and the financial services firms that serve them.

The financial sector uses many independent third parties to provide services that range from cleaning, to the repair of computer systems, to security. Many financial firms are now requiring their service providers and, at times, even their business partners, to have business continuity plans in place as a condition of doing business. We view this as beneficial as this produces a positive cascading effect in the financial services supply chain which increases the overall preparedness for a pandemic.

Interdependencies with other sectors must also be taken into consideration. Financial sector regulators and institutions have been considering their interdependencies with other sectors of the economy. For example, we are considering whether the telecommunications infrastructure would be adequate to support the internet traffic generated by a large number of people working at home, especially the residential portion that connects an employee's residence to major trunks of the internet, and the need for any additional data security measures should employees be required to work from their homes. Similarly, the financial sector is dependent upon transportation, especially public transportation for its employees, and therefore it is vital to understand public transport planning for coping with a pandemic. We have engaged with each of these sectors, as we have during other threats, and we remain committed to working together with these sectors to ensure the needs of the financial community are met.

The President is leading a massive Federal effort that respects and appreciates the role of States and localities, as well as the private sector, in such an event. The Homeland Security Council's Implementation Plan for the National Strategy for Pandemic Influenza contains over 300 critical actions to address the threat of a pandemic. At the end of last year, as part of this effort, the Congress appropriated $3.8 billion dollars for pandemic planning. In addition, there was $2.3 billion appropriated recently for pandemic flu, as part of the emergency supplemental appropriations.

The Treasury has been very active within the financial services sector to provide and share the most current thinking about what a 21st century pandemic could look like, so that sector participants can use the latest information to build and improve plans and scenarios to mitigate the potential risks. The principles that guide our leadership role in the financial services sector are that our planning efforts will be based on medical science, which is provided to us by experts outside of the Treasury, and that planning efforts will emphasize the protection of the life and safety of our fellow Americans, whether they be employees or customers of financial firms, or others, the importance of business continuity within financial firms, and the significant number of interdependencies needed to sustain operations during an outbreak of a pandemic. Please allow me to spend a few minutes describing key elements of our plan, which focuses on coordination, education, outreach, and an effort to exercise and test the plans and procedures that have been developed.

Last year, the FBIIC created a working group to focus on pandemic influenza. The purpose of the group is to identify areas of concern and to identify and share best practices as it relates to business continuity for the financial community. This group has been meeting regularly, and has also been in close communication with the FSSCC.

One concern that we have been often asked about is banknotes and coinage. In the immediate aftermath of any disaster, there may be some movement toward a greater use of currency. This may be no different in the immediate aftermath of a pandemic. In this vein, the Treasury's United States Mint and the Bureau of Engraving and Printing are working with the Federal Reserve Banks to ensure that banknote and coin inventories are adequate should financial institutions need additional supplies. The Treasury and the relevant financial services sector regulators are committed to working with sector participants to address these types of issues before a pandemic, or any crisis, arrives.

Click to expand...

http://www.treas.gov/press/releases/js4342.htm

Avian Flu: The Economic Costs​

June 29, 2006—The avian flu virus, H5NI, has, in the last six to nine months, gone global, spreading from East Asia to affect more than 40 countries. The number of human infections and deaths reported to WHO has accelerated in the past six months. There were 41 deaths in all of 2005, but 54 in only the first half of 2006, more than twice the pace of last year.

The World Bank estimates a severe avian flu pandemic among humans could cost the global economy US$1.25 to 2 trillion – about 3.1% of world gross domestic product.

The severe case scenario, prepared by the Bank’s Development Economic Prospects Group, was relayed by the Bank’s lead economist for East Asia, Milan Brahmbhatt, in a speech to the First International Conference on Avian Influenza in Humans at the Institut Pasteur in Paris, France.

Brahmbatt told the conference, the severe case scenario was based on a 1% mortality rate – or about 70 million people, resulting in a 0.4% decline in world GDP.

He said mortality rates from a pandemic would be much higher in developing countries, with economic losses expected to be twice those of developed countries.

To date, Brahmbatt says in most countries the impact of avian flu at the macroeconomic level has been relatively limited, mainly because the poultry sector is a relatively small part of the world economy.

“But on the other hand, the impact on the poultry sector itself has been pretty severe,” he said. “Partly, that’s happening because birds are dying or they have to be killed off as a means of controlling the disease.

“Secondly, what’s happening is that in many places, the public is afraid of getting infected and so there are big declines in demand for poultry in various countries and that’s hit farmers in the poultry sector pretty severely.”

Brahmbatt says in Romania, for example, which has suffered more than 100 outbreaks over recent months, domestic poultry sales have fallen by 80%, bringing many producers to the verge of bankruptcy.

“In Iraq, only 10% of semi commercial farms remain operational and there have also been large losses in Turkey.

He says it’s also been the case in France, which is one of the leading poultry producers in the European Community. Even in Brazil, which has not experienced an outbreak of the disease, weakening world demand and lower prices have induced the main suppliers to reduce production by 15% this year.

According to the Food and Agriculture Organization (FAO), over 200 million poultry had died or been culled since the end of 2003, most in East Asia. Brahmbatt says the largest declines happened in Vietnam and Thailand, with the numbers there equal to 15 to 20% of the stock of poultry.

But he says Thailand provides an example of a recovery based on strong policy responses. The country, which is the only large net exporter of poultry in East Asia, had experienced a sharp 40% fall in poultry products in 2004, due to import restrictions in foreign markets on its uncooked poultry exports.

“Together with Vietnam, strong control measures have resulted in no new outbreaks of the virus for the past six month,” he said. “Exports have managed to switch from uncooked to cooked poultry exports, which are not affected by trade restrictions, as a result of which exports began rebounding last year. Domestic consumption has also been reviving due to increasing consumer confidence in the safety of cooked products.”

But he says there’s already clear evidence outbreaks have had a severe impact on the poor in some countries. In Vietnam, for example, he says the poorest households rely more than three times as much on poultry income than the richest households.

In Vietnam the bulk of poultry production is still by backyard producers. Brahmbatt says one strategy that has been discussed has been to simply ban backyard poultry production – a move he says would disproportionately reduce the incomes of the poor.

“On the other hand, in economies like Thailand, where more of production is undertaken by industrial and large commercial producers, the economic shock of avian influenza is likely to fall more on these large producers,” he says.

Brahmbatt says in dealing with avian flu, there needs to be careful evaluation of results from various strategies that are being currently implemented to see if they’re meeting expectations.

He cites control strategies such as culling and vaccination of birds. “A linked question is that of the appropriate levels of compensation needed to make culling successful,” he says. “Too little and farmers have an economic disincentive to comply with culling: too much and they may have an incentive to deliberately infect their flocks.”

Brahmbatt says there’s also a need to undertake broader long term measures to strengthen the early detection, surveillance, institutional, regulatory and technical capacity of animal as well as human health.

“Even if we manage to dodge the bullet with avian flu, there are a lot of other animal diseases which are crossing the boundary and infecting human. The technical name for them is zoonoses. And there’s a whole stream of these zoonoses which are coming into being, so this is going to be something which is going to be with us for a while so we need institutions and methods for dealing with this problem.

“And lastly I’d say there’s a lot of scientific work which needs to be tackled – better medications, better vaccines, better anti-virals – how to produce them more quickly and how to produce them more cheaply.

“Once a pandemic starts it’s only then that we get a handle on what the virus precisely is and it’s only then that we can formulate the right vaccine. Traditionally it might take six to nine months to formulate the right vaccine – by which time a lot of people might have died – so that all takes a lot of effort.”

http://web.worldbank.org/WBSITE/EXT...agePK:34370~piPK:34424~theSitePK:4607,00.html

Flu pandemic would pose bankrupcty risk -World Bank​

Thu Jun 29, 2006 11:31 PM IST

PARIS (Reuters) - A human bird flu pandemic could send firms with weak balance sheets spiralling into bankruptcy, particularly in exposed sectors such as airlines, a senior World Bank official said on Thursday.

"It seems clear that businesses that are the most resilient to extreme volatility are the ones more likely to survive a pandemic, or to survive it with relatively less financial damage," World Bank economist Milan Brahmbhatt told a conference on avian influenza in humans at the Institut Pasteur in Paris.

"Bankruptcies would likely surge among highly leveraged firms, and in particularly exposed sectors, such as airlines."

"It would be firms with strong balance sheets and capitalisation that are more likely to survive downturns in demand and cash flow that could last from 6 months up to 2 years," Brahmbhatt said.

A World Bank study released last year predicted a 20 percent decline in demand for tourism, transportation and other key services and estimated a loss to the economy of 2 percent of world Gross Domestic Product (GDP), or $800 billion a year.

Some economic studies using more severe pandemic scenarios have predicted losses of up to five percent of GDP, he noted.

Brahmbhatt said governments needed to plan for policies to facilitate corporate restructuring and getting industries relaunched promptly after the crisis.

He said firms needed to plan for all kinds of unexpected disruptions in supply chains, logistics and the availability of key domestic business services such as travel.

Companies should also build up buffer stocks of key inputs.

"That may eat into short-term profit margins and runs against current "just-in-time" management philosophy, but could help ensure the very survival of the firm," he said.

The current spread of avian flu in the poultry population is also having a varying impact on countries' economies, he said.

"In low income economies like Vietnam, where the bulk of poultry production is still by backyard producers, the impact has fallen mostly on individual rural households, and has only partly been offset by government compensation to farmers."

"On the other hand, economies like Thailand, where more of production is undertaken by industrial and large commercial producers...impacts would be felt not on rural farmers' incomes but through greater unemployment of wage labourers, lost profits and corporate bankruptcies," he said.

http://in.today.reuters.com/news/ne...R_RTRJONC_0_India-257488-1.xml&archived=False

Time For Sitting On H5N1 Bird Flu Data Is Over​

http://www.recombinomics.com/News/06290601/H5N1_Sitting.html

Recombinomics Commentary
June 29, 2006

Indonesia has become the hot spot of avian flu, with the virus spreading quickly in animal populations, and human cases occurring more often there than elsewhere. Yet from 51 reported human cases so far - 39 of them fatal - the genetic sequence of only one flu virus strain has been deposited in GenBank, the publicly accessible database for such information.

The above comments from an editorial in today's Nature are welcome. Declan Butler offered some additional comments in his blog and provided a link to letter by Dennis J Kuchinich and Wayne T Gilcrest to appealing to colleagues to support a request to secretary Michael Levitt to make deposit of H5N1 sequences to a public data within 24 hours of verification as a condition for NIH support. The letter also supports transparency of these and related H5N1 bird flu issues.

The situation in Indonesia is particularly acute. It is now almost one year since the first confirmed human case in Indonesia was reported, yet sequences from that index case are the only human H5N1 sequences publicly available. The sequences were deposited in the WHO private database on August 1, 2005 but were not made public until March 25, 2006 and sequences from six of the eight gene segments have still not been released. Malik Peiris declined comment on direct questions on mutations in the sequences because the sequences were done under contract with WHO. WHO said they couldn't release the sequences without approval from the Indonesian government, and the Indonesian government said that no one had requested release.

The sequences are at Los Alamos and can be released to the public by simply removing the password protect, as was done with the index case. Data released at the Jakarta meeting also raised significant questions about what data is being hidden in the database

WHO's statement on the sequences in the Karo cluster indicated there were no "significant mutations" and no reassortment with human and avian genes. They also indicated that the sequences indicated sensitivity to Tamiflu. However, data presented at the closed door meeting indicated the sequences in the cluster had the S31N polymorphism in the M2 protein, which indicated the H5N1 was amantadine resistant.

Similarly, media was told that the nephew of the index case and his father shared a "minor mutation" indicating the son infected his father. However, data at the closed door meeting indicated the father had 13 additional differences with his son's H5N1 sequence strongly suggesting that the father had been infected by two H5N1 viruses, one from his son and one from an unknown source. The sequence of the H5N1 from the father had evidence for both reassortment and recombination.

WHO consultants have indicated the recombination in H5N1 was rare. However, analysis by WHO fails to detect recombination, which is common in H5N1. Obvious recombination is present in H5N1 generated by the very WHO consultants who say that can't find homologous recombination. These obvious cases were in sequences from Hong Kong in 2003 and 2003 and the sequences were generated via a collaboration between Hong Kong and St Jude labs. The recombination was not described in the peer reviewed publication of these sequences. Obvious recombination was also present in 2003 H9N2 sequences from Korea. These sequences were also generated by St Jude, yet they were also not reported in the peer reviewed paper,

H5N1 bird sequences from Indonesia have acquired Qinghai sequences, including the Qinghai HA cleavage site in at least one isolate from Bali. Similarly, Qinghai sequences are in the H5N1 from the father who was infected by his son. These Qinghai sequences on an Indonesian genetic background are additional evidence fro recombination in H5N1 sequences in Indonesia.

The sequence data is not being shared. The human sequences from Turkey were finally released. However, a request for identification of the WHO confirmed cases was not answered. Nor was a simple question about the cell line or chicken eggs used to isolate the H5N1 from Turkey because the pattern of S227N sequences was unusual.

The time for secrecy regarding these sequences has passed. Release of the sequences and providing minimal information on the source of the sequences should be made immediately. Many of the Indonesian human sequences have bee held for almost a year. The sequences from Turkey were held for six months.

H5N1 is rapidly evolving and this evolution should be matched by researchers who are hoarding sequences for publication. The time for release of the sequences has long since passed.

US funeral industry could be stymied by a flu pandemic​

http://today.reuters.com/investing/...Z_01_N28244073_RTRIDST_0_BIRDFLU-SERVICES.XML

By Justin Grant

NEW YORK, June 29 (Reuters) - U.S. funeral companies would be hard pressed to meet demand for their services in a human bird flu pandemic because of the sheer volume of dead and stringent public health rules that would likely be put into effect, experts say.

Estimates are that if the H5N1 virus -- the current strain of avian influenza -- mutates into a strain that could be passed from human to human, more than 2 million Americans alone could die.

And although more companies provide funeral services today than in 1918 when a human avian flu swept the world, as demand for funeral services increased in another pandemic companies' profits would decrease, industry sources say.

Johnson & Rice Co. analyst William Burns, who owns shares of Service Corp. International (SCI.N: Quote, Profile, Research), the largest funeral and cemetery services company in the world, said funeral services companies often lose money when disasters strike.

"You're in such a hurry to get the deaths taken care of, this is really not a time where the company is focused on making a lot of money," Burns said.

And since care-giving is part of what funeral services companies do, Burns said many would be looking to donate their services, at the expense of profits, in the event of mass fatalities in a pandemic.

Since the current outbreak of avian flu began in 2003, 130 people have died from among the 228 known to have been infected. The 1918-19 pandemic killed an estimated 20 million to 100 million people worldwide. Studies show that it was caused by an avian flu virus -- the H1N1 strain -- that could be passed from human to human.

"There are going to be surges, and how are we going to recover them? How are we going to store them?" John Fitch, a senior vice president at the National Funeral Directors Association, said in a recent interview.

"When they talk about the national pandemic and potentially 2 million people dying in a six to eight month period, this is on top of the normal 2.5 million that die every year. You're talking about 5 million people, almost double the death rate and all of it in a compressed period of time," Fitch said.

The 1918-19 pandemic left people scrambling for places to put the dead as morgues ran out of space and the supply of caskets dwindled. Undertakers and grave diggers were among the sick and dying.

The average funeral home in the United States today has six employees and handles nearly 182 funerals a year, according to the National Funeral Directors Association (NFDA) Web site, http://www.nfda.org/.

"The morgues are going to be backed up. Everything is going to be slowed down, and compounding that is you might have a ban on public gatherings, or quarantines, or restrictions on travel," Fitch said.

Quarantines were common in the United States during the 1918-19 pandemic, and funeral services were restricted to minutes to minimize people's exposure to each other.

The funeral services industry in the United States generates about $11 billion in revenues annually, according to the NFDA. Fitch said on Thursday that he did not know how revenues might be affected by a pandemic because there were too many variables.

The NFDA notes that about 90 percent of funeral services companies in the United States are privately held.

Service Corp. International is working on a contingency plan that would enable it to keep its business running, while lending a hand to local and state governments in a worst-case scenario, company spokesman Greg Bolton said, but he declined to give details.

The U.S. government last month issued a new plan for dealing with a pandemic, which suggests travel restrictions and quarantines. The report estimates that up to 40 percent of the work force could be sidelined at the height of a pandemic.

Batesville Casket Company, a subsidiary of Hillenbrand Industries Inc. (HB.N: Quote, Profile, Research), said in a statement that quarantines could harm its ability to transport and deliver caskets.

"Ultimately it wouldn't mean a boon to the industry," said Daniel Isard, president of Foresight Analysts Inc., a funeral industry consulting firm in Phoenix, Arizona.

"I don't think there's a funeral director in the United States that's going to be smiling about that."

National Zoo Moves Ducks, Chickens in Bird Flu Step ​

--------------------------------------------------------------------------------

WASHINGTON - The National Zoo has removed ducks and chickens from its Kids' Farm exhibit as a precaution against bird flu and "to keep visitors comfortable," officials said on Thursday.

Besides the domesticated ducks and chickens, the zoo is home to hundreds of wild birds ranging from emus and kiwis to vultures, cranes, shrikes, hornbills and hummingbirds.

No cases of the highly pathogenic avian influenza have been found among birds in the United States. Millions of birds have been killed, predominantly in Asia, to slow the spread of the disease, which has killed 130 people since 2003.

The zoo said it moved the ducks and chickens to its research center in Front Royal, Virginia.

It said it followed a number of safeguards for its bird collection, including regular health checks. The zoo also was developing a surveillance program for its birds and instituting the use of disinfectant footbaths in areas used by workers.


Story Date: 30/6/2006


http://www.planetark.com/avantgo/dailynewsstory.cfm?newsid=37052

Avian Flu Case in Mongolia​

http://www.mongolia-web.com/content/view/619/2/

Written by Ulaanbaatar correspondent
Friday, 30 June 2006
AVIAN FLU UPDATE, MONGOLIA: RESULTS OF ADDITIONAL CASE OF H5N1, KHUNT NUUR, SAIKHAN SOUM, NORTHERN MONGOLIA, MAY 4, 2006.


US Embassy, Ulaanbaatar. Mongolia has reported one additional case of H5N1 Avian Influenza, in a wild whooper swan. The swan was found sick at Khunt Nuur, Saikhan Soum, on May 4 in Bulgan, a northern province, during surveillance activities by the Central Veterinary Laboratory. The Ministry of Food and Agriculture did an initial rapid test for H5 and sent a sample to the OIE reference laboratory at Hokkaido University in Tokyo for confirmation of H5N1. This was confirmed on May 29. Active surveillance has been implemented in the western and central parts of Mongolia following the main flyways of migratory birds. A total of 182 samples have been collected from birds belonging to 27 different wild species. The Government of Mongolia (GOM) has quarantined the area and has found no further dead birds. There have been no human cases of avian influenza in Mongolia.

The U.S. Embassy reminds U.S. citizens in Mongolia to review information about H5N1 Avian Influenza A, including suggested precautions, on the U.S. Department of State’s “Avian Flu Fact Sheet,” at http://travel.state.gov/travel/tips/health/health_1181.html The State Department website includes answers to Frequently Asked Questions (FAQ’s), and links to websites of the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). Guidance on how private citizens can prepare for a “stay in place” response to an avian flu pandemic or a variety of other emergencies is available on the websites of the CDC, the American Red Cross (http://www.redcross.org) and the Federal Emergency Management Agency (http://www.fema.gov) and http://pandemicflu.gov/ websites.

WHO Warns Against Bird Flu Mutation

June 30, 2006 1:52 p.m. EST


Nji Che - All Headline News Staff Writer
Geneva, Switzerland (AHN) - The World Health Organization (WHO) on Friday warned against the risk of bird flu mutation into a form that could easily be transmitted from human-to-human. The UN health agency added that there could be more cases of human infection by the end of the year.

According to a report that analyzed 200 known bird flu cases, there have been three phases of human infection since the first one was reported in 2003. All the phases were witnessed during spring and winter in the northern hemisphere.

The document says, "If this pattern continues, an upsurge in cases could be anticipated starting in late 2006 or early 2007."

It adds that, "Moreover, the widespread distribution of the H5N1 virus in poultry and the continued exposure of humans suggest that the risk of virus evolving into a more transmissible agent in humans remains high."

The WHO says the analysis of the bird flu infection pattern is similar to that witnessed in the 1918-1919 Spanish flu outbreak. The epidemic claimed more than 40 million lives across the globe.



http://www.birdflubreakingnews.com/...//www.allheadlinenews.com/articles/7004080247

US monitors: Bird flu in 53 nations

Outbreaks of the H5N1 avian virus have been confirmed in 53 countries, with 16 announcing cases within three months of one another, said Mike Leavitt, secretary of the Department of Health and Human Services, in an updated report released June 29 on U.S. pandemic planning efforts. The report also calls for continued vigilance against a possible pandemic outbreak.

The Agriculture Department said in a report on its pandemic planning efforts, also released June 29, that it has stepped up domestic and international avian flu-detection activities, including the establishment of offices in five Asian countries where H5N1 has hit poultry flocks and humans.

Leavitt said more troubling than the spread of H5NI was the first report of human-to-human transmission of the bird flu strain in an outbreak in Indonesia in May. The World Health Organization confirmed it last week.

Tim Uyeki , a scientist at the Centers for Disease Control and Prevention, helped investigate the Indonesian outbreak, which killed six of seven family members infected with the virus, and helped confirm the human-to-human infection, Leavitt said.

The outbreak started when a fatally ill woman contracted the flu through exposure to poultry and infected other family members, Leavitt said in his “Pandemic Planning Update II” report.

Test results released last week show that the H5N1 virus mutated slightly in one of the victims, a 10-year-old boy, who passed it to his father, who also died, according to the report.

Uyeki said this was the first evidence that a person caught the virus from a human and then passed it on to another person. He stressed that the virus died with the father and did not spread outside the family, the report states.

That outbreak and the continuing spread of H5N1 show that the world is in a race against a highly pathogenic virus and must prepare in every possible way against a potential pandemic, Leavitt said.

The United States has pledged $334 million to assist other nations with pandemic surveillance, detection and containment, Leavitt said. CDC is continuing to monitor the situation in Indonesia, “where, on average, one person died of H5N1 every two and a half days in the month of May,” he said.

Congress has allocated $350 million this year to assist with state and local pandemic preparedness in the United States, and Congress approved this month a $2.3 billion funding request for preparedness in the 2006 emergency supplemental spending bill, Leavitt said.

All but two states have held pandemic planning summits and most have worked with HHS to complete an agreement detailing state and local responsibilities for pandemic planning, Leavitt said.

HHS has also increased tracking of migratory wildfowl in cooperation with the USDA and Homeland Security and Interior departments.

These federal departments, along with the state of Alaska – a crossroads of migratory bird flyways – and the International Association of Fish and Wildlife Agencies, have developed a national framework for early detection of bird flu, the report states.

In its report, the USDA said its Animal and Plant Health Inspection Service is conducting surveillance on wild migratory birds in Alaska and 10 other states.

The USDA Cooperative State Research, Education and Extension Service's Avian Influenza Coordinated Agriculture Project will conduct surveillance on migratory birds in Alaska, California, Washington state and Utah, and test about 7,000 birds this year at a total cost of $19 million, the USDA report states.

The department said it plans to spend $28 million on domestic poultry surveillance this year and another $21 million to coordinate international avian flu projects. This international effort includes the establishment of USDA offices in China, Laos, Cambodia, Thailand and Indonesia that will focus solely on avian flu. ()


http://www.birdflubreakingnews.com/....com/breaking_news/breakingnews.php?id=106215

Friday, 30 June 2006, 14:27 GMT 15:27 UK

Bird flu vaccine '10 years away'

By Matt McGrath
Science reporter, BBC News



Close contact with infected birds can spread the virus to humans
Avian flu experts meeting in Paris have been told that a viable vaccine against the human form of the disease could take 10 years to develop.

Dr David Fedson, a retired professor of medicine, told the conference that there were well-documented problems with the H5N1 virus when it came to making a vaccine.

Scientists normally grow such a vaccine from an inert form of a virus, using chicken eggs as their favourite growing medium.

According to Dr Fedson, who also worked for a number of years in the vaccine manufacturing industry, the vaccine produced from H5N1 was proving particularly difficult to grow up.

It was also proving ineffective at stimulating an immune response that would give a person a good defence against bird flu.

He told BBC News: "Right now, worldwide, we can produce 300 million doses of seasonal flu vaccine, but it turns out that the H5N1 vaccine is so poorly immunogenic and replicates so poorly that... we could immunise globally, with six months of production, about 100 million people.

"From a public health point of view this is catastrophic," the former professor of medicine at the University of Virginia School of Medicine, US, said.

"We have had reverse genetics H5N1 viruses available to work with for three years and after three years this is all we can say: 'We could produce enough vaccine worldwide, for 100 million people'. Is that good enough? I don't think so."

Leadership 'needed'

Dr Fedson's views were echoed by Professor Albert Osterhaus, a leading European virologist based at the Erasmus Medical Centre, Rotterdam.

He was involved in decoding the virus behind the Sars (Severe Acute Respiratory Syndrome) epidemic.

He told the meeting that a global influenza task force was needed to get to grips with the situation.


A mutated virus has yet to take hold in human populations


Global impact of bird flu
Q&A: Bird flu
On the subject of a vaccine, he said: "If a pandemic were to happen tomorrow, we would not have a vaccine; at least not a vaccine with which we could vaccinate the European population or the American population - and we need a vaccine for the world.

"Basically, if we don't invest now in suitable clinical trials, there will be a shortage of vaccine - if we have a vaccine at all."

Governments were in denial about the potential danger and this was the root of the problem, according to Dr Fedson.

"If you look to the UK, France, the Netherlands and Italy (countries with companies that produce vaccine) - are any of the health authorities in these counties spending public funds on clinical trials of H5N1 vaccine? The answer is 'no'.

"Not a single pound sterling is spent by the Department of Health in the UK on clinical trials - why is this so? Contrast this with spend on the Eurofighter for European defence, a weapon system no longer needed. Our priorities have got mixed up. Governments are feckless."

"Why can't governments be driving the boat on this? Especially in the UK. Your experience of developing the meningitis vaccine is a role model of how to do it. The Department of Health said they would be in control, be in charge of data; they said here's the schedule and we have the money - from A to Z, the process worked like a charm."

Commercial world

There was no point blaming the vaccine manufacturing companies, said Dr Fedson, who was at one time director of medical affairs at Aventis Pasteur.

"We've got to get away from the fantasy that pharmaceutical companies are charities - they make hard-nosed decisions about where they are going to make their profits.

"Some companies have sensed that by building supplies or stockpiles of pre-pandemic vaccine, they can make easy money by just selling millions of doses to governments - they don't have to hire a sales force.

"They're doing good business based on governments being fearful of what might happen if they are perceived to have done nothing.

"When governments say they have bought, say, eight million doses of pandemic vaccine, all they are doing is buying a bucket full of antigen, because we really don't know how it is going to be formulated and there is no licensed, registered pre-pandemic vaccine in the world.

"They are hedging their futures."

The First International Conference on Avian Influenza in Humans has been taking place this week at the Pasteur Institute in Paris.


http://news.bbc.co.uk/2/hi/science/nature/5132910.stm

Link to tomorrows (7/1) Bird Flu thread: http://www.timebomb2000.com/vb/showthread.php?t=202541