Avian flu updates page 12

[Martin]

avian flu page 11 at
http://www.timebomb2000.com/vb/showthread.php?t=162847&highlight=avian



Europe hunt widens for infected birds

Fear that mild strain could mutate into deadly virus

Tom Parfitt in Moscow and Jamie Doward
Sunday August 28, 2005
The Observer


Fears that mild strains of bird flu can mutate and fatally infect humans have prompted the UK to push for the early adoption of a new Europe-wide initiative to combat the threat.
The present European Commission directive designed to curtail the threat of bird flu is concerned only with 'high pathogenic' strains, but there are growing concerns that these can originate from 'low pathogenic' strains which can be transmitted to poultry from wild birds.

On Friday, the authorities in Finland detected a case of bird flu in the north of the country which is thought to be a low pathogenic strain. The discovery has added to concerns over the speed with which bird flu is edging towards western Europe.

Experts say that it is only a matter of time before wild birds bring bird flu to the UK. 'Wild birds that have migratory pathways over Europe and the UK will become infected. It is inevitable bird flu will be carried to this country,' Bob McCracken, president of the British Veterinary Association, warned last week.

The UK, which took over the EU presidency last month, has made introduction of a new bird flu directive, which is due to come into force on 1 January, 2007, a key priority. The new legislation will establish the compulsory surveillance of wild birds in an attempt to catch mild strains before they mutate.

The threat posed by bird or avian flu to western Europe is the subject of intense debate as an epidemic grips Russia. Yesterday a leading Russian virologist said the threat could have been detected much earlier if more funds had been available for tests.

'We could have detected the virus two months earlier, when the birds flew to Siberia from the south of the Asian continent,' said Sergei Netesov, deputy head of the Vektor State Scientific Centre of Virology and Biotechnology in Novosibirsk. 'This would have allowed us to forecast the situation's development and start anti-epidemic measures earlier.'

Netesov said he had expected an outbreak 'this year or next' but was short of the resources to track it, an admission that will reinforce fears that Russia acted slowly despite anticipating the spread of the virus. 'We could only check two or three lakes where migratory birds stop this year because of a lack of funding,' Netesov said.

The outbreak of bird flu began in central Siberia in early July and has spread westward to the Ural mountains and the shores of the Caspian Sea.

Russian scientists say the epidemic has stabilised but it could be too late to prevent migratory birds bringing the H5N1 strain of the virus - which can kill humans - to west European countries over the winter. At least 57 people in South-East Asia have been killed by the virus since 2003.

But experts have played down an imminent risk to the UK, saying it is unlikely birds carrying such a virulent strain would be strong enough to reach Britain.

So far no human has been infected in Russia, but the H5N1 strain has killed about 13,000 wild birds and domesticated poultry in seven different regions. More than 112,000 birds have been slaughtered and incinerated to prevent the spread of the disease and several villages remained under quarantine yesterday.

Oleg Kiselyov, head of the Influenza Research Institute in St Petersburg, told The Observer the rapid spread of the infection was 'a signal from nature that a mutated strain that passes between humans could soon appear'.

A bird carrying the killer H5N1 strain rarely infects humans directly, but there are concerns a global pandemic could result if the strain mutates - most likely by mixing with a pig virus - into a form that could spread easily from human to human.

Authorities in the Netherlands have already banned farmers from keeping fowl outdoors, fearing they could be contaminated by migrating birds from Russia. Millions of chickens had to be destroyed in the Netherlands when it was gripped by a bird flu epidemic in 1999. The disease is thought to have cost the country up to £100 million.

However, the government has said that there is no need for a similar ban in the UK.



http://observer.guardian.co.uk/international/story/0,6903,1558028,00.html

 

[Kim99]

http://www.washingtonpost.com/wp-dyn/content/article/2005/08/27/AR2005082700958_pf.html

*U.S. to Triple Airport Quarantine Stations
Health Program Aims to Prevent Infectious Diseases From Entering Country*

By Justin Gillis
Washington Post Staff Writer
Sunday, August 28, 2005; A16

The government plans to more than triple the number of quarantine stations at airports around the country and hire scores of health officers as part of a broad plan to try to stop deadly infectious diseases from entering the United States.

Ten new stations, at airports stretching from Alaska to Puerto Rico, are already open or nearing completion, and about 50 new health officers are undergoing training. The Centers for Disease Control and Prevention plans to build an additional seven stations as soon as it can get the money. Eight stations that have existed for years are gaining staff, so that when the plan is complete, the country will be blanketed by a network of 25 centers designed as a first-line of defense against a global disease pandemic.

In practical terms, the plan will not mean much change for international air travelers, at least in normal times. It does mean that if a passenger gets sick on a flight, when the plane lands it is likely to be boarded by federal health officers specifically trained to recognize exotic diseases, not just by local emergency crews.

If a global pandemic looms, though, the plan calls for the centers to play a key role in setting up a firebreak that would try to keep the disease out of the United States. The stations would help coordinate broad programs under which thousands of air travelers might be subject to medical evaluation, or offered medical pamphlets and advice, before being allowed to enter the country. Federal experts emphasized that passengers would be quarantined only if there is strong reason to suspect they have been exposed to a serious disease, and then only long enough rule out that possibility or get them into medical-isolation wards at hospitals.

"We're not going to lock you up for days," said Jennifer Morcone, a spokeswoman for the CDC, noting the negative connotation the word quarantine once carried. "The goal here is to take care of people."

Many of the new centers are being housed temporarily in small offices or suites, but eventually they will include examination rooms that will allow health officers to isolate and evaluate a few ill passengers at a time, according to the CDC. The centers will never be big enough to quarantine entire planeloads of people but would play a coordinating role if such drastic measures ever became necessary.

Washington Dulles International Airport is getting a new center, with some staff already in place and construction underway on a small office suite. Other centers are opening this year at airports in Anchorage, Boston, Detroit, El Paso, Houston, Minneapolis, Newark, San Diego and San Juan. Quarantine stations have existed for years in Atlanta, Chicago, Honolulu, Los Angeles, Miami, New York, San Francisco and Seattle, but all those are growing.

The CDC aims to open at least seven more quarantine offices when it can get the money, to bring the national total to 25. Cities at the top of the priority list include Charlotte, Dallas, Denver, New Orleans, Philadelphia and Phoenix, but that list is not final and other cities are under consideration.

The 50 or so staff members already hired will more than double the CDC's presence at the nation's airports. Leaders of most of the new and existing stations convened last week in a suburb of Salt Lake City to develop operating procedures.

The CDC's plan calls for placing at least one doctor, not just inspectors, at every airport with a quarantine station. Up till now, even in long-established stations, the nearest CDC doctor was often hundreds of miles away. "This is a dramatic change from where we were a year ago," said Ram Koppaka, acting director of the CDC's quarantine branch.

The plan is a response to rising fears about bioterrorism or a potential pandemic of respiratory illness. For example, experts fear that a highly lethal form of influenza now circulating among birds in Asia, if it undergoes certain genetic changes, could start spreading rapidly among humans, potentially killing millions. In an age of global air travel, such an illness could jump from foreign countries to the United States in hours.

The plan is also an attempt to apply lessons from the 2003 scare over a new disease: severe acute respiratory syndrome, or SARS. Hundreds of thousands of people around the world, including thousands in Toronto, were placed in quarantine and entire cities in China were cordoned off before that ailment was brought under control. It never gained a foothold in the United States, but a few cases came in on planes, and the CDC found itself scrambling to notify potentially exposed passengers.

"We recognized that in SARS, we had a tremendous need for CDC public health officers at points of entry to our country in order to evaluate passengers who had potential exposure in transit," said Julie L. Gerberding, director of the CDC, in Atlanta. "In many of our airports, we don't have on-site facilities to isolate someone who is potentially infectious."

The CDC's plan is winning plaudits from outside experts who are familiar with it. But they cautioned that not even a dramatic expansion of the CDC's presence at airports can guarantee that an infectious organism will not slip into the country. And some noted that recommendations for just this kind of program had been around for years.

"I actually applaud the CDC on this," said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. But he added: "We should have done this a long time ago. Once someone leaves a plane in this country, they get lost into the veneer of humans wherever they go."

The CDC is still developing its plan for the centers and weighing related issues, such as how to notify passengers if an illness is discovered after everyone leaves a plane. That proved a huge problem during the SARS scare, with airlines often unable to supply final destinations or detailed contact information for their passengers.

The day may be nearing when people will be asked for such details as they log onto the Internet to make plane reservations. In a public-opinion survey for the CDC, Harvard University researchers found a strong willingness to comply if people were assured their data would be used only in an emergency.

"If we set up these quarantine centers and find out the passenger in 7B has some sort of suspicious respiratory condition, we need to know immediately who was in 7A and who was in 7C," said Mark A. Rothstein, a bioethicist at the University of Louisville who led a team that studied the CDC's response to SARS. "To wait for paper records could take days -- the whole country could be infected by that point."

Staff writers David Brown and Sara Kehaulani Goo contributed to this report. Brown reported from Atlanta.

 

[Kim99]

http://www.recombinomics.com/News/08280501/H5N1_Bulgaria.html

H5N1 Wild Bird Flu in Bulgaria?

Recombinomics Commentary
August 28, 2005

In an announcement made by the Bulgarian Ministry of Health on 26th (August), the Northern Bulgarian City (or Town) of Fo-la-cha (literal translation, I did a quick scan of the Bulgarian map. i suspect that it MAY be Vratsa or Fuse that is being referred to) reported the discovery of the Avian Influenza. The European Union has asked Bulgarian authorities to take urgent control measures.

The above translation of a boxun report suggest that H5N1 wild bird flu has been detected in Bulgaria. Although Bulgaria has been discussed as a possible site of migration of birds infected with H5N1, there have been no clearly confirmed reports. Several weeks ago dead birds were reported at the mouth of the Volga River at the Caspian Sea and Russia has reported dead birds in Kalmyka, although the cause of death has varied almost daily.

The boxun report would advance bird flu the furthest south and west in Europe. The birds migrating from the Urals are expected to move into the Caspian, Black, and Mediteranian Sea areas, including northern Africa (see map). Since the migratory paths cross, the spread can be extensive, especially when the H5N1 jumps from species to species. One banding study showed a bird from Finland showing up in Texas.

The rapid spread of H5N1 wild bird flu into Europe suggests H5N1 will be worldwide soon. This global reach increases the likelihood of recombinations, leading to efficient human-to-human transmission, which could generate a pandemic that eclipses 1918.

 

[Bill P]

I apologize if this was prewviously posted - I did do a search and didnt see it...
http://www.recombinomics.com/News/08270502/H5N1_H7N7_Finland.

Co-circulation of H5N1 and H7N7 Bird Flu in Europe?

Recombinomics Commentary
August 27, 2005

The announcement of bird flu in a seagull in Oulu, Finland on Friday will probably be followed by an announcement that H5N1 has indeed invaded Europe. Evidence from southern Siberia suggests H5N1 wild bird flu is in northern Siberia, and birds from northern Siberia migrate over Finland, so addition sightings will probably be reported next week (see map). Although tests of the current isolates are projected to last 3 weeks, sequencing of the HA cleavage site is routine, and such a sequence will almost certainly show the 6 basic amino acids (RRRKKR) that are diagnostic for H5N1 from Asia. and HPAI (Highly Pathogenic Avian Influenza), a reporable disease.

H5 has been detected in Europe previously, and the H5 sequenced previously at Chany Lake in 2003 and Primorie in 2001 has many markers found in H5 in Europe. The European H5 reassorted with H7N7 in 2003 to generate H5N7 that was isolated from a mallard duck in Denmark, A/Mallard/64650/03(H5N7).

Because H5N1 from Asia has a multi-basic HA cleavage site, it more easily infects birds, including wild birds such as mallards. Reasortants are created when the same host is infected with two different viruses and H5N7 arose from H5 and H7N7 infecting the same host. The poly-basic cleavage site in H5N1 from Asia gives it a selective advantage and it will probably replace most of H5 from Europe.

The dual infection can also generate recombinants, which involve a mixing or portions of genes. The H5N1 from Qinghai Lake has acquired sequences from European swine via recombination, and its presence in Europe this year will lead to more dual infections and more recombination.

Co-circulation of H5N1 and H7N7 is particularly dangerous, because H7N7 is efficiently passed from human to human. Thus, H5N1 could acquire sequences allowing efficient human-to-human transmission, and this acquisition could happen in mallard ducks, which are known to be infected with H5 from Chany Lake, A/Anas platyrhynchos/Chany Lake/9/03(H5N3), or Primorie, A/duck/Primorie/2633/01(H5N3). Birds infected with H7N7 have also led to isolates from the Netherlands, A/avian/Netherlands/065/03(H7N7).

Although 30 million birds were culled in 2003 to halt the spread of H7N7, its potential return is quite real as is the possibility that H5N1 is already in Scandinavian countries, including Finland.

This potential co-circulation in Europe is clearly cause for concern.


Map

 

[Bill P]

http://www.recombinomics.com/News/08300501/H5N1_More_Recombination.html

Commentary
.
Evidence for More H5N1 Wild Bird Flu Recombination

Recombinomics Commentary
August 30, 2005

"the fact is that in the Mongolia, where the wild bird does not contact with the poultry and the man, it is possible to trace the development of epizootic disease precisely among the population of wild birds", it noted A.Shestopalov.

According to him, Russian and Mongolian virusologists will stay in the Mongolian Altai lakes to the middle of September.

It also noted that recently it returned from The zdvinskeyeo region of the Novosibirskaya Oblast, where earlier was also noted the circulation of the virus of bird influenza.

"according to our observations, among the wild bird there was also case - according to the visual estimations, its livestock is 2 - 3 times less than in the recent years", it noted A.Shestopalov.

A.Shestopalov it also reported that in the course of materials research, delivered from the experimental-production economy of the Siberian scientific research institute of poultry raising (Omsk region), pathogenic material it was not discovered.

"were carry ouied the necessary studies, in this case the chickens, which they infected by the virus chosen in Omsk birds, survived", it noted.

The machine translation above indicates Russian scientists are traveling to Mongolia to study the H5N1 outbreak in the Altai Lakes region. This is where initial isolates in Mongolia originated. Included were fatal infections in whooper swans and bar headed geese. Because this region is report. It offers the opportunity to study the H5N1 in the absence of additional infections, which may be present in domestic poultry.

Indeed, the electrophorgram submitted to OIE by Russia showed a complex pattern of H5N1 related genetic information from a wild bird. Similarly, the isolates from Qinghai Lake suggested some if not most birds had dual infections.

The above report suggest that some of the H5N1 in Omsk was not pathogenic to chickens. This is in marked contrast to the H5N1 from Qinghai lake, which killed experimental chickens within 20 hours. H5 has been reported in the past at both Chany lake in Novosibirsk, as well as Pirmorie in eastern Russia. These earlier H5's were genetically related to H5N2 from Europe. The co-circulation of H5 from Europe and Asia can lead to additional recombinants.

Dual infections lead to recombination, which was also evident in the partial sequence submitted by the Vector lab at Novosibirsk. Although the NA sequence was virtually identical to the sequences from Qingahi lake, the HA sequence had at least one polymorphisms that was absent in the Qinghai lake sequences, it present in isolates from Japan and South Korea. These data suggest the H5N1 wild bird sequences are evolving via recombination.

The latest H5N1 map shows newer outbreaks in eastern Mongolia. These birds have probably already entered China and may be causing dual infections in Primorie as well as Japan and South Korea. These dual infections can lead to additional genetic drift via recombination.

The genetic drift has already produced H5N1 wild bird sequences that are significantly different than H5N1 in Vietnam. The worldwide effort to create a pandemic vaccine has targeted a 2004 isolate from Vietnam. However, such a vaccine is unlikely to be effective against the wild bird sequences.

Collection of additional sequences from Mongolia will help determine how quickly the H5N1 is evolving. Samples have already been comfimed in Japan to be H5N1 positive. WHO is also planning a visit to Mongolia.

Pandemic vaccine efforts should be targeting multiple versions of H5N1. The H5N1 wild bird flu is clearly spreading, and the upcoming migration season may move H5N1 worldwide, increasing the likelihood of additional recombinations leading to efficient human-to-human transmission.

Map

 

[Martin]

Leaders get first flu shots

04sep05
THE Prime Minister and his Cabinet head a list of elite people who will get preferential access to life-saving anti-viral shots if an avian flu pandemic hits Australia.

A leaked Health Department document details the controversial priority list for the shots, devised by a senior medical committee.

Anti-virals ease the effects of the flu, but Australia's stocks only run to 3.8 million doses and they are expensive to make.

Also on the priority list are state premiers, senior bureaucrats, judges and funeral parlour workers.

Others to be protected first will include police and workers in Australia's health services, in water and power, telecommunications, sewerage, and those making vaccines.




And Australian Broadcasting Corporation staff are on the list.

Australia's Chief Medical Officer, Professor John Horvath, said the list was devised to ensure people who carried out critical functions were protected.

"The nation's leaders are the most important of all," Dr Horvath said.

"At the end of the day there's got to be someone to make the decisions.

"And the media – but not all of the media – will be terribly important in the event of pandemic."

Australia's military leaders had their own system to protect themselves, Dr Horvath said.

Medical officials fear the deadly avian flu virus now spreading throughout the world could mutate and infect humans, sparking a pandemic – a deadly global infection without an immediate cure.

A new variant of the virus, H5N1, has killed more than 50 people in Asia.

The lethality of the Spanish Flu of 1918-19, which killed an estimated 40 million to 50 million people, continues to worry health professionals.

The World Health Organisation estimates up to 100 million could die in a pandemic, while in Australia more than 2.5 million would get the flu and up to 13,000 die.

The anti-viral drugs are the first line of defence before vaccines can be developed.

"In the absence of vaccines, anti-virals are the only medical intervention for providing protection against disease and some therapeutic benefit in those who are ill," the pandemic action plan says.

Australia has the largest stock of anti-viral drugs in the world, but still has only about 3.8 million doses.

It is estimated they could protect federal and state governments and a million essential workers for six weeks.

Australia could use three types of anti-viral drugs: Tamiflu, Relenza and Symmetrel.

The UK also has a pandemic plan which would protect the PM, Cabinet, and officials at the BBC first.


http://www.theadvertiser.news.com.au/common/story_page/0,5936,16484340%5E911,00.html

 

[Kim99]

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

PANDEMIC RISK: Bird flu at 'turning point'

Published on September 05, 2005

Human-to-human transmission in four Southeast Asian countries prompts scientists to upgrade danger alert level

The threat of a new bird flu pandemic is looming large as scientists begin to concede that the flu virus has entered the turning-point phase of pandemic development with reports of human-to-human infections in four countries including Thailand.

“It’s apparent to us insiders that [the virus] has already moved from phase 3 to phase 4 [in terms of the World Health Organisations’pandemic alert levels],” said Dr Kamnuan Ungchusak whose work on human-to-human H5N1 strain of avian flu was published in the New England Journal of Medicine in January.

Reports of the infection spreading among humans in four countries including Cambodia, Thailand, Indonesia and Vietnam have suggested to scientists that the virus has become more pathogenic than ever, the doctor said.

“The virus remains virulent enough to sicken or kill another victim who is in close contact with the infected person, said Kamnuan who is the director of the Disease Control Department’s Beureau of Epidemiology.

Reports of human-to-human infection have been most recently documented in a cluster of infections in Indonesia, he said, adding that all of the infected people were in the same family and had not been in contact with any poultry or other sources of disease, aside from infected family members.

All of the group infected with the virus in Indonesia died, said Kamnuan.

“The transition between phase 3 and phase 4 would be a significant shift, any confirmation of human-to-human infection means we are in phase 4,” he explained.

Kamnuan’s revelation contradicts authoroties’ assurances to the public that there has never been a confirmed case human-to-human transmission of the flu virus.

He encouraged the top health authorities to stop providing the public with false information and said that it was time to revise the country’s strategies to handle the pandemic.

“We (the region) have continued to witness the spread of the epidemic across Vietnam, where cases of infections [of the H5N1 virus] among people belonging to the same family have been constantly reported –and this is not a good trend,” Kamnuan said.

If the H5N1 virus continues to develop at this slow pace it could be beneficial to scientists as they would be able to closely monitor the development of the pandemic and be better prepared for

whatever comes next, said Associate Professor Dr Prasert Auewarakul, a virologist who is familiar with influenza pandemic research.

“However, the chance that the virus will mutate [to become highly contagious among humans] is also possible,” he said.

Arthit Khwankhom

The Nation - Bangkok's Independent Newspaper

http://203.150.224.53/2005/09/05/national/index.php?news=national_18514899.html

 

[Kim99]

Not to nitpick, but at least 62 have died, not 55.

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http://seattletimes.nwsource.com/html/localnews/2002463415_flu01m.html?syndication=rss&source=health

County prepares for influenza

By Warren King

Seattle Times medical reporter

King County officials ramped up preparations for a possible pandemic influenza yesterday with efforts to better engage local businesses about their roles.

Representatives of more than 50 large businesses and others have been invited to meet Oct. 3 at Safeco Field to discuss ways to prepare for an epidemic.

Top health officials warn that the epidemic, which could stem from the bird flu that has swept through Asia since late 2003, could kill up to 200,000 in the U.S., including 3,000 in King County, and could immobilize more than one-third of the work force at any given time.

"It's not going to be business as usual for anyone," King County Executive Ron Sims said at a news conference yesterday. "I'm determined we will be as prepared as possible if we face the type of outbreak public-health experts say is possible."

Public Health — Seattle & King County leaders have been planning for the epidemic for more than a year, meeting with emergency, hospital and government officials. But some health officials have said privately they've had trouble getting the attention of business leaders.

A pandemic flu is a new influenza virus that could be a much more serious flu virus than seen in a typical flu season, according to Public Health.

Sims and Dorothy Teeter, interim director of Public Health, said up to 1.2 million King County residents could be infected, including 25 to 35 percent of the work force at any one time.

Businesses need to prepare to operate with employees out sick, or with others working from home to avoid infection or to care for family members, Teeter said.

Telecommuting is one option, she said. Officials are meeting individually with some large businesses and local chambers of commerce.

Last month, Dr. Maxine Hayes, a state health officer, gave a similar warning to hundreds of business leaders at a Rotary Club of Seattle meeting.

"Senior management needs to think about inventory, transportation, distribution," she said. "This is not like a few snow days. ... You need contingency planning if you had to shut down for several months."

No human cases of avian influenza have been reported in the U.S., but 109 people in Asia have been infected by chickens, and 55 of them have died. Experts say the virus, labeled H5N1, could rapidly spread from human to human if it were to combine with an existing human flu virus.

Teeter said epidemic-control measures also could include closing public gathering places, including schools, sports arenas, theaters, restaurants and taverns. Representatives of school districts, fire and police departments also will be at the Safeco Field meeting, she said.

Officials already have met with hospitals, urging them to prepare for more than 5,000 hospitalizations and 450,000 outpatient visits. Hospitals and private doctors have been warned to watch for early signs of an outbreak.And discussions are beginning with other health-care providers about alternative ways to care for patients, Teeter said.

Warren King: 206-464-2247 or wking@seattletimes.com

Copyright © 2005 The Seattle Times Company

 

[Martin]

1.5 million chickens being culled due to bird-flu outbreak
09/05/2005

The Asahi Shimbun


The agriculture ministry has announced plans to cull about 1.5 million chickens following an outbreak of avian flu at poultry farms in Ibaraki and Saitama prefectures.

Officials said it was a relatively weak strain of bird flu and that 504,000 chickens had already been destroyed. An additional 1.024 million birds are to be killed to prevent the disease from spreading.

The area of infection has 30 farms with 4.14 million hens.

Officials of the Ministry of Agriculture, Forestry and Fisheries said there is a strong possibility that the infection was caused by the use of an unauthorized and defective vaccine that contained an active virus. Authorized vaccines contain modified, killed or avirulent viruses or bacteria.

Officials are scrambling to pinpoint the source of the outbreak because even a weak strain of avian flu virus can quickly become highly virulent.

The diluted strain of avian flu was first detected June 26 at a chicken farm in Mitsukaido, Ibaraki Prefecture. Chickens at a total of 30 farms in the prefecture and neighboring Saitama Prefecture have since been confirmed to be infected.

All of the chickens at the infected farms were being raised for egg-laying.

In Ibaraki Prefecture, chickens at farms hit by avian flu account for one-third of all hens in the prefecture.

Amid signs that the area of infection was spreading, the agriculture ministry on Aug. 22 changed its policy of destroying every chicken at the farms in question.

Of the roughly 1,700 poultry farms around Japan, avian flu has been detected at 29 in Ibaraki Prefecture and one at Saitama Prefecture.

For that reason, the ministry concluded that nationwide infection is highly unlikely, officials said.

The ministry, meantime, speculated Friday that some farm operators had used an unauthorized vaccine to quell infection, they added.

Ministry officials suspect that some viruses may have survived a viral inactivation treatment for vaccine production. As a result, any virus that survived the treatment could have been active and transmitted from bird to bird, the officials said.

The DNA sequence of the flu virus was almost identical to those that were confirmed in Mexico, Guatemala and El Salvador between 1995 and 2002, they added.

Even so, ministry officials said it was highly unlikely that avian flu was carried by migratory birds. Aside from the huge distance between Central America and Japan, they noted that no trace of birds infected with the virus had been imported to Japan.

The Japan Poultry Association meantime posted an announcement on its Web site disavowing any knowledge of the use of illegal vaccines.

To prevent a massive outbreak of bird flu in Japan, the farm ministry maintains a stockpile of vaccine for about 7 million chickens. Ordinary farmers do not have access to the vaccine, which so far has not been used. (IHT/Asahi: September 5,2005)

http://www.asahi.com/english/Herald-asahi/TKY200509050206.html

 

[Martin]

Artificial infection suspected in Japanese bird flu outbreak

The Yomiuri Shimbun


TOKYO - (KRT) - Artificial infection, including the use of vaccines, could be behind a weak strain of avian influenza detected in poultry farms in Japan's Ibaraki Prefecture, according to a panel advising the agriculture ministry on bird flu. Unauthorized vaccines could have been used.

Farmers, who have their hands full trying to contain the spread of the bird flu, were taken aback by the possibility of a man-made calamity caused by illegal acts.

Since June, chickens in 28 poultry farms in Ibaraki Prefecture, a key production center of chickens in the country, and a poultry farm in Saitama Prefecture tested positive for the antibody of a virus, showing that chickens were infected in the past.

The virus was detected in chickens at seven of the farms.

An analysis by the National Institute of Animal Health, an independent administrative corporation, found that the genetic makeup of the virus bore a strong similarity to a virus found in Central and South American countries, including Mexico and Guatemala. The virus did not exist in Japan, and it is highly unlikely it was carried to the country by migratory birds.

There also are no indications live birds infected with the virus have been imported.

Hokkaido University professor Hiroshi Kida, head of the advisory panel to the Agriculture, Forestry and Fisheries Ministry, said a vaccine developed using the Central and South American virus was brought into the country and possibly used on some birds.

The ministry has a stock of vaccines in preparation for a massive bird flu outbreak, but it prohibits the general use of them, so vaccines approved by the ministry have not been distributed.

As the virus detected in the farms has a genetic makeup different from that of vaccines on sale abroad, it could have been developed without going through due procedures and then imported, ministry officials said.

Since the use of unauthorized vaccines violates the Drugs, Cosmetics and Medical Instruments Law, the ministry is trying to determine the route of infection and plans to file criminal complaints if illegal acts are confirmed to have taken place.

Farmers in Ibaraki Prefecture were perplexed by the possible use of unauthorized vaccines.

Since June, when inspecting farms, the prefectural government has even checked waste to see if vaccines were used.

A prefectural government official said that so far, no indications pointing to the use of vaccines had been found.

Several owners of poultry farms where the virus has been detected said they did not use vaccines, including those from overseas.

They said they had used several authorized vaccines, but not vaccines for bird flu.

Vaccination can alleviate symptoms of bird flu in chickens, but cannot completely prevent infection. Such vaccination could lead to a bird flu outbreak if the virus is detected at a late stage.

International organizations, such as the World Health Organization, have called on countries to refrain from using vaccines.

The ministry's guidelines for epidemic prevention also bans the use of vaccines, recommending disposal of infected chickens and taking preventive measures against epidemics.

Vaccines are made by chemically eliminating a virus. But incomplete processing can leave infective pathogens in vaccines. Thus, the outbreak of a virus caused by vaccines is possible.

---

http://www.bradenton.com/mld/bradenton/news/world/12554810.htm

 

[Martin]

Avian Flu Could Spread Through Bird Fairs

September 6, 2005 8:04 p.m. EST


Danielle George - All Headline News Staff Reporter

London, England (AHN) - The Royal Society for the Protection of Birds (RSPB) worries that pet fairs could bring the bird flu into Britain and spread it across the country, according to a BBC report.

Authorities continue to emphasize that the risk of an Avian pandemic is low, Dutch farmers have been ordered to keep poultry locked up inside, British doctors have been briefed on a nightmare scenario of a human pandemic and France is stockpiling drugs to protect its population.

The risk of avian influenza being brought into the country through bird fairs is far greater than from migratory water foul coming into the continent, according to the report.

Neil Forbes, one of the UK's leading bird vets, told the BBC, "These places are a cauldron of infection."

The H5N1 strain of bird (or avian) flu, has killed more than 50 people in Asia, led to the destruction of millions of birds, and has now started to spread west.

"The nightmare scenario is you could import a bird from the Far East that carries this virus, that brings it into an auction hall and spreads it to a number of others," Forbes added.

"That then distributes it across the UK and we then end up slaughtering every chicken in the UK."

http://www.allheadlinenews.com/articles/7000047604

 

[Kim99]

http://www.alertnet.org/thenews/newsdesk/COL141587.htm

Bird flu pandemic a question of when, not if -WHO
07 Sep 2005 14:07:59 GMT

Source: Reuters

COLOMBO, Sept 7 (Reuters) - The world is going to face a pandemic of the bird flu strain lethal to humans and Thailand is the only nation in South and Southeast Asia ready to deal with it, the World Health Organization (WHO) warned on Wednesday.

WHO officials said the virus could mutate into a form that could pass easily from one human to another, making it easier for it to spread rapidly across great distances and kill between one million and seven million people worldwide.

"We may be at almost the last stage before the pandemic virus may emerge," Dr. Jai P. Narain, Director of WHO's communicable diseases department told a news conference on the sidelines of a Southeast Asia health summit in the Sri Lankan capital.

"Whether the avian influenza pandemic will occur, that is not the question any more, (but) as to when the pandemic will occur," he added.

"So far there is only one country in Southeast Asia with a pandemic preparedness plan ... Thailand... They have a stockpile of anti-viral drugs," Narain said. "At the same time we are in dialogue with our member countries. We are in the process of preparing this pandemic preparedness plan."

The deadly bird flu virus, now feared to be heading for Europe, killed one person in Vietnam last week, taking the number of deaths in Asia from the disease to 63.

The death took Vietnam's bird flu death toll to 44, with 23 of the victims dying since the virus returned in December 2004, after sweeping through much of Asia in late 2003.

It has also killed at least 12 people in Thailand, four in Cambodia, three in Indonesia and has struck six Russian regions and Kazakhstan, causing the deaths of nearly 14,000 fowl.

Narain said migrating birds posed a serious risk of spreading avian flu around the world and Asia was very vulnerable as winter approaches.

"It is no longer poultry. We are concerned about a whole range of bird species," Narain said.

"The virus has been detected in migratory birds in some former Soviet states where the these birds traditionally fly towards Asia to escape the cold winter months," he added.

 

[Martin]

German states fearing bird flu put poultry in pens

HAMBURG (Reuters) - Two German state governments have issued orders to keep poultry inside pens in some areas to prevent bird flu being spread by migrating wild birds.
The states of Lower Saxony and North Rhine Westphalia have both issued orders that farmers keep poultry inside from September 15 in several parts of their regions used by especially large numbers of migratory birds.

There are fears that wild birds could spread bird flu from parts of Russia and Central Asia where it has broken out.


Two German state governments have issued orders to keep poultry inside pens in some areas to prevent bird flu being spread by migrating wild birds. Chickens are pictured inside their coop at a chicken farm in Beelitz, south of Berlin in this August 23, 2005 file photo. (REUTERS/Fabrizio Bensch)
But the European Union Commission regards the risk as low and says there is no need for governments to ban farmers from keeping poultry outdoors, as the Netherlands has also done.

Germany's federal government in August prepared an emergency order to stop farmers keeping poultry in the open but the new rules were not being put into immediate effect.

However, Germany's state governments have the power to order such bans if they wish.

Numbers of poultry kept outside in Germany have hugely increased in recent years because of consumer demand for free range eggs and meat.

http://thestar.com.my/news/story.as...01_NOOTR_RTRJONC_0_-215492-1&sec=Worldupdates

 

[Martin]

Bird flu pandemic will 'overwhelm hospitals'

FRIDAY , 09 SEPTEMBER 2005

By KAMALA HAYMAN
Hospitals will be overwhelmed and thousands of sick and dying New Zealanders will have to be cared for at home if a bird flu pandemic strikes, experts warn.

The Health Ministry's director of public health, Mark Jacobs, said a flu pandemic, such as bird flu, was potentially the biggest crisis New Zealand had faced.

A new flu virus could infect one in three people, and as many as 16,000 would need hospital care.

Jacobs said the nation's already busy hospitals could not cope with such an increase in demand and many patients would have to be cared for at home by family and friends.

"People will need to be able to help themselves and to help each other," he said.

Another global flu pandemic is "a certainty", the ministry says, but exactly when it will strike is unknown.

Bird flu, which is infecting millions of birds across Asia, Russia and Kazakhstan, has the potential to start a terrifying pandemic at any time, it says.

Bird flu had proved deadly, killing half of all the people with confirmed infections, but it was not very contagious.

The ministry's published National Health Emergency Plan stresses that a flu pandemic is likely to see "all except the seriously ill" cared for at home. This plan – now being fleshed out with details due to be released in a few weeks – suggests community centres or hotels be turned into medical centres.

Flu victims may be asked to stay at home, rather than flood hospital emergency departments, and have their symptoms assessed by telephone.

Canterbury District Health Board chief medical officer Nigel Millar said a pandemic would force the country to "completely rethink" the way health services were delivered.

"We have to be realistic ... making sure hospital is for those people who are most severely affected; where it can make a difference," he said.

Millar said a great deal of uncertainty remained. "We're talking about an infection that hasn't emerged yet and we don't know how it would affect people."

The 1918 flu pandemic predominantly affected young, otherwise healthy people, while the 1968 pandemic struck down the elderly, the frail and the chronically ill.

"We have to have flexible plans and a way of working that can respond rapidly to changing circumstances," Millar said.

The ministry has warned that a substantial number of children – possibly 200 – could be orphaned in a pandemic, and all businesses would face a high level of absenteeism.

Christchurch virologist Lance Jennings has repeatedly warned that the rapidly evolving virus could mutate into a strain with pandemic potential or one that was readily passed between people. Air travellers were likely to carry it to New Zealand within days.

The Wellington School of Medicine has used modelling to forecast the impact of a flu pandemic.

This suggests as many as 3700 people could die and 16,000 need hospital treatment.

Canterbury, with its high number of elderly, was likely to be the hardest hit, with 400 deaths and 1800 in hospital. "It is likely that these levels would overwhelm current hospital capacity," said the study's lead author, Nick Wilson.


http://www.stuff.co.nz/stuff/print/0,1478,3404449a7144,00.html

 

[Martin]

WHO renews flu warnings; Thailand has more avian outbreaks
Sep 9, 2005 (CIDRAP News) – The World Health Organization (WHO) this week stepped up its warnings about the risk of an influenza pandemic, while Thailand reported four new outbreaks of avian flu on poultry farms.

According to a Reuters report, Dr. Jai P. Narain, director of the WHO's communicable diseases department, told reporters at a health conference in Sri Lanka on Sep 7, "We may be at almost the last stage before the pandemic virus may emerge." He was referring to the risk that avian flu in Asia will lead to a human flu pandemic.

Narain said it is no longer a question of whether a pandemic will occur, but only when it will erupt.

"So far there is only one country in Southeast Asia with a pandemic preparedness plan . . . Thailand," he was quoted as saying. He added that Thailand has a stockpile of antiviral drugs.

The recent spread of the H5N1 avian flu virus to birds in Siberia and Kazakhstan has stirred concern that migratory birds may spread it on to Europe, the Middle East, and Africa, thereby increasing the threat of a human pandemic.

Thailand has had four new outbreaks of avian flu in poultry since Sep 1, according to the latest government report to the World Organization for Animal Health (OIE), published today. Three outbreaks were in Saraburi province and one was in Kampaengphet province.

The report said 109 chickens died of the infection and another 76 were killed to contain the outbreaks. All the birds were free-ranging or in backyard flocks with minimal biosecurity.

Thailand has identified 33 avian flu outbreaks in five provinces since Apr 12 of this year, which marked the end of country's "second wave" of H5N1 outbreaks, according to the report. The country has been conducting nationwide surveillance for the disease since Jul 1. Thailand has had no human cases of H5N1 infection this year, but there were 17 cases with 12 deaths last year.

In other developments, the Associated Press reported today that the Netherlands has ordered 5 million doses of antiviral drugs to prepare for a flu pandemic, enough to treat more than 30% of its population of 16 million. The country's Vaccine Institute has contracts with Roche to provide raw materials to make oseltamivir (Tamiflu) and with GlaxoSmithKline to make zanamivir (Relenza), the story said.

The majority of the order is for oseltamivir, which will cost between $37 and $87 per dose, government spokesman Bas Kuik told the AP. He said about half of the order will be ready this year and the rest by the end of next year. The government already has 220,000 doses of oseltamivir, the report said.


http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/sep0905avian.html

 

[Martin]

S. China: perfect incubator for bird flu pandemic?
By Tan Ee Lyn | September 12, 2005

GUANGZHOU, China (Reuters) - The little boy jumped on a crate of clucking chickens as his father called out to him to transfer more birds from a large enclosure into the crate.

In this dank, poultry wholesale market in Guangzhou in southern China, a woman in the next stall selling ducks chomped on an apple while five bare-chested men sat down to lunch.

All around the humans are cages of live chickens, ducks, geese, rabbits, goats, pigeons and pheasants -- the perfect setting for the H5N1 bird flu virus to mix with other viruses or mutate into what experts predict would be the next pandemic strain.

Once the hybrid is easily transmissible among people -- which experts say will ultimately happen as the virus changes -- they predict more than 25 million hospital admissions and up to 7 million deaths globally within a short period.

At least two of the three pandemics in the last century originated in southern China. And it seems more than a coincidence that the H5N1 made its first known jump to humans in 1997 in Hong Kong, which lies in southern China.

So why is this region such a hotbed for new deadly bugs?

"A large proportion of the global population is in this region, and beyond that there is a diversity of animals that are thought to be important in the generation of these pandemic viruses," Malik Peiris, a microbiologist at the University of Hong Kong who has worked extensively on the H5N1 virus and SARS, said in an interview.

"These include waterfowl, particularly ducks which are reared in large numbers in this region, pigs and the fact that poultry, pigs and humans are present in very large numbers and in very close proximity to each other in this region. Not just China but southeast Asia," said Peiris .

PERFECT BREEDING GROUND

Spread across Guangdong province in southern China are tiny farms, where villagers raise small numbers of pigs in open sheds. Outside, chickens and ducks are free to roam.

"In places where you have pigs, birds and humans living close to each other, they create the ecology for the emergence of new strains. In southern China, you can easily see them keeping chickens, water birds very close to pigs and humans. This environment makes gene reassortment more likely," said Paul Chan, a microbiologist at the Chinese University.

Gene reassortment is the closest things viruses have to sex. They can swap genes with other viruses, often allowing them to acquire vastly new abilities overnight.

It is a faster way to change than simple mutation-- which could also lead to a new H5N1 strain deadlier to people.

The H5N1 strain has haunted the world since it made its debut in humans in 1997. It is now endemic in parts of Asia, where it has killed more than 60 people since late 2003.

The crisis deepened this year when wild migratory birds began dying from it in central China and experts have since warned that species which survive could carry the virus all over Europe and Africa within the next two migrating seasons.

So far, the virus has been detected in regions north of China in Kazakhstan, Russia and Mongolia. It has also been found in China's southwestern regions of Xinjiang and Tibet, which hangs just over Nepal and the rest of the Indian subcontinent.

But such worries cannot be farther from the minds of farmers and poultry vendors in southern China, where such husbandry practices have been handed down for generations.

"Sick? I have never been sick!" snapped the woman at the market as she carried on eating her apple.

But health experts continue to be alarmed and governments around the world have hammered out contingencies in the event of a pandemic, which is certain to put a stop to all air travel, trade and other aspects of ordinary life.

NEARING THE END?

Chan said the threat of a pandemic has become infinitely larger with the involvement of migratory birds.

"With land birds you can catch and kill them, but with migratory birds you can't. What we fear is that migratory birds will spread the virus to poultry (in other parts of the world). Poultry is closest to humans, that's the tipping point," he said.

"Up until now, transmission from bird to human is not efficient, but with a lot of contact, you will end up with a lot of human cases. When you have a sufficient number of human cases, there is chance for human influenza to mix with avian virus."

"When that time comes, it wouldn't be a pig, but a human mixing vessel (that produces the next pandemic strain). We are far more efficient mixing vessels than pigs. And once H5N1 becomes easily transmissible in humans, it will be the end. We can do nothing to control this spreading."

The health experts urged for full biosecurity measures at farms, saying everything must be done to keep poultry from mixing with waterfowl and wild birds. They also called for close surveillance of the virus in birds of all types.

"We must make sure our preparedness plans are well organized and ready and we must also get a vaccine ready and make sure it can be mass produced in numbers that are required," Peiris said.


http://www.boston.com/news/world/as...rfect_incubator_for_bird_flu_pandemic?mode=PF

 

[Martin]

Indonesia's health minister warns of wider bird flu outbreak

Monday • September 12, 2005

Indonesia's health minister warned the country could face further outbreaks of bird flu after the disease claimed the nation's fourth suspected victim.

Health Minister Siti Fadillah Supari was answering reporters' questions on Monday about the death of a 37-year-old Jakarta resident who, she said, "very likely" died from bird flu.

"This is a sporadic case. It is possible that it (a new bird flu infection in a human) could take place in another region if that region is still not yet sterile from birds that have been infected with the virus," she said.

An auditor and his two young daughters who lived in a Jakarta suburb died from bird flu in July. The government has said infected chicken droppings were suspected to have caused their deaths.

Health officials were later Monday to take blood samples from relatives of the latest victim, whose work involved "taking care of immigration documents and had made contacts with foreigners," she said.

But the minister denied the latest death could have been caused by human-to-human transmission. Supari said Sunday the country had so far recorded no cases of human-to-human transmission.

"We are still tracing the source which caused the infection to the woman," the minister said.

Blood samples taken from the victim had tested positive for bird flu. Samples had been sent to Hong Kong for further testing and the results would be known in about five days, Supari said on Sunday.

Officials would continue vaccinating millions of chickens across the country while keeping watch for possible new bird flu cases in humans, she said.

The government launched a massive vaccination drive against the disease but has been criticized for carrying out only limited culls.

Steven Bjorge, a medical officer with the World Health Organization in Indonesia, said culling was "very complicated" in Indonesia as statistics suggested 70 to 80 percent of about 1.2 billion chickens in the country were backyard birds.

"The notion that we can easily cull... is almost impossible to implement at this moment," Bjorge said.

"At this moment, it really seems to be difficult to achieve and I can understand the difficulties. We all know about budget problems and so forth in Indonesia," he said at the same press conference.

The World Health Organization requires that poultry within a radius of three kilometers (1.9 miles) from any bird flu outbreak should be killed.

The H5N1 strain of bird flu has killed 62 people in Asia in the past two years, excluding the latest Indonesian case.

Health experts have warned it could spark a global pandemic if it develops the ability to spread quickly among humans. — AFP


http://www.timebomb2000.com/vb/newreply.php?do=newreply&noquote=1&p=1501239

 

[Martin]

Bird flu could kill more than terror attack: Abbott
September 14, 2005 - 1:05AM

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A bird flu pandemic in Australia could be more deadly for the nation than almost any sort of terrorist attack, Health Minister Tony Abbott has warned.

He painted the worst-case scenario of thousands of possible deaths in Australia if there was a pandemic as Indonesia claimed its fourth likely victim from the bird flu.

And Indonesia's health minister has warned there could be further outbreaks to come.

Bird flu, which arrived in Asia in late 2003, has so far killed nearly 60 people in the region.

Public health experts fear the avian flu virus is mutating and could develop the ability to spread easily between humans, with the potential to kill millions in a flu pandemic.

Mr Abbott says Australia has spent $160 million on measures trying to prepare for an outbreak, but still warns the results could be catastrophic if a pandemic were to occur.

"We don't know if a pandemic will happen ... but if one does happen, it will be a public health disaster the magnitude of which this country has not seen at least since 1919, when he had the last few pandemic," he told ABC TV last night.

Advertisement
AdvertisementAbout 12,000 people died from the Spanish flu in Australia in 1919.

While not playing down the dangers of terrorism, Mr Abbott said a flu pandemic could be much worse than the damage wreaked by terrorists.

"There is no doubt about it, a pandemic if it hits Australia and it is of the severity of the 1919 outbreak will potentially kill many thousands of people," he said.

"It's hard to imagine any terrorist attack, short of a nuclear bomb in a major city, that would have a comparable impact."

Across the globe, Mr Abbott warned a similar pandemic to the 1919 Spanish flu could kill tens of millions of people if not appropriate treatment were available.

Although anti-viral drugs were believed to be effective, Mr Abbott said there was nowhere near enough of a stockpile anywhere in the world.

With strong border protection measures already in place to guard against illegal immigrants, Australia would tighten its safeguards if it feared there was a threat from nations which had outbreaks of bird flu.

These measures would include quarantine centres for people arriving off planes from a country experiencing a severe bird flu outbreak who may have the disease.

Opposition foreign affairs spokesman Kevin Rudd, who is in Washington, says the United States would help Australia and other Asian countries if the region experienced a severe bird flu outbreak.

After talks with US Deputy Secretary of State Bob Zoellick, Mr Rudd said the US would channel aid money into helping Australia and other countries in South-East Asia tackle an outbreak of avian influenza.

"I came away from the meeting convinced the US government was taking seriously the avian influenza threat in our part of the world and was putting its shoulder to the wheel through its aid program to assist regional countries in identifying the disease early and in helping to contain any outbreak which occurs," he said.


http://www.smh.com.au/news/health/b.../2005/09/14/1126377322469.html?oneclick=true#

 

[Martin]

One more rural community struck by bird flu in Russia's east

One more rural community struck by bird flu in Russia's east
11:20 | 15/ 09/ 2005




YEKATERINBURG, September 15 (RIA Novosti, Roman Chuvakov) - Bird flu has spread to yet another village in southeastern Russia, the Emergencies Ministry said Thursday.

Tests conducted at a veterinary lab in the Chelyabinsk region confirmed the avian influenza H5N1 virus as the cause of the death of 39 chickens at five poultry farms in the community of Lugovoi this week. No human cases have been detected.

Three other rural communities in the Chelyabinsk province reported outbreaks in August, but no new cases have been registered there so far this month

http://en.rian.ru/business/20050915/41400886.html

 

[Martin]

Birds flu fears haunt Netherlands again
Thu Sep 15, 2005 2:25 PM BST
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By Anna Mudeva

ASTEN, Netherlands (Reuters) - Two years ago, Dutch farmer Pieter van Lierop had to kill his 7,000 chickens with poison gas during a bird flu outbreak. He is prepared to take drastic action to make sure that will not happen again.

Van Lierop's farm in Asten in the southern heartland of the Dutch poultry sector was among the 1,300 farms forced to cull 30.7 million birds to contain the virus that led to one human death in one of the world's top poultry-exporting countries.

"My children couldn't understand how I allowed our chickens to be killed since they were all free of the virus," Van Lierop told Reuters. "It was horrible."

"It cost more money per chicken than we could earn in five years. Many people haven't recovered financially yet. If it repeats again, the chicken sector will disappear," he said.

Two years after the devastating outbreak, fears are back in the Netherlands of a possible return of the disease from migrating birds from Russia, where a virulent bird flu strain, potentially lethal to humans, was found in six regions.

The government rushed to take precautions and made farmers keep all poultry indoors to prevent contact with wild birds.

Van Lierop happily brought his 30,000 free-ranging laying chickens inside next to his other 40,000 birds.

"I'm glad that our government did something in time and it costs nothing. I have invested some 2-2.5 million euros (1.4-1.7 million pounds) (since 2003) and I wouldn't like to lose it," Van Lierop said.

In the neighbouring agricultural town of Someren, farmer Twan Engelen who exports all the hatching eggs produced by his 130,000 chickens to Russia, also hailed the temporary measure.

"We've been through this once and we wouldn't like to risk having it again. It's an insurance against the risk," said Engelen, who lost 120,000 birds and some 2 million euros in the 2003 outbreak that wiped out a third of the Dutch poultry.

EXAGGERATED FEARS?

Dutch scientists, who recommended the precautions to the government, fear that migrating birds moving to warmer areas for winter after nesting in infected Russian regions, could spread the H5N1 virus strain found there to other European countries.

The European Commission, however, sees this as unlikely and viewed the Dutch measures as exaggerated. Brussels said keeping poultry indoors was unnecessary as bird flu has only a remote chance of striking the European Union in the immediate future.

But the Dutch argue the risk for the country's more than 90 million poultry is bigger than the rest of the EU.

"The situation in the Netherlands could be quite explosive because of the huge concentration and numbers of poultry. It is worse than in other countries," said Albert Osterhaus, an avian flu expert at the Erasmus Medical Centre in Rotterdam.

Dutch veterinarians and scientists believe the 2003 outbreak of the different, H7N7 strain, was caused by wild birds that infected outdoor poultry in central Netherlands, then spread to the south and into Germany and Belgium where it raged on a lesser scale.

The H5N1 strain found in Russia has killed more than 60 people in Asia since August 2003.

The Dutch farm ministry's chief veterinarian Peter de Leeuw said the Netherlands had many spots popular among migrating birds that were situated near big concentrations of the country's 5 million outdoor poultry, which raised the risk.

"Many of the poultry farmers have the feeling that bringing the chickens inside is a small measure compared to what might happen if we have an outbreak. All of us still have the pictures of killing poultry in the back of our minds," De Leeuw said.

INTENSIVE FARMING

The tiny Netherlands, one of the most densely populated countries in the world, has seen its livestock sector become highly intensive in the past years, with most animals being raised in closed farms making them vulnerable to diseases.

The country, where land is scarce and canals, rivers and ditches are abundant, is home to 16 million people, over 90 million poultry, 11 million pigs and 1.5 million cows.

Surveillance and eradicating plans have been stepped up since the last bird flu crisis but officials fear that a repeat could damage the sector to a level impossible to recover from.

"Farmers told us it is very, very important to try to prevent another outbreak because they may not survive a second one," De Leeuw said.

The number of Dutch poultry is still well below the 104 million birds before the disease struck and meat production fell by 15-20 percent. The overall costs for the sector, including related businesses, reached some 400 million-500 million euros, according to the Dutch Agriculture Research Institute (LEI).

Strong competition from cheaper chicken meat from Brazil and low world prices also made it hard for the Dutch poultry sector to fully get back on its feet.

SAFER THAN IN ASIA

While the high density of farms increases the risk of disease spreading in the Netherlands, the threat is seen as smaller than in Asia, where the highly virulent H5N1 strain has led to the death of 140 million birds.

The world animal health body OIE says Europe is well set to limit the risk because farm structures are different and the probability of contact with wild birds is smaller than in Asia.

Some 90 Dutch people contracted the H7 avian flu strain in the 2003 outbreak, one of whom died of pneumonia. There are no infected people in Russia yet but the H5N1 virus has killed 63 people in Asia so far.

Scientists fear the virus could kill millions of people worldwide if it mutates and acquires the ability to pass easily from human to human. Dutch farmers are on the alert too.

"We are hearing it's the bad virus in Russia. The last time it killed one person in the Netherlands but if it turns into a pandemic we'll be in big trouble," Van Lierop said


http://today.reuters.co.uk/news/new...RTRUKOC_0_UK-BIRDFLU-DUTCH.xml&archived=False

 

[janswizard]

Family: Rare disease contracted at Orlando park


ORLANDO, Fla. - A young boy who is suffering from brain damage after contracting a rare form of meningitis likely came into contact with the disease while visiting SeaWorld's Discovery Cove water park, his family claims.

According to a lawsuit filed this week, Alexander Dittier and his family visited Discovery Cove from Minnesota last November, FLORIDA TODAY partner WKMG Local 6 News reported. Within days of visiting the park's aviary, the entire family became ill with flu-like symptoms, the report said.

As the family began to get better, the boy's condition worsened.

He was later diagnosed with histoplasmosis, meningitis that led to a permanent brain injury, according to the family. The rare form of meningitis is caused by a fungus that can be transmitted by birds.

Inside Discovery Cove is a giant, walk-through aviary where visitors can feed birds and get their pictures taken with them.

Family members believe the boy came into contact with the fungus while playing with birds at SeaWorld's Discovery Cove theme park.

"Trying to prove that he did contract the disease at Discovery Cove, the family is seeking a court order trying to obtain a soil sample from inside the aviary," Local 6 reporter Mike Deforest said.

The family would then have experts test the soil to test for signs of the fungus.

According to the Mayo clinic, the fungus itself is common and most people are not affected by it. However, in some rare cases, the fungus can cause serious health problems in young children and people with pre-existing conditions.

The victim's attorney said the child had no prior health problems. He said the only place the boy could have come into contact with the fungus or birds is Discovery Cove.

SeaWorld has not responded to the lawsuit.

http://www.floridatoday.com/apps/pbcs.dll/article?AID=/20050915/BREAKINGNEWS/50915006

 

[Kim99]

http://news.yahoo.com/news?tmpl=story&u=/ap/20050916/ap_on_he_me/indonesia_bird_flu_1

Indonesia Reports 4th Human Bird Flu Death

JAKARTA, Indonesia - Indonesia on Friday confirmed its fourth human death from the bird flu virus, and warned that more cases in the sprawling country were inevitable.

Tests from a Hong Kong laboratory showed that a 37-year-old woman who died last week had contracted the H5N1 bird flu virus, said Nyoman Kandon, the health ministry's director general for illness control and environmental health.

He said Indonesia would continue to report cases because the virus was rife in poultry farms across the country. "It will be like in Vietnam and Thailand," he told The Associated Press.

The virus has swept through poultry populations in large swathes of Asia since 2003, resulting in the deaths of tens of millions of birds — and 63 people, most of them in Vietnam and Thailand.

Most of the human deaths have been linked to contact with sick birds. But the World Health Organization has warned that the virus could mutate into a form which is more easily transmitted from human to human, possibly triggering a pandemic that could kill millions worldwide.

 

[Martin]

Businesses prepare for bird flu disruptions
Fri Sep 16, 2005 11:15 PM IST


By Lisa Richwine

WASHINGTON (Reuters) - Global corporations are crafting emergency plans for remote work sites and stockpiles of masks and antiviral medicines in case dire predictions of a worldwide bird flu pandemic come true.

Businesses could face travel restrictions, a sharply reduced workforce and disruptions in supply chains if an especially deadly influenza circles the globe and wreaks havoc for months.

A flu pandemic "is a very different set of circumstances than a typical crisis like a bomb or even a hurricane. It plays out over a much longer period of time," said Tim Daniel, chief operating officer of International SOS, a firm that helps businesses manage health and safety risks for workers.

The H5N1 avian flu virus has killed more than 60 people in Asia. If the virus becomes easy to pass from person to person, some experts predict up to 50 percent of people where the virus is circulating could become ill, and 5 percent could die.

Sick workers would be quarantined, and others would have to stay home to care for ill relatives, or children if schools are closed as a protective measure.

Travel also could be limited in and out of Asia or other areas where the virus was active.

International SOS, which advises big corporations such as Microsoft Corp., General Electric and American Express Co., is providing guidance to firms on everything from proper hygiene to keep a virus from spreading to procedures for repatriating corpses of workers who die overseas.

Many companies are at least considering plans for moving employees to alternate work sites, using videoconferencing to keep operations running and stockpiling flu-fighting medicines, Daniel said.

Roche AG's Tamiflu and GlaxoSmithKline Plc's Relenza are prescription antiviral drugs that may be able to prevent infection or relieve symptoms. Governments around the globe are stockpiling antivirals while researchers try to develop a bird flu vaccine, and companies will have to compete for limited supplies of the drugs.

Some experts say corporations are not paying enough attention to pandemic planning, dismissing the worst-case scenarios as unlikely and hoping the virus can be contained.

"The business community has actually been quite lax in taking this seriously," said Sherry Cooper, chief economist at BMO Nesbitt Burns. Cooper co-authored a recent report that warned of massive disruption to the global economy if the avian flu runs rampant and companies and governments are unprepared.

Corning, a maker of glass for computer screens, flat-panel televisions and fiber optic networks with several plants in Asia, realized the importance of planning for disease outbreaks from the 2003 emergence of the killer SARS virus, said James Schuppert, Corning's director of health services. He described the company's response then as "organized confusion."

"To describe Corning's preparation back then as being poor would probably be an understatement. Corning learned a lot during our SARS experience," Schuppert said.

The firm now has instructions for its facilities depending on the level of bird flu risk in a particular area, with details down to how many masks or gloves should be ordered. Stockpiling of Tamiflu also is possible in areas where local governments or clinics may be unable to provide it, he said.

Some plants may segregate healthy workers from others who show signs of infection with the flu virus but still are well enough to work, he said.

Canadian-based Nortel, a supplier of telecommunications equipment, plans to use more videoconferencing and other technology to maintain operations through a sophisticated communications network, spokeswoman Joanne Latham said.

"We can rely very heavily on that in times when people cannot travel," she said.

Other firms, including shipping company FedEx Corp., said they had plans in place but declined to provide details.

"We're always working on contingency planning, whether it's the hurricane" that devastated the U.S. Gulf Coast or another emergency, FedEx spokeswoman Sandra Munoz said.



http://in.today.reuters.com/news/ne...230617Z_01_NOOTR_RTRJONC_0_India-216419-1.xml

 

[Kim99]

http://www.thejakartapost.com/detaillatestnews.asp?fileid=20050917173215&irec=1

Indonesia promises tough action to counter spread of bird flu

JAKARTA (AFP): Indonesia promised tough action Saturday to counter the spread of bird flu and urged people to remain calm after the country confirmed a fourth death from the virus.

The death last week of a 37-year-old Jakarta woman from bird flu brought Indonesia's toll level with that of Cambodia, while 43 deaths have been recorded in Vietnam and 12 in Thailand.

"We appeal to the public to help us by remaining calm. We will work very hard to minimize this disease so that it will not spread further," Health Minister Siti Fadillah Supari told AFP.

I Nyoman Kandun, the ministry's director general of disease control, said Saturday that a six-year-old girl was also being treated in Jakarta as a "suspected case" of bird flu.

Commenting on mounting international concern that bird flu could mutate into a major killer, Nyoman said Indonesia would carry out "comprehensive efforts" to stop further outbreaks.

Birds would be vaccinated, people visiting infected areas would be monitored, hospitals would be told how to cope with bird flu patients and an information campaign on the virus would be launched, he said.

Jakarta launched a massive vaccination drive against the disease after a man and his two daughters died in suburban Jakarta in July, but has been criticized for carrying out only limited culls.

The World Health Organization (WHO) requires that poultry within a radius of three kilometers (1.9 miles) from any bird flu outbreak be killed.

Health experts have warned that the bird flu virus could spark a global pandemic if it developed the ability to spread quickly among humans. (**)

 

[Kim99]

"H5N1 - Killer Flu" airing on PBS

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

http://www.pbs.org/wnet/wideangle/about/film_s4_f8.html

I've never seen Wide Angle, but apparently it's very good. Should be something worth watching. Tues. Sept. 20 on PBS.

 

[Kim99]

http://today.reuters.com/news/newsA...DIT566330_RTRIDST_0_SCIENCE-BIRDFLU-UN-DC.XML

Reuters: U.N. health chief delivers grim message on bird flu

Thu Sep 15, 2005 2:26 PM ET

By Paul Eckert

UNITED NATIONS (Reuters) - Avian flu will mutate and become transmissible by humans and the world has no time to lose to stop it becoming a pandemic, the head of the U.N. World Health Organization said on Thursday.

Lee Jong-wook, a South Korean doctor, delivered his stark warning as the United States worked to rally states behind a new U.S. plan to fight the disease, which has already killed more than 60 people in Asia and spread to Russia and Europe.

"Human influenza is coming, we know that, and no government, no leaders can afford to be caught off-guard," Lee said.

"We must pounce on human pandemic outbreaks with all medicines at our disposal and at the earliest possible moment," he told a news conference in New York.

"When the pandemic starts, it is simply too late."

U.S. President George W. Bush unveiled a plan at the United Nations on Wednesday under which countries and international agencies would pool resources and expertise to fight bird flu.

His International Partnership on Avian and Pandemic Influenza reflects growing concern that avian flu could becomes a human pandemic, a threat Bush said the world must not allow.

Most of the people killed in Asia since 2003 caught the virus from infected birds. Health experts say the greatest worry is that the highly pathogenic strain of the disease known as H5N1 could mutate and become transmissible between people.

Lee said H5N1 "will acquire this capability -- it's just an issue of timing." Countries far from heavily hit Southeast Asian states would not be safe because the disease was spreading through migratory wildfowl, Lee added.

He urged states like Japan, Switzerland and France with stockpiles of anti-flu drugs to make medicines available for international emergencies.

Paula Dobriansky, U.S. Under Secretary of State for Democracy and Global Affairs, said the United States would convene a senior officials meeting in Washington soon to coordinate policy. Canada will host a global health ministers in the coming weeks to support the U.S. initiative, she said.

Partner countries and agencies include Argentina, Australia, Britain, Canada, China, Japan, Malaysia, Singapore and Russia, as well as WHO, the U.N. Food and Agriculture Organization and UNICEF, Dobriansky said.

© Reuters 2005.

 

[Kim99]

http://www.redherring.com/Article.a...u+Stockpile&sector=Regions&subsector=Americas

U.S. Builds Bird Flu Stockpile

The U.S. government has awarded more than $100 million to Sanofi Pasteur and GlaxoSmithKline to develop drugs against a possible pandemic.
September 16, 2005

Worried that avian flu could spur an influenza pandemic in the United States, the government has awarded more than $100 million to two European pharmaceuticals to help build a drug stockpile.

The U.S. Department of Health and Human Services said Thursday it had awarded $100 million to France’s Sanofi pasteur of Sanofi-Aventis to manufacture a vaccine and another $2.8 million to the United Kingdom’s GlaxoSmithKline for its antiviral drug Relenza.

“These countermeasures provide us with tools that we have never had prior to previous influenza pandemics,” said Mike Leavitt, secretary of Health and Human Services.

The announcement is part of the department’s efforts to buy enough vaccines and antivirals to help reduce the severity of influenza symptoms for 20 million people. Helping drive the agency’s rush to get prepared is the fact that there is no pre-existing human immunity to the virus.

The avian flu spreads through migratory birds, and half of the 112 people who have been infected have died, according to the department. It has also led to the deaths of more than 140 million birds.

The disease has been found in 10 countries, most recently Russia, and is approaching Europe, the department said.

The deal struck with Sanofi requires the Paris-based company to manufacture the vaccine from its U.S. headquarters in Swiftwater, Pennsylvania, from early September through late October. The company will also receive additional fees for storing and formulating the vaccine.

The amount of dosages to be produced has not been set as the company’s vaccine is still going through clinical trials.

London-based drugmaker Glaxo will supply enough Relenza doses to treat 84,300 people. The pharmaceutical company has its U.S. headquarters in Philadelphia.

The contracts with the European companies are part of the U.S.’ approach to curbing the possible impact brought on by the flu. Efforts include surveillance in Asia, where the influenza was first identified.

 

[Kim99]

http://www.todayonline.com/articles/72867.asp

Italy takes measures against bird flu

The Italian cabinet adopted a series of measures as part of a 50-million-euro campaign to help prevent a possible outbreak of the deadly bird flu virus.
.
"An agreement between the Italian government and three large pharmaceutical companies will see around 5.5 million euros (6.7 million dollars) spent on 35 million antiviral vaccinations," said Health Minister Francesco Storace.
.
The remaining funds were to finance the creation of a centre for the study of animal health and a new veterinary health department, under the terms of the cabinet decree.
.
In the event of a pandemic, Italy would boost border controls on animals, meat and live poultry imports and increase the number of police officers working in the field, said Storace.
.
People in high-risk categories would be the first to be immunized including the elderly, those in direct contact with animals like farmers and department officials.
.
Italy has taken a stringent approach to the virus ever since a wave of bird flu in the late 1990s forced the country to slaughter 20 million chickens.
.
Last May, 30,000 turkeys were slayed after testing positive to the virus, although the birds did not develop the full-blown disease.
.
The H5N1 virus, which spread to Russia and Kazakhstan this summer, has killed about 60 people in southeast Asia since 2003.
.
Bird flu has so far been passed only to humans in close contact with infected birds, but scientists fear a global epidemic if the virus mutates and becomes transmittable between humans.
.
Italy has already strengthened controls on imports of live poultry and imposed mandatory labelling of breeding and origin, similar to that required for beef after the outbreak of mad cow disease. — AFP The Italian cabinet adopted a series of measures as part of a 50-million-euro campaign to help prevent a possible outbreak of the deadly bird flu virus.
.
"An agreement between the Italian government and three large pharmaceutical companies will see around 5.5 million euros (6.7 million dollars) spent on 35 million antiviral vaccinations," said Health Minister Francesco Storace.
.
The remaining funds were to finance the creation of a centre for the study of animal health and a new veterinary health department, under the terms of the cabinet decree.
.
In the event of a pandemic, Italy would boost border controls on animals, meat and live poultry imports and increase the number of police officers working in the field, said Storace.

 

[Kim99]

http://www.bordermail.com.au/newsflow/pageitem?page_id=1049565

Sat, Sep 17, 2005

Australia backs bird flu alliance

World action to halt pandemic

UNITED NATIONS: Prime Minister John Howard has committed Australia to a new international partnership to combat bird flu, saying there is a high possibility of an epidemic in the Asia-Pacific region.

US president George W. Bush outlined the International Partnership on Avian and Pandemic Influenza, aimed at limiting the spread of the disease during a potential outbreak, during his address to the United Nations World Summit.

And the head of the UN World Health Organisation warned yesterday that avian flu would likely mutate and become transmissible from human to human.

The disease already has killed more than 60 people in Asia and Mr Howard said action was needed.

“The possibility of a flu epidemic is quite high and its very important that the world and particularly our own region should prepare for that,” he said.

Health Minister Tony Abbott will attend a special international health ministers meeting in Canada later this year to discuss global preparedness, while the issue will be prominent at the Asia-Pacific Economic Cooperation summit in November, Mr Howard said.

“We share the view of the Americans and others that its an area where APEC can and should be active,” he said.

Mr Howard said the Australian government was working at the domestic, regional and wider international level on influenza and pandemic preparedness and response, spending $18 million since 2003 to combat avian influenza and SARS.

Mr Howard also committed $3 million over three years to the new Standing Fund for the Peace-building Commission created by the UN this week to help fragile states recover from wars and conflict and increased Australias contribution to the UN High Commissioner for Refugees from $270,000 to $650,000 this financial year.

Opposition foreign affairs spokesman Kevin Rudd said Labor had been calling on the Government to take action on the bird flu threat for nine months.

 

[Kim99]

http://news.yahoo.com/news?tmpl=sto...0050916/ts_krwashbureau/_wea_katrina_chertoff

As New Orleans flooded, Chertoff discussed avian flu in Atlanta

 

[Kim99]

http://about.upi.com/products/consumer_health_daily/UPI-20050916-040618-7640R

Researcher: Bush pandemic warning too late

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

NEW YORK, D.C., Sept. 16 (UPI) -- A New York City researcher says President George W. Bush's call to remain on the offensive against the avian flu has come too late.

"If we had a significant worldwide epidemic of this particular avian flu, the H5N1 virus, and it hit the United States and the world, because it would be everywhere at once, I think we would see outcomes that would be virtually impossible to imagine," Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, told ABC News.

"The tipping point, the place where it becomes something of an immediate concern, is where that virus changes, we call it mutates, to something that is able to go from human to human."

To date, 57 human deaths from bird flu have been confirmed, despite the killing of millions of infected or suspected infected poultry in Southeast Asia. Scientists say every infected person represents another step closer to the tipping point of the flu mutating and becoming susceptible for human to human contact, instead of the current infection course of bird to human.

A draft report of the federal government's emergency plan obtained by ABC's "Primetime," estimated some 200,000 Americans would die within a few months of a pandemic of bird flu.

 

[O2BNOK]

AVIAN INFLUENZA, HUMAN - EAST ASIA (125): INDONESIA, CONFIRMED
**************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Sponsored in part by Elsevier, publisher of
Trends in Parasitology
<http://www.trends.com>

In this report:
[1] Avian influenza, human - Indonesia
[2] Avian Influenza, human - Indonesia: WHO report

****
[1]

Date: Fri 16 Sep 2005
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Reuters AlertNet Foundation, Fri 16 Sep 2005 [edited]
<http://www.alertnet.org/thenews/newsdesk/SP322731.htm>


Indonesia confirmed its 4th human death from
avian influenza on Friday [16 Sep 2005] amid
growing global alarm that the virus would mutate
and become a pandemic. Speaking in New York on
Thursday [15 Sep 2005], World Health Organisation
Chief Lee Jong-wook said the virus was moving
toward becoming transmissible by humans and that
the international community had no time to waste
to prevent a pandemic.

The H5N1 [avian influenza virus] has killed 64
people in 4 Asian countries since late 2003 and
also spread to Russia and Europe [i.e. European
Russia - Mod.CP]. A senior Indonesian health
official said tests had shown [that avian
influenza virus infection was responsible for the
death of] a woman who died last week in a Jakarta
hospital after she was admitted suffering from
pneumonia and flu-like respiratory problems.

"It's positive for H5N1," I Nyoman Kandun,
Director-general of disease control at the Health
Ministry, told Reuters. Indonesia's health
minister is expected to hold a news conference
later on Friday to discuss the results, which had
been confirmed by a laboratory in Hong Kong.

The woman, 37, died last Saturday [10 Sep 2005].
She lived in south Jakarta near a chicken farm,
although health officials have not said how she
may have [contracted the infection]. "Our task
now as the government is to make sure the public
do not panic. Just like when we get a bomb
threat, we need to avoid panic. Up until now,
there is no proof that there is human-to-human
transfer," Kandun said.

But in a stark warning, WHO Chief Lee, a South
Korean doctor, said it was only a matter of time
before the virus mutated. "Human influenza is
coming, we know that, and no government, no
leaders can afford to be caught off-guard," Lee
told a news conference. "We must pounce on human
pandemic outbreaks with all medicines at our
disposal and at the earliest possible moment."

Most of the people killed in Asia since 2003
[contracted] the virus from infected birds.
Health experts say the greatest worry is that the
highly pathogenic strain of the [virus] known as
the H5N1 avian influenza A virus could mutate and
become transmissible between people. Lee said
H5N1 "will acquire this capability -- it's just
an issue of timing."

Countries distant from heavily hit Southeast
Asian states would not be safe, because the
disease [i.e. the virus] was spreading through
migratory wildfowl, Lee added. Besides Indonesia,
avian influenza has killed 44 people in Viet Nam,
12 people in Thailand and 4 in Cambodia. U.S.
President George W. Bush unveiled a plan at the
United Nations on Wednesday under which countries
and international agencies would pool resources
and expertise to fight avian influenza.

U.N. health authorities have said more cases
could be expected in Indonesia, the world's 4th
most populous nation. The government has launched
a vaccination drive for poultry, but carried out
only limited culling because it does not have
enough money to compensate farmers, and more than
half of all chickens in Indonesia are kept in
backyards.

The WHO says the preferable approach is mass
culling. The virus has spread to 22 provinces out
of 33 in the sprawling Indonesian archipelago,
killing more than 9.5 million poultry since late
2003.

In July 2005, Indonesia confirmed its 1st human
casualties of H5N1 avian influenza -- a father
and his 2 young daughters in Tangerang on the
outskirts of Jakarta. But authorities could not
pinpoint the source that infected the family.

[Byline: Achmad Sukarsono and Paul Eckert]

--
Mary Marshall
<tropical.forestry@btinternet.com>

****
[2]

Date: 16 Sep 2005
Source: WHO Communicable Disease Surveillance & Response (CSR)
<http://www.who.int/csr/don/2005_09_16/en/index.html>


Avian influenza - situation in Indonesia - update 29
-----------
The Ministry of Health in Indonesia has today
confirmed a fatal case of human infection with
H5N1 avian influenza. The case occurred in a
37-year-old
woman who resided in Jakarta. She developed
symptoms on 31 August, was hospitalized on 3
September, and died on 10 September.

The positive test results were received from a
WHO reference laboratory in Hong Kong.

The government has launched investigations,
assisted by WHO, aimed at identifying the source
of the woman's infection and tracing her close
contacts, including family members, neighbours,
and hospital staff engaged in her treatment.

The woman lived in an area with multiple
opportunities for exposure to chickens and ducks.
No recent poultry deaths have been reported in
the area. Poultry samples have been taken by
agriculture authorities as part of the ongoing
investigation.

This is the countryís second laboratory-confirmed case.

In July 2005, a cluster of 3 deaths in one family
was investigated. H5N1 infection was confirmed in
the 38-year-old father but laboratory test
results for his two daughters did not meet
criteria for acute H5N1 infections. WHO reports
only laboratory-confirmed cases.

Investigation of the July family cluster was
unable to determine the source of exposure.
Testing and monitoring of more than 300 close
contacts failed to
detect any further cases.

--
ProMED-mail
<promed@promedmail.org>

[There is only limited evidence deduced from
experiments with laboratory mice that the H5N1
avian influenza virus is undergoing progressive
mutation towards direct transmissibility between
humans. The circumstances in which the 1st 3
human cases in Indonesia acquired infection are
still unclear. Proximity to a farm/slaughterhouse
appears to be the relevant factor in the 4th case
described above. Overall it is surprising that
there have not been more confirmed cases in
Indonesia, in view of the high density of the
human population in the Indonesian archipelago
and the extent of uncontrolled H5N1 avian
influenza disease in domestic and farmed poultry.
- Mod.CP]

[see also:
Avian influenza, human - East Asia (124): Indonesia, susp. 20050912.2703
Avian influenza, human - East Asia (123): Indonesia, susp 20050911.2694
Avian influenza, human - East Asia (117): Indonesia, source? 20050812.2361
Avian influenza, human - East Asia (115): Indonesia 20050810.2332
Avian influenza, human - East Asia (107): Indonesia 20050729.2204
Avian influenza, human - East Asia (106): Indonesia 20050726.2162
Avian influenza, human - East Asia (105): CDC update 20050724.2144
Avian influenza, human - East Asia (104): Indonesia 20050721.2104
Avian influenza, human - East Asia (103): Indonesia 20050720.2094
Avian influenza, human - East Asia (100): Indonesia 20050715.2017
Avian influenza, human - East Asia (98): Indonesia 20050713.1992
Avian influenza, human - East Asia (87): Indonesia... 20050615.1680
Avian influenza, human - East Asia (78): Indonesia... 20050518.1366
Avian influenza, human - Eastern Asia (74): Indone... 20050515.1331]
................................cp/pg/lm


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are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
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[Martin]

The birds have flown, and that's the worry
By Hamish McDonald, Herald Correspondent at Qinghai Lake, China
September 17, 2005

When nomadic Tibetans and Mongols started finding large numbers of bar-headed geese mysteriously dead around the shores of this vast, high-altitude saltwater lake in China's north-west this May, alarms went off that are still ringing in public health agencies around the world.

The bar-headed geese are among numerous migratory bird species that fly to the marshes around Qinghai Lake's western shores and its small islands to breed during the northern summer.

About 6000 birds were found dead or dying around the lake, not only the geese but five other species, including two types of seagull.

The cause of death was quickly diagnosed as H5N1 avian flu, the strain of bird flu that has killed 63 people in South-East Asia since it re-emerged in late 2003. Although so far it infects only people closely handling poultry, it is virulent once caught - about half the people infected have died, against a death rate of 2.5 per cent in the great influenza epidemics of last century.

China's Ministry of Agriculture swung quickly into action, placing quarantine restrictions on villages close to the bird sanctuary, vaccinating all of Qinghai province's 3 million domestic poultry against H5N1, and - unconfirmed Chinese internet postings say - putting down a riot by angry nomadic herdsmen in mid-July.

No cases were found among domestic birds, and the nature reserve has been opened to visitors again, the province's deputy governor, Su Sen, said this week. "But it's quite different to outbreaks among domestic fowl," he added. "You can't slaughter them, so it's difficult to control."

Now Qinghai Lake's wild birds have mostly flown, and that is what is worrying the World Health Organisation and national health authorities from Europe to Australia.

The birds travel huge distances to their winter grounds. The bar-headed geese fly as high as 9400 metres to reach India across the Himalayas. Others fly across to Western Europe and the Black Sea. Some mingle with birds in nearby Siberia that fly to South-East Asia or all the way down to Australia.

For a while, scientists speculated that the virus would stay put: infected birds might be too weak to join the annual migration. But that hope was dashed with discovery of wild birds with H5N1 in Western Siberia and the Altai region of south-western Russian regions in August.

Now scientists are portraying Qinghai Lake as Bird Flu Central, with migrating birds likely to carry the virus as far as Africa via Europe, to India, and perhaps to Australia.

But the dangerous front line for humans remains with domestic fowl, particularly those that are likely to mingle with wild fowl such as ducks and geese.

Authorities have reacted in different ways. Some Russian regions have brought forward the duck-shooting season, presumably to cull migrating birds on the wing. The Netherlands has ordered all domestic poultry to be kept indoors. All round the world, governments are stockpiling vaccines for chickens and antiviral drugs for humans.

But the locale for the fatal combination with a human flu virus remains not the wild wetlands like Qinghai Lake, but most probably the intense farming villages of southern China and South-East Asia, where humans, ducks and pigs live on top of each other.

The thought is not welcome in China, which is thought to have been where at least two of the 20th century's great human flu epidemics originated, and which was caught out trying to suppress the extent of the SARS pneumonia outbreak in 2003.

Yi Guan, a microbiologist at the University of Hong Kong who tracks H5N1, is co-author of a report in the British science journal Nature in July which said the virus was probably carried by wild birds to Qinghai Lake from somewhere in southern China.

China's Ministry of Agriculture responded by shutting down the avian flu surveillance laboratory in Shantou, Guangdong province, along with several similar centres run by foreign researchers.

"They say only they can issue reports," Dr Yi told Reuters this week. "This is because they want to control and manipulate the results."

Hopes of a changing attitude to bad news among Chinese officials rose last week when Beijing announced it was no longer including casualty tolls from natural disasters presumably including epidemics, among its many "state secrets".


http://www.smh.com.au/news/world/th...y/2005/09/16/1126750132856.html?oneclick=true

 

[Kim99]

A new post from Boxun, followed by CanadaSue's interpretation. Scary.

Mainland China birds and beasts flu already started slowly to disseminate

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



Mainland China birds and beasts flu already started slowly to disseminate
Please look at the abundant news hot spot:Birds and beasts flu
(Abundant news on September 17, 2005)
(Editor's note: Below the content is unable to verify, hoped sends the manuscript to provide more concrete information.)
According to the unofficial information, the mainland birds and beasts flu virus already started slowly to disseminate. Is the birds and beasts flu virus's incubation period which the present mainland explodes appears according to the related professional's explanation lengthens the sign, causes the propagation velocity short time to be restricted, moreover the mainland official already started the national infectious disease which issued in the periodicity to report died the city area birds and beasts flu dead used other diseases to be public.
At present China's heavy sickness birds and beasts flu mainly concentrates in the countryside, as seriously needed to isolate the placement spot as the government at many countrysides areas establishment temporary birds and beasts flu, Beijing widely is already promoted in the SARS period Xiaotangshan's measure. But many epidemic diseases areas forbid the locality and nearby person pass in and out, the foreign name is the military work, moreover to is forced the family member which isolates many all to have the situation which was warned by the government, many countrysides areas viral infection basically is the community infection. Entire family, even entire village isolation and seal. (Abundant news boxun.com)





At present also is unable to understand Chinese the countryside area infection situation, according to the Chinese official public measure, in Qinghai, Tibet, the medical department, Guangdong Province, Sichuan and so in the public media divided has issued to the birds and beasts flu urgent preventing and controlling study and preventing and controlling.
The mainland already started to complete the possible nationwide birds and beasts flu the big eruption preparatory work, the correlation birds and beasts flu vaccine, the armed guard army, the related hygienic guard thing, to the guard propaganda and the diagnosis study, simultaneously the Beijing authority already informed the national correlation department to start at in the formerly prevention birds and beasts flu foundation to complete the possible national birds and beasts flu big eruption the preparatory work.

Barefoots Doctor _ (abundant news freely to send manuscript area to send manuscript) (abundant news boxun.com)


Canada Sue:

I've had reason to be waiting for this from Boxun

Here's may pitiful reattempt to 'retranslate' that into English. Not necessarily going sentence by sentence but trying to get the gist of the info across...

Boxun sources have unofficially reciece information that H5N1 is spreading throughout some sectors of the Chinese countryside. It would seem the incubation period is shortened(?), but the duration of INITIAL symptoms is lengthened... **I'm really not too sure on this last part.***

Chinese authorities are making serious attempts to isolate affected regions yet are doing so without informing people what's going on. Instead of using the diagnosis H5N1, they're attempting a coverup using OTHER diagnoses...***makes me rethink some of S. suisse data as well as foot & mouth but if that's the case - man! We're looking at possible bovine infections?*** Part of the silence means people are passing through these areas without knowing the risk, (& no doubt spreading the illness). Methods used during the SARS outbreak are being used once again. ***Oh shit! That means delay & deny, play patient roulette & lie through your teeth to the world.***

They're sealing entire communities off, (good luck!) & are apparently saying that much infection is now present throughout communities. So they're not just talking of a limited H-H transmission here. I don't know if it's becoming efficiently H-H or the nature of the countryside with lots of contact with infected fowl & other species simple means the virus is gaining an opportunity to brute force it's way into more humans & other agricultural species.

It ends by suggesting that several government agencies are geraing up for a huge national effort to get a grip on this. Frankly, if the situation IS as described in this report, they're far too late. They're no longer looking at PREVENTION efforts but a humungous effort to deal with major OUTBREAK.

Time for HK & nearby regions to REALLY surveil

.

 

[Martin]

Drugs plug gap ahead of bird flu vaccine
September 18, 2005 - 7:19AM

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Scientists believe they have the know-how to make an effective vaccine against pandemic bird flu; the problem is how to make enough of it.

As avian flu spreads from Asia into Siberia and Kazakhstan, health experts are increasingly focused on the medical challenge of fighting the disease should it "go human" and start to spread easily from person to person.

A vaccine is the best hope to prevent millions of deaths.

But current global manufacturing capacity, at around 300 million regular flu doses a year, is simply insufficient to meet global needs during a pandemic.

"If you need to vaccinate the whole world, you are not going to do that with existing capacity, which is basically aimed at the over-65s in the West," said Tony Colegate of Chiron Corp, who coordinates production issues for the Influenza Vaccine Supply Task Force, an international industry group.

Adding new production will take time, raising fears that many poor parts of the world are likely to go without.

Advertisement
AdvertisementAt present, 90 per cent of capacity is concentrated in Europe and North America, and the World Health Organisation (WHO) says past experience suggests governments will be reluctant to release supplies for export before domestic demand is fully met.

There will also be a hiatus of four to six months while factories switch to making a pandemic version, once a new strain of humanised bird flu is identified.

In the absence of a vaccine, the job of holding pandemic flu at bay will rest largely on a limited stockpile of antiviral drugs, called neuraminidase inhibitors, that can reduce the severity of flu infection and can speed patients' recovery.

This could buy valuable time to produce a vaccine and introduce other emergency measures, according to the WHO, which accepted a donation of three million doses of Swiss drug firm Roche's Tamiflu medicine in August.

Britain's GlaxoSmithKline says it may make a similar, but smaller, donation of its drug Relenza.

The hope is that intensive use of neuraminidase inhibitors in an area where a pandemic is emerging will delay its spread, or even nip it in the bud altogether.

In the meantime, scientists will be working overtime on vaccine development.

The good news is that some of the technical issues surrounding bird flu vaccine are being resolved.

Although a specific vaccine against pandemic virus cannot be made until the final strain emerges, most experts think the H5N1 strain now circulating is the one they need to target.

As with seasonal flu, the vaccine can be adjusted as the virus changes but the hope is that it will not mutate so much as to escape protection offered by the vaccines now in development.

The most advanced H5N1 vaccine, from France's Sanofi-Aventis SA, has already proved effective at stimulating an immune system response in healthy adults and others are in the pipeline.

US-based Chiron aims to test its H5N1 vaccine in the northern autumn and GlaxoSmithKline plans large-scale clinical trials in 2006.

Even so, Nomura pharmaceuticals analyst Michael Leacock estimates only 75 million doses can be made within a year - equal to just one-quarter of current seasonal flu vaccine output.

And that would require abandoning production of vaccine for seasonal flu, which regularly kills 250,000 to 500,000 people a year.

The H5N1 strain has so far killed more than 60 people in Asia since 2003, but experts fear it will mutate into a mass killer of millions if it becomes more infectious.

Much of the problem lies in the tricky nature of flu vaccine production, which involves cultivation in embryonated chicken eggs and yields only limited amounts of antigen - the key component of a vaccine that triggers an immune response.

Stretching antigen supplies is therefore crucial.

The problem is particularly acute because the quantity of antigen needed to get a response to a bird flu vaccine is much greater than normal.

One way round this may be to use adjuvants - compounds added to a vaccine to boost the immune response - or else to inject vaccine under the skin rather than into muscle.

The long-term answer is to adopt better technology and move away from chicken egg production, which could in any case be at risk if bird flu leads to mass slaughter of poultry.

Cultivating antigen in stainless steel vats of cell culture is widely seen as the way of the future.

But David Fedson, a leading expert on flu vaccines and a former senior executive at Sanofi-Aventis, says cell culture will have little effect on capacity within the next five years.

http://www.theage.com.au/news/World.../2005/09/18/1126981933465.html?oneclick=true#

 

[Kim99]

Two more human bird flu cases suspected in Indonesia as Jakarta closes zoo
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http://www.forbes.com/home/feeds/afx/2005/09/18/afx2230039.html

JAKARTA (AFX) - Two more Indonesian children are suspected of having been infected with bird flu as authorities closed the Jakarta zoo after 19 birds there were found to be carrying the deadly virus, officials said.

Agriculture Minister Anton Apriantono said that Jakarta's Ragunan zoo will be closed to the public through October 17, during which a complete sterilization of the area and treatment of infected animals will be completed.

Apriantono told the ElShinta private radio that 19 out of 27 samples taken from various birds at the zoo, including pigmy chickens and eagles, contained the bird flu virus.

Four other samples were inconclusive and the remaining four were negative, he said.

'Usually two weeks are enough but we decided to raise it to three weeks to make sure unwanted things would not happen,' Apriyantono said of the closure, adding that some 2,100 birds in the zoo's collection will be tested for the virus.

Any bird found carrying the virus would be killed if it was not from a protected species, the minister said.

Meanwhile, an acting spokesman for the health ministry, Sumardi, told the Detikcom online news service that samples from two children suspected of having bird flu have been sent for Hong Kong for further tests.

One patient is now in stable condition, hospital officials told ElShinta radio.

The government has promised tough action to counter the spread of bird flu and urged people to remain calm after the country confirmed a fourth death from the virus.

The death last week of a 37-year-old Jakarta woman from bird flu brought Indonesia's toll level with that of Cambodia, while 43 deaths have been recorded in Vietnam and 12 in Thailand.

 

[Kim99]

Ministry suspects new human bird flu case

http://www.thejakartapost.com/detai...0918.A02&irec=1

After recently confirming the country's fourth bird flu fatality, the Ministry of Health reported another suspected case on Saturday.

MT, a seven-year-old girl, currently being treated at the Sulianti Saroso hospital in North Jakarta, tested positive on her blood test, but negative on the Polymerase Chain Reaction (PCR) test, said Minister of Health Siti Fadilah Supari as quoted by news portal detik.com.

The minister nor other senior officials of the ministry could be immediately reached for confirmation.

The girl was previously treated at the Siloam Gleneagles hospital in Tangerang and was referred to Saroso on Sept. 14. The ministry was still waiting for the results of a second PCR test.

It was also investigating another suspected case, identified only as a family member of Rini Dina, the country's most recent confirmed bird flu fatality. The relative tested positive on the blood test and is currently suffering from flu-like symptoms, such as a fever and sore throat, which are also symptoms consistent with early stages of avian influenza.

"We are taking the patient to a hospital for observation as soon as the family approves," she said.

Siti added that there was a high possibility of other suspected cases and that the public must be vigilant against the spread of the disease. She declared that the country was already in the "third stage of bird flu" and although there had not been any reports of human-to-human transfer of the virus, she added that "it is just a matter of time."

The ministry has prepared 44 hospitals nationwide to handle suspected and reported cases as well as for surveillance efforts.

It is also bringing in some 10,000 doses of bird flu medicine called Tami Flu, which is recommended by the World Health Organization. "We are negotiating with Roche, the Food and Drug Control Agency and WHO to recommend importing the medicine," Siti said.

Given to patients showing clinical symptoms of flu in the first 48 hours, Tami Flu is believed to have been able to mitigate the effects of the virus. "But, if it is given when the patient is already suffering from pneumonia-like symptoms, it will not work," she said.

Indonesia saw its first human fatality in July this year, when the virus killed Iwan Siswara Rafei and his two young daughters. On Friday, WHO confirmed that Rina, who died last weekend, had been infected by bird flu.

http://www.recombinomics.com/News/09180501/H5N1_Indonesia_Phase_6.html

H5N1 Pandemic in Jakarta Indonesia Approaches Phase 6

Recombinomics Commentary
September 18, 2005

MT, a seven-year-old girl, currently being treated at the Sulianti Saroso hospital in North Jakarta, tested positive on her blood test, but negative on the Polymerase Chain Reaction (PCR) test, said Minister of Health Siti Fadilah Supari as quoted by news portal detik.com.

The minister nor other senior officials of the ministry could be immediately reached for confirmation.

The girl was previously treated at the Siloam Gleneagles hospital in Tangerang and was referred to Saroso on Sept. 14. The ministry was still waiting for the results of a second PCR test.

It was also investigating another suspected case, identified only as a family member of Rini Dina, the country's most recent confirmed bird flu fatality. The relative tested positive on the blood test and is currently suffering from flu-like symptoms, such as a fever and sore throat, which are also symptoms consistent with early stages of avian influenza.

"We are taking the patient to a hospital for observation as soon as the family approves," she said.

Siti added that there was a high possibility of other suspected cases and that the public must be vigilant against the spread of the disease. She declared that the country was already in the "third stage of bird flu" and although there had not been any reports of human-to-human transfer of the virus, she added that "it is just a matter of time."

The above comments suggest Indonesia is already at stage 4 or 5 and the pandemic is close to the final stage 6 which is defined by sustained human-to-human transmission.

Human-to-human transmission was clear in the initial family cluster, which involved 3 members of a family of a government auditor (38M). His eight year old daughter was the index case, showing symptom on June 24. The time gap between her symptoms and her 1 year old sister who developed symptoms on June 29 is a strong signal of human-to-human transmission. Such a 5-10 day gap has been present in almost all familial clusters in Vietnam, Thailand, and Cambodia. WHO however, has refused to acknowledge the virtual certainty of human-to-human transmission in all or most of those cases, which account for more than one third of confirmed cases. Instead WHO maintains that the vast majority of cases come from poultry, thereby contributing to more human-to-human transmission within families, which is clearly happening in Tangerang.

The WHO position is compounded by use of lack of lab tests or false negatives to exclude patients. In the family of the auditor, only he is an official case because his PCR test was positive. There were only two serum samples from the index case and both were positive in tests by two independent outside labs (in Hong Kong and Atlanta). There was no doubt that the child died from H5N1 bird flu, but since the serum samples were collected just three days apart, the rising titer (a sign of recent infection) had not risen four fold in the three days, so only the father was called a confirmed case. This exclusion justified the repeated claims of "no evidence of human-to-human transmission", when in fact there was little doubt that the gaps in onset dates of June 24, 29, and July 2 indicated the index case infected her sister and father directly or indirectly.

The comments above indicate there is another familial cluster between the fatal case of the immigration officer and one of her relatives, who is also laboratory confirmed. Both of these clusters are in families of government workers who would have little direct contact with poultry or pigs. Moreover there are two neighbors with symptoms and the two familial clusters live in the same area of Tangerang, southwest of the center of Jakarta.

This concentration of fatal, lab confirmed H5N1 is the highest ever reported and is likely to represent a fraction of the human cases because there are no reports of infection in those most associated with poultry and pigs.

Sequencing data from the earlier familial cluster indicates there is no reassortment with human genes and the sequence is similar to sequences found in poultry in Java. Since H5N1 is endemic to Indonesia and extremely limited testing in Tangerang found H5N1 in pigs, poultry, and a pet birdcage, the opportunity of infections from animals and humans is extremely high.

WHO has yet to issue a warning to family members caring for relatives with H5N1 infections, thereby contributing to the human-to-human spread, which has been clear since the beginning of 2004 in Vietnam.

Instead, words of assurance are issued to the press and official counts bury the human-to-human transmissions and maintain a pandemic stage 3 when clearly the level is at 4 or 5 and will soon be phase 6.

WHO's failure to inform is hazardous to the world's health. H5N1 does not read press releases. In evolves via recombination and acquisition of mammal polymorphisms, which increases the likelihood of efficient human-to- human transmission.

 

[Kim99]

Tamiflu/Amantadine Cocktail Anyone?
--------------------------------------------------------------------------------

FEATURE-US children's hospital on frontline in bird flu war
16 Sep 2005 01:01:15 GMT
Source: Reuters

"'Early on in the pandemic there will be no other options except for antivirals,' Govorkova said in an interview. Amantadine did at one time work to treat H5N1 but it no longer does because the virus has developed resistance.

She is working to see if combining flu drugs into cocktails will provide better protection and has found some indication that they do. Tamiflu and amantadine may work well together."

http://www.alertnet.org/thenews/newsdesk/N0526780.htm
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Tamiflu and Amantadine Prevention of H5N1 Bird Flu

Recombinomics Commentary
September 17, 2005

She is working to see if combining flu drugs into cocktails will provide better protection and has found some indication that they do. Tamiflu and amantadine may work well together.

The above comments on synergies between Tamiflu and amantadine have not been well covered in the media. Most of the attention is focused on Tamiflu, but the view paints a partial picture of the anti-viral options.

Tamiflu has been the focus of most H5N1 anti-viral reports. This focus was increased in the recent ABC Primetime show on avian influenza preparedness. The report raised the consciousness of the American public and the Tamiflu portion focused on stockpile shortages in general and the US shortage in particular. The emphasis on Tamiflu is due to the fact that the H5N1 isolated from patients in Vietnam and Thailand was amantadine resistant, so the only class of antivirals available was the neuramindase inhibitors, and only Tamiflu was readily available.

However, that availability has been impaired by countries stockpiling Tamiflu, coupled with a limited production capacity. Thus, most purchase requests are back-ordered and attention has focused on limited supplies. However, the utility of Tamiflu is also an issue, because although it has been shown to inhibit H5N1, the inhibition has only been partial at FDA approved doses, so higher doses may be required. Moreover, like all anti-virals, the effectiveness quickly diminishes, so it is limited to the time that the antiviral is being taken. Prophylactic courses require 10 pills for 10 days, so use over a extended period of time greatly increases the number of courses per person, which has strong cost and availability implications.

The other neuramindae inhibitor, Relenza, has been made in very limited quantities. However, increased public awareness and demand may result in an increased availability of Relenza.

However, the H5N1 being spread in Russia, Kazakhstan, and Mongolia has brought the amantadines into the antiviral spotlight. 16 sequences from Qingahi Lake in China have been published, and none have amantadine resistance markers. Similarities in sequences between isolates from Qinghai Lake in China and Chany Lake in Russia suggest that most or all sequences of H5N1 from wild birds are amantadine sensitive. The amantadines are sold as Symmetrel (amantadine) and Flumadine (rimantadine) and are much less expensive and more widely available because they are off patent and sold by generic drug companies. Although resistance can develop, thus far there is no evidence of resistance in H5N1 from wild birds in the countries listed above.

Because the amantadines target one gene (M2) and the neuraminidase inhibitors target another gene (NA), the two drugs can be taken together and will compliment each other, as long as both targeted genes are susceptible to each drug class

 

[Onebyone]

The government plans to more than triple the number of quarantine stations at airports around the country and hire scores of health officers as part of a broad plan to try to stop deadly infectious diseases from entering the United States.

So what kind of check points have they set up the check the health of all the millions of illegals crossing the southern border? It could well sneak in on the blood of one of them.

 

[Kim99]

Here's another translation of the Boxun article in post #34 from someone who speaks fluently:

PeterPan from curevents:

The Avian Influenza Has Slowly Begun Spreading in Mainland China

[Boxun Disclaimer]

Information from "unofficial sources" indicate that the Avian Influenza has begun spreading in Mainland China. According to medical experts, the incubation period (i think) of the strain spreading in China has been observed to be rather long, thus controlling the spread of the virus in the short run. Authorities have covered up the fatalities from the Avian Influenza by reporting them as having succumbed to other diseases in their weekly Infectious Disease Report.

Currently, the majority of the areas afflicted by the virus appear to be rural villages. The severity of the situation has forced Chinese authorities to establish Temporary Quarantine Zones in several of the villages. The control measures implemented by Beijing in Xiaotangshan during the SARS period have already been carried out in full force. Citing military exercises as an excuse, many of these affected villages have imposed qurarantines and placed restrictions on people's movements. Affected households have been warned by authorities. It has also been observed that most of the infected cases so far appear to have involved clusters. Whole households and even entire villages have been sealed off and isolated.

While there is little news available about the status of these villages, information derived through the control measures announced, it is understood that Qinghai, Xichang, Guangdong, Sichuan etc have had articles calling for strict adherence to the control measures and educational information concerning the Avian Influenza published.

The government has begun preparations in anticipation of a nationwide Avian Influenza epidemic - "Avian Influenza related vaccines" (didn't know that they existed, let they're the trial ones) manufactured, PLA Epidemic Control Units activated, Personal Protective Equipment prepared and studies and exercises aimed at controlling the outbreaks have been carried out. The Central government has also issued a warning to provincial governments to begin implementing measures in anticipation of the epidemic.

http://www.peacehall.com/news/gb/ch...509170040.shtml