OT: 'Bird Flu Pandemic Warnings Intensify - Nations To Exercise Plans'

While the world's attention has been distracted by the dramatic fight over the fate of the E.U. Constitution, among other things, a potential global bird flu pandemic is still quiety brewing away in China.
Here are the latest reports and warnings - including the first national exercises for the feared (and apparently inevitable) explosive world-wide outbreak.
In addition to these news stories, see also:
'The Coming Global 'Bird Flu' Pandemic - Warnings Increase As China Claims A Cure' http://www.nwointelligence.com/NEWS189.HTM
'The Deadly 1918 Flu - The Elite's Instrument Of Global De-Population?'
'SARS And Flu - News Reports And Pandemic Alerts' http://www.nwointelligence.com/SARSFLU.HTM
The Coming Flu Pandemic: 'Deadly flu virus shipped worldwide by accident' http://www.nwointelligence.com/NEWS14.HTM
You'll find a complete index of these and other essential news stories on the 'Current News You Need To Know On The Collapse Of The U.S. Dollar, The Declining U.S. Economy, The Rise Of China, And The New World Order' page at http://www.nwointelligence.com/newsitem.htm , which is updated daily.
Risk of bird flu 'higher than ever'
Brisbane Courier Mail, Australia 2 June, 2005.
THE risk of avian influenza, or bird flu, entering northern Australia through the Northern Territory is higher than ever, Menzies School of Health Research's Bart Currie said yesterday.
And he predicts up to 44,000 people could die within eight weeks if the disease hit our shores without a vaccine to prevent its spread. Professor Currie, who is the infectious diseases physician at Royal Darwin Hospital, was speaking at the Charles Darwin Symposium Series 2005 yesterday.
He said bird flu was Australia's No. 1 communicable disease threat and the likelihood of the disease spreading was now at its highest.
"There are two billion domestic ducks in Asia," he said. "And the ducks are the ultimate source because it comes from wild birds
into domestic ducks so the risk of it happening is higher than ever.
"Sooner or later it will mutate into something much more dangerous to humans."
He said the Federal Government was taking the disease threat seriously, as was the Territory Government.
Professor Currie said the threat to the NT was from people coming in from South-East Asia.
"We are worried that someone could arrive who is highly infectious with this new virulent flu, land in Darwin Airport having infected the people on the plane, who then disperse it to the northern suburbs through their families.
"Within a week or two of that person landing in Darwin we could have a major outbreak on our hands.
"The impact on hospital infrastructure will be greater than any other health threat ever experienced."
Professor Currie also spoke of the potential threat of Japanese encephalitis outbreak in the NT through mosquitoes carried by monsoonal winds from Papua New Guinea. __________________________________________
National exercise prepares for bird flu
The Age, Australia, June 3, 2005
Australia's preparedness for a bird flu outbreak will be tested in a national exercise later this year.
Agriculture Minister Warren Truss and Health Minister Tony Abbott announced that Exercise Eleusis will involve a hypothetical scenario to test how well agriculture and health departments can work together to identify, contain and eradicate an animal disease which can be transferred to humans.
The scenario will be played out between November 29 and December 1.
Mr Abbott said avian influenza - a disease carried by birds - had killed 53 people and led to the destruction of millions of birds in Asia.
"WHO (the World Health Organisation) has said Australia is as well prepared as any country in the world to respond to avian flu," Mr Abbott said in a statement.
"This exercise provides an ideal opportunity for health authorities to work through our national response plans in close collaboration with our counterparts in agriculture.
"Avian influenza is a real threat to Australia, and has the potential to significantly damage our agriculture industries and affect human health."
Mr Truss said it was important that people working with birds remained vigilant and reported anything unusual to agriculture authorities.
Bird flu response put to the test in SA
ABC Online, Australia, 30 May, 2005
South Australia's ability to cope with an outbreak of avian bird flu is being put to the test, in a simulated emergency disease outbreak beginning today.
Exercise 'Adventurous Goose' will involve more than 125 people over four days, and comes ahead of a national simulation later this year.
The state's chief vet Robin Vandegraaff believes the state is better prepared than five years ago, but there is always more to learn.
"I'm actually quite confident that we'll be able to demonstrate effectiveness here, but of course we're aiming to expose any weaknesses we have with the view to concentrating them, targeting them and improving them for the future," he said. __________________________________________
Secrecy of avian flu plan criticized
By Bill Zlatos, Pittsburgh Tribune-Review, Thursday, June 2, 2005
The state has a plan to deal with a possible flu pandemic, but it's a secret -- and that could be dangerous, warns a public health expert. The Pennsylvania Department of Health must publicize its plan on who gets first dibs on the limited supply of vaccine if there is an outbreak of avian influenza, said David Piposzar, former executive director of the Center for Public Health Preparedness at the University of Pittsburgh.
"If we don't understand the priority or basis for making these kinds of ethical decisions when we have a shortage of medication, then we all may do something that is not in the interest of the common good," he said. "Self-interest will reign. Chaos will reign. The social structure will break down."
His comment Wednesday is in response to the state Health Department's decision not to disclose its plan for dealing with an avian flu pandemic.
The plans would be implemented if the virulent avian influenza A, also called H5N1, spreads to this country. Since May 19, the federal Centers for Disease Control and Prevention has counted 97 human cases of avian influenza A in Vietnam, Thailand and Cambodia. More than half of those infected, 53 people, have died.
People have little natural immunity to H5N1.
"If these H5N1 viruses gain the ability for efficient and sustained transmission between humans ... an influenza pandemic could result, with high rates of illness and death," the CDC reports.
Delaware and New Jersey disclose their influenza response plans, according to a report in The Patriot-News newspaper in Harrisburg. Pennsylvania and Ohio do not. Maryland has released 22 pages of its plan.
"There are many different opinions on whether the plan should be public or kept secret," said Troy Thompson, a spokesman for the Pennsylvania Health Department. "But we're not in a position to debate what's right for other states.
"It's not necessarily that we're keeping anything 'top secret.' It's more of an issue of making sure this issue doesn't get misused."
The department is concerned that terrorists could use information such as where the vaccine is stored and where the vaccinations will be given to disrupt the plan.
"We don't want to put that out there and jeopardize the security of our information," Thompson said.
Piposzar understands the need for keeping sensitive information like that secret. But he contends the rest of the plan should be disclosed, publicly debated and that health officials should conduct drills to see how the plan works.
"I want evidence that we as a nation can mount the kind of program to rapidly immunize or provide medication to our citizens in a short period of time," he said.
The University of Pittsburgh Medical Center is developing its own plan for a potential avian flu outbreak.
"I am interested to know what the state plan is," said Dr. Loren Roth, who heads UPMC's task force. He also is senior vice president, Quality Care, and chief medical officer of UPMC.
Roth said it is his understanding that the Pennsylvania plan is similar to the national plan, which is posted on the Web site of the U.S. Department of Health and Human Services.
The national plan echoes the vaccine rationing that went on during the early part of the past flu season, when a U.S. supplier's plant in England was shut down because authorities couldn't vouch for the purity of the doses. The plan calls for reserving vaccine for priority groups, including those involved in health care and those in professions at higher risk of infection. Vaccine also would first go to age groups more susceptible to infection and to patients with specific conditions.
Roth said the drug oseltamivir, known by its brand name Tamiflu, might be effective in treating or preventing avian flu. But it and similar vaccines are in short supply.
If there is a limited supply of medicine and many people are infected, he said, a plan would have to address the amount of available medicine, where it is and how quickly more can be made and shipped to suppliers. ____________________________________
Can Tamiflu save us from bird flu?
By Debora Mackenzie, NewScientist.com news service, 2 June 2005
AMID ominous signs that H5N1 bird flu is acquiring the ability to spread more readily among people, many health authorities are pinning their hopes on Tamiflu, the only available antiviral drug known to block the replication of the virus. But can the drug really help stop an emerging flu pandemic?
Even if efforts to develop a vaccine are successful (New Scientist, 26 March, p 10), it could take many months to produce the billions of doses needed in the event of a pandemic. By then it might be too late. So in the meantime, the World Health Organization is stepping up its efforts to acquire a massive stockpile of Tamiflu (oseltamivir), which it hopes will at least slow any emerging flu pandemic.
Recent cases of H5N1 in northern Vietnam have caused concern because of signs that the virus is changing. It has become less lethal and is occurring in larger clusters than past cases. Last month studies also revealed that the virus is diverging genetically.
Tamiflu can save lives if it is given early, no more than two days after symptoms first appear. But last month the WHO reported that a patient in Vietnam had a strain of H5N1 resistant to Tamiflu. So could the drug become useless before the pandemic even begins?
Luckily the resistant viruses may be poor at spreading, according to Fred Hayden of the University of Virginia, a leading expert on antiviral therapy. The mutation that made the Vietnam virus drug resistant also occurs in a normal human flu strain, making the virus a hundred times less contagious. In Japan, which uses Tamiflu for ordinary flu epidemics, the mutation appears in 16 per cent of treated children, yet such viruses almost never go on to infect others.
It is probable that the same will be true of any drug-resistant strains of H5N1. This assumption needs to be tested as soon as possible, Hayden says.
But even if Tamiflu remains effective in most cases, it might not be enough to stop a pandemic. The real difficulty with the WHO's antiviral plan, Hayden says, will be finding and treating all the cases and contacts in time. "But that doesn't mean we shouldn't try," he adds.
Ira Longini of Emory University in Atlanta, Georgia, says much depends on how fast the virus spreads. If each infected person passes the virus to fewer than two other people on average, then isolating and treating all cases and their contacts with antivirals could slow or even stop an epidemic, he calculates.
But health workers would not be able to keep up with the virus if sick people infect between two and three others, as happened in the 1918 flu pandemic. Drug stockpiles would still help save lives, Longini says, but would not halt the outbreak.
The best chance of the antiviral strategy succeeding will be in the early stages, when the virus might still spread slowly. The trouble, however, is that most stockpiles of Tamiflu are being acquired by rich countries in Europe and North America, not poor countries such as Vietnam, where any H5N1 pandemic is most likely to start.
What's more, Tamiflu is in short supply. Seventeen countries have ordered stockpiles of the drug from the Swiss company Roche, which holds the patent, and 10 more are said to be discussing purchases. The UK's order for 14.6 million five-day courses of treatment will take two years to fulfil, for instance. The drug is made from a plant in limited supply, and Roche is still trying to develop methods for synthesising it from scratch.
There are two other drugs that target the same enzyme as Tamiflu. But zanamivir (Relenza) must be taken by inhalation and is not widely available, while peramivir was dropped by US company Johnson & Johnson, which thought it unlikely to be profitable. BioCryst, the small Alabama firm that created peramivir, is still trying to find a new partner.
In Asia, H5N1 had already evolved resistance to another class of antivirals, including amantadine, by 2003. These resistant strains are just as deadly and contagious as non-resistant strains. "The Chinese have been incorporating amantadine in their chicken feed, so we have lost that as a treatment," says Robert Webster of St Jude Children's Research Hospital in Memphis, Tennessee. This also suggests that Chinese farmers have been fighting bird flu outbreaks since before 2003, although China officially reported its first outbreaks only last year. _______________________________________
Bird flu warning on medicine
By Matthew Lee, Hong Kong Standard, June 4, 2005
Taking anti-influenza medicine needlessly may hasten the spread of bird flu by decreasing the drug's force against the virus, a doctor warned.
Public awareness of bird flu - which the World Health Organization predicts could infect 30 million and kill 7.5 million people worldwide - has been lowering in the past few months while the risks remain just as high, Center for Health Protection controller Leung Pak-yin said Friday.
He warned against taking Tamiflu, which is seen as the last defense against the H5N1 virus, as a preventive medication for common flu.
``If people take Tamiflu whenever they catch common flu, when a flu pandemic comes the virus may already be drug-resistant, and that will affect the whole picture of infection control,'' Leung said.
Tamiflu and Relenza are believed to be the two most effective medications to treat both influenza A and B viruses, including the bird flu virus.
The government has earmarked an extra HK$245 million to increase stocks of Tamiflu to 20 million tablets by the end of the year.
There were three flu pandemics in the 20th century - in 1918, 1957 and 1968.
``When a flu pandemic hits, there will usually be a second or third wave attack,'' Leung said.
``If we used up most of our stock even before the pandemic, we would have no defense when the virus launched its next round of attacks.''
He anticipated that about 15 percent of Hong Kong's population, or about one million people, would be infected if the widely expected bird flu pandemic hits locally.
``Unlike Sars, we can hardly avoid contacting the flu virus when the pandemic hits.
``Instead, we aim to keep the infected patient numbers low and protect medical staff against the infection, so that we can delay the damage and buy time for more powerful medications or vaccines to be developed,'' he said.
But Leung also said there is no sign that the H5N1 virus is mutating into a form capable of being transmitted between humans, or of human flu virus H3N2 mutating to contain genes of bird flu virus. Either scenario would be vital to the pandemic.
A list of possible isolation camp sites will be compiled later, including locations that were used during the Sars crisis, and vacant buildings. If there is massive infection, home isolation will be considered first.
The center's consultant, Thomas Tsang, also revealed that the trend of human flu infection seems to strengthening. Expecting the trend to continue for the next two weeks, he warned that it could extend to August.
``Usually, the trend drops in April and May,'' Tsang said. ``But we are seeing an upward trend [and] will continue monitoring if the number of infection keeps rising.''
Leung was reported recently as saying the reason for this upward trend is similar to that in 2001, when three kinds of flu virus were active at the same time - H3N2, H1N1 and influenza B.
The average consultation rates for flu among private doctors and public doctors were 90 and 12 per 1,000, respectively, in the week ending May 28.
Most of the recent cases have been the California strain of the H3N2 virus.
``There is no 100 percent protection,'' said Tsang. ``Maintaining good personal hygiene remains the best line of defense.'' ____________________________________
A primer on bird flu
The Manila Bulletin, The Philippines.
I keep reading about the potential of bird flu causing a flu pandemic? How can a disease that affects birds cause diseases in humans? Please elaborate on this topic and on the bird flu epidemic that is going on around Asia. - Gina L., Angeles City
Bird flu or avian influenza is a viral disease that normally affects only birds, and occasionally pigs. All species of birds are susceptible to the disease, but most especially domestic poultry.
Several strains (subtypes) of the influenza virus can cause bird flu. Some of these strains cause only mild illness, but a few, like the H5N1 strain, the causative agent of the ongoing bird flu epidemic in Asia, causes "highly pathogenic avian influenza," a highly contagious form of the disease that has a mortality rate approaching 100 percent.
An outbreak of "highly pathogenic avian influenza" can be devastating to the economy of a country, but of graver concern is the possibility of the virus crossing the species barrier and jumping to humans, a situation that has happened before. The great flu pandemic of 1918-1919 that spread around the world in less than six months and which killed an estimated 40-50 million people was traced by experts to a bird flu virus that acquired the capacity to infect humans.
The ongoing bird flu epidemic started to affect several Asian countries in December 2003. To date, the disease has affected millions of poultry and other birds in Thailand, Vietnam, Laos, Cambodia, China, Japan, South Korea, Hong Kong, Taiwan, Indonesia and Malaysia. The outbreak has been contained in some of these countries, notably Japan, South Korea and Malaysia, but is still continuing in the others. The Philippines, fortunately, has remained bird flu-free.
There is mounting evidence that the strain (H5N1) of the virus that is causing the current bird flu outbreak has the potential to trigger a worldwide flu pandemic among humans. The virus has in fact infected humans already. As of May 19, 2005, there have been 97 confirmed cases (with 53 deaths) of the flu in humans. The cases were reported by Thailand, Vietnam and Cambodia, with Vietnam accounting for 76 cases and 37 deaths.
Up to the present, all the people who have developed the illness have been infected by birds, there is no concrete evidence yet that the virus has already acquired the capacity for human to human transmission, a prerequisite for rapid spread of the disease among humans and that can result in a pandemic. But many experts say it is just a matter of time before this occurs. The avian and human influenza viruses can exchange genes when a person is simultaneously infected with both viruses. If and when this gene swapping occurs, a completely new subtype of the virus that is transmissible from human to human will arise.
Can the world prevent an imminent influenza pandemic? Many experts doubt if this can still be done, but the World Health Organization (WHO) is saying that if the right actions are taken quickly, an influenza pandemic can still be averted.
The most effective way to ward off an influenza pandemic is to reduce human exposure to the bird flu virus. This is achieved through the rapid detection of poultry outbreaks and the immediate employment of control measures such as the culling of all infected or exposed poultry stock, and the proper disposal of carcasses.
Another effective preventive measure is the restriction on the movement of birds within and between countries. The Philippines has contributed its share with regard to this measure. The Philippine government has banned the import of poultry from countries affected by bird flu. Recently, the Bureau of Animal Industry culled about 500 parrots imported from Indonesia. The parrots were for export to Europe but were seized by Philippine coastguards on their way to Manila from Saranggani (Philippine Indonesia order).
The WHO has also urged vaccine laboratories to develop a vaccine against the influenza H5N1 virus as soon as possible. The currently available influenza vaccines are not effective against the H5N1 strain of the virus, but they have some value in averting a pandemic. When administered to high-risk groups, such as poultry cullers, they prevent the possibility of a human becoming infected with human and avian viruses at the same time, a situation that will enable the avian and human viruses to exchange genes and give rise to a strain that is capable of human to human transmission.
(Note: Address inquiries on health matters to Dr. Eduardo G. Gonzales, DLSU College of Medicine, Dasmariñas, Cavite 4114) ______________________________________
Bird Flu: Danger of a Global Pandemic
Reuters, May 30, 2005
LONDON - Scientists warned on May 25 that not enough is being done to combat a strain of avian flu in Asia that many fear could trigger the next global flu pandemic.
The World Health Organization has said the spate of human bird flu cases in Vietnam this year suggests the deadly virus may be mutating in ways that are making it more capable of being passed between humans who so far are not immune to the infection.
Here are some key questions and facts about bird flu.
What Is Bird Flu?
* Avian influenza is an infectious disease of birds caused by strains of the influenza virus. The disease, which was first identified in Italy more than 100 years ago, occurs worldwide. * All birds are thought to be susceptible to infection with avian influenza, though some species are more resistant than others. * Infection causes a wide spectrum of symptoms in birds, ranging from mild illness to a highly contagious and rapidly fatal disease resulting in severe epidemics. The latter is known as "highly pathogenic avian influenza." This form is characterized by sudden onset, severe illness and rapid death, with a mortality that can approach 100 percent. * Fifteen sub-types of influenza virus are known to infect birds, thus providing an extensive reservoir of influenza viruses potentially circulating in bird populations.
Is Bird Flu Harmful to Humans?
* Human fatalities from avian influenza were unknown before 1997, when six people in Hong Kong died after being infected with the H5N1 strain of the disease. But the destruction of Hong Kong's entire poultry population-around 1.5 million birds-within three days, reduced opportunities for further direct transmission to humans, and may have averted a pandemic. * In April 2003, a Dutch veterinarian who had been working on a farm infected with bird flu became ill with an H7 strain of the disease and died of pneumonia. The vet did not take medication against avian and human flu.
Human Casualties from Bird Flu
* 37 Vietnamese have died since late 2003. The disease has also killed 12 Thais and four Cambodians.
Could Bird Flu Become a Human Pandemic?
* Although avian flu is very infectious in birds, it does not spread easily among humans. There is a danger, however, that an avian virus may mix with a human one and form a new disease. * The new virus could share genetic material from both viruses, being highly infectious like human flu and dangerously fatal like the avian variety. * According to a WHO report earlier in May, the spate of human bird flu cases in Vietnam this year suggested the deadly virus may be mutating in ways that are making it more capable of being passed between humans. * The finding points to the greatest fear of health experts that the H5N1 virus could unleash a pandemic and kill millions around the globe if ever it gained the ability to be transmitted among humans efficiently. * New influenza strains have caused pandemics, most recently in 1956-1957 and 1967-1968, killing a combined 4.5 million people. ________________________________________
Bird flu death toll five times what had been reported, China
Newswire,com. 29 May, 2005.
An official from China's agricultural department said the death toll from bird flu in the West of China is five times greater than official reports had stated. The number of migratory birds killed was much larger than people had thought, he said. He added that the reports refer only to the death of birds and that no humans have died.
Rumours are rife among experts and throughout the internet that there has been a massive cover-up. People are saying nobody really knows how bad the situation really is/was. Rumours abound that many humans have perished.
Officials now say more than 1,000 migratory birds have died after being infected with the H5N1 strain of bird flu. The H5N1 is the most lethal one. Official reports had talked about just 178 birds, all of them geese, perishing in Qinghai Lake - now, they say the real number is over 500.
China has not reported one human death from bird flu - even though nearby countries such as Vietnam have had 38 deaths. In total, the number of human deaths from bird flu in South East Asia has totalled 54.
Health experts say that in order to tackle a possible pandemic which could spread to humans and become a human-to-human transmissible disease, we need accurate, reliable information. If authorities are not able to provide reliable figures it is virtually impossible to know what to do and when and where to do it. A pandemic could kill millions and millions of people throughout the globe. _________________________________________
Prepare for pandemic, expert warns
Global economy could shut down within days 'The loss of human life will be devastating'
By Elaine Carey,Medical Reporter, Toronto Star, 5 May, 2005 The next influenza pandemic will shut down the global economy within days, leaving the world in chaos, yet industrial nations are doing nothing to prevent it, says an article in the New England Journal of Medicine.
"We need bold and timely leadership at the highest levels of the governments in the developed world," writes Dr. Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota, in today's issue.
"The loss of human life even in a mild pandemic will be devastating and the cost of a world economy in shambles for several years can only be imagined."
Osterholm, a leading expert on infectious diseases, says the world's nations have become so interdependent for food, drugs and other supplies that a pandemic that would shut down international travel would be devastating.
"When you shut down transportation ... it will cause disruption within hours and chaos within days," he said. "Look at what SARS did to Toronto and that was so limited in terms of duration."
Even if Canada could produce enough influenza vaccine for its entire population, "the economy will tank because the rest of the world won't have it and the rest of the world supplies a great deal of resources and goods to Canada," he said. "It is not enough to have a national interest. You've got to have international interest."
But most of the developed world is not listening, he said.
"This is not a major issue on the G-8 agenda and it should, unfortunately move right to the front."
Dr. Paul Gully, Canada's deputy chief public health officer, said in an interview it would be impossible to shut down international borders if a pandemic struck because countries have become so interdependent.
And past pandemics have shown that shutting borders doesn't stop the spread of disease anyhow, said Gully of the Canadian Public Health Agency. The 1918 pandemic spread very quickly even though there was limited air travel.
"It's going to spread anyway and we don't think closing down the air system, closing borders, would in fact be possible," he said. "But we have to deal with that and discuss it and agree to that beforehand."
Interest in pandemics was really spurred by SARS with the sudden recognition that infectious diseases could have such an economic impact, he said.
Canada is involved in efforts to develop an international plan to deal with a pandemic and also to assist Third World countries deal with one, he said.
Osterholm said a worldwide co-operative project has to be launched aimed at producing and delivering a pandemic vaccine for everyone in the world.
But even if that started tonight, it would still take years to develop enough capacity to produce it, he said.
"Frankly the crisis could for all we know have started last night in some village in Southeast Asia," he said. "We don't have any time to waste and even if we did have some time, the kinds of things we need to do will take years. Right now, the best we can do is try to survive it. We need a Manhattan Project yesterday."
But Gully said even if a vaccine could be developed for the globe, most Third World nations don't have the ability to deliver it to their citizens.
"The challenge in the developing world is having a health system infrastructure to utilize it ... that is a question mark."
A pandemic vaccine can't really be developed beforehand because scientists don't know exactly what virus it will be until it hits, he said.
"We can go so far but we certainly can't develop a vaccine and stockpile it. That's the nature of the beast."
Osterholm and other health experts say it's not a matter of if but when the next pandemic hits. They occur every 30 to 40 years and the last one hit Hong Kong in 1968, 37 years ago.
If the current H5N1 strain of avian flu virus in northern Vietnam becomes a pandemic, as many experts predict, it could rival that of 1918, which killed an estimated 50 million people, Osterholm writes. With the world's current population, that could mean 180 million to 360 million deaths worldwide.
(These news items are posted under 'Fair Use' provisions) _____________________________________
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