HANOI (Reuters) - Vietnam, where the bird flu virus has killed more than 40 people, has two new suspected human deaths from the disease, state media reported on Saturday.
The Tuoi Tre (Youth) newspaper quoted a report from a hospital in the central province of Quang Binh as saying two patients who showed symptoms of bird flu infection had died in the past week.
The report said the victims, a 14-year-old girl and a 26-year-old man, had eaten duck and a chicken's egg around a week before they got sick.
The girl died on October 23 and the man died on October 26.
Doctors at the hospital said they both had severe respiratory problems, fever and lung infection, symptom similar to bird flu.
(CBS/AP) China and Thailand on Friday ruled out bird flu in several human illnesses but the region's anxiety mounted as officials called for measures to prevent an outbreak that they warned could infect millions of people.
"The situation right now is extremely grave," said Jia Youling, China's chief veterinary officer. He warned that it was only a matter of time before his country has a human infection if it fails to stop more outbreaks among its vast poultry flocks.
Chinese authorities said tests confirmed that a 12-year-old girl who died in a village with an outbreak didn't have the virus. And Thai health officials said three French tourists who were suspected of contracting bird flu were found not to have the disease.
The virus has killed at least 62 people across Asia since late 2003.
Most of the people infected with the H5N1 strain of bird flu have had contact with sick birds. Health experts fear that if it mutates into a form that is easily transmissible between people, it could spark a pandemic, possibly killing millions.
In related developments:
A second manufacturer is beginning mass production of a vaccine to protect against bird flu, and the Senate moved Thursday to invest far more, $8 billion, on preparations in case the influenza strain ever sparks a worldwide epidemic. Before the Senate acted, Health and Human Services Secretary Mike Leavitt awarded a $62.5 million contract to Emeryville, Calif.-based Chiron Corp. to manufacture bird flu vaccine for a national stockpile. A competitor, Sanofi-Aventis of Paris, began manufacturing $100 million worth of a similar vaccine last month.
In Indonesia, authorities were testing chickens that died last week on Bali. Indonesian Agriculture Minister Anton Apriyantono warned that the virus could spread quickly through the densely populated archipelago since wild pigeons and other birds already were infected. "The condition (of bird flu) is critical because it has been found to have infected pigeons," he said. "We can all imagine how long and how far pigeons can fly." Bird flu has killed four people and sickened three others in Indonesia so far this year.
France's Health Ministry said it could not confirm the Thai statement, but tests in France made public Thursday showed that one of the tourists was free of bird flu.
Australia's health minister warned that his nation might have to close its borders in the event of a human epidemic, while a Hong Kong lawmaker suggested arming the public to shoot migratory birds. Health Minister Tony Abbott said the island continent of 20 million people would shut itself off from the rest of the world if a human flu pandemic breaks out. "The best way of ensuring that you don't get infected with something like this, in the absence of an effective vaccine, would be isolation," Abbott told Australian Broadcasting Corp. radio.
In Hong Kong, lawmaker Tommy Cheung proposed allowing the public to carry guns and shoot migratory birds suspected of carrying the virus. "Perhaps what we should do is give each person a gun," said Cheung, who has a reputation for making unusual proposals, "and when we see a migrating bird, we can just shoot it down, so Hong Kong would be a much safer place."
In China, officials went on television to try to reassure the public, saying they were capable of stopping the virus. They said human cases would be quarantined and warned that anyone who tries to hide and outbreak would be punished.
Jia also warned that the huge numbers of wild birds migrating through China in coming weeks made it unrealistic to believe that the country could "absolutely eliminate" the virus.
The country has reported three outbreaks over the past two weeks that have killed hundreds of chickens and ducks, but the government says there have been no human infections.
"Prevention and control of bird outbreaks is of chief importance. If we fail to do that well, then sooner or later there will be transmission from birds to humans," Jia, the veterinary official, said at a news conference shown live on national television.
China's latest outbreak occurred in a village in the central province of Hunan where the 12-year-old girl died after developing a high fever.
Chen Xianyi, vice director of the Health Ministry's department of disease control, said tests showed she died of pneumonia.
"The test results were negative" for bird flu, Chen said.
Still, a WHO spokeswoman said the U.N. agency was waiting for official word from Beijing.
"We'd like to know what tests were conducted," said spokeswoman Aphaluck Bhatiasevi.
In Bangkok, the Health Ministry reported that lab tests showed three French tourists who became ill after visiting Thailand were not carrying the virus.
Their cases caused alarm when initial tests on the Indian Ocean island of Reunion suggested they might be carrying the virus. But more testing in Paris found no virus, the ministry announced.
GENEVA (Reuters): The World Health Organization on Friday warnedthat if bird flu arrived in Africa the risk of human infectioncould match that in Asia and "push fragile health systems closeto the brink of collapse".
Any arrival of the deadly H5N1 virus on the vast continentwould be "of great concern" for human as well as animal healthbecause disease detection among both was weak, the WHO said.
Migratory birds are heading south for Africa from Siberia,where outbreaks among poultry have occurred. The birds arebelieved to play a role in the transmission of H5N1 to domesticflocks.
In Africa, as in parts of Asia where the virus is now endemic,many households keep backyard flocks, which often mingle freelywith wild birds or share play areas with children, according tothe United Nations health agency.
"With few exceptions, notably in large commercial farms,surveillance for avian disease is non-existent," it said in itsfirst public risk assessment for Africa.
Bird nutrition is poor and high mortality common, increasingthe likelihood that H5N1 outbreaks will be missed, it added. Since the outbreak first surfaced in Asia in late 2003, 62people have died in Vietnam, Thailand, Cambodia and Indonesia andthe virus has spread to Europe's eastern border.
Experts fear it will mutate into a form that could spreadeasily among people, triggering a pandemic. Millions of peoplecould die.
Asia-Pacific disaster managers to discuss bird flu
Ruetrs, UK,
26 October, 2005.
CANBERRA, Oct 26 (Reuters) - Disaster management officials from around the Asia-Pacific region will discuss the availability of anti-viral medication when they meet for a bird flu summit in Australia next week, officials said on Wednesday.
Officials responsible for disaster management in the 21 member nations of the Asia Pacific Economic Cooperation (APEC) group are due in Brisbane on Monday to discuss regional cooperation in the event of a possible bird flu pandemic.
The meeting is to examine ways for APEC countries and economies to share information about an outbreak and discuss ways to coordinate a response if bird flu turns into a virus that could be passed from human to human.
"The availability of antivirals will be an issue in an appropriate response," said an Australian official who declined to be identified.
Any recommendations from the meeting would be considered by APEC leaders at their November summit in South Korea.
APEC groups Australia, Brunei, Canada, Chile, China, Hong Kong, Indonesia, Japan, South Korea, Malaysia, Mexico, New Zealand, Papua New Guinea, Peru, The Philippines, Russia, Singapore, Taiwan, Thailand, United States and Vietnam.
More than 60 people in Southeast Asia have died of bird flu since 2003, while tens of millions of birds have died of infection or been culled.
The meeting comes after two academics in Australia urged the Australian government to consider issuing compulsory licences to overcome patent barriers and allow local companies to manufacture generic antiviral drugs.
Australian National University researchers Buddhima Lokuge and Peter Drahos said the move would overcome patent barriers which prevent the production of generic versions of the antiviral drugs oseltamivir and zanamivir, marketed as Tamiflu and Relenza.
Australian companies could then produce the antivirals to boost domestic stockpiles and export surplus medication to such regional states as Laos, Vietnam and Cambodia, which lack the capacity to manufacture their own drugs.
"Control of the disease in potential source countries is in Australia's national interest," Dr Lokuge said in an article published in the Medical Journal of Australia on Wednesday.
"Patent owners would be entitled to adequate remuneration under such a licence, and thus would receive payments for doses it does not have the capacity to produce."
Patents for Tamiflu are currently held by Roche Holding AG
Oct. 27 (Bloomberg) -- European Union scientists and researchers from Sanofi-Aventis SA have developed the first human vaccine for the H7N1 bird flu virus, which can spread from poultry to people.
While the H5N1 strain is responsible for killing at least 62 people in Asia since 2003, H7N1 may also be deadly to humans. The virus mutated in 1999 into a highly pathogenic form in Italy, where 13 million birds died or were destroyed, and was related to the H7N7 outbreak in the Netherlands that led to the slaughter of 25 million birds in 2003.
``The risk of H7 emerging as a pandemic influenza strain is considered to be lower than H5N1,'' the European Commission said in a statement issued today in Brussels. ``Nonetheless, it is expected that the H7 research will be a valuable resource for pandemic vaccine development in the future.''
The H5N1 strain has infected people and poultry in Asia and was found earlier this month in wild and farmyard fowl in Romania, Turkey and Croatia. Individuals and institutions are buying up stocks of influenza drugs such as Roche AG's Tamiflu in anticipation that H5N1 will trigger a pandemic flu.
Health officials fear that the bird-flu virus may mutate into a form that can spread among humans. That, in turn, may spark a worldwide outbreak of lethal flu similar to one that killed as many as 50 million people worldwide in 1918.
Tamiflu, Relenza
Tamiflu, approved for the treatment and prevention of flu, has been shown to fight the H5N1 bird and human virus strains in test-tube and animal tests. The World Health Organization recommends governments stockpile antiviral drugs as part of pandemic preparation.
Roche yesterday stopped shipping Tamiflu in various countries, including the U.S. and Canada, to ensure that the medicine is available during the flu season. The Basel, Switzerland-based company has agreed to meet with generic companies to increase Tamiflu capacity.
GlaxoSmithKline Plc, whose flu treatment Relenza competes with Tamiflu, said today it will seek partners to increase production of the medicine. The company, Europe's biggest drugmaker, is also preparing to convert some of its manufacturing facilities to produce a ``pandemic flu vaccine'' and said it's developing an H5N1 prototype pandemic vaccine for which clinical trials will begin ``shortly.''
`Reverse Genetics'
The EU's H7N1 vaccine is the first to be developed using a technique called ``reverse genetics'' that is simpler, safer and more precise than the traditional production method of injecting the virus into eggs, according to the EU. The bloc contributed 2.1 million euros ($2.6 million) to the project.
Clinical trials on the vaccine are expected to begin next spring, the commission said. Scientists and researchers involved in the H7N1 vaccine research project come from the U.K.'s Health Protection Agency, Italy's Istituto Superiore di Sanita, the U.K.'s National Institute for Biological Standards and Control, the U.K.'s University of Reading, Norway's University of Bergen and France's Sanofi Pasteur, Sanofi-Aventis's vaccines business.
Bird flu has taken its biggest toll on Vietnam, which has reported 91 cases and 41 human deaths since December 2003, according to the World Health Organization. Thailand follows with 19 cases and 13 deaths while there have been four human fatalities each in Cambodia and Indonesia.
TONY JONES: Well, Hungary is claiming a major breakthrough in developing a bird flu vaccine. It says its vaccine has already been successfully trialled and could be ready for mass production by March next year. Hungary's Health Minister is so convinced he even used himself as a human guinea pig in the trials. Already, Indonesia and a number of other countries have expressed interest in the vaccine, but doubt has been cast on it by the World Health Organisation. Shortly we'll speak to the Health Minister, Tony Abbott, but first Michael Edwards has this report. It was produced by Annamaria Talas.
MICHAEL EDWARDS: It's an unlikely looking threat, but one that's making its way west across Europe. Bird flu, responsible for more than 60 deaths in Asia, has now infiltrated several European countries. With the virus on its doorstep, Hungary claims its scientists have jumped ahead of the rest of the world to develop a vaccine.
DR JENO RACZ, HUNGARIAN HEALTH MINISTER (TRANSLATION): Hungary has 100 years of tradition in vaccine research and development. This provided a solid base for the researchers. We have our own vaccine production facilities, research and production available in Hungary and this made it possible to develop the H5N1 vaccine.
MICHAEL EDWARDS: Hungary's susceptibility to bird flu has become acute. The H5N1 virus has already been detected in nearby Romania and Russia. Now Hungary is convinced it's found a vaccine - the country's health minister so confident, he's even inoculated himself.
DR JENO RACZ (TRANSLATION): When the first human vaccine was completed, I volunteered to be the first to receive the test vaccine. It had risks, so if I didn't consider the likelihood of a new flu virus a very serious threat, I wouldn't have lined up to do it.
MICHAEL EDWARDS: 100 people were used in the trial, the costs running into millions of dollars, with the National Epidemiology Institute devoting its expertise to the task. Hungary's chief medical officer says it has proof beyond doubt it will be effective.
DR LASZLO BUJDOSO, CHIEF MEDICAL OFFICER (TRANSLATION): A new vaccine is considered effective if there is a 2.5 times increase of antibodies in the blood. Our vaccine increased the levels of antibodies to a 10 times higher level.
MICHAEL EDWARDS: It's taken six months to develop the vaccine. While several other countries, including Australia, are developing their own, Hungary claims it's already got strong interest in its product.
DR JENO RACZ (TRANSLATION): Several south-east Asian countries, Arab countries, countries of the European Union, our neighbours and countries overseas showed interest for the vaccine. If we were in production now, we could have sold tens of millions of vaccines.
MICHAEL EDWARDS: Indonesia is one of the countries who want the Hungarian vaccine, but the World Health Organisation and the European Union have sounded a warning, questioning its quick development time and its effectiveness if the virus mutates. Australian virologist Alan Hampson also has some concerns about the Hungarian claims.
ALAN HAMPSON, VIROLOGIST: There are a number of issues about making the vaccine against the H5 virus because of the potential danger of the virus still, even though it has been modified, and because the virus, as a modified organism, comes under the control in most countries of the genetics regulators. And, so, in Australia, for example, it's taken a little while, I believe, to get through those issues and make sure that everything is right up to speed in terms of safety and regulation.
MICHAEL EDWARDS: CSL is developing Australia's vaccine. Its trials are scheduled to be finished early next year, with a company spokeswoman saying the best case scenario would be public release towards the end of 2006. Australia is set to host its own regional bird flu summit in Brisbane next week. Michael Edwards, Lateline.
Federal Health Minister Tony Abbott has cautiously welcomed news that Hungarian scientists have developed a vaccine for bird flu.
Hungary's Health Minister, Dr Jeno Racz, has told Lateline he is so confident about the vaccine he has been inoculated himself.
But not everyone is as optimistic.
Mr Abbott, who has just returned from a major conference on bird flu in Canada, says the Hungarian vaccine only protects against the current disease, which is still limited to birds.
Mr Abbott says the real danger is that that disease mutates into a human strain.
"Even if it is an ... effective vaccine against H5N1, it may not be ... an effective vaccine against any pandemic strain that ultimately emerges," he said.
CSL trial
Mr Abbott says the Federal Government remains committed to a trial of a bird flu candidate vaccine by Australian company CSL.
"We've invested $5 million in the CSL trial because we certainly think that a candidate vaccine makes a lot of sense," he said.
"The Americans had a go at a candidate vaccine and it seems that their candidate vaccine is not particularly effective.
"So while this Hungarian announcement is encouraging, I think we would want to look closely at it before we suddenly said, 'Whacko, this is great'.
"I don't know very much about the Hungarian vaccine industry, I do know that CSL is a highly respected vaccine manufacturer with a very good record not just here but right around the world in producing high quality effective vaccines."
The Health Minister says he would be happy to follow his Hungarian counterpart's lead and be inoculated as part of the trial.
"I'm happy to do whatever I usefully can in the fight against bird flu," he said.
"But I saw footage of people enthusiastically volunteering, Australians enthusiastically volunteering to trial CSL's candidate vaccine on television just the other day."
Multi-pronged approach
But Mr Abbott cautions that there is no "one answer which is some kind of a magic bullet against a pandemic flu".
He says biosecurity and reporting procedures are also being considered in an effort to keep Australia free of bird flu.
"Certainly the conference in Ottawa ... was focused on how do we ensure that this disease doesn't escape from birds to humans?" he said.
"We're looking at better biosecurity measures, we're looking at trying to ensure that farmers report their sick and dead birds rather than eating them or sending them off to market.
"We're looking at better ways of compensating farmers whose flocks have to be destroyed for health reasons."
Funeral directors are meeting in Canberra to discuss the potential risks to staff if there is a bird flu pandemic.
The Australian Funeral Directors Association says its members will be at the frontline of any pandemic and a vaccine will be made available to them, along with emergency workers.
Association spokesman Warwick Hansen says health officials will address the meeting and members will discuss a management plan.
Mr Hansen says infection control will be a key issue, especially for embalmers.
"We just want to see that we can safely handle deceased people who are suffering from such a disease and yet once again protecting our staff and our families," he said.
He says the industry needs to understand how governments will classify bird flu, as that will affect the way bodies are handled and funeral services are conducted.
"In New South Wales in particular, there is a system where they have what they call a list 'A' and a list 'B' disease," he said.
"If it is a list B disease, which means highly infectious, well then deceased are placed in body bags and those body bags are not to be opened under any circumstances."
BETSY McCALLUM had planned a three-week trip to China, Vietnam and Thailand next March. She and a friend looked forward to visiting a relative who worked in Beijing and then exploring some of the places that "none of the tourists go to."
But then Ms. McCallum, a retired real-estate broker from Manasota Key, Fla., heard about the bird flu threat and began having second thoughts about her vacation. "What if there's an outbreak?" she wondered. "Would I be increasing my risk of getting it by going on my trip during the peak of flu season?"
For people making vacation plans, the H5N1 avian flu strain is beginning to loom large. And while the virus may not have mutated into a human disease, at least at this point, travelers are concerned. Ms. McCallum, for example, decided to stay home after consulting with her sons, both doctors, and a friend who manages a pharmaceutical company in Taiwan. "Maybe I'm chicken," she said. "But I'd rather play it safe."
Here are some of the most common questions about bird flu and travel:
Q. What is bird flu?
A. It is an infection among birds that is transmitted through saliva, nasal secretions and feces, according to the Centers for Disease Control and Prevention. What makes the particular strain of bird flu H5N1 so worrisome is that it can now also infect people. In 1997, the first case of bird-to-human transmission was recorded in Hong Kong, according to the C.D.C. So far, this strain of flu has not had any sustained human-to-human transmission. But scientists are concerned that the virus might adapt to more easily infect people.
Q. Where are the bird flu outbreaks?
A. Human infections are reported this year in Cambodia, Indonesia, Thailand and Vietnam, according to the disease control agency. As of Oct. 24, bird flu outbreaks linked to H5N1 had been recorded in poultry and other fowl in Cambodia, China, Indonesia, Kazakhstan, Malaysia, Russia, Thailand, Vietnam, Turkey, Romania, among other countries.
Q. Should I get a flu shot before I travel to affected areas?
A. Yes. Even though conventional flu shots do not prevent your contracting avian flu, health professionals advise getting a flu shot - particularly if you are over 65, are pregnant or have a weakened immune system. Dr. Phyllis Kozarsky, a consultant to the C.D.C's Division of Global Migration and Quarantine and a professor at Emory University, says there is a chance that if you are infected with bird flu and another flu strain, the viruses could mix genes so the avian flu could acquire the characteristics of a strain more easily transmitted.
Another option is the antiviral medication Tamiflu, which, based on limited data, may be effective in preventing or treating bird flu, according to the C.D.C. In August, the State Department sent Tamiflu to its embassies and consulates in southeastern Asia for distribution to government employees and their families.
Q. Should I cancel my trip to an area where there are documented bird flu cases?
A. Probably not. "One misconception about bird flu is that it is highly contagious among humans," said Dr. R. Bradley Sack, director of the Johns Hopkins International Travel Medicine Service. "But that's not true." In fact, there have been only a few cases in which very close physical contact with an ill, infected person has caused disease in a healthy person. "As a generalization, I think it is safe to say there has been no indication that human-to-human transmission is occurring, except in rare instances," he said.
Dr. Sack said visitors to countries with bird flu cases should take several precautions, which include staying away from markets with live chickens and ducks, washing their hands frequently and not eating undercooked poultry. If the bird flu mutates and if it becomes a pandemic - and Dr. Sack says those are two big "ifs" - then it will not really matter where you are, "because you probably won't be safe anywhere." He added, "I would not cancel any trips to areas that have been affected by bird flu."
Q. How do I know if it isn't safe to travel?
A. The Centers for Disease Control posts regular travel notices - and, if needed, warnings - for travelers at its Web site (www.cdc.gov/travel). "The risk to humans, at this point, is still extremely low," Dr. Kozarsky said. "But we are monitoring the situation closely." To date, the C.D.C. has only issued one travel health warning, during the SARS epidemic of 2003. "When there is evidence of transmission outside the areas or populations initially affected, and inadequate containment, then we will be poised to do something," Dr. Kozarsky said.
But we are not at that point yet. "People feel as if the avian flu is more widespread than it is. They think that if they travel to a country whose poultry is affected, they are at a high risk," she said. But she sees no evidence of that yet.
Q. What are the travel experts doing about bird flu?
A. Many are still traveling. Phil Carta, the president of an Ocala., Fla.-based tour operator called New Adventures, which specializes in tours to the Seychelles, Mauritius and Réunion, is planning a personal trip to Hong Kong, Thailand and Cambodia in December. He is taking all the precautions, including getting the flu shot and bringing antiviral medication. He is also traveling with a medical kit that includes antibacterial wipes and a digital thermometer. "I'm going to be in some remote villages in Thailand, and let's just say I won't be petting any chickens while I'm there," he said.
Western countries have failed Asia in its attempts to control the bird flu epidemic now threatening poultry flocks in Europe, a Massey University researcher says.
Professor Roger Morris, an epidemiologist, said yesterday that the influenza outbreak could have been confined to Asia and controlled if the West had provided the assistance sought.
"The global community has failed to respond adequately to calls for help in stemming spread of the disease."
The H5N1 strain of influenza has led to the deaths of millions of birds and more than 60 people. The virus does not spread easily between people, but experts fear it could change to do so, causing a global pandemic that kills millions of people.
No one knows when this might happen.
Professor Morris and his team members have studied the epidemic and its risks in Asia and the likely consequences if it reaches Britain. They have written reports on it for Governments and the United Nations Food and Agriculture Organisation.
One of his doctoral students has been studying bird flu in Hong Kong, particularly the role of live bird markets and the species involved, especially quail.
"[Quail] are the hidden item in the equation. They play a significant role in the disease, as do ducks."
Professor Morris said the United States and Europe had virtually ignored repeated Asian calls for help.
Badly affected countries such as Vietnam and Indonesia could not afford all the necessary control measures.
"There was a big need particularly to vaccinate poultry and to take whatever measures were appropriate, for example, through live bird markets. The countries have taken measures.
"They were pressured in the early days to cull large numbers of poultry," he said.
"Village farmers were told they would be compensated. Most were not compensated or were not compensated adequately, so they have hidden the disease since."
Repeated efforts to start studies on aspects of the disease had foundered for lack of financial support.
"It's only when the disease has hit the corner of Europe that there has been some global pandemic panic."
Controversially, Professor Morris has also spoken out against individuals stocking up on Tamiflu treatment pills, although he supports the Government having a stockpile.
He said infected humans in Asia had a variable response to the drug.
"I totally support there being national resources that would be used on the right people at the right time.
"I'm concerned about people buying it and using it under the wrong circumstances and assisting in development of resistance [by viruses]."
Professor Morris does not have a personal supply of the drug, although he does keep masks at home.
Doctors have varied opinions on whether to prescribe Tamiflu for people to store. Many do prescribe it for this purpose and stocks have run short.
THERE'S unwelcome news for regular flu sufferers anxious to refill prescriptions for the bug-busting medication Tamiflu. Join the queue. Australia has contracted a serious case of bird flu panic, and the worried well have cleaned out stocks of the antiviral drug known in science circles by its chemical name of oseltamivir.
According to the manufacturer of Tamiflu, the Swiss pharmaceutical giant Roche, chemists' shelves won't be ringing up sales again until next month. A second shipment is expected at the end of December, said local spokesperson Rita Corrente.
Further, anyone hoping to get on the Tamiflu waiting list without a prescription will be disappointed. Earlier this month the National Drugs and Poisons Schedule Committee rejected a proposal to make it available from pharmacists over-the-counter.
Aside from the wait, a trip to the GP, and the $50 price tag for a pack of 10 capsules, virologist Steve Wesselingh says there's another reason why people hoping to protect themselves from bird flu should hold off, leaving Tamiflu for those at high risk of catching old-fashioned but dangerous human influenza A and B. At least for now.
"Tamiflu or other antivirals can be utilised to prevent or to treat infection, but in terms of preventing infection you need to be taking it at the time you're exposed," says Wesselingh, director of Melbourne's Macfarlane Burnet Institute for Medical Research and Public Health. He adds the obvious: "That's difficult to predict."
Wesselingh's point is particularly apt given that there's no evidence that Australians - human or avian - have contracted either of the potent strains of the avian H5N1 influenza A virus found in east Asia and parts of eastern Europe. The overseas body count remains low. As of October 24, the World Health Organisation (WHO) reports 121 people in Indonesia, Vietnam, Thailand and Cambodia have contracted the virus, probably from handling infected birds. Sixty-two have died.
Although the immediate health risk is small, the race is on to build-up a national stockpile of Tamiflu as well as Relenza, a second - and Australian-designed - drug that restricts the replication of influenza in an infected person. Should the worst strains of H5N1 build resistance to Tamiflu, Relenza promises to be an unexpectedly vital second line of pharmaceutical defence.
That's a distinct possibility, cautions the WHO. Of all the 15 subtypes of avian influenza H5N1 mutates the fastest and has a "documented propensity to acquire genes from viruses infecting other animal species".
Add it up: strains of the most worrisome subtype of bird flu are predisposed to develop the ability to not only infect people in close contact with animals, but to be transmitted easily from person to person. Worse, when it comes to H5N1 we humans are "naive", Wesselingh points out.
"That means our immune systems will give us no immediate protection against the virus." According to Wesselingh, it takes about two weeks to develop disease-fighting molecules called antibodies. "That means you're going to get very sick from influenza for the first few days to a week," he explains.
Researchers worldwide are racing to design a vaccine able to prevent infection in the first place by priming the immune system to kill the invading virus. But why is it taking so long to stock up the national medicine chest and crank out what many think is little more than a fancy version of the vaccine available for each year's battle with the flu bug?
The glib answer is, "politics and profits". Although international epidemiologists, virologists, medical providers and the WHO have warned for decades that the planet could at any time be hit by a deadly new strain of influenza - akin to the Big Ones of 1918-1919, 1957-1958 and 1968-1968 - national leaders have until now remained reluctant to spend the money.
Kay McNiece, a spokesperson for the Commonwealth Department of Health and Ageing, says the Government has contracted for 3.9 million courses of antivirals, mostly Tamiflu but also Relenza. "The minister is looking into buying more Relenza," she says.
Until this new surge in demand for antivirals, drug companies chased dollars primarily in so-called "lifestyle drugs" such as Prozac and Viagra. Little effort and funding was given to vaccine research, with notable exceptions such as Australia's Melbourne-based CSL Ltd.
The consequence is that development has been left largely to small teams of government-funded scientists like the Australians who developed Relenza. As today's Weekend Australian Magazine shows, that can be a long and often soul-destroying experience.
With minimal attention accorded to slow-sellers like Tamiflu - Roche sold only about two million courses worldwide in 2001 - there's been no push to make manufacturing more efficient. Case in point: the spice star anise. A wild variety of the humble plant contains the "adjuvant", a vital ingredient Roche uses to boost Tamiflu's effectiveness.
Until bird flu hit the headlines it mattered little that production of Tamiflu was limited by the availability of star anise, sourced in China only from March to May. Now, Roche has synthesised the active ingredient New Scientist magazine reported this month. That leaves only Cipla, the Indian manufacturer of a generic version, at the mercy of Mother Nature.
Both Roche and GlaxoSmithKline, the manufacturer of Relenza, are now cranking up production. GlaxoSmithKline has even announced plans to reopen a Melbourne production facility shut in 2000. Gearing up production, though, means just that. It takes months to get packets of tablets rolling off the production line in quantity. What's more, experiments with mice published in July suggest that the current dose may not be enough to save patients infected with a highly virulent strain of bird flu.
The fact that some strains of H5N1 avian influenza are so lethal - even in birds - has also slowed the development of a vaccine, notes University of Melbourne virologist Lorena Brown. "In poultry infected with highly pathogenic strains of H5N1, the virus can infect any cell in the animal's body, not just the lungs," she says.
The bottleneck, notes Brown, is that the virus kills cells within the eggs used to grow the virus in production. While CSL won't reveal details of how it's sidestepped this problem, Brown says the solution is a sophisticated process of genetic engineering called reverse genetics. It involves fiddling with the "H", or hemagglutinin, part of the virus's coat so that it's less toxic. By the way, the "N" stands for neuraminidase.
Over at CSL, spokesperson Rachel David says experts have jumped the genetic hoops and have a candidate vaccine against samples of H5N1 provided by the WHO. Two weeks ago they began the first clinical trials with 200 healthy human volunteers at two sites in Melbourne and Adelaide. If all goes well, she predicted that so-called Phase Two clinical trials may be ready to go in early February.
From there? "We'll compile a dossier for the Therapeutic Goods Administration, the Australian regulator," David says, optimistic that due to the urgency it will give the thumbs up or thumbs down quickly. Judging by experience from its conventional flu vaccines, David says it should take just six weeks to get the production lines rolling.
Under the best-case scenario, it would take three months to produce the 40 million doses required to immunise the Australian population. Then everyone can relax, especially the usual suspects who come down with garden-variety flu despite their annual flu shot. At least, they'll know that Tamiflu will be back on the chemist's shelf, nestled neatly beside packs of Relenza.
RIXENSART, Belgium, Oct. 28 (UPI) -- U.K. drug giant GlaxoSmithKline PLC says clinical trials for a vaccine against the H5N1 strain of bird flu will begin soon and should be done by summer.
"We're pulling out all the stops to do everything we can to be ready to help various governments to have their planning in place at the time, and if, there is a catastrophic event," said Glaxo Chief Executive J.P. Garnier.
At Glaxo's Belgium facility Dr. Emmanuel Hanon leads a pandemic-flu team of about 25 scientists trying find the right mix to make a flu vaccine effective against a broader range of virus strains, the Wall Street Journal reported Friday.
"The good news is that even a mismatched vaccine would probably be better than no vaccine, but the bad news is that it is going to be difficult to be confident of making an exact match" for any human-to-human strain, says John Treanor, an expert in virology at the University of Rochester in Rochester, N.Y.
WASHINGTON - Have you got Tamiflu? A friend of mine proudly told me he scored a prescription for his whole family. Another friend is also trying to wangle a prescription, even though there’s no guarantee that Tamiflu will work. “It saved 80 percent of the mice in the laboratory study,” he said.
Tamiflu is the antiviral drug that might, or might not, provide some protection against avian flu, the bird epidemic that might, or might not, mutate into a deadly disease that humans can catch from other humans. Already there are reports that the virus that causes avian flu has mutated at least enough to become immune to Tamiflu. Nevertheless, I predict a run on Tamiflu in this country, if only because Americans are a pragmatic people.
They have observed what happened after Hurricane Katrina. They have heard the president talk about deploying the military during a pandemic. They have guessed, more correctly than they may realize, that, whatever their government is doing to prepare for the arrival of bird flu, it isn’t enough.
One word: Short-termism
This country is uniquely positioned badly to prepare for any kind of pandemic, natural or terrorist-made. It isn’t that we aren’t smart enough: It’s that the culture, at the moment, doesn’t encourage it. Here’s why: Short-termism.
A few weeks ago, a blitz of front-page stories announced new bird flu initiatives. The president met with vaccine manufacturers! The secretary of health and human services went to Asia! As far as I can ascertain, much of this happened because the president and his Cabinet colleague had read John Barry’s excellent book 'The Great Influenza'
But a week’s worth of publicity doesn’t substitute for many years of collaboration between the government, the pharmaceutical industry and the rest of the research community. The solution to any pandemic disease lies not merely in development of vaccines or cures but also in development of scientific techniques, legal mechanisms and commercial incentives to speed up production of vaccines. Instead of years, it should take weeks, even days, to move from identifying a deadly virus to finding a vaccine that prevents infection. Instead of looking for temporarily effective antiviral drugs, this country should put its resources into finding ways of boosting the human immune system itself. A flurry of news stories can never sustain that project, particularly in a country that at the moment produces no vaccines at all.
Don’t hate them
Before politicians invest in vaccine technology, they and the voting public will have to get over their hatred of the drug companies. To some degree, this hatred is rational: High drug prices paid by Americans and by no one else in the world are a huge social burden. To some degree, it is irrational: Drug companies make miracle cures, not weapons of mass destruction.
This dislike has been a major obstacle to Congress’ efforts to persuade American companies to start making vaccines. Companies need incentives to do the research; or guarantees that someone will buy their finished vaccines; or protection from lawsuits by users of vaccines that will not have been widely tested; or some combination of the above.
The Senate subcommittee on bioterrorism recently wrote a sensible bill proposing that the government pay for research in the early phases of pharmaceutical innovation, much as it does in the early phases of warship innovation.
It makes sense - but ask yourself if you can bear the thought of Merck or Pfizer’s collecting a cent of your tax dollars. Then you’ll understand the depth of the problem.
Finally, Americans and their leaders will have to get over their love affair with intelligent design
Changes needed
We’re also stuck with magic solutions: silver bullets, protective amulets, Tamiflu prescriptions.
Until we elect politicians, pay businessmen and support scientists and science educators who can come up with something better, that is all the flu preparedness we’ll ever have.
Anne Applebaum is a member of the Post’s editorial page staff.
Beijing: China insisted there had been no documented human cases of bird flu in the country despite three outbreaks among poultry in the past week while in Romania a dead heron was diagnosed as carrying the deadly H5N1 virus marking the disease's further spread through Europe.
China has reported three outbreaks of bird flu in the past week, in the northern region of Inner Mongolia and the provinces of Hunan and Anhui.
"At present the three outbreaks were stamped out and no new cases found," Jia Youling, chief veterinary officer of the ministry of agriculture, told journalists.
"According to the ministry of health, there are no reports of human infection," Jia said at the press conference organized by the State Council, China's cabinet.
"The top priority is to prevent the occurrence of avian flu among domesticated birds," Jia said. "If we fail to do that, then sooner or later the disease will be transmitted from birds to humans."
Beijing's reassurances came amid growing concerns worldwide about the spread of bird flu, with Romania confirming on Friday a heron found dead last week in the country's northeast was carrying the virulent H5N1 strain.
The virus has killed more than 60 people in Asia since late 2003.
Experts fear a pandemic that could kill millions across the globe if H5N1 acquires genetic material from a human influenza virus and becomes easily transmittable from one human being to another.
The Romanian government said tests by scientists in Britain confirmed the heron had the virus, marking the country's first case outside the Danube delta region. The bird was discovered near the border with Moldova.
"Tests carried out by the laboratory in Weybridge (England) have confirmed the presence of the H5N1 virus" in the heron, Agriculture Minister Gheorghe Flutur said.
Europe is on maximum alert for the further spread of the H5N1 strain, which has already also been detected in Croatia, Russia and Turkey, a westward sweep health experts believe is caused by birds migrating ahead of the winter.
China is also under threat from migratory birds, with three of eight global migration routes going through China, veterinary officer Jia said.
Taiwan and Hong Kong also stepped up precautions on Friday.
WASHINGTON -- Bird flu may kill millions, or it may fizzle out among the chickens. But if it does spread among humans, the legacies of earlier flu pandemics offer at least two lessons on what to expect:
-- There will probably be a warning. An early "smoldering" phase of relatively few deaths might offer a grace period to get started on a vaccine or reduce large shortages of treatment drugs.
-- If the flu does catch fire, a large proportion of the dead will be healthy young adults, either because they don't have immunity to the flu strain or because their defense systems go into dangerous overdrive.
Those likelihoods, based on recent studies of the catastrophic 1918-19 Spanish flu and two later pandemics, may figure prominently into the federal government's long-awaited blueprint to prepare for and respond to a flu calamity.
Knowing a pandemic might kill large numbers of working-age adults would be vital background for health authorities deciding which Americans would get scarce supplies of flu vaccines and treatment.
"The healthy, the young are critical members of society," said Shelley Hearne, executive director of Trust for America's Health, a Washington group that tracks public health issues. "They keep the lights on, the water running, they are the first responders. These are the people needed the most in a major health crisis."
Using the past to predict the future is tricky, given that scientists have limited historical information. The U.S. has experienced only three flu pandemics since 1900; all told different stories.
Each was caused by a different bug. And battles against the viruses were waged in vastly different societies, by doctors whose treatment tactics corresponded to the state of knowledge at the time.
Still, all three flus had this in common: They qualified as pandemics not because of their large death tolls, but because they were "novel" viruses -- new strains unrecognized by contemporary immune systems.
The two most recent pandemics -- the Asian flu of 1957-58 and the Hong Kong flu of 1968-69 -- shared an important characteristic: Each virus became novel through a genetic process called "reassortment."
Viruses survive by entering healthy cells, hijacking their hosts to replicate before spreading. Sometimes two viruses enter the same cell. If a human virus and a bird virus meet, they might swap genes -- reassort -- and create a novel strain.
The final product can be nasty. Hong Kong flu killed 40,000 more people in the U.S. than a routine flu. Asian flu killed 60,000 more.
"The concern is, you get the virulence from the avian flu, but the contagiousness from the human strain," said Dr. James Campbell, a researcher at the Center for Vaccine Development at the University of Maryland School of Medicine.
The 1918-19 Spanish flu pandemic, on the other hand, was a bird virus that mutated differently. Somehow it spread among humans without picking up human genes. That mysterious jump, along with its awesome death toll -- 500,000 Americans -- is why experts fear the current bird flu could be devastating.
"We have no idea how many (mutations) it would take before it takes off in humans," said researcher Richard Webby, a flu specialist at St. Jude Children's Research Hospital in Memphis, Tenn. "It could be it needs to change two amino acids. It could be it needs to change 20 to 30."
But despite their distinct biological origins, the three 20th century pandemics provide strong hints of how the next one might run its course.
Health experts once assumed pandemics acted like tornadoes, arriving with almost no warning and spreading with little interruption. But recent research found early waves are sometimes mild and account for few deaths. One study of New York City showed the Spanish flu caused modest death in the spring of 1918 before blooming into a full-blown crisis in the fall. The 1968-69 pandemic, which was initially mild in many countries, caused most of its deaths in the second season.
On the other hand, the 1957-58 pandemic spread aggressively in its first season. With only three pandemics to study, experts are unable to predict how the next pandemic might unfold.
Meanwhile, death records from the last three pandemics show unusual mortality among young, healthy people.
In a typical flu season, the elderly account for about 90 percent of fatalities. But in a flu pandemic, "you have about half the deaths or more in people under 65," said Lone Simonsen, an epidemiologist at the National Institute of Allergy and Infectious Diseases and a co-author of recent studies on the topic.
This pattern was particularly strong in 1918-19. Deaths soared among the young, while mortality among the elderly didn't even suggest a severe season.
"For some reason, the pandemic was extremely severe in the young adults," Simonsen said.
Esther Day Passman, 90, of Jacksonville, Md., was a toddler when her 26-year-old mother became ill with flu. The young woman had visited her stricken brother, a soldier just returned from World War I, according to family accounts.
"My father said, "Don't go, he's dying and everyone is scared to death of the flu,"' Passman said. "But she went."
Within days, flu hit the entire family -- Passman, both her parents and two brothers. A hay-padded wagon was used to transport them from rural Maryland to family in Pennsylvania. Everyone recovered but Passman's mother, Isola Day.
"My mother lived for about two or three days," Passman says. "I have a beautiful picture of her."
Young adults' vulnerability in a pandemic may be linked to the fatal overreaction of their strong immune systems. With a serious flu, the lungs may be flooded by too many immune cells, leading to inflamed tissues, clogged air passages and cells unable to properly absorb oxygen.
Or, younger people may not have immunity. Studies have shown people who were 77 or older in 1968-69 carried effective antibodies from being exposed to a similar flu virus around 1892.
"There was some benefit from having those old antibodies hanging around from childhood," Simonsen said.
HONG KONG, dpa - Up to three quarters of people in Asia believe there will be a bird flu pandemic with people in Taiwan, Singapore and Hong Kong the most anxious, according to a survey Thursday.
Seventy six per cent of Taiwanese, 74 per cent of Singaporeans and 68 per cent of Hong Kongers believe bird flu will eventually develop into a pandemic, the poll of 2,500 Asians found.
Seventy per cent of people in Hong Kong, Korea and Taiwan and more than half of people in China and Singapore believe bird flu will be a serious problem within the next six months.
As alarm over the spread of the H5N1 virus mounts, people across the region are unhappy with their governments' response to the potential impact of bird flu so far.
Seventy five per cent of people in Taiwan, 67 per cent of people in Korea and 48 per cent of people in Hong Kong said they thought their government's response had been less than adequate.
China was the country where people had done most to adjust their diets to take a potential outbreak into account with 44 per cent saying they were eating less poultry.
Thirty nine per cent of people in Taiwan, 33 per cent of people in Hong Kong, 29 per cent of people in Korea and 26 per cent of people in Singapore said they had also changed their diets.
Six out of 10 people in Hong Kong, Korea, Singapore and Taiwan said they thought their government should provide people with vaccinations against bird flu.
In Taiwan and Korea, respondents felt strongly that imports of birds should be prohibited with 82 per cent and 69 per cent respectively in favor of an outright ban.
In Hong Kong and Singapore, less people were in favor of banning poultry imports with 58 per cent and 50 per cent of respondents respectively in favor of the move.
Forty five per cent of Koreans said they favored sealing the country's borders if there was a bird flu pandemic compared to 42 per cent of Singaporeans, 37 per cent of Hong Kongers and 24 per cent of Taiwanese.
The survey was carried out by market research firm TNS which conducted interviews in China, Korea, Singapore, Taiwan and Hong Kong on Oct. 25 and 26.
TNS associate director Stephen Yap said: "The survey confirms that the bird flu threat is top of (people's) minds across the region and uncovers a growing impatience and sense of urgency around the issue, especially in Hong Kong, Korea and Taiwan.
"While the appropriate steps to combat bird flu are still being evaluated, policymakers must also place careful consideration as to how to placate an increasingly alarmed public."
All flu viruses are divided into three groups - A, B and C. Humans tend to get flu from types A and B. Type A only can cause pandemic.
The influenza viruses type A are made up of 16 H subtypes and 9 N subtypes. The H subtypes are epidemiologically the most important. They govern the ability of the virus to bind to and enter cells, where multiplication of the virus then occurs
The only subtypes known to cause pandemics are the H5 and H7. Not all the H5 and H7 subtypes cause severe disease in poultry (not all are highly pathogenic).
The N subtypes govern the release of newly formed virus from the cells.
When H5 and H7 viruses are allowed to circulate in poultry populations they can sometimes mutate into highly pathogenic forms. This has happened and a highly pathogenic (deadly) strain called H5N1 has emerged. This bird flu strain is highly contagious (among birds) and kills most of the birds it infects.
The dangerous bird flu strain is called H5N1. If this strain evolves (mutates) by exchanging genes with a normal flu virus that commonly infects humans, it could learn to spread among humans as easily as it spreads among birds. The mutated H5N1 virus strain would be much more deadly than any flu virus humans experience today.
Synopsys:
-- 3 Groups of Flu Viruses - A, B and C
(Reuters) - Vietnam, where the bird flu virus has killed more than 40 people, has two new suspected human deaths from the disease, a hospital official said on Saturday.
Here is a chronology of bird flu developments:
Dec 15, 2003 - South Korea confirms a highly contagious type of bird flu at a chicken farm near Seoul and begins a mass cull of poultry when the virus rapidly spreads across the country.
Jan 8, 2004 - Vietnam says bird flu found on poultry farms.
March 16 - China declares it has stamped out bird flu.
Sept 27 - Thailand says it has found a case where one human probably infected another with bird flu. It says this is an isolated incident posing little risk to the population.
Oct 8, 2005 - Turkey reports first cases of bird flu, raising concern on Europe's doorstep. It is later confirmed as the type dangerous to humans, the H5N1 strain.
Oct 10 - The European Commission announces a ban on imports of live birds and feathers from Turkey to the 25-nation EU.
Oct 15 - British tests identify H5N1 in three ducks found dead in Ceamurlia de Jos in Romania, the first incidence in mainland Europe of H5N1.
Oct 17 - Greece says H5 bird flu -- which can range from a mild form to H5N1 -- has been detected on the Aegean island Chios, the first such case in an EU member state.
Oct 21 - Hungary says a vaccine against the deadly strain of bird flu has proven effective. Scientists also detect the H5 avian flu virus in wild swans found dead in eastern Croatia.
Oct 23 - Britain says that a parrot that died in quarantine in Britain has been found to have the deadly H5N1 strain.
Oct 25 - Indonesia reports the death of a man from bird flu which, according to the World Health Organization, brings the human death toll throughout Asia to 62, comprising 41 in Vietnam, 13 in Thailand, four in Indonesia and four in Cambodia.
Oct 29 - Director of hospital in Vietnam says two people showing symptoms of the bird flu virus have die. A third person is being treated in a hospital.
'Is Tamiflu A Prescription For Survival?'
Further down this page, you'll also find a comprehensive selection of the finest books on Urban Survival and Survival in the City. You can also click on the Amazon.com button under each of these titles to read extracts from, or reviews of them, or to place an order.
This expertly-written book on Survival Skills in the City, by John Wiseman, authFor the beautiful woman inside every woman...
Live a healthy, balanced, beautiful life!
Scientists Make Human Vaccine for H7N1 Bird Flu Virus
Bloomberg,
October 27, 2005.
Hungary claims major breakthrough in bird flu vaccine development
Australian Broadcasting Corporation,
TV Program Transcript - 'Lateline',
Broadcast 26 October, 2005.
Reporter: Michael Edwards
Hungarian bird flu vaccine 'of little use'
Australian Broadcasting Corporation,
29 October, 2005.
Are You Prepared For A Natural Disaster, Pandemic Or Other Emergency?
We highly recommend
Click here for the best Books on Self-Sufficiency and Independent Living
Funeral industry ponders bird flu risks
Australian Broadcasting Corporation,
October 29, 2005..
With Threat of Avian Flu, Go or Stay Home?
'Practical Traveler'.
By Christopher Elliott,
The New York Times,
October 30, 2005.
Recommended books for Health Professionals and Public Health Officials:
For more books on Plagues and Pandemics, see below on this page.
West failed to stem bird flu says researcher
By Martin Johnston,
New Zealand Herald,
26 October, 2005.
Order these bestselling books on Emergency Home Preparedness...
See below for additional Emergency Home Preparedness titles
Science races bird flu clock
by Leigh Dayton,
The Australian,
October 29, 2005.
Invaluable home and professional resources on Influenza and Bird Flu
Clinical trial set for a bird flu vaccine
United Press International,
28 October, 2005.
We can’t kill bird flu with silver bullets
By Anne Applebaum,
The Washington Post,
in The Canton Repository,
Friday, October 28, 2005
Dealing with recovery issues, abuse or addiction?
Bird flu virus spreads in Europe
Sify.com, India,
Saturday, 29 October, 2005.
Interested in learning from history?
You can also download dozens of free classic history books!
In Predicting Bird Flu's Course, Science Looks to the Past
by Bruce Taylor Seeman,
©. 2005 Newhouse News Service
October 28, 2005.
Traveling abroad on business or pleasure? Want to learn a foreign language?
Click on the banner above for a wide range of foreign language courses, instructional
audio cassettes, CDs, videos, phrasebooks and electronic translators.Up to 75 percent of Asians living in fear of bird flu
The China Post,
29 October, 2005.
Which is the dangerous bird flu virus strain, and why?
Written by: Christian Nordqvist,
Editor: Medical News Today,
Category: Flu/Bird Flu/SARS News,
Article Date: 29 Oct 2005.
--Type A only can cause pandemics.
--Type A made up of 16 H and 9 N subtypes
--Subtype H epidiomologically the most important
--Only H5 and H7 (not all) can cause severe disease in birds
--H5 and H7 if allowed to linger in flocks can mutate
--H5N1 is current deadly bird flu strain
--If H5N1 mutates, humans have a serious problem worldwide
Chronology - Bird flu developments
Reuters, UK,
29 October, 2005.
(News items are posted under 'Fair Use' provisions)
See also:
'The Monster At Our Door: The Global Threat Of Avian Flu'
'Three Essential Books For Every Bird Flu Health Provider,
Public Health Official Or Influenza Researcher''The 1918 Flu Virus: An Instrument Of Global Depopulation?'
Index of other Current News Stories on Bird Flu, Avian Inflenza
and the Global Pandemic risk.More bestselling titles on Influenza, Epidemics and Plagues
Want to order,find or review a new or current book on Bird Flu, Viruses or Pandemics?
Search for it here by title, keyword, or author...
We have provided in the boxes below a live, continually-updated listing of the Current Bestselling Books on Survival Skills at Amazon.com, our order fulfilment partners. Please click on any of these titles to read extracts from, or reviews of, these books. You can also place an order for any of themt at the same time with Amazon.Com, if you wish, and enjoy speedy delivery plus the low Amazon.Com price!
Current Bestselling Books on Survival Skills:
We also highly recommend the superb 'SAS URBAN SURVIVAL HANDBOOK'.