[Health] 7 million Americans could die in the next pandemic

NoCarrier

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Act before the crisis

SEATTLE POST-INTELLIGENCER EDITORIAL BOARD

http://seattlepi.nwsource.com/opinion/209485_avianed.html

Health officials have offered a warning and a challenge.

Bird flu could mutate to spread among people, creating a worldwide pandemic that would kill millions. Although studies differ wildly on the potential death tolls, one estimate holds that as many as 7 million Americans could die. Worldwide, the figure might run to 100 million, if some assumptions about survival rates and past epidemics were to hold true.

The numbers are speculative enough to argue against panic but real enough to demand governments' efforts to head off the worst scenarios. At a conference of federal, private and corporate experts in Michigan this week, officials said an experimental vaccine against the avian flu H5N1 could go into testing this spring.

But approval of the vaccine could be several years away, possibly too late for a disease that has raged in chickens and other birds since at least 1997 and could transform itself to attack humans at any time. That argues for greatly increasing the stocks of antiviral drugs, which, if given within the first two days of illness, are extremely effective. According to an Atlanta Journal-Constitution report, France has ordered 13 million doses of Tamiflu and U.S. officials have discussed adding 8 million doses to a stockpile of 2 million.

Science has created greater ability than ever to recognize a potential pandemic. It's up to government leaders to make good use of the chance to prepare reasonably for an uncertain but looming threat.
 

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Vietnam to host regional bird flu conference amid growing outbreak

http://www.canada.com/health/story.html?id=3d2affc2-d218-4e6d-a5aa-ed53cbb6822e

HANOI, Vietnam (AP) - Vietnam will host an international conference later this month to discuss ways to combat the growing bird flu outbreak that has killed 12 people in Vietnam in a month, an official said Tuesday.

Meanwhile, authorities in southern Ho Chi Minh City banned people in major parts of the city from raising poultry for the rest of this year and ordered the slaughter of all ducks citywide in a bid to keep the disease from spreading.

Ho Chi Minh City will host the Feb. 23-25 conference that is a followup to last year's meeting in Thailand where delegates from concerned countries met amid an outbreak that spread to 10 Asian countries, killing or forcing the slaughter of more than 100 million birds. Last year's virus jumped from people to poultry and has killed 32 in Vietnam and 12 in Thailand in the past year.

The UN Food and Agriculture Organization and the World Organization for Animal Health will sponsor the event, which will also include the World Health Organization and donors from a number of countries, said Anton Rychener, FAO representative in Vietnam.

"There are a certain number of issues we are discussing, mostly regional co-operation, to devise a common strategy as to how to fight against the outbreak," he said. "This is actually a follow up to compare notes and to see what countries have done."

Meanwhile, Vietnamese officials are grappling with how to slow the spread of infection among poultry. The virus has been reported in stocks nationwide and many provinces and the national Animal Health Department have proposed limiting the number of birds - especially hatchlings from infected areas - taken to markets to avoid further spread, said Bui Quang Anh, director the Animal Health Department in Hanoi.

In Ho Chi Minh City, 55,000 ducks that tested negative for the disease will be slaughtered and frozen for sale, while another 125,000 will be destroyed with farmers being compensated, said Phan Xuan Thao, deputy director of the municipal animal health bureau.

The slaughter, which will wipe out all ducks in the city, is expected to be completed by Feb. 6, and officials have announced a ban on raising all poultry in the main parts of the city for the remainder of 2005, he said.

Vietnam has killed or slaughtered about one million birds nationwide since the start of this year. Most outbreaks have occurred in small household farms.

"The next 10 days will be a critical time as the increase in poultry transportation and cool temperature favours the spread of the virus," Anh said, referring to Lunar New Year festivities, which begin Feb. 9.
 

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Cambodian woman 1st confirmed bird flu death outside Vietnam in outbreak

http://www.canada.com/health/story.html?id=0bcfaca0-8555-4a6b-bca2-d3891a363273

HANOI, Vietnam (AP) - A Cambodian woman became the first person confirmed to have died from bird flu outside Vietnam in an outbreak that has killed 13 people in a month, a doctor said Monday.

The 25-year-old woman who died Saturday in a Vietnamese hospital tested positive for the deadly H5N1 strain of the virus, said Phan Van Tu, a doctor at the Pasteur Institute in Ho Chi Minh City, where the test was conducted.

Relatives had reported dead poultry in her village and her brother died four days earlier with similar symptoms, but no tests were done on him, he said.
 

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Bird Flu Spate Signals Easier Transmission

http://www.latimes.com/news/science...story?coll=la-news-science&ctrack=1&cset=true

Outbreaks that killed 12 in Southeast Asia raise fears of a mutated virus spread by humans.
By Charles Piller
Times Staff Writer

February 1, 2005

After smoldering through the summer and fall, avian flu has erupted again in Southeast Asia with 12 confirmed deaths since late December, the latest a 10-year-old Vietnamese girl who died Sunday.

Thailand has reported widespread outbreaks among farm poultry, and Vietnam, where all the fatalities have occurred in the last month, now counts bird or human infections in nearly half of its provinces.

The growing number of cases suggests that the virus may be mutating into a form that is more easily transmitted to and among humans, increasing the possibility of a pandemic.

"The situation in Southeast Asia right now is the most significant setup for a very serious public health crisis that I've seen in my 30 years in this business," said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "We're sitting on a time bomb."

Vietnamese officials have struggled to contain the virus, deploying riot police at some checkpoints around Ho Chi Minh City to prevent an influx of infected birds during this month's Lunar New Year celebrations.

The government has destroyed more than 1 million domestic poultry in an effort to control the outbreak. But the virus has become so widespread that the mass slaughter of birds has been abandoned in some infected areas.

Since July, about 1 million birds have died or been culled in Thailand, compared with about 40 million culled during the first few months of last year.

Authorities believe the virus has a natural reservoir in wild fowl, which continually reinfect domesticated flocks.

Fear of avian flu has become pervasive in the region. People in China, including Hong Kong, as well as in Japan and Thailand have begun to snap up supplies of Tamiflu, the one drug that is effective in suppressing the virus.

If Switzerland's Hoffman-La Roche, Tamiflu's only supplier, tripled production, it would still take it six months to make enough to supply 1 million people for five weeks, said Dr. Klaus Stohr, head of the World Health Organization's global influenza program.

The strain of avian flu affecting Southeast Asia, known as H5N1, emerged in Hong Kong in 1997.

But it has spread rapidly in the last year, killing 44 people out of the 58 infected in Vietnam and Thailand, according to the WHO and the Vietnamese government.

Incidents in which the virus is believed to have been transmitted from one human to another have sparked the greatest concern.

One case involved three brothers near Hanoi, the Vietnamese capital. The first, Nguyen Huu Viet, 47, was admitted to a Hanoi hospital, suffering high fever, acute shortness of breath and a pounding headache. He died Jan. 9.

Soon after, his 42-year-old brother came down with similar symptoms, although he recovered. The third brother is under observation.

At first, Vietnamese public health authorities blamed the illnesses on raw duck blood pudding the brothers had shared.

But because the middle brother's symptoms appeared a week after the normal 10-day incubation period for avian flu, experts now believe he contracted the disease while caring for his dying brother.

The case resembles that of a Thai family, in which a young girl who had touched sick birds apparently infected her mother. The mother lived separately and had no contact with infected fowl but later cared for the sick child, according to a report last week in the New England Journal of Medicine.

Both the girl and her mother died in September. Another caregiver, the child's aunt, became critically ill but recovered.

Such cases suggest that the virus was passed between people during sustained contact. The fear is that the virus will mutate into a form that allows it to be transmitted with only casual contact, which would multiply the number of cases.

Southeast Asia is a fertile environment for mutation because frequent contact between densely packed human and poultry populations creates many opportunities for bird and human viruses to exchange genes.

Health authorities in South Korea, Japan, Taiwan, Indonesia, China and Malaysia, all of which battled bird flu last year, have reported no recent outbreaks. In Hong Kong, an infected migratory heron was found in January, but the city has protected commercial flocks.

Officials in Cambodia and Laos likewise have reported no new outbreaks, but monitoring is notoriously incomplete in those countries, said Henry L. Niman, an infectious-disease expert who maintains an Internet mailing list on avian flu.

"All these numbers are artificially low," he said.

One sign that there may be unreported cases is the death of a 25-year-old Cambodian woman in Vietnam on Sunday. She had traveled to a Vietnamese border town seeking medical help.

Health officials have not confirmed that she had avian flu, but her symptoms were consistent with infection.
 
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