(CNN) -- For Ugandan beachcomber George Bukenya, identifying bird flu is like identifying pornography -- he says he'll know it when he sees it.
"I've been here four years and I've never seen the bird flu. I heard about it in Asia and other places, but I've never seen a bird here with the flu," he said.
Like the thousands of fishermen and other Ugandans living off Lake Victoria, Bukenya has little expertise in determining if the birds that share the shore are carriers of the potentially deadly H5N1 virus.
Lake Victoria is a major destination for hundreds of species of migratory birds, many of those either coming from Europe or Asia, or having contact with birds from those regions.
Experts widely believe that the H5N1 bird flu strain from Asia is being spread by these birds as they seek warmer weather in the northern winter. (See bird migration patterns)
So far, the H5N1 strain has hit 16 nations, infected 121 people and killed 62, mostly in Asia, the World Health Organization says.
That strain does not spread easily from person to person, but health experts say they fear that it could mutate and acquire the ability to infect large numbers of people.
There have been three pandemics in the past century, and global health experts have said the world is overdue for another.
Agriculture officials from across Africa are trying to counter growing fears that they are not prepared to handle a possible outbreak of the lethal H5N1 virus.
This village -- like many across the continent -- could be an avian flu hot zone: more wild birds are coming, chickens in cages are for sale nearby and there's a high congestion of people -- many who will return to their own villages for the holidays.
According to locals on the beach, there is little guidance from authorities on what to do if bird flu mutates into a virus that can be passed on to humans.
"We are not scared at all, because we believe God can do it for us," says one person.
While the religious have faith, the scientists have a warning:
"If the virus is coming to Africa it will start in eastern Africa and the capacity of the services in most of these countries are not what we see today in Romania and Turkey, which is a good response," says Joseph Domenech, chief veterinarian at the U.N. Food and Agriculture organization.
Many experts say African governments won't be able to contain the virus -- even though many of them have already banned bird imports.
Complicating the Africa equation: Tens of millions of people on the continent have weak immune systems because of the high incidence of HIV/AIDS.
"It could be a disaster," says Celia Abolnik, senior research scientist at the Onderstepoort veterinary institute.
"I think in that regard something like bird flu could spread very quickly."
Abolnik is leading South Africa's effort to keep the bird flu at bay. Her scientists are stationed at migratory routes and in the lab, netting and testing birds.
A similar bird flu strain crippled South Africa -- the world's biggest producer of ostrich meat -- last year.
Authorities ordered tens of thousands of ostriches culled and compensated farmers.
Beachcomber Bukenya says he wonders if Ugandan authorities can afford to fight bird flu and compensate farmers ordered to cull poultry too.
And what happens in Africa has implications for the rest of the world. Many of the migratory birds -- potential flu carriers -- flying to Africa now will return to Europe and Asia in a few months.
KIGALI, Nov. 2 (Xinhuanet) -- Although the deadly bird flu hasn't reached Rwanda, residents in impoverished Kigali are debating whether to kill their chickens and what meat to eat if the diseasedoes arise.
Following an avian influenza outbreak in Europe, fears are fueled that the African continent has been exposed to the risk of bird flu as migration birds from Europe during the winter is highly likely to be the carrier of the deadly H5N1 virus.
Health experts and veterinarians from more than 40 African countries are currently participating in the week-long seventh African Union conference for animal resources in Rwandan capital of Kigali, focusing on the predicted threat of the H5N1 strain which has killed more than 60 persons in Asia.
"The radio said bird flu was coming and I know the danger," said Frontie Kekamei, 45, a taxi driver in Kigali, capital of the tiny African country of Rwanda.
"My family have come to an agreement to kill all the 8 hens and 10 geese we are keeping but to frozen the meat as soon as Kigali tests the disease," said Frontie, "without chicken, my wife and I have no meat to feed our three kids and my 72-year-old mother."
Poultry is often the only meat that many Africans can afford. In the hunger-hit continent with almost half of its population live below one dollar a day, people depend on chicken as their main protein sources.
Experts worry that mass killing of chickens will worsen the current food shortage on the continent where drought has left 14 million Africans at the edge of hunger.
Worse of all, the poultry crisis may come ahead of time since dozens of African countries, including Kenya, Ethiopia, Nigeria, Uganda, Tanzania and the like, have banned fowl imports from virus-infected nations. As an excessive measure to ward off bird flu, Sudan and Algeria even announced to forbid any animal import, regardless of its origin.
"The TV said Rwanda had just banned poultry imports from China,Vietnam and Europe, so I put my price higher to 2,000 Rwandan Franc a kilo. My chicken is local, and that means safe," said a poultry vendor on Wednesday, carrying in each of his hands one henin a food market in Kigali.
According to statistics from the Rwandan Agriculture Ministry, the land-locked tiny country has few poultry farms. Over 95 percent of frozen or live chickens residents here consume are from Uganda or even Europe. And statistics show in western African country Senegal, the import of frozen chicken products multiplied fivefold between 1998 and 2004.
Just like Rwanda and Senegal, most African countries have seen a 20 percent annual increase in poultry imports for the past several years and become highly dependent on imported chicken now.
"Africa's poultry industry is weak and bird flu make the disadvantage visible," said an official with the African Union. "To feed themselves well, Africans have lots of challenges to confront."
HANOI, Nov. 3 (Xinhuanet) -- A 25-year-old woman from Vietnam's Hanoi capital city has been hospitalized after showing bird flu symptoms, local newspaper Youth reported Thursday.
The woman from Dong Da district was admitted to the Hanoi-based Bach Mai hospital on Tuesday. She developed many symptoms similar to bird flu ones. She had fever and suffered from pneumonia.
The hospital has sent specimens from her to the National Institute for Hygiene and Epidemiology for bird flu testing. The woman's mother said she had bought semi-processed chicken at a local market for meal at home. Four people in her family had eaten the meat. After that, only her daughter exhibited the bird flu symptoms.
Vietnam has reported no new bird flu patients since late July, Vietnamese Deputy Health Minister Trinh Quan Huan said at press briefing on Wednesday. Up to 91 Vietnamese people have been infected with bird flu since the disease started to break out in the country in late 2003. Of them 41 have died.
To cope with potential bird flu outbreaks, the ministry is mapping out a national rehearsal plan on fighting the disease, he said, adding that the country will stage the rehearsal in Hanoi, southern Ho Chi Minh city and central Nha Trang city in mid-this month. The ministry has also warned that local people should not eat fowls and their products.
At a press briefing last week, Bui Quang Anh, director of the Vietnam Veterinary Department, said Vietnam has, since early last month, spotted two bird flu outbreaks, one in southern Dong Thap province and another in southern Bac Lieu province. Some 400 out of a flock of 600 ducks in Dong Thap, and part of a flock of more than 1,000 ducks in Bac Lieu died of bird flu.
The country is facing a high risk of large bird flu outbreaks, especially in the southern Mekong Delta and the northern Red Riverdelta, since weather conditions are favorable for the development of bird flu viruses, he said.
PREY ROGNIENG, Cambodia - When the half-starved chickens started dying this summer and the barefoot children developed fevers here in this village of thatched huts and emerald rice fields, residents were terrified and deeply divided about the cause of their misfortune.
Some blamed bird flu and took their weakened children to a clinic in a nearby provincial city, where a medic diagnosed human influenza instead. But other residents said it was witchcraft by the only village resident not born here, 53-year-old Som Sorn, who moved here eight years ago when she married an elderly local farmer.
When Mrs. Som Sorn's husband went into the jungle to cut wood one afternoon and she began cooking rice over a fire on the dirt floor of her hut, a local man with a machete took action and later collected $30 in donations from grateful neighbors, a month's wages.
"The assassin grabbed her hair, pulled her head back and cut her throat," said Ya Pheorng, the village leader. "Her neck was almost completely severed."
The sorcery allegation and grisly killing underline what United Nations and American officials describe as the difficulty of preventing a global human epidemic of bird flu: the disease is most prevalent among poultry and wild birds in impoverished rural areas of Southeast Asia with low levels of literacy, high levels of superstition and very little health care.
If the disease does make the jump from transmission by birds to person-to-person transmission, the crucial question will be whether the first few cases can be isolated quickly. If not, frightened people nearby could start fleeing, carrying the disease to big cities and then around the world by jet. In a telephone interview at the end of a recent weeklong trip to Southeast Asia, Michael O. Leavitt, the secretary of health and human services, compared the early stages of a flu pandemic to the beginnings of a forest fire.
"If one happens to be at the source of the spark, it's simple to put it out with your foot," he said. "The question is, will we be there?"
Only four countries, all in Southeast Asia, have had laboratory-confirmed human cases of bird flu so far: Cambodia, Indonesia, Thailand and Vietnam. Cambodia is the poorest, with the most rudimentary health system outside urban areas.
Cambodia's difficulties and small successes in fighting bird flu are indicative of the struggle that lies ahead. Scientists predict the struggle could last for many years and may have to be fought in other poor areas as well, notably in India and Bangladesh and East Africa. But United Nations officials say the disease will probably remain most prevalent and most dangerous here in Southeast Asia, where chickens wander freely in and out of homes and even apartment buildings, mixing constantly and intimately with people to an extent not found in most other countries.
In two decades of turmoil beginning in the 1970's, most of Cambodia's doctors died in the Khmer Rouge's killing fields or fled the country. Many of the country's current generation of health care professionals can scarcely read or write and received rudimentary medical training in Vietnamese, a language they barely speak, during the Vietnamese occupation in the 1980's.
Since the first chickens began dying of bird flu in Cambodia in January 2004, the country has made some progress, with modest foreign assistance, in controlling the disease in poultry and keeping people healthy. Yet formidable gaps linger in the country's defenses.
Those gaps highlight the continued mismatch between limited efforts to slow the spread of bird flu among poultry in developing countries and increasingly large efforts by industrialized countries to prepare for a possible human outbreak. The United States and other industrialized countries are spending billions of dollars to stockpile antiviral medicines and other gear for treating people who may become infected. But the United Nations' Food and Agriculture Organization has been able to collect only $30 million from industrialized nations since February for a campaign to delay or prevent an epidemic, a little over one-sixth of the $175 million and rising that the F.A.O. says is needed.
In Phnom Penh, Cambodia's capital, American and German foreign aid has just helped supply the latest Western equipment to a virology lab at the Cambodian government's animal health department. But the virus samples are taken for testing from chicken carcasses brought in from all over the country to a moldering building next door. Researchers cut apart the carcasses in a room with no air-conditioning and a fan that blows air out the windows and across an alley. A crowded elementary school with no glass in its windows is just 10 yards away.
"They need to completely seal this area," said Dr. Lu Huaguang, a Pennsylvania State University avian virologist temporarily working in Phnom Penh to help set up the virology lab.
At the Food and Agriculture Organization's office a few blocks away, Tsukasa Kimoto, the chief representative, talks proudly of an innovative program to train the country's 6,000 village animal health workers to identify bird flu and report it immediately. But only 500 of these workers have been trained so far, he acknowledged, and the virus may be back soon, as it appears to be most active here from December through March.
Most of the poultry in Cambodia roams so freely that if one bird is found sick, it is practically impossible to catch and kill nearby birds to curb the spread of the disease, Mr. Kimoto said.
"Chasing those chickens one after another is a rather tedious thing - we don't have the people," he said.
At Cambodia's Health Ministry nearby, Dr. Chea Chhay, the under secretary charged with leading his country's fight against avian influenza, proudly described how teams of researchers were ready to drive on an hour's notice to regions reporting bird deaths. But many villages lack phones, to say nothing of doctors, and it may take a day or two during the rainy season for anyone from a remote village even to reach a phone.
[President Bush asked Congress on Nov. 1 to approve $7.1 billion for bird-flu prevention and treatment, including $251 million for early detection overseas.]
Drive just 35 miles west from Phnom Penh to this small village and the logistical challenge of confronting bird flu is even more apparent. The government built a small concrete-walled clinic eight years ago in an adjacent village, but electrical lines were never extended from the nearest town and no generator was installed so the clinic's lights have never worked.
The clinic's director, Pol Wana, was about to complete junior high school when the Khmer Rouge took over in 1975 and shut all schools. He never returned to school, but leads a staff of 10 in diagnosing ailments and prescribing and distributing medicine.
The government asked him to look out for bird flu, he said, but has not given him a clear list of symptoms.
Mai Morm, a 76-year-old farmer, stopped by the clinic late one morning to pick up medicine for a chronic cough. He said if any of his chickens fell sick, he would not tell anyone for fear the government might arrange for the rest to be slaughtered without compensation. "If they were very sick before they died then I might throw them in the brush," he said. "But if they were only a little sick, I'd probably eat them."
The killing of Mrs. Som Sorn was first reported by the small Cambodia Daily in an article about sorcery. The killer had not expected anyone to identify him to the police, and was surprised to be arrested and sentenced to 15 to 20 years in prison, Mr. Ya Pheorng said. Neighbors who paid her killer were not prosecuted after making further payments to the police, the village leader added.
Besa Korn, a 51-year-old village resident who was not among those making donations to the killer, said the true cause of the summer illnesses might never be known. But life has clearly improved since Mrs. Som Sorn's death, she added.
"Everyone in the village has been very happy since then," she said. "And we have had no more illness."
PEOPLE were moving house in fear of the neighbour's pet budgie as confusion and panic over bird flu spread, a bird specialist said.
And panicky bird owners were letting their pride and joy fly the coop or putting them down based on an irrational fear of contracting the virus, Professor Bob Doneley said.
But Prof Doneley said it was more likely that a meteor would hit a light plane, which would then fall on someone's head, than it would be to contract bird flu off the neighbour's pet bird.
"I had a phone call from one of my bird-owning clients asking me to call his neighbour to reassure her she that wouldn't have to sell her house and move out because of his birds," Queensland's only registered bird specialist said today.
"Talking with colleagues around the world it's not an isolated incident - there's people letting their birds go, people putting their birds down, people moving away from people who own birds.
"Everybody is becoming incredibly fearful of birds in general and it's unfounded."
Prof Doneley, from the University of Queensland's veterinary school, said "anti-bird paranoia" was gripping the public.
His West Toowoomba vet surgery was being swamped with inquiries from panicked bird owners, he said.
He said "three or four" people were calling daily wanting to know if they should move house because of their neighbours' parrots, finches and budgies.
"The chances of getting bird flu off a pet bird or your neighbour's birds are so infinitesimally small," Prof Doneley said.
"You're more likely to have a light plane hit by a meteor and fall on your head than somebody getting bird flu off their cockatiel."
Authorities have confirmed the dangerous H5N1 strain of bird flu in South East Asia, Russia and Eastern Europe but not in Australia.
They fear an epidemic, or pandemic, if the strain mutates to spread between humans.
Prof Doneley said the threat was real, but many people misunderstood what the real risk was.
"The real risk is if somebody gets bird flu from chickens, which is the most common species affected, and that virus then changes enough to become passed from people to people," he said.
Prof Doneley urged people to use commonsense and stay calm.
"I think we only have to look at what happened with the SARS epidemic," he said.
"That was going to be the end of the world as we knew it, and it just quietly fizzled out.
"Maybe this will happen this time, or maybe it won't."
The World Bank has described the potential economic impact of a global bird flu pandemic as a "grave concern".
Its latest report on East Asia's performance said areas were already feeling the impact from outbreaks.
Losses due to the disease and control measures such as culling have led to declines of 15% to 20% in the poultry stock in Vietnam and Thailand.
The warning came after regional leaders met in Bangkok for talks dominated by discussion of ways to tackle bird flu.
The foreign ministers of Cambodia, Laos, Burma, Thailand and Vietnam have already agreed to co-operate closely to control the spread of the disease and develop a human vaccine.
Further talks are expected in the prime ministers' meeting on Thursday.
The H5N1 strain of bird flu has killed more than 60 people in South East Asia since late 2003.
'Severe demand shocks'
The World Bank urged the international community to avert a possible catastrophe.
"But all agree it could lead to at least several million human deaths."
It added that the most immediate impacts might arise not from actual sickness, but from the "unco-ordinated efforts of private individuals to avoid becoming infected, as well as public policy actions like quarantines and travel restrictions".
The bank said these could lead to "severe demand shocks for services sectors such as tourism, mass transport, retail, hotels and restaurants".
The short term effect of the pneumonia-like disease SARS in 2003 was, the report says, equivalent to about 2% of incomes in East Asia. That killed about 800 people.
BBC economics correspondent Andrew Walker says that apart from these warnings, the report is generally positive.
The bank notes that economies in East Asia have adjusted well to some fairly serious shocks, notably the doubling of oil prices.
China's fight against bird flu received a strong shot in the arm yesterday the government has earmarked a special fund of 2 billion yuan (US$246.6 million) for epidemic control.
"(We) must realize the severe and compelling situation in bird flu control, maintain high vigilance, and never let down our guard," said a statement from a State Council (China's cabinet) meeting held yesterday in Beijing.
The meeting, presided by Premier Wen Jiabao, decided to set aside the amount from this year's central budget for prevention and control of the highly pathogenic avian influenza.
It also announced that it would reactivate the national command headquarters to co-ordinate efforts against bird flu.
Observers noted the size of the fund exactly matches the budget allocation made in April 2003 to fight against the SARS (severe acute respiratory syndrome) contagion.
In addition to funding, the State Council said, any failure, delay or cover-up in reporting outbreaks will be dealt with harshly, according to sources.
Information about epidemics will be released accurately and in time, and technological co-operation with other countries and international organizations will be further enhanced, they said.
In case of a new outbreak, measures such as culling, disinfection and quarantine should follow immediately to eradicate any infection at the site, the statement said.
The meeting stressed that the country's priority is to ensure no one is infected.
China has reported and brought under effective control three bird flu outbreaks among poultry over the past month in North China's Inner Mongolia Autonomous Region, and East China's Anhui and Central China's Hunan provinces.
No human case has been reported.
The State Council statement said the country should improve emergency procedures and prevention and treatment measures for human infection, and strengthen monitoring of live poultry markets.
In particular, veterinary workers at the grassroots level should receive more training, and livestock-raising methods should be transformed so that poultry is raised under advanced, hygienic standards and on a large scale.
Most Chinese poultry is raised in scattered, small courtyard farms with little attention to hygiene, making them vulnerable to a possible contagion, Jia Youling, director of the Veterinary Bureau under the Ministry of Agriculture said on Friday.
Other measures adopted at the meeting included stepping up immunization in border areas, poultry farms and wetlands; and giving priority to the development of effective vaccines.
Yesterday's meeting came amidst reports of more bird flu outbreaks elsewhere in the world, while various areas in China stepped up countermeasures.
Thailand yesterday reported a fresh outbreak of bird flu among poultry in the central province of Ang Thong, the seventh province to be hit by the latest flare-up of the disease, Reuters reported.
Thai Foreign Minister Kantathi Suphamongkhon said his country and Cambodia, Myanmar, Laos and Viet Nam have agreed to co-operate fully to prevent outbreaks of the deadly H5N1 strain of bird flu in the region, according to a Xinhua report.
Meanwhile, China has suspended poultry and poultry-product imports from 14 countries, including Thailand, Viet Nam and Cambodia, where bird flu cases have been reported, according to the Ministry of Commerce.
Also yesterday, a seminar in Beijing brought together Chinese agricultural and quarantine officials and their United States counterparts to discuss ways to stop the spread of bird flu.
SINGAPORE (AFX) - The World Bank said growth in East Asia's emerging economies will slow to 6.2 pct in 2005 from 7.2 pct in 2004 and will suffer severely if a bird flu pandemic breaks out.
For 2006, their average gross domestic product (GDP) growth is projected to stay at 6.2 pct but a pandemic would set off shocks in regional economies, the Washington-based lender said in its twice-yearly regional outlook.
With East Asia already affected by a cyclical slowdown in the technology sector and higher oil prices, the spectre of a bird flu pandemic looms as a major threat to the region, it said.
If the H5N1 virus mutates into a form that makes it easily transmissible among humans, the immediate impact could be similar to that of the Severe Acute Respiratory Syndrome (SARS) outbreak two years ago, the World Bank said.
'There are great uncertainties about the timing, virulence and general scope of a future human flu pandemic but all agree it could lead to at least several million human deaths.
'The most immediate economic impacts of a pandemic might arise, as in SARS, not from actual death or sickness but from the uncoordinated efforts of private individuals to avoid becoming infected, as well as public policy actions like quarantines and travel restrictions.'
The World Bank said these could lead to 'severe demand shocks for services sectors such as tourism, mass transport, retail, hotels and restaurants etc. as well as supply shocks due to workplace disruption.'
The World Bank gave no estimates on how much East Asian economies will suffer from a pandemic but said several rural areas in the region were already feeling the impact from outbreaks, particularly the poultry sector.
In Vietnam for example, which has accounted for more than two-thirds of the 60 people killed by the virus in Asia since 2003, the outbreak has already caused an impact due to lost economic activity, the World Bank said.
'At the overall macroeconomic level, costs so far have been fairly limited ... but could rise significantly going forward, and have already been high for specific sectors and communities,' it said.
The World Bank urged the international community to avert a possible catastrophe.
'There is clearly a priority on curbing avian flu 'at source' in the agricultural sector, through implementation of strong animal and human health surveillance, disease control and mitigation measures, thereby reducing the probability of a far more costly human epidemic,' the World Bank said.
'Policy makers everywhere need to give the influenza threat top political attention and priority to avert, delay or mitigate what could be a global disaster,' it said.
In its report, the World Bank noted that the slower growth in 2005 expected for the region is due to reduced export orders, higher energy prices and a cyclical downswing in the technology sector.
For economies like Indonesia, the impact of higher oil prices will still be felt in 2006 after the government announced moves to slash fuel subsidies.
Barring a bird flu pandemic, the World Bank predicted 2006 growth of 8.7 pct for China, 7.5 pct for Vietnam, 6.0 pct for Indonesia, 5.3 pct for Malaysia, 5.0 pct for the Philippines, 5.0 pct for Thailand and 6.1 pct for Cambodia.
For the more advanced East Asian economies, the bank predicted 2006 GDP growth of 1.8 pct for Japan, 4.4 pct for Hong Kong, 4.6 pct for South Korea, 4.7 pct for Singapore and 4.1 pct for Taiwan.
The government issued a thick report Wednesday on planning for a potential avian-flu outbreak, warning of huge health and economic costs, and of possible travel restrictions and enforced quarantines.
The release of the report, in tandem with congressional hearings on a possible pandemic, continued a recent cram course for Americans and their lawmakers that began this fall when the Senate and President George W. Bush turned their attention to the disease.
The report includes lessons learned from Asian experiences with the flu since it emerged in 1997, and with the SARS outbreak of 2003. It suggests that in a serious outbreak, the United States might have to implement travel restrictions and perhaps enforced quarantines.
Bus, train and subway systems might be temporarily closed by the Department of Health and Human Services, says the report.
It provides figures that, if extrapolated globally, paint a stunning picture.
For example, it estimates that the U.S. health costs alone of a moderately bad pandemic, not including disruption to the economy, would be $181 billion. This figure describes a pandemic like that of 1968, which killed about 34,000 Americans, a figure close to the annual average of flu deaths now in a larger U.S. population. Yet the 1918 pandemic killed 500,000 Americans, among at least 20 million deaths worldwide. And economic disruption, through travel limitations and a sharp rise in sick days, would likely be enormous.
The report predicts that an avian flu pandemic would kill from 209,000 to 1.9 million Americans. Outside estimates of a global toll have ranged as high as 50 million or 60 million.
A day after Bush said he would ask Congress to approve $7.1 billion in emergency bird-flu spending, Michael Leavitt, secretary of health and human services, released the long-awaited report and took questions from congressional committees.
Leavitt, calling the government's goal "inspiring preparation, not panic," cautioned that the probability of the bird flu virus's mutating into a strain easily spread among humans was unknown. Still, he said, "the troubling signs are clearly there." He said the government hoped to have on hand 20 million courses of vaccine for a similar strain of flu and then, within six months of a human-to-human outbreak, to produce 300 million courses.
Leavitt said he wanted the technologies for doing so "to be domestically produced." For now, the only U.S.-based flu vaccine-making facility is a Pennsylvania plant owned by Aventis Pasteur.
The Senate has already approved $8 billion in emergency bird-flu spending based on a plan similar to Bush's; the House has yet to act.
Senators, generally supportive, warned Wednesday that new money should not be provided by cutting back other public health spending in ways that ultimately could weaken a bird flu response.
"This is a true emergency," said Senator Tom Harkin, Democrat of Iowa, "and it ought to be handled as such." Lawmakers also heard from John Barry, author of "The Great Influenza," a book about the 1918 flu that Bush said he had read. Barry described horrific symptoms: "People turned so dark blue from lack of oxygen that physicians reported they had difficulty distinguishing between black patients and white patients," he said. "People could bleed from their eyes, ears, as well as nose and mouth." Barry asserted that the public today was more vulnerable to flu, and not less so, than in 1918, because modern medicine had kept more people alive - cancer or AIDS patients, for example - with impaired immune systems.
WASHINGTON - Senators asked federal health officials Wednesday how they would spend the $7.1 billion dollars President Bush requested a day earlier to prepare the nation for a possible outbreak of the avian flu
"Our goals in seeking this funding are to be able to produce a course of pandemic influenza vaccine for every American within six months of an outbreak," Health and Human Services Secretary Michael Leavitt told the Senate Appropriations Committee.
Leavitt fielded questions from senators on how the president's budget request would be used. The funding will also help provide antiviral drugs and other medical supplies to treat more than 25 percent of Americans.
"We do not know if this virus will set off a global pandemic," Leavitt said. "We do know one will happen at sometime."
Sen. Thad Cochran, R-Miss., chairman of the Senate Appropriations Committee , asked Leavitt how quickly Congress needs to act.
"The request before us is described as an emergency. Is it urgent?" Cochran asked.
"We are in a vulnerable situation if it moves person to person," Leavitt responded.
Federal officials said Wednesday that the United States might impose travel restrictions if the bird flu or other super-influenza strain mutates to a person-to-person virus.
A pandemic would send out alarms nationwide for states and cities to ration scarce medications and triage patients to prevent further spread past hospital rooms, according to the federal plan.
The plan follows Bush's announcement on Tuesday on how to prepare the nation for a possible outbreak with a preparedness strategy.
Centers for Disease Control and Prevention Director Julie Gerberding said antiviral drugs have made remarkable progress and could possibly limit the spread of the flu even if a vaccine is not yet available.
"Guidance emphasizes the importance of using antivirals first of all for treatment for people who identify flu-like symptoms and see a clinician within 48 hours. These drugs can reduce the severity and the duration of their symptoms," Gerberding told the Senate panel. "We really do have drugs now that are widely useful for reducing flu complications."
The Bush administration's long-awaited strategy gives guidance to officials on how to organize a plan for their communities.
Asian bird flu has killed more than 60 humans in Southeast Asia, mostly in Vietnam. It has not yet spread from human to human, but in the worst-case scenario outlined by international scientists, it could cause millions of deaths worldwide.
Pandemics, or worldwide outbreaks, strike when the easy-to-mutate influenza virus shifts to a strain that people have never experienced before, something that happened three times in the last century.
The president requested $7.1 billion from Congress to fight a pandemic, including $1.2 billion to stockpile vaccines for 20 million Americans. The government already has ordered $162.5 million worth of vaccine to be made and stockpiled against the Asian bird flu, more than half to be produced in a U.S. factory.
Bush said the bird flu has affected more than 120 people and has had a fatality rate of about 50 percent. While the virus has spread in birds across the globe, no reports of the strain have been recorded in the United States.
The plan includes:
- $1.2 billion to stockpile enough vaccine against the current H5N1 flu strain to protect 20 million Americans, the estimated number of health workers and other first responders involved in a pandemic. If a similar bird flu causes a pandemic, the shots should provide some protection while better-matched versions are manufactured.
- $1 billion for the drugs Tamiflu and Relenza, which can treat and, in some cases, prevent flu infection. Enough to treat 44 million people and prevent infection in 6 million others is headed for the federal stockpile. States were told to buy 31 million treatment courses, but Bush is funding only a quarter of their anticipated bill.
- $251 million for international preparations, including improving early warning systems to spot novel flu strains before they reach the U.S.
- $100 million for state preparations, including determining how to deliver stockpiled medicines directly to patients.
- $56 million to test poultry and wild birds for H5N1 or other new flu strains entering the U.S. bird population.
- A call for Congress to provide liability protection for makers of a pandemic vaccine, which unlike shots against the regular winter flu would be experimental, largely untested.
FOX News' Melissa Drosjack and The Associated Press contributed to this report.
US health officials say they have persuaded companies to speed up the delivery of flu drugs and that a new US bird flu pandemic plan would help modernise the vaccine industry.
But the officials had to defend their avian influenza plan from criticism.
The $US7.1 billion ($A9.6 billion) plan focuses on building stockpiles of drugs and encouraging companies to develop vaccines, and asks states to step up with substantial contributions of their own.
The H5N1 avian flu has infected 122 people and killed 62 in four countries - Indonesia, Vietnam, Thailand and Cambodia.
It has become entrenched in poultry flocks across much of Asia and into Europe.
The fear is that H5N1 will mutate into a form that can easily infect and pass among people, causing a pandemic.
An experimental vaccine will help only a little and drugs that can help control it are in scarce supply.
US Health and Human Services Secretary Michael Leavitt said Roche AG, maker of Tamiflu, and GlaxoSmithKline , which makes Relenza, would be able to produce more of the drugs.
"We have vendor representations that they can deliver, as part of our stockpiling effort, 20 million courses by the fourth quarter of 2006 and up to 81 million courses by the (northern) summer of 2007," Leavitt said.
The 81 million would represent roughly a quarter of the US population - a figure the World Health Organisation has suggested as a target for countries to use in preparing for an influenza pandemic.
The federal government would pay for about 50 million treatment courses and states would pay for the other 31 million.
Leavitt said another key goal was to build the capacity to produce 300 million courses of flu vaccine in six months.
Some members of the US Congress, who must vote for the funds to pay for the plan, criticised the government for moving too slowly.
One senior Democratic Senator Tom Harkin complained the plan required states to pay for 31 million treatment courses of Tamiflu and Relenza.
"How are you going to ask Louisiana right now to come up with money for that? Take Mississippi," he said - naming the two states hardest hit by Hurricane Katrina last August.
Some basic facts:
-Type A flu viruses cause pandemic flu. A pandemic is the worldwide spread, in humans, of a flu virus to which most people have no natural immunity. This can happen when an old flu virus reappears after a generations-long absence. It can also happen when a flu virus new to humans acquires the ability to spread easily from person to person.
-Type A flu viruses are subtyped according to proteins on their surfaces. There are 16 different H proteins and nine different N proteins. All H and N proteins occur in birds.
-Human disease has traditionally been caused by three H subtypes - H1, H2, and H3
-Recently, humans have become ill after catching new H subtypes - H5, H7, and H9 - from birds. It's feared that one of these subtypes will emerge as the next flu pandemic - particularly the H5N1 virus causing an unprecedented global epidemic among domestic and wild birds.
-Bird flu viruses come in two varieties, depending on how efficiently they kill birds. Low pathogenicity avian influenza (LPAI) is not as deadly. High pathogenicity avian influenza (HPAI) - apparently limited to the H5 and H7 viruses - kills up to 100 percent of infected birds. The current H5N1 bird flu virus is an HPAI virus.
-In a typical flu season - the seasonal flu, not pandemic flu - there are 30,000 to 50,000 deaths in the U.S. and 20 to 30 times that number of flu deaths worldwide.
Flu Time Line
1580 - First recorded influenza pandemic began in Europe and spread to Asia and Africa.
1700s - Influenza pandemics in 1729-1730, 1732-1733, 1781-1782.
1878 - A disease causing high mortality in poultry becomes known as the "fowl plague." Fowl plague is now called HPAI avian influenza.
1800s - Influenza pandemics in 1830-1831, 1833-1834, and 1889-1890. The last of the three - called the Russian flu - spread through Europe and reached North America in 1890.
1918-1919 - The "Spanish flu" circles the globe (though some experts think it may have started in the U.S.). Caused by an H1N1 flu virus, it is the worst influenza epidemic to date. There are more than half a million U.S. deaths; worldwide death estimates range from 20 million to 100 million. The pandemic comes before the era of antibiotics - which are now essential in treating the secondary bacterial infections that often kill flu-weakened patients - so it's difficult to say whether this flu would have the same dreadful impact in the modern world. But it is a very frightening disease, with very high death rates among young, previously healthy adults.
1924 - The first outbreak of HPAI avian influenza - bird flu - in the U.S. It does not spread among humans.
Flu in the Mid-20th Century
1957-1958 - The "Asian flu" causes the second pandemic of the 20th century. Caused by an H2N2 virus, it begins in China and kills 1 million people worldwide, including 70,000 Americans.
1968-1969 - The "Hong Kong" flu causes the last flu pandemic. It was caused by an H3N2 virus and killed some 34,000 Americans. The relatively low death toll is thought to have been due to two factors. First, the virus contained the N2 protein humans had been exposed to before. Second, an H3 virus circulated around the turn of the century, giving some immune protection to elderly people who'd caught the flu back then.
Mid-1970s - Researchers realize that enormous pools of influenza virus continuously circulate in wild birds.
1976 - Swine flu breaks out among a handful of soldiers stationed at Fort Dix, N.J. One dies. It's an H1N1 virus, and health officials worry that they are seeing the return of the 1918 H1N1 Spanish flu pandemic.
As the virus is circulating among U.S. pigs, President Gerald Ford calls for a crash vaccination program. Despite delays, a vaccine is made and a quarter of the U.S. population is inoculated. There were 25 deaths from a rare paralytic complication of the vaccination (Guillain-Barre syndrome). Nobody else died of swine flu, which never caused an epidemic.
1983 - The second HPAI outbreak in the U.S. Caused by an H5N2 virus, it does not spread among humans. However, this severe poultry epidemic strikes chickens, turkeys, and guinea fowl in Pennsylvania and Virginia. It is finally brought under control after the destruction of 17 million birds.
1996 - HPAI H5N1 bird flu is isolated from a farmed goose in Guangdong, China.
May 1997 - The first person known to catch H5N1 bird flu dies in Hong Kong. The virus has been causing an epidemic among poultry in the city.
November-December 1997 - There are 18 new human cases of H5N1 bird flu in Hong Kong, 12 with direct contact with infected poultry. Six people die. Officials destroy 1.4 million chickens and ducks.
Recent Flu Events
April 2003 - The Netherlands reports H7N7 bird flu in over 80 human cases with the death of one veterinarian.
Mid-2003 - H5N1 bird flu spreads in Asia, but it is either undetected or unreported.
December 2003 - Tigers and leopards in a Thailand zoo die of H5N1 bird flu after eating fresh chickens. It's the first time bird flu has been seen in large felines.
Jan. 11, 2004 - Humans in Vietnam come down with H5N1 bird flu caught from poultry. There is a high death rate among infected people, but the disease does not spread from person to person.
Jan. 23, 2004 - Thailand reports human H5N1 bird flu infections.
February 2004 - The last HPAI outbreak among U.S. poultry. A flock of chickens in Texas comes down with an H5N2 virus. A quick response by state and federal officials keeps the virus from spreading beyond this one small flock. There are no human cases.
Feb. 1, 2004 - Vietnam investigates a family cluster of H5N1 cases. Person-to-person spread cannot be ruled out, but the virus is not spreading among humans.
Feb. 20, 2004 - Thailand reports H5N1 infection of domestic cats in a single household.
Oct. 11, 2004 - H5N1 infection spreads among tigers in a Thai zoo.
Feb. 2, 2005 - Cambodia reports its first human case of H5N1 bird flu. It is fatal.
April 30, 2005 - China reports that wild birds are dying at a lake in central China. The lake is a major stop along migratory pathways. Within weeks, more than 6,300 wild birds are dead.
July 21, 2005 - Indonesia reports its first human case of H5N1 bird flu.
October 2005 - H5N1 is reported in poultry in Turkey and Romania and in wild birds in Greece and Croatia.
Nov. 1, 2005 - The WHO's official count of human cases of H5N1 reaches 122, with 62 deaths, in Vietnam, Thailand, Indonesia, and Cambodia.
By Daniel J. DeNoon, reviewed By Louise Chang, MD
SOURCES: Infectious Diseases Society of America. World Health Organization.Nature web site. European Society for Veterinary Virology web site. Indiana State Department of Health web site. U.S. Health and Human Services web site. CDC web site.
No one knows whether the bird flu now migrating across the globe will cause a human pandemic, but researchers say it is inevitable that some flu virus eventually will.
"It's like predicting the Big One in California," said Dr. Arnold S. Monto, an epidemiologist at the University of Michigan and a former president of the American Epidemiological Society. "We are overdue for another pandemic. But we don't know when it will hit."
Unlike seasonal flu or more serious epidemics that can move through large regions, pandemics leap across the world, spreading through populations with little or no immunity.
In the last century, there have been three major flu pandemics, each of which originated with birds.
In 1918, the Spanish flu spread, killing 500,000 people in the United States and as many as 50 million worldwide - more than all the battlefield deaths of World War I. In 1957, the Asian flu traveled across the world, killing 2 million people, including about 70,000 in the United States. The 1968 Hong Kong flu killed 1 million people, with 34,000 deaths in the U.S.
Multiple strains of flu virus circulate harmlessly in birds and humans. Small mutations cause a drift in the virus that produces seasonal flu.
Every so often, mutations create a significant shift in a strain that is especially unfamiliar to the human immune system.
Dr. Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia, said each of the various pandemic strains seemed to reemerge every 68 years.
"These viruses are always around … always bubbling under the surface," Offit said. "You get to the point where the entire population is susceptible because nearly everyone around for the last pandemic has grown up and died," leaving few people with residual immunity.
The bird flu strain that has spread from Asia to Europe is known as H5N1. The first outbreak came in Hong Kong in 1997, forcing the government to order the eradication of chickens, ducks and geese.
Though the virus did not readily infect humans, there was a chance it eventually could mutate into a form that could be easily transmitted.
Recent research has shown that the H5N1 virus bears genetic similarities to the 1918 flu. And unlike many other flu viruses originating in birds, H5N1 can spread directly from poultry to people without passing through another species, such as pigs, increasing the risks.
"It's the most dangerous influenza virus that I've ever seen," said Richard G. Webster, a flu researcher at St. Jude Children's Research Hospital in Memphis, Tenn., who has conducted several key studies of H5N1.
Some experts downplay the likelihood of an H5N1 pandemic.
More than 120 million birds in Asia have died or been culled because of bird flu, but human infections have been relatively rare, about 120 cases since 2003.
Monto said genetic changes that made the virus easily transmissible could just as easily decrease its virulence.
"If it was easy for this to happen, it would have happened already," Monto said.
He estimated the chances of an H5N1 pandemic at no more than 5%.
But scientists agree that it is only a matter of time before some pandemic strain emerges.
In an age when travelers can spread disease across the world in a matter of hours, bolstering the nation's ability to manage the crisis is overdue, experts said.
"If a pandemic happens, it would be devastating," Monto said. "So we have an obligation to prepare."
Global threat
An avian flu pandemic could kill 2 million to 7.4 million people worldwide, according to the World Health Organization. Almost all of the 120 known human cases involve people who were in close contact with infected birds.
Pandemics
An influenza pandemic is an outbreak of disease that occurs when a new influenza A virus appears in the human population, causes serious illness and then spreads easily from person to person worldwide.
Travel bans, drug rationing and armed guards outside hospitals could all be implemented if the H5N1 strain of bird flu mutates and begins spreading from human to human, Bush Administration officials said in plans released today and in testimony before Congress.
Health and Human Services (HHS) Secretary Michael Leavitt said a flu pandemic could infect up to one-third of the U.S. population, possibly killing anywhere from 209,000 to 1.9 million. It would spread fastest among school-age children, infecting 40 percent of them, Leavitt said.
The plan urges local officials to begin planning now for how they would handle an outbreak in their communities. Key elements in planning should include triage centers that would keep infected individuals out of hospital emergency rooms, to prevent spreading the flu to other patients and staff.
President Bush yesterday outlined his $7.1 billion strategy, which is centered on deetecting and containing any outbreaks before the virus reaches the U.S. and improving the vaccine industry so that massive quanitites of vaccine could be produced and distributed quickly.
No one can predict when the next flu pandemic will occur, though public health officials are worried about the H5N1 strain now killing millions of birds in Asia and elsewhere. H5N1 is not now capable of spreading from person to person but that could change quickly.
There have been three flu pandemics in the last century. Modern air travel could hasten the spread of any lethal virus, adding to the risk already posed by the annual global movements of millions of ducks, geese and other migratory fowl.
Critics of the Bush plan said it was too little, too late.
"While it is welcome news that the administration is focused on vaccine research and stockpiling in the event of a pandemic flu, the question is how will the administration handle distribution and communications with a system that has failed to meet seasonal flu vaccine demands in three out of the last five years?" Sen. Hillary Rodham Clinton (D-NY) asked.
Defending the Bush plan was Dr. Rajeev Venkayya, special assistant to the president for biological defense policy. He called it a "crash program" that would make a start at preparing the United States for a possible outbreak of avian flu in people and help the rest of the world as well.
North China's Hebei Province joined efforts with Beijing on Tuesday in launching a move to cut off all the possible spreading channels of the bird flu.
The outbreak of bird flu in central China's Hunan Province and east China's Anhui Province in late October has drawn much attention from the government of Hebei and Beijing.
To prevent and control the spread of the H5N1 virus, the government of the two places agreed to establish a joint checkup and prevention mechanism, carrying out a strict exam along the 10-kilometer border of Hebei and Beijing.
The governments of Hebei and Beijing will hold regular meetings to discuss measures against bird flu.
Source: Xinhua
WASHINGTON (Reuters) - The United States, China and France announced new efforts to fight a possible pandemic of avian flu, including $500 million to monitor the virus in poultry and practice runs for dealing with a dreaded outbreak.
U.S. officials detailed parts of their $7.1 billion plan to prepare for H5N1 avian influenza should it begin a human pandemic and defended their proposal to critics who said it was late and incomplete.
The U.S. plan includes $251 million to help detect and contain outbreaks in affected areas before they spread. It includes cash for testing an experimental H5N1 vaccine in Vietnam and support in helping countries develop their own plans.
A special Cabinet meeting held by Chinese Premier Wen Jiabao decided to set aside 2 billion yuan from this year's fiscal budget to prevent the spread of bird flu, according to state radio and Xinhua news agency.
The H5N1 avian influenza has infected 122 people and killed 62 in Vietnam, Thailand, Cambodia and Indonesia. It has decimated poultry flocks across many parts of Asia and has been detected in birds in Europe over the past month.
It is making steady mutations that scientists say could allow it to spread easily from person to person and cause a catastrophic global pandemic.
The World Health Organization has been urging countries to prepare as quickly as possible and hope an H5N1 pandemic does not come soon -- although WHO says some sort of pandemic is inevitable.
France announced the first test of its readiness to tackle an outbreak of bird flu -- a practice run sealing off an area around a village in the west of the country on Thursday.
A meeting in Brisbane of the Asia-Pacific Economic Cooperation forum earlier in the week ended without specific recommendations, but Australian officials later discussed holding a simulated avian flu outbreak to help them prepare for a real one.
NEW OUTBREAKS
Thailand reported a new outbreak of bird flu in poultry on Wednesday and officials said the illegal movement of birds, especially fighting cocks and ducks, might be spreading the virus.
Laboratory results confirmed H5N1 in chickens and pigeons in the central province of Ang Thong.
Six of the seven infected provinces were clustered in central Thailand, with the other, Kalasin, in the northeast where fighting cocks might have caught the deadly disease from those in the infected central region, livestock officials said.
Health officials have expressed concerns that migratory birds could carry the virus from the edges of Europe to Africa where they fear it could spread quickly.
"The threat is a real one," said Dr. Karim Tounkara, an expert on animal resources in the African Union.
"If we have cases of this disease, it will be real havoc for the continent because the mortality rate (among birds) can reach 80 percent. Once the domestic birds are infected, then the virus spreads like a fire in the bush," he told Reuters at a bird flu meeting in the Rwandan capital, Kigali.
In New York, Wildlife Conservation Society veterinarian William Karesh said he did not anticipate migratory birds spreading the flu to North America since there was little mingling of birds from the two hemispheres in the Arctic.
"I think it's going to fly here, but in an airplane carrying infected people," Karesh told a meeting sponsored by Time magazine.
"It won't come to North America in wild birds."
Karesh echoed recommendations from U.N. officials who have advocated spending more cash on controlling H5N1 in birds. "Go upstream and contain it at the source," Karesh advised.
There has been real concern in Europe but reports suggested poultry sales were recovering from a sharp fall last month.
In France, home to Europe's largest poultry sector with an annual turnover of 6 billion euros, sales were still reported to be down although there were signs the slide was slowing.
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MONTREAL (AFX) - Canadian pharmaceutical firm Replicor has discovered a compound to treat influenza infections that could potentially be used to fight the deadly H5N1 bird flu, the company's chief executive officer told Agence France-Presse.
'We're developing a drug with broad spectrum antiviral activity that works against several virus families, particularly influenza, and could work against the H5N1 virus,' Replicor's Michel Bazinet said.
The company said in a statement the compound has been shown to 'effectively treat influenza infections in mice'.
And, in tissue cultures, it showed 'potent activity' against more than 10 strains of influenza including H1N1, H3N2 - similar to the 1918 Spanish flu and the 1968 Hong Kong flu, respectively - and influenza B.
But its efficacy against H5N1 has not yet been tested, Bazinet said.
The company is currently in talks with two specialized Texas laboratories to conduct such experiments and is actively seeking an alliance with a major pharmaceutical company to fund further development.
Drugs such as Tamiflu and Relenza are often touted as the only known defense against a possible pandemic.
THE WORLD'S vaccine manufacturers will be in a race against time to forestall calamity in the event of an influenza pandemic.
But now, life-saving inoculations may be available more readily than before, thanks to a new technique to more efficiently produce the disarmed viruses that are the seed stock for making flu vaccine in large quantities.
The work is especially important as governments worldwide prepare for a predicted pandemic of avian influenza.
New lab-made virus
Writing in the online edition of the Proceedings of the National Academies of Science (PNAS) , a team of researchers from UW-Madison and the University of Tokyo report a new way to generate genetically altered influenza virus.
The lab-made virus - whose genes are manipulated to disarm its virulent nature - can be seeded into chicken eggs to generate the vaccine used in inoculations, which prepare the human immune system to recognise and defeat the wild viruses that spread among humans in an epidemic or pandemic.
In their report, a team led by UW-Madison virologists Yoshihiro Kawaoka and Gabriele Neumann, describes an improved `reverse genetics' technique that makes it easier to make a seed virus in monkey kidney cells, which, like tiny factories, churn out millions of copies of the disarmed virus to be used to make vaccines.
In nature, viruses commandeer a cell's reproductive machinery to make new virus particles, which go on to infect other cells and make yet more virus particles.
Non-virulent viruses that serve as the raw material for vaccines are made by vaccine makers using a monkey kidney cell line.
According to the University of Wisconsin-Madison press release, the technique reported by the team improves upon a previous reverse genetics method (developed by Kawaoka's group in 1999) by significantly reducing the number of plasmid vectors required to ferry viral genes into the monkey kidney cells used to produce the virus particles to make vaccines. "Compared with other types of cells, which are not approved for vaccine production, it is not always easy to introduce plasmids into the monkey kidney cells, which are approved for such use," says Kawaoka, an influenza expert and a professor of pathobiological sciences in UW-Madison's School of Veterinary Medicine.
Because they are not known to carry any unknown infectious agents and do not cause tumours, monkey kidney cells are used routinely for generation of seed strains for vaccine production.
Especially advantageous
According to Kawaoka, "application of the new system may be especially advantageous in situations of outbreaks of highly pathogenic avian influenza viruses."
When a new strain of highly virulent influenza emerges to infect humans, vaccine makers must tailor their vaccines to match it because, genetically, the virus is always different. Depending on how quickly new strains are identified, genetically disarmed and subsequently generated in the lab for use to make vaccines in large quantities, the process is a race against time and can take months.
Efficient