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Wednesday 21st August 2019

Bird Flu Diary

24th January 2012

As the threat of an avian flu pandemic continues to build - at least in the media - news and comment from the world press has maintained a steady flow. Here, in a new diary format, we bring you up to date with the latest stories - in summary form - from the four corners of the globe.








Latest Statistics (March 2010)

Human Cases: 489

Human Deaths: 289 (63%)


Man dies of bird flu in southern China

24th January 2012

A man in the southwestern Chinese province of Guizhou has died after three days of hospitalisation, according to official media reports.

None of the men with whom the man had contact seemed to show any signs of sickness so far.

But researchers fear that the H5N1 strain of influenza, also known as bird flu, could become far more deadly if it were to mutate into a form that could be easily spread between human beings.

Currently, H5N1 kills most strains of birds it infects, and kills 60% of all of the humans it infects.

The virus is mainly active in East Asia during the winter months, and one other person has also recently died after being infected by H5N1.

Last week, Vietnam also reported one bird flu fatality, in an 18-year-old man who worked with poultry on a duck farm.

A two-year-old boy in Cambodia also died of bird flu, last week. The Chinese man who died was 39 years old.

He died in intensive care in a hospital in Guiyang, the capital of Guizhou, after suffering from fever for a few weeks.

While the Chinese report failed to say whether or not the man had recent contact with birds, the Hong Kong Department of Health said that the man had not had any contact with poultry, according to reports it had received.

While researchers have reported cases in which the virus spread from birds to humans, cases in which the virus spread between human beings are much less common.

But Chinese authorities are worried that the virus may be able to spread more rapidly than usual during Chinese New Year, which is currently taking place, since so many people will be travelling in crowded buses and trains to visit their family.

Migratory birds also disperse the virus between distant locations.

A 39-year-old bus driver from Shenzhen died of the virus only a few weeks ago, more than a day's travel by train from Shenzhen.

According to World Health Organisation (WHO) estimates, there have been 343 human deaths of the 582 confirmed H5N1 infections since 2003, marking out the bird flu virus as unusually deadly.

The WHO has never identified a sustained human-to-human spread of the virus.

To date, official counts record 27 mortalities among Chinese and 60 among Vietnamese people from H5N1.

Scientists around the world have now decided to suspend research into a modified version of the virus that had already been proven to spread quickly between mammals.

While the research may eventually produce a vaccine, it is also controversial.

The Spanish flu outbreak killed between 20 million and 40 million people around the world, around the beginning of the last century.

Researchers usually conduct studies on ferrets, since the mammals transmit viruses in much the same way as humans.

The scientists plan to use the following two months to communicate the results of their studies to the scientific community at large.


China calls for calm after bird flu death

3rd January 2012

Chinese health authorities have urged people to remain calm following the death of a man in the southern city of Shenzhen, home to some 10 million people, which neighbours Hong Kong.

The man, identified only by his surname Chen, died last weekend in hospital after he contracted the bird flu virus, but officials are urging citizens not to panic.

Thousands of chickens were recently culled in Hong Kong after health authorities found they were carrying the H5N1 bird flu virus. The man seems to have contracted the virus from infected poultry.

Shenzhen's health authorities are insistent that the virus does not spread from person to person, and that Chen must have contracted the virus directly from a bird, although they could not trace the infection to a specific chicken or fowl.

Chen's is the first reported human bird flu case in 18 months in China. When he developed a fever two weeks ago, the hospital initially diagnosed him with severe pneumonia.

The man, who was 39 years old and drove a bus for a living, had not left Shenzhen in the month before he died.

The man had also not had any contact with poultry.

The H5N1 virus is very deadly, and the human immune system is ill-equipped to fend it off.

In previous infections, the breathing complications arising from the human immune response to H5N1 were fatal in about 60% of cases.

However, according to the World Health Organisation (WHO), H5N1 has never been identified in a sustained human-to-human epidemic.

Following the discovery that some poultry had been infected, authorities in China and Hong Kong have been trying to stop the disease from spreading among livestock.

Hong Kong's bird flu alert level is still 'serious', following the discovery that some chickens were carrying H5N1.

Poultry is now much harder to come by in Hong Kong and southern China.

China leads the world in terms of poultry population, and people in rural areas often live in close contact with the birds.

In a statement issued following Chen's death, the Shenzhen Centre for Disease Prevention and Control said that the virus that had been found was 90% similar to H5N1 viruses previously isolated in ducks.

They said that this genetic similarity ruled out the possibility of a human-to-human infection, and argued that the virus is not currently transmissible between people.

Hong Kong's Centre for Health Protection confirmed that the strain is similar to the one found in wild birds in Hong Kong.

The virus that killed Chen should also theoretically be susceptible to amantadine, a drug commonly used to slow viral infections to a rate that does not kill human sufferers.

But researchers are worried that the virus could mutate, transforming into something that could spread from person to person rapidly and efficiently.

Theoretically, such a virus would kill large numbers of people in a pandemic.


The human nose too cold for bird flu virus

15th May 2009

UK researchers say that bird flu may not become a major threat to humans because our noses are too cold for the virus to thrive.

The team from Imperial College London recreated the nose's environment and found that at 32 degrees Celsius, avian flu viruses lose function and cannot spread. It is likely that the viruses have adapted to suit the warmer 40 degree environments in the guts of birds. Publishing their findings in the journal PLoS Pathogens, they said a mutation would be needed before bird flu became a human problem.


Bird flu vaccine target found

27th April 2009

A new study has discovered how the human body responds to the H5N1 avian influenza virus, paving the way for possible new developments in vaccines against the disease.

Researchers looked at blood samples from patients from Vietnam who were recovering from infection with bird flu, taking antibodies from them and observing how they reacted to various proteins found on H5N1.

The study gives a clearer picture of exactly what part of the bird flu virus is seen by the immune system once a person becomes infected.

One particular protein, PB1-F2, was identified as a potential target for attack by immune systems to stop the spread of the virus, and therefore for the development of future vaccines.

Such techniques can lead to new tools for testing the potential protective activity of vaccines already under development.

Karen Midthun, acting director of the US Federal Drug Administration’s Center for Biologics Evaluation and Research, said the findings could also lead to new tests to detect infections, and improved therapies.

The transmission of highly pathogenic avian H5N1 viruses from poultry to humans have sparked efforts to prepare effective vaccines and therapies including polyclonal or monoclonal antibodies, the team wrote in the preamble to their study, which was published in the online open-access journal PLoS Medicine.

But researchers pointed to a lack of information on protective immune responses against the viruses, and said they hoped to characterise the B cell responses in convalescent individuals as a way of helping to design future vaccines and treatments.

Researchers in the study adapted an existing technique using genetically modified viruses, or phages, to create fragments representing the proteins found in the H5N1 virus.

When the proteins were mixed with the antibodies from the recovering Vietnamese patients, they were able to observe which fragments were attacked by the patient's antibodies.

Researchers believe that PB1-F2 contributes significantly to the virus’s ability to cause disease, which has never been observed to cause such an immune response before, according to senior article author Hana Golding.

Lead author Surender Khurana and co-authors Yonaira Rivera, Jody Manischewitz, and Lisa King also contributed to the study, together with Kanta Subbarao, Amorsolo Suguitan Jr of the National Institute of Allergies and Infectious Diseases and Cameron Simmons of the Hospital for Tropical Diseases in Vietnam's Ho Chi Minh City, Vietnam. Biomedicine researcher Antonio Lanzavecchia from Switzerland was also named as co-author.

Avian influenza has infected more than 400 people worldwide since 2003, about 60% of whom have died.

So far, no cases of avian flu have been reported in the United States.

While most avian flu infections in humans involve people who have come into contact with infected poultry, experts fear the virus could mutate to be transmissible between people, sparking a global pandemic.

Infection risk for bird flu workers

27th April 2009

A BBC Freedom of Information request has shown there were two incidents at a government laboratory where workers could have caught the bird flu virus.

The accidents - reported under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) - occurred at the Veterinary Laboratories Agency (VLA) in Surrey. The VLA's chief executive Peter Boriello said: "A key part of this is working with the HSE to ensure that lessons are learned from RIDDOR reportable incidents."

Compound that may fight bird flu

15th April 2009

Scientists in Hong Kong and the US have identified a synthetic compound which appears to fight bird flu.

Bird flu cases rise in Egypt

3rd April 2009

In Egypt, the number of bird flu cases has risen yet again to 61, making six new human infections over the past month.

Egypt is the most populous Arab country and the one hit hardest by bird flu outside Asia.

A two-year-old boy from the province of Bohaira, in the north, is believed to have become infected after coming into contact with poultry carrying the disease.

The boy was taken to hospital earlier this week after coming down with a fever during a family visit, where he was treated with the drug Tamiflu.

Even though it is recommended by experts, health authorities in Egypt do not compensate farmers for birds that need to be culled.

In the last six years, at least 410 people have contracted the H5N1 avian influenza virus.

The infections have occurred in 15 countries and caused 254 human deaths, and entailed the culling of some 300 million birds in 61 countries.

The human dead include 23 Egyptians, contact with domestic birds carrying the virus being the most common infection route.

In Egypt, where approximately 5 million households derive their main source of food and income from domestic poultry, comparatively few people have been infected.

This recent case comes just over one week after a two-year-old girl in the province of Qena was found to have contracted the virus.

One day after the girl's symptoms began, she was moved to a hospital specialising in treating the disease and given the drug oseltamivir. Her condition eventually stabilised.

Cases in Egypt have been sporadic, and just over one third have been fatal.

However, experts fear that the H5N1 virus could become transmissible from one human to another, bringing devastating consequences worldwide.

The virus responsible for the Spanish flu pandemic, also known as the 1918 flu pandemic, which killed somewhere between 20 and 50 million people worldwide, was less deadly than a potentially mutated H5N1 bird flu virus.

Billions of dollars are currently being spent by governments in preparation for a potential outbreak, and at least 17 governments and 12 companies are developing bird flu vaccines.

India's trees are a Tamiflu source

2nd April 2009

Trees in a biodiversity hotspot in western India could yield a key substance needed to make Tamiflu.

Bird flu mix up could have been disastrous

5th March 2009

It has emerged that virulent H5N1 bird flu was sent out by accident from an Austrian lab last year.

Bird flu death in Vietnam

2nd March 2009

A 32-year-old Vietnamese man has died of avian influenza, in what is both the second case and the second death from bird flu in Vietnam this year.

His is also the 109th case of bird flu in a country that has reported the second highest number of both cases and deaths since the World Health Organisation (WHO) began its tally in 2003.

Having contracted the virus by eating diseased poultry in the province of Ninh Binh, 90 km (56 miles) south of Hanoi, the man was ill for two weeks before dying in a hospital in the capital.

His death comes less than one week after the death of a 23-year-old woman in Quang Ninh province, east of the capital - the country's first case of bird flu in 2009.

Outbreaks of H5N1 avian influenza have been reported among Vietnamese poultry stocks in the provinces where both deaths occurred.

The disease has spread to millions of birds around the world, especially in East Asia.

Though it can already be spread among humans when they come into contact with infected birds, scientists fear the virus could mutate.

If the H5N1 virus were more easily spread by human-to-human contact, millions could be killed in the resulting pandemic.

China, Vietnam, and Indonesia have all begun vaccinating their poultry.

However, it is hard to ensure that free-roaming birds in domestic situations do not pose a threat.

In addition, some have raised questions about the vaccines, saying that they may stop outward signs of the disease from showing, while allowing the disease to spread.

In Vietnam, the number of confirmed bird flu cases and deaths bottomed out at zero in 2006, from 61 cases and 19 deaths in the year before.

Since then, numbers in Vietnam have been significantly smaller.

The total number of bird flu deaths in Vietnam (109 total cases and 54 deaths) is the second highest in the world, after Indonesia's 141 total cases and 115 deaths.

So far this year, there have been more bird flu cases in China than in Vietnam, with seven confirmed cases and four deaths.

Areas of the world experiencing conditions of drought may be more susceptible to bird flu outbreaks, as was the case with three deaths in central China last January.

Nie Ben said that as drinking water becomes more scarce for wild birds, they may come into closer contact with domestic fowl, increasing the chances of cross-infection.


China 'puzzled' by cases of bird flu

10th February 2009

China's Health Ministry is puzzled by eight human cases of bird flu.

No evidence of China bird flu epidemic says WHO

27th January 2009

The WHO said there was no evidence of a bird flu epidemic in China after a fifth person dies.

Second woman dies from bird flu in China

19th January 2009

Bird flu claims another life in China.

First bird flu death in China in a year

7th January 2009

China disinfects after woman died from bird flu, the first death in a year.

Farmers in dark over bird flu

22nd December 2008

Poultry farmers in the eastern Chinese province of Jiangsu, site of a recent outbreak of avian influenza, say they know little about what is happening and have seen little help from the government.

China's official Xinhua news agency said officials had culled 377,000 birds on farms around Dongtai city and neighbouring Hai'an county after an outbreak was confirmed to have been caused by the deadly H5N1 virus.

But poultry farmers were unaware of the potential health risks of the outbreak, and local official news outlets said they hadn't reported the story.

"We lost about 40,000 or 50,000," a poultry farmer near Dongtai city said. "Now, even the chicks are getting infected. We are having to deal with this ourselves. We are burying them in pits."

Dongtai is home to an estimated 10 million farmed poultry.

"They haven't managed to come up with a vaccine yet, and we have had no help from officials. If, as you say, this disease could be a danger to human life, then we didn't know about it. The government should send people down here to take care of it," she added.

Lack of information

Another farmer in the area, surnamed Li, said he didn't know about the outbreak, or what caused it, despite announcements by the Agriculture Ministry in Beijing.

"Chickens die as a normal part of running a poultry business," he said.

"I'm not sure when this took place. There are so many poultry farmers in this region. I haven't heard anything locally about whether this was in fact bird flu. It is only one of the diseases that can affect poultry, after all," Li added.

The first farmer partially confirmed a report by the Hong Kong-based Information Center on Human Rights and Democratic Movement in China, which said some sick chickens had been taken to Shanghai, Shandong, or Guangdong and sold in the wake of the oubreak.

"All of the farms did this. A few would die every day, and then we would just sell them anyway."

She said the poultry merchants then realised there was a problem and started to drop the prices they would give for the chickens.

Local media silence

She said she had heard no announcement from the Agriculture Ministry and had no idea where the chicken carcasses ended up.

She had no idea that the central government was offering compensation of 10 yuan per chicken to farmers who slaughtered sick birds.

In the absence of any new vaccine, she said, she would be forced out of business.

Local news outlets said they hadn't reported the story.

"We haven't heard anything about this," a duty editor in the newsroom of the Dongtai Daily News said.

"Our reporters haven't said anything about it ... I don't know [if there is a reporting ban on this]. That's all I can tell you. I can't say if this is true or if it isn't. How many chickens actually died? What was the disease?"

An employee on duty at the Dongtai television station said they hadn't reported the story either, although he had heard the news.

"No, no. This is provincial-level news. I saw the report, but I don't know the actual details. No, [we didn't report it]."

Roadside checks

But local police said strict controls were being imposed on the movement of any poultry in the area.

An employee who answered the phone at the Sancang township police station, where a large number of poultry farms are concentrated, said the area had been placed under quarantine to ensure that no sick poultry was taken elsewhere.

"The government has dispatched people to every intersection in this area, and they are carrying out roadside checks to prevent infected chickens from being moved around. The checks are continuing. They have been going on for some time now, although I don't know the details."

The deadly H5N1 strain of bird flu, which has killed more than 200 people and ravaged poultry flocks worldwide since 2003, was found on a chicken farm in Dongtai city and in another farm in Hai'an county, China's Agriculture Ministry said in a statement on its website.

The virus hasn't been reported in any other locations, and UN Food and Agriculture adviser Vincent Martin sought to play down fears of an outbreak of bird flu in China, which has already seen three confirmed human deaths from bird flu this year.

Martin said the FAO had been notified by Chinese authorities about the outbreak, which could have been triggered by migratory birds.

Original reporting in Cantonese by Lillian Cheung and in Mandarin by Fang Yuan. Mandarin service director: Jennifer Chou. Cantonese service director: Shiny Li. Translated and written for the web in English by Luisetta Mudie. Edited by Sarah Jackson-Han.

H5N1 outbreak in Hong Kong

15th December 2008

Chickens on a Hong Kong farm have tested positive for H5N1 avian influenza, raising the territory's bird flu alert threat level to "serious".

Authorities are planning to look into claims that eggs from mainland China could have carried the virus into Hong Kong, where measures against bird flu are severe.

In order to prevent the spread of the virus, all of the farm's chickens, and those within a 3 kilometre radius, have been slaughtered.

The chickens were infected with the H5N1 strain of bird flu, which can spread to humans.

The H5N1 virus is under constant mutation, and a further change in transmissibility could potentially kill millions worldwide.

This was Hong Kong's first farm outbreak in five years in spite of mass vaccinations.

Such an outbreak could signal that the virus has gone through another mutation.

Health Secretary York Chow said that the death of 60 chickens on the farm was reported last week, and a series of tests confirmed that the chickens died of avian flu.

In the course of testing, three dead chickens were examined and 20 samples of faeces were gathered.

Officers wearing masks, medical suits and rubber gloves began the mass culling of tens of thousands of chickens soon after.

The officers were shown stuffing large amounts of chicken carcasses into bags.

In the past, the H5N1 virus prompted the mass culling of over one million birds each time.

Wong Yi-chuen, who worked at one of the stricken farms, said that the deaths of the chickens had been scattered, and that not as many chickens had died as in previous outbreaks.

A three-week ban on live poultry imports was imposed to contain any potential spread of the virus.

Chicken traders who have been hit by the ban on live chickens have claimed fertilised eggs brought from mainland China may be spreading the disease instead.

The affected farm was one of many in Hong Kong which are allowed to import fertilised eggs from mainland China.

The imports are meant to help Hong Kong farmers breed their own poultry.

But some bird flu experts dismissed the possibility of bird flu being spread by the live chicken embryos.

Leo Poon, a microbiologist from the University of Hong Kong said that it is very unlikely that the eggs would be infected with H5N1, because chickens that contract H5N1 would almost certainly stop laying eggs.

On the other hand, Poon did not rule out the possibility that the surfaces of eggs may be tainted with faecal matter contaminated with the virus.

Chow said officials would ban all chickens from leaving farms for three weeks as well as suspending imports of chicken, poultry, and birds.

The last bird flu outbreak in Hong Kong happened when the virus resurfaced in Asia in 2003.

The World Health Organisation says H5N1 has killed more than 200 people in 12 countries.


Teen dies of bird flu in Indonesia

13th November 2008

A 15-year-old Indonesian girl has died of bird flu in central Java.

Wild ducks may spread bird flu

10th November 2008

New scientific research has found that wild migratory birds may be more important carriers of avian influenza viruses from continent to continent than previously thought.

In a multi-pronged research effort to understand the role of migratory birds in the transfer of avian influenza viruses between Asia and North America, researchers found evidence that the virus may be carried accross continents by wild ducks; specifically the northern pintail.

The findings have important implications for highly pathogenic avian influenza virus surveillance in North America, according to scientists with the US Geological Survey (USGS), the US Fish and Wildlife Service in Alaska and the University of Tokyo.

Almost 50% of the low pathogenic avian influenza viruses found in wild northern pintail ducks in Alaska contained at least one of eight gene segments that were more closely related to Asian than to North American strains of avian influenza.

However, none of the samples contained completely Asian-origin viruses and none were highly pathogenic forms that have caused deaths of domestic poultry and humans.

Study co-author Chris Franson, a research wildlife biologist with the USGS National Wildlife Health Centre said the findings, published in the journal Molecular Ecology, challenged current assumptions that transmission through migrating birds was rare.

The role of migratory birds in the global spread of the highly pathogenic H5N1 bird flu virus is still the subject of fierce debate in the scientific community.

Previous studies examined bird species that are not transcontinental migrants or were from mid-latitude locales in North America, regions far removed from sources of Asian strains of avian influenza, Franson added.

Samples were obtained from more than 1,400 northern pintails from locations throughout Alaska, with the help of local scientists and native communities.  

Those containing viruses were compared to virus samples taken from other birds in North America and Eastern Asia where northern pintails - a common species in both North America and East Asia - are known to winter.  

Researchers chose northern pintails as the focus of the study because they are fairly common in North America and Asia, they are frequently infected by low pathogenic avian influenza, and they are known to migrate between North America and Asia.

Co-author John Pearce, a USGS research wildlife biologist in Alaska said the research validated our current surveillance sampling process for highly pathogenic avian influenza in Alaska. It also showed that genetic analysis was an effective tool in the surveillance of pathogens.


Beat bird flu, vaccinate now

9th October 2008

UK scientists claim a vaccine now could help save lives in a future bird flu pandemic.

H5N1 is not the only threat

23rd September 2008

Another form of bird flu that infects humans could be a killer too.

Bird flu death in Indonesia

11th September 2008

An Indonesian man from Tangerang has died of bird flu.

Bird flu vaccine hope

2nd September 2008

An experimental bird flu vaccine gives strong protection in mice.

1918 flu antibodies still working

18th August 2008

A team of influenza and immune system experts say that antibodies from survivors of the 1918 flu pandemic, the worst in human memory, are still effective against the highly deadly virus.

The researchers suggested new and better ways to fight viruses - especially new pandemic strains that emerge and spread before a vaccine can be formulated.

Their findings come from a study of 1918 pandemic survivors, now aged 91 to 101, who all lived through the pandemic as children.

Researchers found that their immune systems still carry a memory of that virus and can produce antibodies that kill the 1918 flu strain with surprising efficiency.

Writing in the journal Nature, researchers said they were surprised to find that the study subjects still had the cells floating in their blood so long after the devastating pandemic, which killed between 50 million and 100 million people.

James Crowe of Vanderbilt University in Tennessee, who helped lead the study, said the antibodies that the team isolated were 'remarkable' for their ability to grab onto the virus very tightly and almost never fell off.

The same antibodies were able to protect mice from the 1918 virus, which swept around the world at the end of World War I, using a very small amount of antibody, Crowe said.

The immune system can call upon T-cells or B-cells in fighting off micro-organisms like viruses or bacteria. The B-cells are made in the bone marrow and makes antibodies which flag and attack the invading organism.

In most of the survivors tested by Christopher Basler and colleagues at the Mount Sinai School of Medicine in New York, the B-cells made antibodies highly attuned to the 1918 flu strain.

US Centers for Disease Control and Prevention expert Terrence Tumpey worked on a team that resurrected the 1918 virus taken from buried victims of the epidemic and tested it in mice, some of whom were given the antibodies from the elderly survivors.

Those who got the antibodies lived, while those given placebos died.

Crowe called for further research to see if the immune systems of people who had had other strains of influenza were as strong. He said the fact that the survivors were infected in childhood could account for their strong immune responses.

He said the findings might pave the way for designer antibodies to fight many other kinds of virus.

The 1918 flu virus was an H1N1 strain that apparently came straight from birds, similar to the H5N1 avian influenza circulating in Asia, Europe, the Middle East and Africa.

Crowe said the study meant that that human beings can make long lasting immune responses to bird influenza. He and his team now plan to get antibodies from people vaccinated with experimental shots for the H5N1 avian influenza.

Now circulating in Asia, Europe, the Middle East and Africa, H5N1 mostly affects birds but it has infected 385 people since 2003, killing 243.

Experts warn that H5N1 could mutate into a form that passes easily among humans, sparking an overdue pandemic which could kill millions, and against which current vaccines have not been tested.

In the meantime, Crowe said, antibodies from survivors might make a good interim treatment during the months while a pandemic vaccine is formulated, manufactured and distributed.


Measures to ensure H5N1 vaccine stockpile

15th July 2008

Several measures to be put in place for adequate vaccine stockpile in the event of a H5N1 pandemic.

Experts identify bird flu genes

14th July 2008

Experts in Japan, Indonesia and the United States have identified some of the genes in the H5N1 avian influenza virus which enable it to replicate.

The 100 genes were found in a population of fruit fly which had been infected with a modified version of the bird flu virus.

All viruses rely on host cell proteins and their associated mechanisms to complete the viral life cycle, providing a possible route for treatments to target bird flu.

Experts including Yoshihiro Kawaoka, a leading virologist and bird flu expert at the University of Tokyo, infected fruit fly cells with genetically altered H5N1 virus.

The fruit fly has a relatively small number of genes - 14,000 - making it a simpler subject for studies.

The team found some proteins that were important for influenza virus replication, identifying about 100 genes. At least three of these proteins exist in human cells, and are also important for flu virus replication in humans.

Further testing will be needed to see if any other genes are repeated in humans. After that, the team will turn its attention to host proteins, onto which the virus binds in cells.

Kawaoka said future drugs could inhibit the interaction between the host proteins and the virus, stopping it from replicating itself.

The H5N1 virus is still primarily an avian disease, which has ripped through poultry flocks mostly in Asia and Africa since 2003.

But it is capable of limited transmission to humans, and has killed 243 of the 385 people it has infected to date.

Experts fear the virus could mutate to a form easily transmissible between humans, sparking the next influenza pandemic which could kill millions globally.

Meanwhile, Japan's health ministry said it had found no evidence that the antiviral drug Tamiflu causes abnormal behaviour in young people. Some reports had associated oseltamivir with psychiatric symptoms including suicide in young people, leading to concerns among regulators.

Many countries are stockpiling Tamiflu, manufactured by Swiss-based Roche, as it is believed to be the best hope in the event of an influenza pandemic.

Three rounds of review by the US Food and Drug Administration (FDA) have found no evidence that oseltamivir contributed to neuropsychiataric events. 


China plans flu vaccine plant

23rd June 2008

A small Canadian biotech firm has announced plans to build and operate a new facility to manufacture influenza vaccine in the central Chinese province of Hunan.

Toronto-based Microbix Biosystems Inc said the plant would cost an estimated C$200 million, and would be one of the largest facilities in the world, producing 100 million doses of flu vaccine annually after it begins production in 2013.

Currently, global annual influenza vaccine capacity is less than 500 million doses.

The news boosted shares in the tiny company, which is listed on on the Toronto Stock Exchange. Share prices rose by 11.3% immediately after the news.

The Hunan provincial government has committed to investing a further C$100 million to the project to produce an initial 100 million doses. Microbix plans to raise another C$100 through licensing partners.

The company now plans to seek regulatory approval for its vaccine in several countries, including the United States, Canada and Europe.

Health authorities in Beijing want to increase the percentage of its vulnerable population that receives the influenza vaccine to 20% from just 2% now. The target coverage will require an additional 400 million doses of vaccine.

Microbix director Mark Cochran said having a vaccinated population was really important for China. But he said the market was also important elsewhere in the world, as a better vaccinated population was likely to better withstand an emerging strain of pandemic influenza.

He said that while the new factory would focus on meeting China's seasonal vaccination needs, the company would also consider exporting the vaccine, depending on the level of demand in China and around the world.

Microbix brings to the deal its Virusmax technology, which enables vaccine plants to produce more vaccine in a shorter time.

The pressure is on to speed up preparedness strategies amid the threat of an influenza pandemic, which experts fear may be caused if the H5N1 avian influenza virus mutates to a form that is easily transmissible between humans. Part of that mutation process has already been observed in one strain of the virus.

A substantial gap remains between supply and demand, global health experts warn.

World Health Organisation officials are discussing plans to further boost production capacity for pandemic vaccines. They plan to continue strongly to support the seasonal influenza vaccination programme, and to use production capacity off-season to make pandemic vaccines.


Bird flu vaccine shows promise

16th June 2008

A clinical trial by corporate researchers in the United States says a new bird flu vaccine made using monkey cells instead of chicken eggs appears to be safe and effective.

Baxter International said its vaccine against H5N1 avian influenza underwent the phase I/II safety trial involving more than 250 people, and produced a strong immune response in people who received two doses.

The vaccine, called Celvapan, is made in Bohumil in the Czech Republic. During the trial, researchers measured antibodies in volunteers in Austria and Singapore, saying those vaccinated showed an immune response similar to the body's defense against a natural virus infection.

In a report published in the New England Journal of Medicine, Baxter scientists said the vaccine was the first bird flu vaccine to be made using cells in a lab dish instead of chicken eggs.

H5N1 kills chickens rapidly, and the right type of chicken eggs are difficult to obtain.

But they said that adding an immune system booster called an adjuvant did not make the vaccine work any better.

The team, led by Hartmut Ehrlich, vice president of global research and development for Baxter's BioScience business and colleagues, found the lack of booster effect was puzzling as adjuvants have helped other bird flu vaccines.

Apart from Baxter, another 15 companies are currently known to be developing H5N1 avian influenza vaccines.

So far, there have been 382 human cases of the H5N1 bird flu virus, mostly in south-east Asia, of which 241 have died in 15 countries.

Most cases have been in poultry workers and at present the virus cannot pass that easily from human to human, but if that changes it will pose a potential threat across the world. Experts fear a pandemic strain could emerge, killing millions of people.

While there is no guarantee that the vaccines currently in development will offer protection against an emerging strain of pandemic flu, world health experts say it is better to be prepared, especially as existing vaccine manufacturing capacity could be quickly converted in the event of pandemic.

Fertilised chicken eggs have been used until now to produce all influenza vaccines.

But they are available only seasonally, creating a time constraint in the manufacture of yearly vaccine. This could affect the world's ability to prepare for a pandemic, experts say.


H5N1 found in Hong Kong market

9th June 2008

Bird flu virus found at a poultry stall in one of the territory's many markets.

EU approves bird flu vaccine

20th May 2008

The European drugs regulator has given the go-ahead to GlaxoSmithKline's pre-pandemic avian influenza vaccine, a form of vaccine which may confer initial protection in the early stages of an influenza pandemic before an updated version becomes available.

Prepandrix, which is designed to give protection against the H5N1 strain of the virus, is the first such vaccine to get a licence across the 27 EU member countries.

GSK said it was planning for a predicted influenza pandemic - which may or may not be caused by H5N1 - by investing in the development of two bird flu vaccines, and by boosting production of the antiviral drug Relenza through its own manufacturing plants and through capacity shared with partners.

Other governments, including the US and Switzerland, have already started stockpiling Prepandrix, which GSK says has worked effectively against various H5N1 strains circulating in Asia, Europe and Africa.

Experts warn that the H5N1 virus, which has ripped through poultry flocks in East Asia since 2003, could mutate into a form transmissible between humans, killing millions.

Sanofi Aventis and Novartis have also been working on bird flu vaccines.

Meanwhile, GSK says it has invested a total of US$2 billion in research and expanding production capacity.

The UK government has stockpiled millions of doses of Roche's antiviral Tamiflu in the event of a pandemic caused by a strain of H5N1, but is now reviewing its position after receiving advice that its one-drug strategy may be flawed.

The World Health Organisation (WHO) reports a cumulative total of 382 human cases of the H5N1 bird flu, mostly in southeast Asia, of which 241 have been fatal.

Most cases have been in poultry workers and at present the virus cannot pass that easily from human to human. But global experts have warned for several years that an influenza pandemic is long overdue, urging governments to make preparation well in advance.

GSK, which is likely to receive a boost from the news that H5N1 may now be showing some resistance to Tamiflu, has added several manufacturing lines to meet current demand and stockpile orders for Relenza.

The company’s two H5N1 flu vaccines went into clinical trials in Germany in March 2006.

Single flu jab not enough

15th May 2008

The UK government is reviewing its position on flu vaccines after research highlighted how no single drug will be capable of treating all the victims of a global flu epidemic.

Tests carried out with the H5N1 strain of bird flu have revealed that it is developing resistance to the anti-viral drug Tamiflu.

The study by the Medical Research Council, published in Nature, emphasises the need to stockpile more than one type of drug.

The UK government has stockpiled millions of doses of Tamiflu but after receiving advice that its one-drug strategy may be flawed, it is reviewing its position.

So far, there have been 382 human cases of the H5N1 bird flu virus, mostly in south-east Asia, of which 241 have died.

Most cases have been in poultry workers and at present the virus cannot pass that easily from human to human, but if that changes it will pose a potential threat across the world.

Researchers focused on the drugs Tamiflu and Relenza and found that in characterising a mutation in the structure of N1 that has been observed in human cases of H5N1, discovered the virus became resistant to Tamiflu, while still remaining susceptible to Relenza.

Dr Steve Gamblin, who led the research, said stockpiling any one drug to prepare for a potential H5N1 pandemic is unlikely to provide adequate cover.

He added: “There is a huge imperative to develop further drugs and it is likely a future pandemic will need to be tackled using a three or four-pronged approach, much as we tackle HIV today.?


Soldier checked for bird flu

22nd April 2008

South Korea is testing to see if a soldier involved in the mass cull of poultry has caught bird flu.

Bird flu free Myanmar

21st April 2008

Myanmar declares itself free of bird flu.

US bird flu jab uses cold virus

18th April 2008

US researchers test experimental bird flu jab that uses common cold virus and bits of DNA from H5N1.

S Korea culls 3m birds

17th April 2008

South Korea culls 3m birds as the country battles its worst avian influenza outbreak in four years.

China's bird flu vaccine

14th April 2008

China's drugs regulator has approved production of a human vaccine for the H5N1 avian influenza virus, the first to be developed in the country.

The State Food and Drug Administration gave the go-ahead for the vaccine, which was developed by Beijing Sinovac and the Chinese Center for Disease Control and Prevention (China CDC).

Based on whole, inactivated virus particles of a H5N1 strain identified by the WHO in Vietnam, the vaccine has been through two phases of clinical trials on a total of 402 participants, showing its safety and ability to induce an immune response against bird flu.

Sanofi-Aventis, GlaxoSmithKline and Novartis have also received production licenses for bird flu vaccines, but none has yet been approved in China.

Third phase trials have yet to be carried out, as there has been no massive spread of H5N1 influenza in people. This means the vaccines are still only licensed for production, not for adminstration to the general population.

China CDC researcher and chief scientist of the Sinovac vaccine Dong Xiaoping, said part of the reason for going ahead with the vaccine now is that it would be possible to update and modify vaccine production based on the existing vaccine, in the event that a pandemic strain of H5N1 were to emerge in humans. Further clinical trials would not be needed, Dong said.

Before such a strain emerged, the vaccine would be stockpiled to offer as much protection as possible in the early stages of an outbreak, he added, saying that H5N1 had not yet mutated as much as was predicted.

The approval comes shortly after a study published by top Chinese health experts, who conclude that human-to-human transmission of bird flu probably did occur between a father and son in the eastern Chinese province of Jiangsu last December.

Researchers investigated the death of the 24-year-old son from H5N1. The man's 52-year-old father developed typical flu symptoms, and was diagnosed with H5N1. He survived only after receiving early antiviral treatment.

They found evidence of the son's exposure to poultry, but none on the part of the father, who had nonetheless been significantly exposed to his son while he was sick.

New bird flu outbreak in South Korea

7th April 2008

South Korea confirm new outbreak of bird flu at duck farm in the south west.

Fatal bird flu in Pakistan

4th April 2008

WHO confirms the first cases of people dying in Pakistan from bird flu.

Indonesian child has bird flu

31st March 2008

A 22-month-old girl from Sumatra's Bukit Tinggi has tested positive for bird flu.

Indonesia needs help with bird flu

25th March 2008

The United Nations' top veterinary expert has called for more resources to be aimed at preventing avian influenza infections in humans in Indonesia.

The Food and Agricultural Organisation (FAO)'s chief veterinary officer says the country needs more help if it is to rein in the virus and prevent it from mutating to form a strain which can pass between humans, potentially causing the next pandemic influenza.

The FAO's top vet, Joseph Domenech said Indonesia's human mortality figures from bird flu had risen to 100 at the beginning of this year.

He said more human cases would follow if the world did not focus more on containing the disease at source.

While most of Indonesia's human bird flu cases can be traced back to contact with infected poultry, experts fear a mutated form of the H5N1 virus, which has ripped through poultry flocks in Asia and Africa since 2003, could spark a pandemic, killing millions around the world.

They are watching the virus carefully for signs of such mutations.

Domenech said the avian influenza situation in Indonesia was "grave", and he called for all international partners and national authorities to step up efforts to halt the spread of the disease in animals and make the fight against the virus a top priority.

He expressed concerns that the high level of virus circulation in birds in Indonesia could create conditions for the virus to mutate and to finally cause a human influenza pandemic.

Birds in 31 out of 33 provinces were affected by the virus, although health teams were working in 193 out of 448 districts in Indonesia, he said.

According to the FAO, the virus is endemic in Java, Sumatra, Bali and southern Sulawesi with sporadic outbreaks reported from other areas.

Domenech said Indonesia was facing an uphill battle against a virus that is difficult to contain. Major human and financial resources, stronger political commitment and strengthened co-ordination between the central, provincial and district authorities were required to improve surveillance and control measures, he added.

Since the H5N1 virus emerged in southeast Asia in late 2003, it has claimed more than 220 lives around the world.

Bird flu shows signs of mutation

11th March 2008

H5N1 has shown signs of mutation and can kill humans easily if treatment not given early enough.

Bird flu restriction lifted

5th March 2008

Defra said restrictions imposed to combat bird flu in Dorset have been eased.

Bird flu pandemic warning, Asia

5th March 2008

A WHO expert warns the bird flu virus is 'firmly entrenched' in Asia and a pandemic is possible.

Vietnam, China bird flu alert

26th February 2008

China have announced a bird flu outbreak after two deaths.

Wildlife link to new diseases

25th February 2008

International conservation experts have teamed up for the first time with public health experts to produce a map detailing the world's hotspots for emerging infectious diseases (EIDs).

The map uses data spanning 65 years, which shows that the majority of new human diseases come from wildlife.

Conservationists say a reduction of conflict between humans and animals could limit future outbreaks of new diseases.

In their report, published in the journal Nature, researchers from the Zoological Society of London (ZSL), the University of Georgia in the US, and Columbia University's Earth Institute, the researchers present a detailed map of EIDs.

Analysing the map, they said global EID resources had been poorly allocated in the past, and that efforts should focus more on conservation work, which limits conflicts between humans and animals.

The team analysed 335 emerging diseases from 1940 to 2004, then used computer models to see if the outbreaks correlated with human population density or changes in latitude, rainfall or wildlife biodiversity.

Co-author Kate Jones, a research fellow at ZSL, said the analysis revealed that conservation work was of critical importance in the prevention of new outbreaks.

One of the approaches might be to conserve areas rich in biodiversity from development, she said.

The team found that 60% of EID events were caused by non-human animal sources, and that 71% of the outbreaks plotted came from pathogens with a wildlife source.

These included the emergence of Nipah virus in Malaysia in the late 1990s, which is thought to have come from fruit bats, with pigs as a mixing vessel to enable the jump to humans. In China, the SARS outbreak in China has been linked to horseshoe bats and civet cats, both of which are seen on sale in markets.

More recent examples include the emergence of avian influenza, or H5N1, Ebola, and the West Nile virus.

Wildlife campaigners welcomed the findings. Peter Daszak of the Wildlife Trust said if the world continued to ignore the important preventative measures outlined in the report, then human populations would continue to be at risk from pandemic disease.

The team warned that the number of events originating from wild animals had increased significantly over time, supporting the theory that zoonotic EIDs represent an increasing and very significant threat to global health.

Marc Levy, global change expert at Columbia University's Earth Institute, said massive growth in the human population was cramming wildlife into ever smaller areas, increasing pressure on both systems and resulting in more things crossing the species barrier.

The main sources of EIDs are mammals that are most closely related to humans, while some can be picked up while hunting or by accident. Livestock are also a common reservoir for pathogens, and newly emerging diseases can be lethal because humans have no resistance to them, Levy added.

The main hotspots were located in low latitude regions, like South Asia and South-East Asia, which were not the financial focus of global funds to prevent the spread of EIDs, the report said.

John Gittleman from the University of Georgia's Odum School of Ecology said that bringing ecological sciences and public health together paved the way for advancing the field of EID study in a dramatic ways.

Experts called for better biosecurity measures, like screening people who had contact with wild birds or mammals in hotspot areas.

Chinese woman dies of bird flu

25th February 2008

Authorities in the southern Chinese province of Guangdong have confirmed the death of a woman in the province from avian influenza.

The woman, a 44 year-old migrant worker who was working in Haifeng county in the eastern part of the province, probably contracted the virus after eating infected poultry that she kept in her backyard, the provincial government said.

Her samples had tested positive for H5N1 carried out by the Guangdong Centre for Disease Prevention and Control. The Health Ministry in Beijing has yet to confirm the result.

Thomas Tsang, controller of the Centre for Health Protection in neighbouring Hong Kong, said the woman kept chickens that had got sick and died during the incubation period of her illness.

Tsang said the most likely route of transmission was from the sick poultry she kept and that she was mostly likely to have acquired avian influenza from this source.

While well-cooked meat is safe, experts have warned the public about handling H5N1-tainted animals or meat without protection.

The woman first sought treatment from a local clinic for fever, cough and pneumonia after falling ill, according to a statement released on the provincial health department's website.

She was admitted to the Haifeng county hospital, but her condition was too serious by that stage for treatment to work, the statement said.

The woman's death is the third confirmed from bird flu in China this year; one was reported in the central province of Hunan, while another occurred in the southwestern region of Guangxi.

A man in the eastern province of Jiangsu also died in December from the disease, which has ripped through poultry flocks in East Asia since 2003.

China has the world's biggest poultry population, with a large proportion of birds roaming around, belonging to individual smallholders.

The health authorities have struggled to contain a number of outbreaks, ordering mass culls and launching widespread inoculation and biosecurity campaigns in the countryside, which is home to 900 million people.

The Guangdong statement said there were no signs that anyone who had had contact with the woman had developed symptoms so far.

International experts fear the virus could mutate into a form that is easily transmissible between humans, sparking a global pandemic that could kill millions.

In Hong Kong, Tsang said the authorities would step up biosecurity controls on poultry and people coming into the former British colony, with mandatory testing of any person showing signs of pneumonia who has visited Guangdong in the past six months.

Of the 29 human cases confirmed to date in China, 19 have been fatal. According to WHO data, there have been 232 human deaths globally from the H5N1 strain and 366 confirmed cases of infection since 2003.

Indonesia bird flu deaths rise to 100

29th January 2008

Indonesian death toll has risen to 100 which is almost half of the total worldwide fatalities.

Under the tongue flu vaccine

29th January 2008

A flu vaccine that is adminstered under the tongue may provide better protection from type A influenza, researchers in Japan, France and the United States have found.

The study, published in the Proceedings of the National Academy of Sciences, carried out a series of experiments on mice.

The mice were given two doses of either live or inactivated flu virus sublingually, which means that the vaccine is absorbed through the mucus in the mouth.

The vaccine administered in this way was shown to provide protection against a lethal dose of influenza given to the mice.

Such a delivery method would enable the vaccine to be administered to large numbers of people in areas which lack easy access to the qualified medical staff needed to inject people with needles.

The vaccine would also appeal to those who do not like needles, and perhaps encourage more people to get vaccinated against influenza.

Needles can also carry side-effects, including pain and swelling.

Previously, researchers had found complications could occur with a nasally administered vaccine if the flu virus travelled into the central nervous system.

But this did not happen with the vaccine given to mice under the tongue.

Researchers concluded that the safety of the sublingual vaccine was now well established.

They said the under-the-tongue vaccine could be a more effective avenue than traditional approaches for vaccinating against both seasonal flu and pandemic flu.

But some experts warn that research like this does not always translate well from animals into humans.

The WHO estimates that seasonal influenza causes between 250,000 and 500,000 deaths every year around the world.

Governments are also stockpiling pandemic influenza vaccines, primarily targeting avian H5N1 viruses, for emergency use. However, no-one is sure whether further mutations of bird flu will render them useless.

Experts believe the next pandemic could cause disease in two billion people, and kill millions globally.

Indian bird flu spreading

28th January 2008

Officials say bird flu epidemic spreading further in West Bengal with 13 of 19 districts affected.

Accidental spread of bird flu

18th January 2008

A WHO report suggests the H5N1 virus may sometimes stick to surfaces or be kicked up in fertiliser.

India bird flu fight hampered

22nd January 2008

A lack of education among local people about avian influenza is hampering efforts to contain an outbreak of the virus among poultry in India.

Health workers in the eastern state of West Bengal are urgently trying to educate villagers about bio-security, and prevent them from dumping dead poultry in ponds.

Officials said a planned cull of 400,000 chickens was not yet complete, and might take at least two more weeks to implement.

More than 60,000 birds have died of the H5N1 bird flu strain in three districts in the state, according to test results from the agriculture ministry.

Officials are also investigating bird deaths in three other districts, some of which lie more than 300 kilometres (180 miles) from the earlier outbreaks.

The wide area across which the outbreak has spread is alarming to health experts.

The World Health Organisation (WHO) has called the outbreak the most serious yet to emerge in India.

West Bengal's chief minister, Buddhadeb Bhattacharjee, said there was no need for panic, however.

Health officials and veterinary staff were warning villagers against dumping dead fowl in ponds and water tanks, as this would increase the likelihood of the virus spreading.

In Margram village, the epicentre of the outbreak, people were being urged to report all poultry deaths to the authorities.

Anisur Rahaman, the state's animal resources minister, said the lack of education among local people about bird flu had compounded the problems of the authorities and delayed the culling of birds.

Volunteers were trying to spread the word, as smiling children were seen holding up dead birds with their bare hands for television cameras.

Many villagers are refusing to hand over their poultry to veterinary staff for culling, saying the government compensation, equal to about a dollar a bird, was not enough.

The outbreak is the fourth to hit India since 2006, although no human infection has yet been reported.

Lab tests are still pending, but officials say they believe the poultry are infected with the most virulent form of H5N1, which has ripped through poultry flocks in Asia and Africa since 2003.

Most of West Bengal's border with Bangladesh has been sealed after the H5N1 virus spread to poultry in 25 of that country's 64 districts.

Scientists worry that H5N1 could mutate into a form able to pass easily between humans, sparking the next influenza pandemic and possibly killing millions.

H5N1 'stable'

11th January 2008

Outbreaks of H5N1 have been contained and virus remains stable.

Bird flu found in Israel

4th January 2008

Officials in Israel say H5N1 has been found in dead chickens from a kindergarten petting zoo.

Flu jab may help against H5N1

2nd January 2008

A regular annual flu vaccine may offer some protection against avian influenza, researchers say.

Scientists at the National Institute for Infectious Diseases Lazzaro Spallanzani in Rome found that the blood of volunteers who had received the seasonal flu shot had antibodies which may be of some use against H5N1.

Bird flu, which is so far only proven to have infected humans who came into contact with sick poultry, has infected 341 people in 13 countries, of whom 210 have died.

Health experts warn that the virus may be changing to become more easily transmissible between humans, and that this could spark a pandemic, with the potential to kill millions globally.

Researchers Cristiana Gioia, Maria Capobianchi and colleagues tested the blood of 42 volunteers, and added H5N1 virus to it in the laboratory.

They found that in some of the samples, antibodies were present that acted against the bird flu virus.

Their findings, published in the journal Emerging Infectious Diseases, also showed a few immune cells called CD4 T-cells had recognised and acted against the H5N1 virus.

They said seasonal flu jabs boosted the frequency of such reactions.

Seasonal vaccination can raise neutralizing immunity against (H5N1 avian influenza) virus, they concluded.

They also suggested their findings could help explain why H5N1, which only rarely affects people, is even rarer among the elderly.

Older people, although not previously exposed to H5N1 subtype, may have gained protective immunity by previous infections sustained by circulating influenza virus strains, the study said.

Several types of influenza circulate globally among people at any given time and these strains constantly mutate. This means flu vaccines have to be reformulated every year to match the mutations.

Health experts around the world are trying to boost rates of annual flu vaccination both to cut the number of deaths caused by seasonal influenza, and to give additional protection in the event of a pandemic.

Mass seasonal vaccines will boost overall vaccine capacity, making it easier to start making enough vaccines when the next flu pandemic emerges.

Bird flu in Pakistan

18th December 2007

A man has died from avian influenza in Pakistan, the first confirmed human death from the H5N1 virus to be recorded in the country.

Five other people have also been confirmed as infected with the virus, with a second death - the man's brother - still under investigation in the North West Frontier Province following the infections in late October.

The health ministry said the five other bird flu patients had all now recovered.

This is the first time Pakistan has recorded human infections with H5N1, which is still mainly an animal disease. Outbreaks in poultry have already occurred, however, with the first one recorded in 2006.

No further cases in birds or people had been recorded in the past two weeks, however, according to federal health secretary Khushnood Akhtar Lashari.

The World Health Organisation (WHO) is putting together an investigative team which will arrive in Pakistan in a few days' time.

The cases bring the worldwide number of human H5N1 infections to 340, with 209 deaths from the disease to date, according to WHO figures.

Bird flu has so far mostly been traced to contact with sick birds, but experts fear the virus may mutate to a form easily transmissible between humans, causing a pandemic which could kill millions globally.

WHO said there were a further eight suspected cases in the Peshawar region of Pakistan, and two of them had died, but H5N1 was yet to be confirmed.

It was not yet clear whether the cases had shown any signs of being transmitted between humans, nor whether the virus had shown any signs of mutating to do so.

Indonesia has had the heaviest toll, with 115 human cases including 92 deaths, followed by Vietnam with 100 cases and 46 deaths.

World ill-prepared for bird flu

11th December 2007

The risk of a world-wide influenza pandemic is as great in late 2007 as it was in mid-2005, and the world is still poorly prepared, according to a new report.

The report, published jointly by the United Nations System Influenza Coordinator (UNSIC) and the World Bank, says most countries' pandemic preparedness plans pay scant attention to operational readiness at local level, or to cooperation plans with their neighbours.

It quoted the World Health Report 2007 as saying that “There will be an influenza pandemic, sooner or later? with the potential to result in millions of deaths and severe social, economic and humanitarian consequences.

It adds: "We have a unique opportunity to prepare for the pandemic now and to significantly mitigate its potential impact."

Initial progress has been made in the initial, emergency phase of the global response to avian influenza, type A virus H5N1.

Significant improvements have been seen in diagnostic and surveillance capacity globally. But it is still inadequate in a number of countries, particularly in Africa.

Based on data from 146 countries, the report was circulated at an international ministerial conference on bird flu, in New Delhi, India.

WHO director-general Margaret Chan warned delegates that the next pandemic would occur through adaptive mutations.

Scientists currently have no idea when and how the pandemic will occur, or whether the current high fatality rate of 61% in humans would be maintained, she said.

Chan also warned that national preparedness for an influenza pandemic must extend beyond the health and agricultural sectors and take into account maintenance of essential services such as food and public transport.

Experts have long warned that bird flu and other major health crises of animal origin could be worsened by climate change, and the increased risk of pathogens travelling over large distances in a very short period, due to modern air travel.

Further investment is needed to focus on prevention at the source - animals - and in developing countries.

David Nabarro, senior UN system coordinator for avian and human influenza, said that while many countries say they have developed national preparedness plans, their preparedness for a pandemic is still highly patchy, with insufficient attention to sectors other than health and their operational aspects.

The report identifies a need to expand from emergency, short-term responses to sustained medium- and longer-term strategies with an increased focus on bio-security in both family and commercial poultry production systems.

It stresses the importance of intensive responses in locations where there is continued transmission of avian influenza among poultry and where the virus is entrenched.

It also calls for the increased involvement of different economic and social sectors, as well as humanitarian organisations, in pandemic planning in order to mitigate the social, economic and humanitarian impact.

Bird flu fears 'human-to-human'

7th December 2007

Chinese authorities report that the father of a Chinese man who died from the H5N1 strain of bird flu last week has also been diagnosed with the disease.

A 52-year-old man surnamed Lu from the Nanjing, the capital of the eastern province of Jiangsu, became feverish with the H5N1 strain on Thursday, according to the National Disease Authority, as reported by the Ministry of Health. The man's son had died five days earlier.

This latest case brings the number of confirmed human infections in China to 27. The Ministry of Health said the World Health Organisation had been notified.

Humans can contract H5N1 from close contact with infected birds, but scientists fear the disease could mutate into a version that spreads from person-to-person, raising the spectre of a global pandemic. How either of the two men might have contracted the virus remains unknown.

Official media had reported that the son became ill without having had any contact with dead poultry, nor had any outbreaks of the deadly virus been reported in the province.

China is home to the world's largest human and poultry populations, and birds roam freely in much of the country. Scientists say China is central to the global fight against bird flu, and it could be the crucible for the next pandemic.


Chinese man dies of H5N1

3rd December 2007

A Chinese man died from the deadly H5N1 strain after being admitted to hospital with severe chills and fever.

No outbreaks of bird flu had been reported nearby and he had no known contact with dead poultry.

Scientists fear the virus could mutate into a form easily passed between humans setting off a pandemic and potentially putting millions of lives at risk.


Indonesia stalls bird flu deal

27th November 2007

The Indonesian government is a key player in the race to produce vaccines against bird flu, but has said it will refuse to cooperate with global health researchers unless agreements are in place to protect its intellectual property, and to ensure that poorer countries have access to affordable vaccines in the event of a pandemic.

A spokeswoman for the country's health ministry attending negotiations hosted by the World Health Organisation (WHO) in Geneva said her minister was adamant that no samples - which are crucial for tracking the mutation of the virus - would be sent overseas without a written agreement in place for each one to ensure they were not used for commercial reasons.

Jakarta is concerned that while the poorest countries are expected to toe the line on international scientific cooperation, they are often last in line when it comes to access to key treatments.

In January, frustrated that an Indonesian strain of the virus had been used to make a vaccine that most Indonesians would not be able to afford, the country stopped cooperating with the WHO and made a deal to send samples to Baxter Healthcare, an American company, in return for a low-cost vaccine and help in building vaccine factories in Indonesia.

The current agreement means the Indonesian government will still have leverage if it seeks to negotiate affordable vaccines with big pharmaceutical companies at an affordable price.

At this week's meeting, Health Minister Siti Fadillah Supari insisted on "equitable sharing of benefits arising from the use of viruses" at the meeting.

As viruses mutate rapidly both before and during a pandemic, the global sharing of samples is crucial to tracking their development and developing appropriate vaccines and treatments. It is also necessary to see whether the pathogen has become drug resistant or grown more transmissible.

Indonesia wants a "material transfer agreement" for each virus sample sent to foreign labs, which it says would help to ensure that its samples could not be commercially exploited without its consent.

The talks are aimed at reaching a new agreement to replace a 50 year-old sample-sharing agreement, which WHO has agreed needs updating.

Bird flu at second farm

20th November 2007

The government confirmed that a second outbreak of the H5N1 strain of bird flu had been identified in a turkey flock at a farm on the Norfolk/Suffolk border.

Hill Meadow farm, in Knettishall, was one of the four farms where culls were being carried out because they had been in "dangerous contact" with Redgrave Farm, where the first case was identified.

The farm's 9,000 turkeys were all killed, according to information released by the Department for the Environment, Food and Rural Affairs (Defra). 

Defra's acting chief veterinary officer Fred Landeg said: "The laboratory test results today highlight the importance of poultry keepers in the area being extremely vigilant."

Geese face slaughter

15th November 2007

Geese are still wandering in open air in fields close to bird flu farm in Suffolk.

Bird flu in Suffolk

13th November 2007

6,500 birds are being culled following the discovery of bird flu in turkeys on Sunday at Redgrave Farm near Diss, in Suffolk.

The government has said that birds on four more sites will also be culled as a "precautionary measure."

The Department for Environment Food and Rural Affairs (Defra) has confirmed that the birds are infected with the H5N1 strain. A protection area of 3km and a 10km surveillance area have been put in place around the farm.

Officials said around 10% of birds had died in the night. All the birds kept on the farms - around 6,500 in total - will be culled.

A Defra spokeswoman said they were now attempting to establish the movements of people and birds into and out of the site. In Bury St Edmunds, Defra has set up a national and local disease control base in order to communicate with bird keepers.

Bird movement and contact with wild birds is being monitored and restricted inside the designated zones.

Acting chief vet Fred Landeg said Defra was keeping an "open mind" regarding how bird flu infected the site, but that it could be connected with recent outbreaks in the Czech Republic and Germany.

Pandemic vaccine capacity boost

6th November 2007

A global drive to produce vaccine to be used in the event of a flu pandemic has meant that vaccine is being made available for stockpiling quicker than was previously thought.

Recent scientific advances and increased vaccine manufacturing capacity are behind the rosier picture.

Previous estimates had forecast that 100 million courses of pandemic influenza vaccine based on the H5N1 avian influenza strain could be produced immediately with standard technology.

But capacity now looks likely to grow faster than expected, with a cumulative total of 4.5 billion pandemic immunization courses being made by 2010.

The revised projections have improved the outlook for global pandemic preparedness, according to Marie-Paule Kieny, Director of the Initiative for Vaccine Research at the World Health Organasation (WHO).

However, she warned that a total of 6.7 billion courses - one for every person on the planet - would be needed over a six-month period to protect everyone.

The pressure was still on to speed up preparedness strategies amid the threat of a pandemic, which experts fear may be caused if the H5N1 avian influenza virus mutates to a form that is easily transmissible between humans. Part of that mutation process has already been observed in one strain of the virus.

A substantial gap remained between supply and demand, Kieny said.

One technical advance which has helped the situation is the discovery that a water-in-oil delivery method for the pandemic vaccines enables far less of the precious antigen - which stimulates the immune response - to be used per dose.

WHO experts and officials are also discussing plans to further boost production capacity for the pandemic vaccines. They plan to continue strongly to support the seasonal influenza vaccination programme, and to use production capacity off-season to make pandemic vaccines.

They are also exploring ways for a quick change of manufacturing facilities from inactivated to live, but weakened, influenza vaccines. Such a switch would take place at the start of a pandemic, as soon as the pandemic strain was isolated from the first infections.

It is hoped that the industry will be in a position to make enough vaccine for everyone on the planet within a six-month period by 2012, WHO said in a statement.

Indonesian boy has bird flu

29th October 2007

A three-year-old boy has tested positive for bird flu but his life is not in danger.

UK bird flu outbreak from duck

25th October 2007

Scientists have produced a computer model which predicts that 73% of avian flu outbreaks in the UK would not spread farther than the infected farm they originated from, but wider-scale outbreaks were more likely to be found in the duck meat industry.

The Department of Environment, Food and Rural Affairs (DEFRA) asked a team working at the University of Liverpool to design the computer model to simulate how outbreaks of avian flu might spread.

The study showed that areas of highest risk were East Anglia, Lincolnshire and South Yorkshire because of the prevalence of duck meat companies in these regions. Duck meat was identified as a potentially higher cause of outbreaks because ducks "often do not show signs of the disease and as such delays diagnosis and control of the infection".

Children more at risk from bird flu

25th October 2007

New findings suggest the bird flu virus may find children's lungs faster.

Bird flu mutation bad for humans

5th October 2007

The H5N1 avian influenza virus has mutated into a form that will enable it to infect humans more easily, researchers say.

The virus, previously adapted to live in the body temperature of a bird at 41 degrees Celsius (106F), has mutated so as to survive in the cooler environment of the human upper respiratory tract, according to Yoshihiro Kawaoka of the University of Wisconsin-Madison.

Kawaoka and his team have now identified a specific change that could make bird flu grow in the upper respiratory tract. The viruses now circulating in Africa and Europe were considered to be closest to becoming a human virus, he said.

Recent samples of virus taken from birds in Africa and Europe all carry the mutation, Kawaoka and colleagues report in the Public Library of Science journal PLoS Pathogens.

Kawaoka said he had published the findings not to scare the public, but to keep the scientific community abreast of the latest developments.

However, the virus would have to make more mutations yet if it were to become capable of passing easily between humans and causing a pandemic, which experts fear could spread rapidly around the world, killing millions.

H5N1 was carried across Asia to Africa and Europe by migratory birds after a mass outbreak among wild waterfowl in 2005 at Qinghai Lake in central China, where hundreds of thousands of migratory birds congregate.

The descendants of that strain are the ones that carry the mutation, and were closer to human influenza, Kawaoka said.

He said researchers were unsure of precisely how many more mutations would be needed for H5N1 to spark a pandemic.

The virus has infected 329 people globally since 2003, of whom 201 have died.

While the virus is widely considered to infect humans who come into contact with infected birds, researcher concluded that a girl in Thailand probably passed the virus to at least her mother in September 2004, causing fatal disease, in the first published account of probable secondary human transmission, resulting in severe disease, of any avian influenza virus.

Singapore's bird flu detector

24th September 2007

A research team in the southeast Asian city state of Singapore has developed a hand-held device which they say can detect the presence of avian influenza in a quick and simple test.

The device can identify the presence of the H5N1 bird flu virus within 30 minutes, they report in Nature Medicine.

The device tests throat swabs taken from patients, and is able to isolate, purify, and then amplify viral DNA from the samples, and recognise bird flu.

Currently available tests take several hours to get a result at the very least. The containment of an outbreak of bird flu, should it mutate to a form able to easily infect humans and to be transmitted between them, would depend on the speed of response in the early stages of any outbreak.

The research team from the city state's Institute of Bioengineering and Nanotechnology said the new kit could be used to test people on the spot, either at the point of infection in a new outbreak, or at airports and other transport hubs.

Their device -- which they have dubbed a 'mini-lab' -- is 440% faster than other tests on the market at the moment, and just as sensitive, according to the article.

In tests, a prototype of the device delivered accurate results within 28 minutes when tested on samples of the H5N1 virus, they said.

So far, the 328 humans who have been confirmed infected with H5N1 since 2003 have had some contact with sick poultry. Of these, 200 have died.

Although current forms of the virus are more dangerous to birds than to humans, and find it hard to cross the species barrier, experts fear the virus could mutate into a form easily transmissible between humans and spark a pandemic, killing millions globally.

Bird flu confirmed in China

18th September 2007

China try to reassure consumers that poultry safe to eat after H5N1 confirmed.

Bird flu mutations predictable?

11th September 2007

Scientists in the United States say they have developed a way to produce vaccines which may predict the mutation of a lethal influenza virus before it emerges.

The team, collaborating between the National Institutes of Health (NIH) and Emory University School of Medicine, published findings in the journal Science in August, showing how they had created mutations in the part of the H5N1 avian influenza virus that would direct it to infect bird or human hosts.

Led by vaccine specialist Gary Nabel of the NIH's National Institute of Allergy and Infectious Diseases (NIAID), the team may now be in a position to predict future strains of H5N1 before they emerge, including strains which may become easily transmissible between humans.

So far, the 328 humans who have been confirmed infected with H5N1 since 2003 have had some contact with sick poultry. Of these, 200 have died.

Experts fear the virus could mutate into a form easily transmissible between humans and spark a pandemic, killing millions globally.

NIAID director Anthony S. Fauci said the research was significant, because it could help to contain a pandemic in its early stages, as experts could begin to consider the design of potential new vaccines and therapeutic antibodies pre-emptively.

Usually, samples of existing influenza virus strains are needed to prepare a vaccine. Inactivated forms of the virus are delivered in immunisation programmes, and the person being immunised is able to make antibodies which will help repel the virus if they are later exposed to it.

However, viruses are always mutating, so updated forms of vaccine must be produced to keep up protection levels. This makes it difficult to predict how effective a vaccine made today will be against a virus that emerges tomorrow.

Nabel's team began by focusing only on the mutations that affect how H5N1 viruses recognize and enter human cells, which is different from how it latches on to bird cells, using clues from the virus that caused the devastating 1918 flu pandemic.

They succeeded in identifying some of the genetic changes that might have to happen for H5N1 to infect humans, and again for it to become easily transmissible between humans.

They produced artificially mutated viruses in the laboratory, and discovered a broadly reactive antibody in mice which could neutralise these artifical strains in both humans and birds.

Nabel said his team's research built on studies of influenza proteins by structural biologists, which enabled them to target a critical region of the virus that affected its mutations.

He said such a structure-based vaccine design might enable the team to respond to the future threat of a pandemic before the first outbreak occurred.

Bird flu in German poultry farm

28th August 2007

An outbreak of deadly bird flu has been identified in a southern German poultry farm, a spokeswoman for Bavaria's environment ministry said.

The spokeswoman said dead ducks from the farm in Wachenroth in Bavaria's Erlangen-Hoechstadt area had tested positive for the highly pathogenic H5N1 strain of the virus.

The farm has been sealed off and all 160,000 birds in the farm culled.


Bird flu death in Indonesia

16th August 2007

An Indonesian girl has died of bird flu, taking the country's death toll from the virus to 83. 

The 17-year-old maid from Tangerang west of Jakarta died after falling ill with a high fever. The most common way for humans to become infected with the H5N1 virus is through contact with sick fowl, but officials were still investigating how she contracted the disease. "She suffered from high fever and breathing difficulties," ministry official Muhammad Nadirin said.

The victim's employer told hospital director Maruzzaman Naim that the girl, who came from Cilacap in Central Java, had only been working for three months in the area.


Bird flu death in Bali

13th August 2007

A 29 year-old woman has died of bird flu on the popular tourist destination of Bali, health officials said.

Her five-year-old daughter has also died recently, though it was unclear if the child, who used to play with chickens, had also contracted the H5N1 virus.

The woman, who came from the western part of the Hindu island, died in hospital Sunday after suffering a high fever and multiple organ failure, according to a doctor at the hospital in the island's capital, Denpasar.

From a village in the district of Jembrana, 105 km (65 miles) from Denpasar, the woman had lived in a house with sick and dying chickens in the back yard for several weeks. She only presented for medical help after several days of symptoms, and was then transferred to an isolation unit in the Balinese capital.

Officials said there had been sick chickens around the woman's house and many had died suddenly in recent weeks.

The health ministry's bird blu centre said test results were also pending on a two-year-old girl from the same neighbourhood who had also become ill and who was now recovering in hospital.

Bali's tourist industry was dealt a severe blow following several deadly bomb attacks in recent years, and the news of bird flu in the vicinity is unlikely to help.

Officials said they had already put in place measures to contain the outbreak, including culling poultry and testing of humans.

Bayu Krishnamurthi told a news conference the government was working very hard to prevent the spread of the virus to nearby villages, although he admitted there were weaknesses in the island's surveillance and response systems.

Experts say the deadly H5N1 virus has been endemic in Balinese poultry since 2003, when it began to spread across the Asia Pacific region.

Ngurah Mahardhika, a scientist on an expert panel of the country's bird flu commission, said experts had been expecting some cases in humans.

Officials said the carcasses of the dead chickens had not been burned according to government guidelines, but buried or fed to other animals.

So far, humans who have been infected with H5N1 have had some contact with sick poultry. Experts fear the virus could mutate into a form easily transmissible between humans and spark a pandemic, killing millions globally.

More bird flu in Burma

6th August 2007

BANGKOK - Authorities in the central Burmese region of Bago have confirmed a new outbreak of avian influenza, officials told RFA’s Burmese service.

"This time, it started among backyard chickens and ducks,? government veterinary expert and former director general of the country’s livestock breeding and veterinary ministry Than Hla said. “Then it spread to farms in some way.?

He confirmed reports that 3,800 chickens had already been slaughtered on a poultry farm in Letpandan town, 145 kms (90 miles) northwest of Rangoon, and that laboratory tests had confirmed they were infected with the virulent H5N1 strain of bird flu.

“Letpandan is a small town; it doesn’t have big farms and it happened only on that farm,? Than Hla said.

Outbreak said under control

An official in the Bangkok office of the UN’s Food and Agriculture Organization (FAO) said the outbreak was now under control.

Than Hla said veterinary experts were called in on July 28 after a outbreak in ducks. This later spread to the poultry farm.

“This time, the outbreak is different from the previous wave in Mandalay, where it happened in many farms at the same time...It happened only on a single farm in Letpandan, and it did not spread to other farms.?

“After culling the birds we quarantined the area and put under intensive surveillance. So far no new cases were found,? he said.

“Since it is rainy season here we are facing a lot of trouble in burying or destroying the animals. When we dig the ground to bury them, all the water comes out and the cost of fuel is too high to burn them, but we are doing our best,? he told reporter Khin Maung Soe.

The Letpandan outbreak came just days after the authorities reported outbreaks on two poultry farms in Mon state, about 300 kms (180 miles) south of the former capital, Rangoon.

About 300 chickens were slaughtered on those two farms, in the first known outbreaks of bird flu since June. Burmese authorities culled 660,000 birds last year to contain the spread of the deadly virus, which has ripped through Asian poultry flocks since 2003 and caused 319 cases in humans, 192 of which were fatal.

Experts fear the virus could mutate to a form easily transmissible between humans, sparking a flu pandemic of massive proportions.

Original reporting in Burmese by Khin Maung Soe. Edited by Khin May Zaw. Burmese service director: Nancy Shwe. Written for the Web in English by Luisetta Mudie and edited by Sarah Jackson-Han.

US awards vaccine contracts

16th July 2007

The US government has awarded contracts worth a total of US$132.5 million to two pharmaceutical companies to expand their manufacturing capacity to meet demand for new vaccine in the event of a global influenza pandemic.

The Department of Health and Human Services awarded the two cost-reimbursable contracts to sanofi pasteur and MedImmune, to fund a revamp of their existing facilities over five years.

This means that the two companies will now retrofit their manufacturing facilities to prepare them to make extra quantities of vaccine in the event of an influenza pandemic. They will also pledge to keep the facilities up and running so as to start operating at very short notice if necessary.

While many fear the deadly H5N1 avian influenza virus may mutate to a form easily transmissible between people, there is no guarantee that the virus which eventually causes a pandemic - which experts see as inevitable - will indeed be bird flu.

HHS Secretary Mike Leavitt said it was necessary to prepare for a pandemic, even though no-one was sure of when one would strike, or with what degree of severity.

"These contracts are important advances in the path of preparation because they help the nation build its capacity to respond," he said in a statement.

The five-year contracts were awarded to sanofi pasteur, a manufacturer of a US-licensed egg-based inactivated influenza vaccine product, for US$77.4 million and to MedImmune, a manufacturer of a US-licensed egg-based live, attenuated vaccine product, for US$55.1 million.

The contracts provide funding for renovation of manufacturing facilities and manufacturing warm-base operations for two years with options for an additional three years of warm-base operation. "Warm-base" refers to the stipulation that the facility be kept open so as to commence operation at short notice.

Upon completion, the facilities are forecast to expand domestic pandemic vaccine manufacturing capacity by 16%, the HHS statement said.

They would also make possible year-round production of pre-pandemic influenza vaccines for the national stockpile. Currently, vaccine production for the stockpile is limited to just three months in any given year.

The HHS Pandemic Preparedness Plan includes the establishment of pre-pandemic influenza vaccine stockpiles for 20 million persons in the critical workforce and the expansion of domestic pandemic vaccine manufacturing surge capacity for 300 million persons within six months of the onset of an influenza pandemic.

The contracts would be managed by the Office of Biomedical Advanced Research and Development Authority (BARDA), formerly the Office of Public Health Emergency Medical Countermeasures, under the aegis of the HHS, it said.

Czechs confirm H5N1 bird flu

12th July 2007

Poultry at two farms in the eastern part of the Czech Republic have been confirmed by laboratory tests to be infected with the deadly H5N1 avian influenza virus, officials said.

The State Veterinary Authority (SVS) said the virus was found at the two farms, which have a total population of 71,000 poultry, bringing the number of outbreaks at Czech farms to four.

All birds on the farms were scheduled to be culled, according to standard isolation and quarantine procedures.

SVS spokesman Josef Duben said officials had expected the result.

The first bird flu case was found in the eastern part of the country at a turkey farm in June.

The two farms where disease was reported are within a 3-km (1.9-mile) protective zone around another farm where H5N1 had been found.

Vets have extended the standard 3-km protection zone and 10-km surveillance zone to include the two farms.

Meanwhile, German scientists have discovered that the bird-flu virus which has killed a number of swans in southern Germany shared a common origin with the Czech outbreak.

"We assume infected wild birds infected both the Czech poultry and the water fowl in Germany," The German Press Agency (DPA) quoted Elke Reinking, spokeswoman of the Freidrich Loeffler Animal Health Institute (FLI), as saying.

DNA tests showed a 99.2% match between the bird flu outbreak in the Czech Republic and the virus found in dead swans in Nuremberg.

Germany has confirmed a total of nine cases of bird flu caused by H5N1 in recent weeks.

The H5N1 bird flu virus, which experts fear could mutate into a form easily transmissible between humans, has also been found in geese and turkeys in farms in Hungary and Britain this year.

According to the World Health Organization, the H5N1 virus has killed nearly 200 people out of more than 300 cases globally since 2003.

Bangladesh battles bird flu

4th July 2007

Bangladesh, where around five million people depend on poultry farming for a living, has yet to see a human case of avian influenza.

But a World Bank advisory body is teaming up with a leading Bangladeshi NGO to raise awareness of the lethal H5N1 strain of bird flu, which has spread to dozens of farms since March.

There have been no known cases in Bangladesh of people being infected with the H5N1 bird flu virus.

Better education is one of the main areas of focus. Poultry is the country's fastest-growing livestock sector, employing millions of people, and the project aims to help small farmers to put measures in place to improve both their farming practices and their productivity.

A statement from an IFC advisory body called the SouthAsia Enterprise Development Facility (SEDF) and the group BRAC said the project would raise awareness among more than 10,000 small poultry farmers and retailers.

"IFC has global experience dealing with the avian influenza. We are using our expertise and BRAC's experience and outreach in the sector to help protect farmers, small and medium enterprises, and other stakeholders," said Deepak Adhikary, deputy general manager of IFC-SEDF.

Fifty-one farms in 16 districts have already been hit by the avian flu bug, forcing the authorities to cull nearly 255,000 poultry, according to figures from the Ministry of Agriculture and Fisheries.

The virus has killed 191 people worldwide since late 2003 and scientists fear the H5N1 virus could mutate in a form that easily passes between people, triggering a pandemic.

In total, 317 people are known to have been infected globally and contact with sick or dead poultry tends to be the common link.

Man dies of bird flu in Vietnam

19th June 2007

A 20-year-old Vietnamese man has died of bird flu, the first human death to occur in the country from the virus since 2005, officials said.

The death, in the northern province of Ha Tay, was announced by official media, but none of the recent five cases of H5N1 infections have yet been confirmed by the World Health Organisation (WHO).

The disease, which has ripped through poultry flocks in Asia and spread to Europe and Africa, has killed 191 people out of 313 confirmed cases since the outbreak began in 2003.

Two other people have recovered, and two are still being treated for the virus, which recently resurfaced on poultry farms in the region..

Officials culled ducks and chickens at eight farms in Bac Giang province after it was found that 690 birds died of avian influenza there.

"Bird flu virus is widely present in the environment and has infected many poultry flocks. Therefore, it can happen anywhere now," a government statement quoted Deputy Agriculture Minister Bui Ba Bong as telling a meeting on Saturday.

At the same meeting, Prime Minister Nguyen Tan Dung approved an order to import another batch of 200 million doses of bird flu vaccine to battle the outbreaks that have struck 16 provinces, including Bac Giang, and two cities.

He told a meeting that tight controls must be imposed on Vietnam's 70 million ducks, who should not be allowed to roam free unvaccinated.

WHO said carrying out all effective measures in the provinces was challenging, but that Hanoi was aware and alert where bird flu was concerned.

Vietnam's programme of poultry vaccination and other measures has been described by international health experts as a model for keeping the H5N1 virus at bay, but this year it has spread nationwide in ducks and chickens.

The latest death raised Vietnam's toll since late 2003 to 43 people.

Bird flu antibodies found

4th June 2007

Researchers have successfully treated mice infected with the H5N1 avian influenza virus with antibodies derived from humans who survived the disease.

The international team of scientists said the findings would provide a promising basis for the search for a bird flu vaccine or treatment of the disease, should the virus become easily transmissible between people.

But further trials were needed, according to researcher Anthony S. Fauci of the US National Institute of Allergy and Infectious Diseases (NIAID).

If these findings were confirmed in further studies, however, human monoclonal antibodies could prove to be valuable therapeutic and prophylactic public health interventions for pandemic influenza, Fauci said.

Published May 29 in the online journal PLoS Medicine, the research was carried out by Kanta Subbarao and colleagues at NIAID; Antonio Lanzavecchia and colleagues from the Institute for Research in Biomedicine, Bellinzona, Switzerland; and Cameron Simmons of the Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

The antibodies were derived from four Vietnamese adults who survived an H5N1 influenza infection between January 2004 and February 2005. The samples were taken with the consent of the patients shortly after they recovered.

The antibodies were extracted by Lanzavecchia in Switzerland using a process he developed, and screened at NIAID for any antibodies able to neutralise H5N1. Eventually, four monoclonal antibodies were produced in Switzerland and used to treat mice infected with a severe form of avian influenza. Two of the antibodies produced survival rates of 100% and 80% respectively, while all the mice without the antibodies died within a week.

During the flu pandemic of 1918-19 serum from recovered flu patients was given to new victims, often saving lives.

The findings show that human antibodies with potent H5N1 influenza virus neutralizing ability can be rapidly generated from the blood of convalescent patients and that they work well to both treat H5N1 infection and prevent death from such infection in mice.

The researchers plan to produce more antibodies with a view towards eventual clinical trials in humans.

Pupils and teachers offeered drugs after child become infected with bird flu

29th May 2007

School pubils and staff are being offered anti flu drugs after a child became infected in the bird flu outbreak in North Wales. the child, who lives close to the farm in Corwen where H7N2 strain was first discovered is responding well to treatment.

Bird flu in Wales

25th May 2007

A case of bird flu has been confrmed in Wales, but it is not the H5N1 strain.

World prepares for pandemic

24th May 2007

The United States defence department has announced its plan for dealing with a possible influenza pandemic, including learning from Singapore's experience of Severe Acute Respiratory Syndrome, or SARS.

Officials said the department had teamed up with other federal agencies, and was as ready as it could be, given the current situation with avian influenza, or bird flu, a possible candidate for the next pandemic which experts warn is inevitable.

The Pandemic Influenza Implementation Plan, part of the Bush administration's initiative on pandemic preparedness, is aimed at informing the public about the government's response to a pandemic.

The Department of Defense will work with the Department of Homeland security, using its expertise in biological threats.

It will tell people how to help curtail the spread and mitigate the effects of a possible flu pandemic.

The 1918 "Spanish" flu pandemic killed millions in the United States.

Containment was a top priority in the plan, which in turn depended on early detection and action, officials said.

The H5N1 virus has already ripped through poultry flocks in Asia and Africa, and has also been found in Europe. It has yet to mutate to a form that is easily transmissible between humans.

The first line of defence against bird flu is isolation and mass poultry culls, which have been continually taking place throughout East and Southeast Asia since 2003.

The defence department plan also included research and development, together with stockpiling of appropriate anti-viral vaccines and medicines, officials said in a statement.

US officials also have conducted extensive interviews with medical experts in Singapore on how they successfully dealt with the deadly severe acute respiratory syndrome, or SARS, epidemic that occurred worldwide between November 2002 and July 2003.

Meanwhile, China has confirmed an outbreak of the H5N1 virus among poultry in the central province of Hunan, but it reported no human cases of the disease.

The outbreak, in the southern province of Hunan near a lake which is a key stopping point for migratory birds, was contained after more than 11,000 birds were culled, official media reported.

The birds had tested positive for H5N1.

Worldwide, the virus has killed 185 people since 2003, including 15 in China, according to the World Health Organisation (WHO), which has struck an initial deal ensuring that all countries share samples of the virus to further research, and that poor countries get access to any future pandemic flu vaccines.

The resolution adopted by the World Health Assembly commits the WHO to working out rules to guarantee "timely sharing of viruses" between affected countries and WHO, and ensure "fair and equitable distribution of pandemic influenza vaccines at affordable prices in the event of a pandemic."

But it is not specific about what a fair distribution of vaccines or timely sample sharing actually means. It also does not specify the details surrounding the formation of a pandemic flu vaccine stockpile, or how the stockpile would be distributed.

Mike Leavitt, Secretary of Health and Human Services, welcomed the approval of the first US vaccine for humans against H5N1.

"To date, H5N1 avian influenza has remained primarily an animal disease, but should the virus acquire the ability for sustained transmission among humans, the potential for an influenza pandemic would have grave consequences for global public health. Pandemics happen, and we must minimise the impact of the next pandemic when it comes," he said in a statement on the department's website.

He said his department had been making significant investments in vaccines, antivirals, and research, awarding US$1 billion in contracts in 2006 to develop cell-based vaccines against both seasonal and pandemic influenza in the hope of vaccinating all US residents within six months of the declaration of a pandemic.

"Also, we are working on dose-sparing measures to enable us to produce more treatment courses for more people...We have also developed community mitigation strategies should a pandemic break out and continue to encourage vigorous state and local planning," Leavitt said.

He said the approval was the result of a collaborative effort between the Food and Drug Administration and the National Institutes of Health, which funded the vaccine research through its National Institute of Allergy and Infectious Diseases. To date, the health and human services department had purchased 13 million doses of this vaccine, enough to cover 6.5 million people, he added.

The department provides information to the public via its website, www.pandemicflu.gov.

Bird flu continues in SE Asia

7th May 2007

An Indonesian man has died, bringing the number of deaths from avian influenza in the country to 75. Meanwhile, a fresh outbreak of the H5N1 virus has been reported on a Vietnam duck farm.

The Indonesian man died on May 3, and was confirmed as having bird flu shortly afterwards by the Aijkman Molecular Biology Institute, local media reported.

The 29-year-old trader fell ill in late April in Pekanbaru city on Sumatra. He was later transferred to another hospital.

Bird flu has been found in 11 Indonesian provinces to date.

In Vietnam, veterinary officials said the virus was found in a duck flock in the central province of Nghe An, also in early May.

Nearly half the flock had died, and specimens later tested positive for an H5 influenza virus, health officials said.

Other flocks in the area have been culled, and disinfection and quarantine measures have been put in place around the affected area.

Millions of poultry have been slaughtered in Vietnam since the outbreak began in December 2003.

To date, Vietnam has detected over 2,000 bird flu outbreaks among poultry, leading to the killing or the forced killing of over 40 million birds, or about 15% of its poultry population, according to a recent World Bank report on the country. The direct cost of bird flu in Vietnam is estimated at 200 million US dollars so far, the bank said.

The World Health Organisation (WHO) has called on Vietnam to speed up poultry vaccinations. Waterfowl are a reservoir for the disease and can spread the H5N1 virus in their droppings as they roam through rice fields. Ducks often show no symptoms of sickness, making it harder to contain the virus.

Animal health officials say 60 of Vietnam's 64 provinces have so far finished or nearly completed the first of a two-phase vaccination campaign which targets up to 90% of the country's poultry.

The virus has killed 170 people in 11 countries, most of them in Indonesia and Vietnam, according to the WHO.

Bird Flu discovered in Ghana

4th May 2007

The H5N1 strain of bird flu has been found at a chicken farm 20km east of capital Accra.

Bird flu vaccine stockpile 'feasible'

1st May 2007

Governments and manufacturers say it should be 'feasible' to create a global stockpile of vaccine against the avian influenza virus.

In a meeting hosted by the World Health Organisation (WHO) in Geneva, they also set out steps towards developing a mechanism to ensure that poorer countries have broader access to pandemic influenza vaccines.

Called in the wake of negotiations with Indonesia, which stopped sending crucial samples of H5N1 virus found in its human and poultry populations, the April 25 meeting brought together countries that have experienced human H5N1 infections, donor countries, and vaccine manufacturers from industrialised and developing countries.

Participants heard that recent scientific studies on H5 vaccines had shown them to be safe and immunogenic, and that it was realistic to expect that vaccines offering cross protection (against immunologically related but different viruses not contained in the vaccine) could be developed.

They agreed to make further efforts to examine whether and how to establish a stockpile of H5N1 vaccine and a mechanism for broader access to pandemic vaccine when the next influenza pandemic occurs.

Representatives of vaccine manufacturers in developed and developing countries told the meeting that they were willing to work with WHO to pursue the possibility of an H5N1 vaccine stockpile and a mechanism for broader access to pandemic vaccine, WHO said in a statement on its website.

The International Federation of Pharmaceutical Manufacturers and Associations, the industry organization that represents research-based pharmaceutical companies, said that it forecast increased manufacturing capacity for seasonal influenza vaccines in the next three to five years, to meet potential growing demand.

WHO said it would now set up expert groups to focus on the details of how to create, maintain, fund and use an H5N1 vaccine stockpile. It said it would continue to work for broader access to pandemic vaccine.

Participants agreed that the work on virus sharing, H5N1 vaccine stockpiles, access to pandemic vaccines and other means of strengthening pandemic preparedness must all be based on the International Health Regulations (2005), the regulatory framework aimed at protecting global health security.

WHO holds bird flu vaccine talks

24th April 2007

The World Health Organisation (WHO) is holding a meeting April 25 to discuss ways to increase the access of developing countries to potential pandemic vaccines.

It will follow on from negotiations with the Indonesian government in Jakarta, and bring together representatives from countries affected by H5N1, plus vaccine manufacturers and donors.

Potential outcomes include an agreement on mechanisms for access to vaccines, including stockpiling options, the WHO said in a statement on its website.

Meanwhile, Japan and the United States have pledged up to US$18 million in grants to help six developing countries develop their own manufacturing capacity for a potential pandemic influenza vaccine.

An initial tranche of US$2.5 million would be given immediately to Brazil, India, Indonesia, Mexico, Thailand and Vietnam under the programme, WHO said.

"With increased developing country flu vaccine production, there is a dual life-saving benefit.," Marie-Paule Kieny, Director of the WHO Initiative for Vaccine Research, said in a statement.

"Countries will be able to protect their populations against seasonal influenza, which causes up to half a million annual deaths worldwide, as well as millions of cases of severe illness."

"In addition, should a pandemic emerge, production lines at these facilities can be converted to manufacture vaccine based on the pandemic strain," she added.

The grants are part of the implementation of the Global pandemic influenza action plan which aims to close the influenza vaccine production gap of several billion doses, the WHO said in a statement on its website.

It will still take a minimum of three to five years for those countries to begin producing vaccine locally. Other measures would need to be taken in the meantime to ensure access to crucial vaccines, and this would be addressed at the April 25 meeting, the agency said.

Bird flu vaccine approved in US

17th April 2007

The United States drug regulator has approved the first ever vaccine for humans against avian influenza.

The vaccine against the H5N1 virus could be used in the event that the current virus mutated into a form with the ability to spread between humans, the Food and Drug Administration (FDA) said in a statement.

"Should such an influenza pandemic emerge, the vaccine may provide early limited protection in the months before a vaccine tailored to the pandemic strain of the virus could be developed and produced," the FDA said.

Nearly 300 people worldwide have caught bird flu, almost certainly from contact with sick poultry, since 2003 and more than half of them have died.

The H5N1 virus has ripped through poultry flocks in Asia and Africa, with millions of birds culled.

While the virus is a version of the influenza A virus, it is different from seasonal influenza, where infection ranges from mild to serious symptoms in most people.

In humans H5N1 is far more severe and happens quickly, with pneumonia and multiple organ failure commonly seen.

Indonesia cuts deal with WHO

30th March 2007

The Indonesian authorities have announced they will resume sending crucial samples of the bird flu virus to the World Health Organisation (WHO), as long as they aren't used to make vaccines commercially.

The deal enables the WHO to continue its vital work in tracking the development of the virus in humans. Indonesia has had the largest number of human cases of avian influenza, and several strains of the virus circulate in the country. The virus has ripped through poultry flocks in Asia and Africa since 2003.

It also addresses Jakarta's concerns that while the poorest countries are expected to toe the line on international scientific cooperation, they are often last in line when it comes to access to key treatments.

In January, frustrated that an Indonesian strain of the virus had been used to make a vaccine that most Indonesians would not be able to afford, the country stopped cooperating with the W.H.O. and made a deal to send samples to Baxter Healthcare, an American company, in return for a low-cost vaccine and help in building vaccine factories in Indonesia.

The current agreement means the Indonesian government will still have leverage if it seeks to negotiate affordable vaccines with big pharmaceutical companies at an affordable price.

Indonesia loses three more to bird flu

29th March 2007

Health officials say three more people have died from bird flu bringing the total to 69.

Egyptian girl gets bird flu

28th March 2007

A three-year-old Egyptian girl has tested positive for the deadly H5N1 avian influenza virus, the country's official media reported.

Hajer Mohamed Awadallah, was taken to hospital in the southern town of Aswan, the state news agency MENA quoted the Ministry of Health as saying.

The girl went to hospital with a high temperature and other symptoms of bird flu, MENA said. Because she had been in contact with domestic poultry, she received Tamiflu, the standard treatment for the symptoms of the disease, it added.

Egypt has one of the highest death ratios for any country in the world, with 13 dead from bird flu since February 2006. The last death, of the 21st case, was on 15 Februrary.

The girl was in a stable condition and the rest of her family were being closely monitored, officials said.

Egyptian boy catches bird flu

13th March 2007

A four-year-old Egyptian boy has become the country's latest confirmed case of avian influenza, the World Health Organisation (WHO) said in a statement.

The boy, from Ad-Daqahliyah governorate, first developed symptoms on March 7, health officials said.

The case has been confirmed as the deadly H5N1 strain of bird flu, which has been found in poultry throughout Asia, and is now reaching Europe and Africa, researchers from the Egyptian Central Public Health Laboratory and by the US Naval Medical Research Unit No 3 said.

The boy, who was exposed to sick birds during the first three days of March, was admitted to hospital March 8 and is in a stable condition, WHO said.

Contacts of the boy remain healthy and are being closely monitored.

Of the 24 cases confirmed to date in Egypt, 13 have been fatal.

Lao girl dies of bird flu

13th March 2007

A teenager from Laos has died of bird flu, the first case reported by the southeast Asian country, the World Health Organisation (WHO) said in a statement.

The 15 year-old tested positive for the deadly H5N1 strain of avian influenza, which has ripped through poultry flocks across the region since 2003.

The Vientiane girl's infection was confirmed in February, and she was sent to a hospital in neighbouring Thailand for treatment, before her death was announced by the Lao Ministry of Health, WHO said.

Avian flu control lifted

9th March 2007

Measures to tackle bird flu outbreak at Suffolk are lifted.

Burma culls poultry hit by bird flu

5th March 2007

Burma's military government has ordered the slaughter of 1,500 chickens after 68 birds died from avian flu in the former capital Rangoon, although Burmese officials cite no evidence of human infections.

"For the time being, we have no human cases," Kanokporn Coninx, avian influenza coordinator at the World Health Organization (WHO), told RFA's Burmese service.

"It happened on one farm. We are monitoring all members of the family. There are 12 of them. We have been closely monitoring them and their neighborhood. They haven't shown any signs of infection," she said.

Other United Nations officials were still waiting to gain access to the area where the outbreak occurred.

No help requested

"The Burmese government hasn't asked for any special assistance from us after this new outbreak," said Tang Zhenping, who represents the U.N. Food and Agriculture Organization (FAO) in Burma.

"The FAO is providing assistance with three projects. They are now continuing," he added.

Tang said he hoped a regional expert from the FAO who was currently in the country would be allowed to visit the affected area soon.

He said he had been informed that four poultry markets close to the affected area had been closed, although sources in the area told RFA that chickens were still being sold.

A government official from the Ministry of Livestock Breeding and Fisheries has said the infection probably came from migrating birds.

But Tang said it would be premature to make statements about the infection route ahead of further investigations.

Information promised soon

David Nabarro, U.N. coordinator for avian and human flu, has recently said he believes the current spread of the H5N1 strain of avian influenza has more to do with the poultry trade than with migrating wild birds.

International groups say state-run media are slow to respond to bird flu outbreaks. Since the outbreak started last Monday, the authorities have made no public announcements in the media.

Maung Maung Nyunt, director general of the Ministry of Livestock Breeding and Fisheries, told RFA that more information would be released to the media soon.

Burma suffered its first bird flu outbreak in March 2006. The government announced that Burma was clear of bird flu in September 2006.

Original reporting and translation by Min Zin for RFA's Burmese service. Burmese service acting director: Nancy Shwe. Written and produced for the Web in English by Luisetta Mudie. Edited by Sarah Jackson-Han.

Bird Flu Briefing

16th February 2007

08022007_turkeyfarm1.jpgAs the spectre of 'bird flu' or avian influenza reaches our shores we take a look at its history and consider the likelihood of a pandemic.

1 What is bird flu?

Avian influenza or 'bird flu' is a highly contagious bird disease, caused by influenza A viruses. In birds, the viruses can present with a range of symptoms from mild illness and low mortality, to a highly contagious disease with a near 100% fatality rate. All bird species are thought to be susceptible to avian influenza. Migratory birds such as wild ducks and geese can carry the viruses, often without any symptoms of illness, and show the greatest resistance to infection. Domestic poultry flocks, however, are particularly vulnerable to epidemics of a rapid, severe and fatal form of the disease.

2 Where has the disease come from?

Avian influenza known as ‘fowl plague’, first appeared in Italy in the late 1870s, and the US in 1924-25.

Prior to the present situation, outbreaks of highly pathogenic avian influenza in poultry were considered rare. Since 1959, only 24 outbreaks of highly pathogenic avian influenza had been recorded worldwide. The majority have had limited geographical spread with a few confined to a single farm or flock; only one spread internationally.

However in 2003, a serious outbreak occurred in the Netherlands and spread to Belgium and Germany. More than 250 farms were affected and 28 million poultry slaughtered. In 2004 the H5N1 strain of avian influenza surfaced in South East Asia and spread west through Europe and Africa. Cases were also reported in the US and Canada, but these were attributed to different strains of the virus – H2N2 and H7.

3 How does it spread?

The bird flu virus can be spread by:

• Direct contact with secretions from infected birds, especially faeces.

• Contaminated vehicles, equipment, personnel, clothing, water or feed.

In addition, the virus can remain viable in contaminated droppings for long periods and this helps it to spread either through ingestion or inhalation.

Some scientists also believe that migratory waterfowl / wild birds can transmit H5N1 to domestic poultry. It is known that wild flocks suffer from the virus, and it is thought that they can pass the virus on to domestic poultry as they migrate. This has yet to be proved scientifically.

4 What are the different strains of the virus?

There are many different subtypes of influenza A virus. The most virulent are called highly pathogenic avian influenza (HPAI) and can reach epidemic levels among birds. Of these, subtype H5 is of greatest concern to human health. There are 9 different forms of H5 ranging from highly pathogenic to relatively harmless. However it is the strain H5N1, and 4 associated sub types, which causes greatest concern. All are deadly to birds, and can cause disease - and death - in humans.

The bird flu virus currently affecting poultry in Britain and some parts of Asia and other areas is the highly pathogenic H5N1 strain of the virus.

5 Why are we so worried about H5N1?

There is most concern about the H5N1 virus because:

• It is able to cross the species barrier from birds to humans.

• It has caused the greatest number of cases of infection and deaths.

Consequently it has the potential to develop into a flu pandemic, although at present H5N1 is not able to spread easily to / between humans. However the characteristics of this virus could change over time, and give it the ability to   spread easily within the human population.

This could occur if:

• The virus mutates and improves its’ ability to adhere to human cells.  

• Genetic material is exchanged between human and avian viruses during co-infection of a human or pig. A process known as ‘reassortment’.

6 How do humans catch bird flu?

Bird flu was thought only to infect birds until the first human cases were seen in Hong Kong in 1997.

H5N1 is able to infect people because it is able to cross the species-barrier. In human populations, where domestic pigs and wild and domestic birds live in close proximity with people, the mingling and exchange of human and animal viruses can more easily occur. Those who have become infected have had close direct contact with infected birds.

Pigs are thought to be important to the potential transmission of the virus because they can host both bird and human ‘flu. Scientists believe that they could act as ‘mixing vessels’ for the reassortment of the virus.

Human infection with avian influenza viruses usually causes mild conditions such as conjunctivitis (eye infection) and mild flu-like symptoms, with one notable exception, the highly pathogenic H5N1 virus. More severe infection can lead to pneumonia, acute respiratory distress, viral pneumonia, and other severe and life-threatening complications.

7 How many people have caught bird flu?

Since the recent outbreak of bird flu in 2003, the World Health Organisation has been notified of 271 cases of human infection, resulting in 165 deaths worldwide, as at the beginning of February 2007. This comprises laboratory confirmed cases only.

Reports have been made by the following countries:

• Azerbaijan

• Cambodia

• China

• Djibouti

• Egypt

• Indonesia

• Iraq

• Nigeria

• Thailand

• Turkey

• Vietnam

All human cases have coincided with outbreaks of highly pathogenic H5N1 avian influenza in poultry. To date, Vietnam has been the most severely affected country, with 93 cases and 42 deaths.

8 Could the virus mutate?

Between 1918–1920, it is estimated that 50 – 100m people died in the Spanish Flu pandemic. The disease is thought to have affected 20% of the world’s population, killing approx. 2.5 – 5% of sufferers.  This pandemic was caused by H1N1, a subtype of the species Influenza A virus (avian flu virus).

Research into the H1N1 genome has indicated a relatively small number of changes can have disastrous consequences. When the 1918 virus was compared with today's human flu viruses, scientists noted that only 25 - 30 of the virus's 4,400 amino acids had changed. However these changes allowed the virus to spread easily through the human population.

In 2003, world-renowned virologist Robert Webster published an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives. On September 29, 2005, David Nabarro, the newly-appointed Senior United Nations System Coordinator for Avian and Human Influenza, warned the world that an outbreak of avian influenza could kill anywhere between 5 million and 150 million people.

Many governments worldwide are preparing for a pandemic, and the UN ands WHO are monitoring the situation on an ongoing basis.

9 Is a vaccine available?

At present there is no specific vaccine available, although several products are under development.  Only antiviral drugs, such as Tamiflu, are available – these may help limit symptoms and reduce the spread of the disease if a pandemic occurs. The Government has stockpiled sufficient drugs to treat 25% of the population if a pandemic occurs. However reports from Vietnam suggest that patients have become partially resistant to Tamiflu.


Natural resistance to bird flu

13th February 2007

A US study suggests that some people may be naturally immune to the effects of avian influenza.

Researchers from the St Jude's Children's Research Hospital have found that natural resistance to flu strains could be translated into immunity against bird flu itself. In studying mice and humans they found that seasonal human flu (H1N1) and bird flu contain a closely related neuraminidase (N1), a disease spreading agent, meaning that people immune to the former could have a similar resistance to the latter.

The researchers immunised the mice with DNA that caused their cells to make neuraminidase from the H1N1 virus. They then examined the mice's immune response to the human N1 and avian N1 which had been isolated from a patient in south east Asia. They found that all the mice survived infection from a manmade flu virus containing human N1, while half died after being infected with avian N1.

In tests on 38 human volunteers they found similar encouraging results, the researchers saying that "the human data suggest that a proportion of people have low titer [concentration of] antibodies against H5N1 influenza because of prior exposure to H1N1 viruses or routine influenza vaccination."  Further work, however, is necessary to indicate there is actual protection in humans against avian flu.

Indonesian womes dies from bird flu

12th February 2007

A 20-year-old women has become the country's 64th human victim after testing positive for bird flu.

'Biosecurity lapse' caused H5N1 outbreak

12th February 2007

Recent outbreak of the deadly strain of bird flu H5N1 was caused by poor biosecurity.

Egyptian girl dies of bird flu

7th February 2007

A 17-year-old Egyptian girl has died from bird flu after being initially diagnosed with human flu. She is thought to have been infected with avian influenza after coming into contact with infected birds.

The H5N1 virus has been detected in at least 19 of the country's 26 provinces. It was not yet known whether the latest victim had been infected with a mutated strain of the virus which has begun to show some resistance to the antiviral medication Tamiflu, health officials said.

Cleared of Bird Flu

8th February 2007

08022007_turkeyfarm1.jpgHealth experts have said that a second worker involved in dealing with the bird flu outbreak on the Suffolk farm where the H5N1 virus was confirmed has tested negative for avian flu.

The testing was carried out by the Agency overnight using tests which now allow a result to be obtained very rapidly, important if the results proved to be positive. A vet who became ill after attending the farm has already tested negative for bird flu and seasonal flu. The HPA said it was the season for respiratory infections and other workers may develop flu-like symptoms.

Although the Environment Secretary David Miliband said the risk to humans remains 'negligible,' the Department of Health wants to ensure it has adequate resources to deal with the ‘very remote possibility’ of a human flu pandemic.  A cull of 159,000 turkeys took place on a Bernard Matthews farm; the outbreak of bird flu on the Lowestoft farm was confirmed by the environment secretary David Miliband who said he was determined to ‘stamp it out’.   Strict controls are in place around the farm to prevent any further contamination across the country; a 3km protection zone and a 10km surveillance zone are in place around the site.

Speaking in the House of Commons, David Miliband told MPs that the response to the Suffolk outbreak had been, ‘rapid, well co-ordinated and appropriate’.   He continued by adding, "Our goals in this case are clear. To stamp out the disease, protect public health, to protect animal health and welfare, and to regain disease-free status for the UK." He added that eating properly prepared and cooked poultry and eggs carried no risk to humans at this stage.

Scientists are now trying to locate the source of the disease which has been identified as the "highly pathogenic" Asian strain of the H5N1 bird flu virus. Dr Jonathan Van Tam, a flu expert from the Health Protection Agency said, “It is important to remember that H5N1 avian flu remains largely a disease of birds. The virus does not transmit easily to humans, as evidenced by the 270 or so confirmed infections worldwide to date, versus the millions of people exposed to poultry everyday in SE Asia. Almost all human H5N1 infections so far have been associated with close contact with dead or dying poultry and in all human cases there has been no evidence of efficient human to human transmission."

He added that the local health protection unit in Suffolk is working with Defra, the local NHS and the State Veterinary Service, ensuring that all workers involved are provided with antiviral drugs and given the necessary information and advice. 

The government has already spent £200m on stockpiling antiviral drugs to treat one in four of the population, and in the event of the disease turning into a pandemic it has 2m doses of vaccines to protect medical and emergency staff. Tamiflu, the antiviral drug likely to be used by most governments, can be taken as a preventative treatment although there is no evidence it will stop people being infected. It could relieve flu symptoms and help the body to fight the virus, say doctors. There have been concerns, however, that H5N1 is developing resistance to Tamiflu. It is presently only available in the UK on prescription. The stockpiles of Tamiflu could be a first line of defence for priority groups in the event of a pandemic. 


Nigeria's first bird flu death

1st February 2007

A 22-year-old woman from the Nigerian city of Lagos has died of the H5N1 virus, health authorities have confirmed after testing.

Her mother and two other people had also died, though their test results had been inconclusive, they said.

The samples had been sent to overseas laboratories and to the World Health Organization (WHO) for further testing.

The case is the first confirmed bird flu death in sub-Saharan Africa.

Japan confirms H5N1 in birds

31st January 2007

Japanese agricultural officials have confirmed that an outbreak of bird flu in the western prefecture of Okayama was caused by the deadly H5N1 strain of the virus.

A separate outbreak was also suspected at a poultry farm in the southwestern prefecture of Miyazaki, the country's biggest poultry-producing region, the agriculture ministry said.

No human infections have been reported so far.


Third bird flu outbreak in Japan

29th January 2007

Japan confirm a third outbreak of bird flu - although they are still determining if it is H5N1.

Cat owners risk bird flu

25th January 2007

A study on cats found that the virus is changing in felines more quickly than thought.

S Korea orders poultry, pig cull

23rd January 2007

South Korean health officials have ordered the slaughter of more than 660,000 poultry and pigs following the spread of avian influenza to a fifth farm outside the capital Seoul.

The new infections were still within the 10 kilometre quarantine zone around the initial outbreak in the northern city of Cheonan, 50 miles (80 kilometres) to the south of Seoul.

The health ministry says the virus was brought in by wild geese.

Since ravaging Asia's poultry in late 2003, the H5N1 virus has killed more than 150 people worldwide.

Infections among people have been traced to contact with infected birds, but experts fear the virus could mutate into a form that could create a human pandemic.


Bird flu outbreak confirmed

16th January 2007

Outbreak of bird flu at a poultry farm in Japan was the deadly H5N1 strain of the virus.

Cold snap could bring bird flu

11th January 2007

A cold snap predicted for February could bring bird flu to Britain.

Indonesia bird flu cases

11th January 2007

15032006_H5N1.jpgPersahabatan Hospital in the Indonesian capital, Jakarta, one of two hospitals specially designated to treat cases of avian influenza, is now overwhelmed with patients in a sudden flurry of new cases.

A teenager died last week from bird flu, the fourth fatality this year caused by the H5N1 strain of influenza which has ripped through poultry flocks in the country, killing 61 people since 2003.

Nine people with bird flu symptoms were currently being treated at the hospital, where isolation rooms were now at full capacity, a doctor said.

Seven of them come from the same town in to the east of Jakarta, Bekasi.

The largest known cluster of human bird flu cases worldwide occurred in May 2006 in the Karo district of Indonesia's North Sumatra province, where as many as seven people in an extended family died.

Bird flu is endemic in around half of Indonesia's 33 provinces and the vast, developing country has struggled to contain the disease, which experts warn could become a global pandemic killing millions if the virus mutates to a form easily transmissible between people.

New human cases of bird flu

10th January 2007

15032006_H5N1.jpgThree new human cases of bird flu have been reported; one in the eastern Chinese province of Anhui, and two in Indonesia.

The 37-year-old Chinese farmer tested positive for the virulent H5N1 strain of influenza, which has killed 157 people worldwide since the outbreak began in 2003, the official Xinhua news agency reported.

"The man, surnamed Li, developed symptoms of fever and pneumonia on 10 December and was discharged from hospital on 6 January in Tunxi, Anhui Province, after a full recovery," the agency said.

The Chinese Center for Disease Control and Prevention (CDC) confirmed on Monday that Li had tested positive for the deadly H5N1 strain.

The Anhui provincial health department reported the case on Tuesday and it has already reported it to the World Health Organisation (WHO), and relevant information had also been conveyed to the health agencies of Hong Kong, Macau and Taiwan, the health ministry was quoted as saying.

Local health authorities told Xinhua that those who had had close contact with the patient had been released from medical observation. The ministry said no animal bird flu cases were reported in the area and local authorities were closely monitoring the situation, the agency reported.

Meanwhile, Indonesia's Ministry of Health has reported an additional two cases of human infection with the H5N1 avian influenza virus to the WHO.

The first case was a 14 year-old boy from West Jakarta, who developed symptoms on 31 December 2006 and remains in hospital, the WHO said in a statement on its website. "Deaths among poultry in the neighbourhood have recently been reported. The source of exposure is currently under investigation," the statement said.

The second case was a 37 year-old woman from Tangerang, Banten Province. She developed symptoms on 1 January and remains in intensive care. Initial investigations suggest sick poultry as the possible source of infection, the WHO said.

Of the 76 human cases confirmed to date in Indonesia, 57 have been fatal.

The H5N1 avian influenza virus has spread across Asia and the Middle East to Africa, sparking mass poultry slaughter wherever it is found. Experts fear a global pandemic could kill millions if the virus mutates into a form that is easily spread among humans.

Bird flu has also been confirmed in a fourth Vietnamese province after tests on 70 ducks showed they had died from H5N1.

Flu jabs for poultry workers

9th January 2007

01052006_birdflu1.jpgThe government is offering free flu jabs to people who work with poultry.

In an attempt to prevent new forms of bird flu emerging, more than 60,000 farmers, poultry workers and vets are to be offered vaccinations against seasonal influenza. Information packs are being sent to all registered poultry and approved slaughterhouses in England.

The Department of Health has said it hopes the move will stop those who work with birds catching human and bird flu viruses concurrently, which would allow the viruses to mutate and form into new, contagious strains. The government was keen to reassure the public that avian flu only posed a risk to those who came into regular contact with infected birds and that the immunisation programme was a precautionary measure based only on “theoretical concerns?. David Salisbury, the Department of Health’s director of immunisation said, “There are concerns that those who work in close contact with poultry and who could also contract human seasonal influenza could act as a mixing vessel for new forms of bird flu if they became infected with an existing strain. You end up with something that has genetic material from two different viruses and then you have no immunity at all because you have got a completely new virus.?

Although the risk of pandemic bird flu arriving in Britain is low, a cold winter in Eastern Europe could cause waters to freeze and force migratory birds into the UK in search of warmer lakes and seas.

The government has bought additional doses of the seasonal flu jab to cover the new immunisation programme and has pledged £500,000 for NHS trusts to administer the jabs.

Chan in bird flu warning

5th January 2007

Margaret Chan, the first Chinese citizen to become the head of a UN agency, has taken office at the helm of the World Health Organisation (WHO), warning that avian influenza is still a global public health threat.

The former Hong Kong health chief and bird flu expert said reports of the H5N1 virus had begun to surface after a quiet period, and that poorer countries were at the greatest risk.

The WHO is particularly concerned about an outbreak on a poultry farm in Vietnam, the first in that country in almost a year.

Chan has promised tough measures against countries that fail to comply with detection and testing requirements, or that hinder the develop of vaccines.

"The next pandemic, if it occurs, will be very devastating... we are very concerned of the likelihood of a pandemic," Chan said.

Vietnam family bird flu-free

2nd January 2007

Vietnamese health officials have said that a family suspected of having bird flu after eating sick chickens has not contracted the H5N1 virus.

The four people from the southern province of Ca Mau, where thousands of ducks and chickens were slaughtered in an outbreak last month, had tested negative for the virus, they said.

There have been no human infections confirmed since the emergence of the H5N1 virus outbreak, the first in Vietnam since August.

But officials say the risk of further outbreaks elsewhere in the country is still high, due to wild bird migration and poultry smuggling.

Vietnam bird flu outbreak

20th December 2006

Vietnam confirmed H5N1 bird flu outbreak among its domestic poultry in the south of the country.

Dead birds tested for bird flu in France

18th December 2006

4,000 chickens died on a French farm on Saturday.

Bird flu at S. Korean quail farm

13th December 2006

South Korean health officials have confirmed an outbreak of bird flu at a quail farm in the north of the country, the third in a month.

The quail farm at Kimje, 262 kilometres (162 miles) southwest of the capital, Seoul, is home to 270,000 quail.

The health ministry has quarantined the farm and are removing the quail, 3,000 of which have already died. All poultry within 500 meters (1/3 of a mile) of the farm will be slaughtered.

South Korea has already reported outbreaks of the H5N1 avian influenza virus at two chicken farms in the same area.

No human infections have been reported so far, according to the health ministry.

South Korean authorities have slaughtered more than five million poultry in a bid to contain bird flu since 2003.

Key to bird flu fight

4th December 2006

24052006_birdcages1.jpgThe world may need to spend an extra US $1.2-1.5 billion in the next 2-3 years on attempts to prevent bird flu turning into a global pandemic, and on emergency preparedness if it does, according to the World Bank.

Prompt, uniformly distributed payments to farmers whose birds are killed because of avian flu are needed to help battle the disease, according to a new World Bank-led report.

Funds to pay farmers whose birds are culled could encourage early reports of the disease, according to the report by the World Bank, the Food and Agriculture Organisation and the International Food Policy Research Institute.

In a report issued ahead of a bird flu conference in Mali, the Bank said its projections were for funding beyond the US $1.9 billion pledged in January in Beijing.

It calculated them as "a result of the rapid and sustained increase in animal and human outbreaks both within and across countries throughout Asia, Europe, the Middle East and Africa", it said.

But it said they represented a fraction of the potential US $1.5-US $2 trillion costs of a severe human influenza pandemic.

Since 2003, the H5N1 strain of avian influenza has infected 258 people in 10 countries, with 154 known deaths from the virus.

Experts at the World Health Organisation (WHO) and elsewhere believe that the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred.

South Korea culls dogs, pigs

29th November 2006

South Korea has begun a mass slaughter of pigs and dogs in the southern city of Iksan, following a cull of 127,000 chickens and 6.8 million eggs in an attempt to prevent the spread of bird flu.

Officials said 436 pigs and four dogs had been killed. They defended the decision to slaughter non-poultry species, saying that it was common practice in other countries but not widely publicised.

A further 700 dogs - bred on farms for consumption - were to be killed, although pigs were still the main focus, as they were more susceptible to infection with the H5N1 virus, they said.

The government has said it will compensate farmers for lost livestock, but gave no further details.

Since ravaging Asia's poultry in late 2003, the H5N1 virus has killed at least 153 people worldwide. Infections among people have been traced to contact with infected birds, but experts fear the virus could mutate into a form that could create a human pandemic.

Dogs bred for food are regularly slaughtered in South Korea, where dog meat is widely consumed, especially among middle-aged men who believe it boosts stamina and virility.


Singapore tries bird flu vaccine

22nd November 2006

11102006_Singapore400.jpgResults have been published of a trial in Singapore of a new vaccine which aims to offer protection against various forms of avian influenza, or bird flu.

Preliminary findings of a trial carried out by manufacturers Baxter show the vaccine can produce antibodies able to neutralise a wide variety of H5N1 strains.

The trial on humans in Singapore showed that more than 75 percent of those injected with the vaccine were able to produce the antibodies.

However it was not yet clear how efficacious the vaccine would be in the case of a real infection with H5N1, as the trials only measured the subjects' ability to produce antibodies.

The vaccine, according to Baxter research chief Noel Barrett, reacts not only with the strains from which it is made, but also with highly divergent strains of H5N1, a virulent form of bird flu which has yet to develop into a form which can pass easily between humans.

Global health experts have warned that a flu pandemic could occur if the virus mutates to a form transmissable between people, and that millions may die before a vaccine is found.

Produced using a cell-based technology and taking about 11 weeks to produce, Baxter's vaccine may offer protection against strains which emerge in 6 months', 12 months', or even two years' time, Barrett said.

Most flu jabs are still made today using a 50 year-old egg-based method, taking up to 28 weeks to produce.

Barrett said the vaccine seemed to work well even at the lowest dose.

An earlier Baxter study found that 100 percent of mice immunised with the vaccine survived the Vietnam strain, the Hong Kong strain and the Indonesian strain of the H5N1 virus.

The clinical trial involved 270 healthy adults from Singapore and Austria and was carried out between June and September this year.

£3bn plan for flu pandemic

8th November 2006

09072006_infectious_diseases1.jpgA £3bn plan to fight any future flu pandemic over the next three years looks set to be approved by the government.

The plans include stocking up on antibiotics, vaccines, protective masks and antiviral drugs in preparation for a pandemic and any economic disruption, hospitalisations and deaths that could be caused by a mutation of avian flu.

Just over 250 people are known to have been infected by the flu strain H5N1, which has killed 152 people worldwide. But public health experts have predicted it may develop into a pandemic strain causing millions of deaths in the next few years.

Health secretary Patricia Hewitt is now set to look at proposals over coming weeks but will need to consider the implications on resources for current health service operations.

The government is expected to invest for the first time in millions of facemasks for the general public, while healthworkers will have access to more elaborate face protection.

Additional antibiotics will be used to treat any secondary infections that can cause death in people with the flu, while the government will triple its usual supplies of the antiviral drug Tamiflu at a cost of almost half-a-billion pounds.

The plans have been developed using computer modelling, which along with medical measures, other actions like closing schools and keeping people isolated through 'social distancing' would reduce the impact of the disease.

The UK may also follow Finland and Switzerland and order pre-pandemic vaccines for the entire population at a cost of £1bn, although scientists disagree on its worth, as it is based on the current strains of H521 and may not work on later mutations.

The winter is expected to bring migratory birds to Europe that may be infected with H521.

Bird flu gene identified

6th November 2006

15032006_H5N1.jpgChinese scientists have identified a gene in the H5N1 bird flu virus that they say is responsible for its virulence in poultry, paving the way for new vaccines.

There are many different strains of H5N1, some of which kill more than half the people they infect, while others do little or no harm.

Bu Zhigao at the Harbin Veterinary Research Institute said researchers could now understand how the virus becomes lethal, and the molecular basis for its pathogenicity.

The researchers zeroed in on the virulent gene after analyzing two closely related strains of the H5N1 obtained from infected geese in Guangdong in 1996 - one highly pathogenic in chickens and the other harmless. Differences between the two strains were located in four genes, they found.

The scientists designed four genetically modified viruses each containing one of the four genes in question and tested them on laboratory chickens.

Only chickens infected with the modified virus containing the highly pathogenic gene died. The other chickens had no signs of disease, the scientists wrote in this month's issue of the Journal of Virology.

"Now that we know the special role of the [highly pathogenic] NS1 gene, we can think about developing a vaccine," Bu said, adding that a vaccine that neutralizes the gene known as NS1 could be quickly designed.

The scientists come from the Ministry of Agriculture's Animal Influenza Laboratory, the National Key Laboratory of Veterinary Biotechnology, Chinese Academy of Agricultural Sciences and the Harbin Veterinary Research Institute.

H5N1 remains largely a disease in birds although it has killed over 150 people, mostly in Asia, since 2003. Experts fear it could spark a pandemic and kill millions of people if it begins to transmit efficiently among humans.

Meanwhile, Chinese scientists have rejected the results of a study that reported a prevalent new strain of bird flu in the country, saying they have not found significant variants to the virus.

The Hong Kong and U.S. scientists who carried out the study said the new strain - called H5N1 Fujian-like - was found in almost all poultry outbreaks and some human cases in southern China and was now also the primary version in Hong Kong, Laos, Malaysia and Thailand.

The Hong Kong and U.S. researchers "lack scientific proof," said Chen Hualan, director of the National Bird Flu Reference Laboratory.

"The so-called `Fujian-like virus' is not a new variant of the virus," the China Daily newspaper quoted Chen, whose lab does isolation and gene sequence analysis on samples from every domestic bird flu outbreak, as saying.

Guan Yi, one of the study's authors, said he had not seen data from Chen's lab and could not comment on her claims.

But "the data from our systematic influenza surveillance was subject to scientific peer review and published in an international journal of high repute," Guan, who heads the emerging infectious diseases lab at Hong Kong University, said. "I therefore stand by those findings."

New strains of viruses emerge regularly, but health experts need to know when any one becomes dominant so they can work to develop a vaccine.

Concerns are particularly strong that the virus could mutate into a strain easily passed between humans and spark a pandemic.

Most human infections have been traced to contact with sick birds.

International health experts have repeatedly complained about Chinese foot-dragging in cooperating on investigating emerging diseases such as bird flu and SARS, which emerged in southern mainland provinces in late 2002 and eventually killed 774 people worldwide.

The study, released in the Proceedings of the National Academy of Sciences, charted the spread of the new strain by testing geese and ducks found in live markets in six southern mainland provinces beginning in June last year.

Over the course of the year, the new strain became more pervasive, the study said. Among the 108 samples taken from poultry this April and June, 103 - or 95 percent - were infected with the Fujian-like strain, the scientists said.

The researchers said it was unclear how the strain had emerged or spread so widely.

Chen said that, between last year and this year, the lab had isolated viruses in waterfowl in the mainland's southern regions that were reported to the United Nation's Food and Agriculture Organization and the Paris-based World Organization for Animal Health.

"These viruses all remain steady in gene type and there is no marked change in their biological characteristics," she was quoted as saying.

Guan said he "would welcome this information being made available so that the world could have a comprehensive picture of the origin and evolution of H5N1 variants."

New bird flu strain emerges

31st October 2006

Despite mass vaccinations of poultry in China, the bird flu virus continues to evolve.

Samples collected from poultry markets in southern China over the last year show that a variant of the virus has spread outward from a single province and supplanted strains in the rest of the region, researchers report. The result calls into question the steps taken so far to contain the virus, which public health officials fear could give rise to a deadly worldwide flu pandemic.

In early 2004 the H5N1 bird flu virus spread from poultry in China to southern Asia and has since been identified in birds as far away as Europe and north Africa. In principle, vaccination of domestic chickens and other birds could limit the virus's transmission and thereby its ability to evolve into a more transmissible form. With that goal in mind, China announced last November that it would begin vaccinating 14 billion domestic chickens against H5N1.

Since that time, however, the virus seems to have become even more entrenched in domestic poultry, report Chinese and American researchers in a paper published online October 30 by Proceedings of the National Academy of Sciences USA.

The team collected samples from over 50,000 seemingly healthy birds between July 2005 and June 2006 at live poultry markets in six provinces of southern China. They identified H5N1 in 2.4 percent of birds, primarily domestic ducks and geese, up from 0.9 percent the year before.

To identify the source of the ongoing transmission, the researchers selected 390 virus samples from infected birds, determined their genetic sequence and compared these sequences with known variants of the virus. One strain, hailing from the province of Fujian, appeared in only 3 percent of birds collected up to September 2005. Between April and June of 2006, however, Fujian-like viruses were responsible for 95 percent of infections.

Offshoots of the Fujian variant were isolated in the 22 human cases of bird flu reported in China since last November, and the strain has sickened birds in Laos, Malaysia and Thailand, where it also infected people, the group notes.

A weakness in China's vaccine may have allowed the previously local variant to become widespread, the researchers surmise. They analyzed serum samples from 76 chickens for signs of antibodies against three H5N1 variants, including the Fujian-like strain. The presence of antibodies is a sign that a vaccine has taken effect.

Almost all of the samples displayed two to four times more antibodies to the other two variants than to the Fujian virus, suggesting that the vaccine given to the chickens was less effective against that strain, the researchers point out.

The result highlights the need to supplement vaccination with other measures as part of a broader program of monitoring vaccinated chickens with surveillance afterwards.

World plans poorly for bird flu

18th October 2006

A third of countries which have drawn up flu pandemic plans have failed to set out how they would distribute medical treatment, a report has found.

Researchers at the John Hopkins Bloomberg School of Public Health and Ben Gurion University Israel studied 45 national pandemic plans. They warned resources would be scarce, so decisions on who should get drugs or vaccines should be made in advance, as prioritising treatment could help reduce death and disease.

The World Health Organisation (WHO) has urged every country to develop and maintain a national plan on bird flu. It also recommends nations prioritise the allocation of pharmaceutical resources among the population.

Researchers looked at 19 plans from developed nations and 26 from developing countries. In total, these represented around two-thirds of the world's population - 3.8bn people.

The report, Priority Setting for Pandemic Influenza: An Analysis of National Preparedness Plans, found almost half of the plans they examined favoured antiviral medications, such as Tamiflu, while 62% prioritised giving citizens a flu vaccine.

This was an unexpected finding, researchers said, as antiviral treatment may be the only pharmaceutical intervention available in some countries, and no more than 14% of the world's population could expect to be vaccinated within a year of pandemic.

Singapore revises bird flu plan

11th October 2006

11102006_Singapore400.jpg Three key changes are being made to Singapore’s response to a possible bird flu pandemic, based on lessons learnt from the preparedness exercises Sparrowhawk 1 and 2 conducted earlier this year.

Speaking at a flu pandemic training session for voluntary organisations, the Minister of State for Health Heng Chee How said the first main area of improvement is the line between government polyclinics and GPs.

Also reviewed is the work of public and private hospitals in an outbreak. Previously, government-backed restructured hospitals were to manage all flu patients who required hospitalised care, while non-flu patients would be referred to private hospitals. But the exercises showed it would be very difficult fully and effectively to segregate such cases in a pandemic, and both public and private hospitals will be required to manage both.

Initially, the plan was to centralise treatment at the city-state's 18 polyclinics. But most Singaporeans consult their family doctors in the private sector for acute illnesses like influenza, and the government's preparedness exercises showed that with some coordination it should be able to organise more than 1,000 GP clinics to provide primary care to the community.

Under the new plan, all hospitals are to have a dedicated group of staff or an ‘infection control response team’. According to Mr Heng, the training exercise highlighted that it was impractical to expect that all staff have the same level of readiness and training and to be able to sustain a high level of readiness over a prolonged period of time. Instead, hospitals will maintain and roster a team of dedicated health-care workers who are very well versed in the handling of infectious cases.

Central to the plan is the concept of a three-pronged or ‘3P’ approach involving the Public, Private and People sectors in the event of a pandemic. As a result of the exercises, inter-agency, cross sector collaboration was now well in place border agencies, healthcare institutions and security agencies were ready, Heng said.

The government is stressing the importance of continued training and practical exercises to prepare against bird flu, rather than just planning on paper and ‘hoping the telephone numbers will still work when they are actually needed’.

In June this year, the World Health Organisation (WHO) reported evidence of the first human-to-human spread in Indonesia, where a child who was thought to have come into contact with infected poultry, infected his father. It was a confirmed human to human transmission, but no further spread outside of the exposed family was documented or suspected.

To date, the H5N1 virus does not infect humans easily, and it is very difficult for the virus to spread from person to person.

But all influenza viruses have the ability to change, and scientists are concerned that the H5N1 virus could mutate, infect humans and spread easily between them, thus causing a worldwide outbreak of the disease.

Currently there is no commercially available vaccine to protect humans against the H5N1 virus which has affected 251 people with 147 deaths in ten countries.

Should a pandemic hit Singapore, the Ministry of Health (MOH) says it will be able to vaccinate the entire population, 4-6 months after the new flu strain is confirmed.

Lim Kok Peng, Deputy Director for Contingency and Scenario Planning, MOH, on obtaining the vaccine, says “We are not first in line, but we are not last.��?

The MOH also predicts that any outbreak would enter Singapore from beyond its borders and could reach Singapore within days or weeks of emerging, with two or more waves lasting about six weeks each, in the same year.

The nation will rely on Tamiflu as a form of prevention of the spread while a new vaccine is being developed, but even this will face increased resistance. According to the MOH, an outbreak of bird flu will be more infectious than Severe Acute Respiratory Syndrome, or SARS, with an incubation of seven days.

It is estimated that some 11,000 people in Singapore could be hospitalised during the first wave of the outbreak, should it occur.

Statins fight flu

5th October 2006

01052006_birdflu1.jpgScientists believe that statins, the cholesterol-lowering drugs, could play a key role in combating a flu pandemic.

In a letter to The Times, flu researchers say that preliminary evidence shows that statins may have such potential that further studies are essential. The experts say that urgent research is needed into the contribution statins could make as existing drugs and vaccines are unlikely to contain a flu pandemic.

The letter is signed by David Fedson, a retired Professor of Medicine at the University of Virginia; Susan Chu, editor of the influenza website fluwikie.com, and Peter Dunnill, Professor of Biochemical Engineering at University College London, a leading expert on flu vaccines.

They say that although the potential use of statins has been known for approximately three years there appears to be resistance to further investigation.

Statins are known to reduce an extreme immune system response - a cytokine storm, which is often the cause of death in patients who contract virulent forms of flu. Studies looking at people who were already taking statins to lower cholesterol levels, who also contracted pneumonia, indicate that the drugs reduce death rates dramatically.

Statins, if shown to be effective, would greatly enhance the world’s ability to cope with a pandemic. There would be major advantages in treating a pandemic in this way, as statins are cheap and mass-produced.

1918 epidemic key to bird flu

28th September 2006

15032006_H5N1.jpgResearch published in the journal Nature suggests that the 'Spanish' flu outbreak, which killed up to 50 million people in 1918-19, was caused by an overreaction in the immune system.

The research, by a team at the University of Washington in Seattle, has implications for the understanding and treatment of the H5N1 avian flu and other strains with the potential to cause a pandemic.

The team used a reconstructed virus to infect mice, and also infected a control group of mice with a less virulent human strain of flu. Analysis has already shown that the 1918 virus has similarities to H5N1, although belonging to a different strain, H1N1.

The Spanish flu virus produced a much more extreme immune reaction in the lungs of the mice, activating genes that kill off infected cells. Although this is designed to protect the body, if the reaction is too strong it can cause as much damage as the disease itself.

The researchers hope that they may be able to develop a method of reducing this reaction, so that the patient is not harmed by infections with virulent forms of flu. A dual treatment could then be used: with an antiviral drug to kill the virus, and an anti-inflammatory moderating the activity of the immune system. 

Bird flu measures announced

20th September 2006

10042006_flying_swans.jpgThe Department for the Environment, Food and Rural Affairs (DEFRA) has announced new measures to prevent an outbreak of bird flu in Britain.

In order to address fears that bird flu could arrive through migrating birds a surveillance operation will be mounted to check for infected wild birds, concentrating on favourite spots of migrating waterfowl.

The programme is being introduced in time for the autumn migration of water birds from more northerly latitudes. It will test three main groups of wild birds:

• Live birds (which are then released);
• Shot birds (shot as part of normal legal wild fowling activities); and
• Certain species of dead wild birds found in designated areas.

The particular species to be targeted will be those thought to be a greater risk for introducing avian flu such as ducks, geese, swans, gulls and waders.

The zones to be included in the surveillance include the northern and West Midlands, the south coast, parts of the West Country, Anglesey, eastern Scotland and much of East Anglia. The programme will also focus on poultry farms which could be at risk from the H5N1 bird flu virus.

Defra said the likelihood of a dead wild bird found to be infected is very small, although Britain's deputy chief vet Fred Landeg expressed concerns in August over bird flu being passed to farm birds by migrating birds.

UK's Chief Veterinary Officer Debby Reynolds said “This new targeted strategy ensures that our operation is as sharp as possible?.  She added “We are doing most work in areas where there is a greater likelihood of finding virus but we will continue to be vigilant in checking for avian influenza right across the UK."

H5N1 breakthrough?

17th August 2006

15032006_H5N1.jpgScientist claim to have made a breakthrough in the development of bird flu drugs designed to treat humans should an outbreak occur in the population.

Scientists say they have discovered a weakness in the structure of the H5N1 virus which could be exploited in the development of treatments.

The scientists caution that an effective drug treatment targeting the weakness could be around five years away, which may not be in time to prevent a large-scale human outbreak

Bird flu summit

29th June 2006

01052006_birdflu1.jpgThe World Health Organisation has revealed it believes limited human-to-human transmission of the bird flu virus did occur in an Indonesian family in May.

But it said that the incident did not signal a major change in the spread of the disease.

The WHO made its announcement at the end of a three-day bird flu conference in the Indonesian capital, Jakarta.

The case of seven family members who died from bird flu has drawn attention to Indonesia's growing problem. WHO said its investigation suggested the virus had been passed between the family members in Sumatra.

The WHO also found that the virus had mutated in one case, but not in a way that made it more easily transmissable between people.

Nevertheless, according to both the WHO and Indonesian government, the virus is widespread among poultry in the country and the focus should now be on implementing Indonesia's national strategy to contain bird flu.

Thirty-nine people are now known to have died from the disease in Indonesia.

The virus cannot yet pass easily from one person to another. But experts fear it could mutate and in its new form trigger a flu pandemic, potentially putting millions of human lives at risk.


Bird Flu in America?

10th May 2006

31052006_medical_mask1.jpgBird flu has yet to hit the United States, but TV producers, with their minds on ratings, are already speculating about what would happen should the avian influenza virus mutate to a form that can be passed from human to human. On 9 May, the American Broadcasting Company (ABC) aired the movie entitled Fatal Contact: Bird Flu in America, which portrays the deadly consequences of one businessman's trip to Hong Kong, where he picks up a mutated form of the virus from a factory worker and brings it back home to the United States.

What follows is a nightmare of some 20 million deaths worldwide, accompanied by hoarding of vaccines, food shortages and economic disaster. And this, the film hints, is only the beginning.

To the director's credit, the movie does start off with a responsible disclaimer that "this film is a fictional examination of the question 'what if'". But that hasn't calmed the fears of several experts who, having seen the film, think it may give the wrong impression.

John Barry, historian and author of a bestselling book on the real 1918 pandemic (The Great Influenza: The Epic Story of the Deadliest Plague in History) served as consultant to the film, although he says not all of his ideas were incorporated. "The ending, I think, is more than simply overdone," he said in a discussion about the film with the public-policy group Trust for America's Health. But, he adds, "one benefit of this movie is that it raises people's awareness".

Several experts balk at is the extreme calamity in the film, and some technical errors in showing how the disease might spread. During the American businessman's return flight home, the 'Typhoid Mary' character wipes his mouth on a napkin, which is picked up by a bartender who then places a virus-laced olive into the martini of another passenger.

Michael Osterholm, associate director of the US Department of Homeland Security's National Center for Food Protection and Defense, notes that the main pathway of transmission of a pandemic virus will probably be coughing and sneezing, rather than this sort of hand-to-hand transmission, making it less likely to spread quite so easily.

There are a few other scientific glitches in the film, including doctors hanging about in wards wearing only flimsy paper masks. But on the whole, the devil isn't in the details, but in the overall message, said experts in the Trust for America's Health discussion.

"It will lead people to believe that we have lost control of the situation," said Osterholm. "We know that a pandemic could be serious, but we also know that we will get through a pandemic." The ending, says Osterholm, leads one to believe that the avian flu is "going to wipe out the world". He doesn't think that's a likely outcome.

It seems probable that there would be some panic, confusion and mistakes should a pandemic form of flu hit the United State, but the film surely steps over the line of a reasonable scenario, says Jacqueline Ruttimann in Nature.

Bird flu cluster alarm

24th May 2006

24052006_birdcages1.jpgThe World Health Organisation (WHO) says it is extremely worried about a cluster of recent human deaths from the virulent H5N1 strain of bird flu. Seven people from the same family in northern Sumatra, Indonesia, died from the disease earlier this month.

Peter Cordingley, a WHO spokesman, said there was no sign of diseased poultry in the immediate area. Indonesia is second only to Vietnam in the list of countries with the most bird flu deaths.

The Ministry of Health in Indonesia confirmed an additional case of human infection with the H5N1 avian influenza virus. The case occurred in a 32-year-old man, who developed symptoms on 15 May and died on 22 May.

The case is part of a family cluster in the Kubu Sembelang village, North Sumatra. The man is the seventh member of an extended family to become infected with the H5N1 virus and the sixth to die. An initial case, though unconfirmed, is also thought to have died of H5N1 infection. The newly confirmed case is a brother of an initial case. His 10-year-old son died of H5N1 infection on 13 May. The father was closely involved in caring for his son, and this contact is considered a possible source of infection.

Although the investigation is continuing, preliminary findings indicate that three of the confirmed cases spent the night of 29 April in a small room together with the initial case at a time when she was symptomatic and coughing frequently. These cases include the woman’s two sons and a second brother, aged 25 years, who is the sole surviving case among infected members of this family. Other infected family members lived in adjacent homes.  Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing.

Both the Ministry of Health and WHO are concerned about the situation in Kubu Sembelang and have intensified investigation and response activities. To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred.

Full genetic sequencing of two viruses isolated from cases in this cluster has been completed. Sequencing of all eight gene segments found no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations. The viruses showed no mutations associated with resistance to the neuraminidase inhibitors, including oseltamivir (Tamiflu). Experts have long feared that if the virus did mutate into a form that passes easily between humans, there could be worldwide pandemic of the disease.

More Bird Flu in Norfolk

1st May 2006

01052006_birdflu1.jpgTwo poultry farms, close to a farm in Norfolk infected with bird flu, have found the disease in their livestock, further tests will be carried out at the two farms. A Defra spokesman said that the two free range flocks will be slaughtered on suspicion of an avian notifiable disease. The infected areas are close to Witford Lodge Farm, where 35,000 chickens were slaughtered after the H7 avian flu strain was found.

The Department for Environment, Food and Rural Affairs (Defra) said that preliminary results indicated the farms were affected by the H7N3 strain of avian flu. The strain found at Witford Lodge Farm, which is in North Tuddenham about 13 miles (20km) west of Norwich, was also the H7 type.

Officials said risk to the public remained "extremely low" despite the fact that a poultry worker at Witford Lodge had contracted the virus in the form of conjunctivitis. The strain is virulent among chickens but less of a threat to humans than the H5N1 variant. A Heath Protection Agency spokeswoman said that no other poultry workers at the farm had shown symptoms of illness caused by H7 avian flu.

A restricted zone has been created, extending 1km from each of the infected premises. Debby Reynolds, chief veterinary officer, said the working hypothesis remained that the most likely source of the virus was from another premises or from wild birds. A spokeswoman from Defra said the two new farms which tested positive for avian flu did have the same owner.

An outbreak of an H7 variation, H7N7, in the Netherlands in 2003 led the Dutch government to order the slaughter of more than 30 million birds. This outbreak in the Netherlands infected more than 80 people and led to the death of one vet.

The H5N1 virus has killed more than 100 people in Asia. Neither strain poses a large-scale threat to humans as bird flu cannot pass easily from one person to another, though some experts fear the H5N1 virus could mutate and trigger a flu pandemic, potentially putting millions of human lives at risk.

Avian Flu

4th March 2006

04032006_Chickens1.jpgSince 2003 Bird flu (avian flu) has spread from VietNam all the way across the globe to Nigeria (West Africa) and Italy (well into the European Union). Over 150 million birds have died. The number of human deaths is also going up, almost 100 people have so far died as a result of bird flu infection.

Here is a country-by-country breakdown of confirmed cases of avian flu in humans, as reported by the United Nations World Health Organization (WHO):

The list also shows countries that have confirmed cases in birds but not so far in humans.

The WHO identifies early 2003 as the starting point for the latest of three waves of the disease, the first of which began in Hong Kong in 1997.

As of 9th March, WHO had clinical confirmation of 175 cases of bird flu in humans during the current wave, of whom 96 have been fatal.

The largest number of fatal cases have occurred in Vietnam, with 42 deaths.

Eighteen people have died of bird flu in Indonesia, 14 in Thailand, eight in China and four each in Cambodia and Turkey.

As of 9th March, Iraq counted two human deaths due to bird flu and India confirmed one case of human death.

Vietnam: First human case: Dec. 2004
Total human cases: 93, of which 42 fatal

Indonesia: First human case: July 2005
Total human cases: 25 cases, of which 18 fatal

Thailand: First human case: Sept. 2004
Total human cases: 22 cases, of which 14 fatal

China: First human case: Feb. 2003
Total human cases: 12 cases, of which eight fatal

Cambodia: First human case: Feb. 2005
Total human cases: four, all fatal

Turkey: First human case: Jan. 2006
Total human cases: 12, of which four fatal

Iraq: First human case: Jan. 2006
Total human cases: one, fatal

Other countries that have confirmed cases of the H5N1 avian flu virus in either wild or domestic birds, but no human cases to date (Source WHO):

South Korea: Dec. 2003, declared disease free Sept 2004

Japan: Jan. 2004, declared disease free July 2004

Laos: Jan. 2004, in poultry

Malaysia: Aug. 2004, declared disease free Jan. 2005

Russia: July 2005, in Siberian poultry

Kazakhstan: Aug. 2005, in poultry and migratory birds

Mongolia: Aug. 2005, migratory birds

Belgium: Oct. 2004, in two imported eagles

Taiwan: Oct. 2005, in a consignment of smuggled birds

Romania: Oct. 2005, in poultry

Britain: Oct. 2005, in an imported parrot

Croatia: Oct. 2005, in wild birds

Kuwait: Nov. 2005, in a migratory flamingo

Ukraine: Dec. 2005, in poultry

Nigeria: Feb. 8, 2006, in chickens; first outbreak in Africa

Azerbaijan: Feb. 9, in migratory birds

Bulgaria, Greece and Italy: Feb. 11, in swans

Slovenia: Feb. 12, in a swan

Austria, Germany and Iran: Feb. 14, in swans

Egypt: Feb. 16, in domestic poultry

France: Feb. 18, in wild duck

About half of all humans who have been infected with the H5N1 bird flu virus strain, the most lethal one, have died. Most of these deaths have taken place in south east Asia. It is likely to have a much lower death rate in developed countries, where health care services are better and swifter. Some antiviral drugs (e.g. Tamiflu), if administered to the patient within three days of symptoms appearing, can be effective in achieving a complete recovery. It is crucial that infected patients are treated swiftly.

Since the new year, there have been some human deaths in Turkey, raising concerns that perhaps the virus is starting to transmit among humans more easily. Authorities there, after extensive investigation, found that all deaths were among patients who had been in constant contact with infected birds (meaning they got it from birds, not other humans) though the possibility of human to human transmission has not been ruled out.

The more humans the virus infects, the greater the chances are that it will mutate and become a human transmissible one (infect from human-to-human). If the H5N1 virus strain infects a human who has the normal flu it then has the opportunity to exchange genetic information with the human flu virus. It could pick up, from the human flu virus, the ability to spread among humans. Hopefully, when it does exchange genetic information, it may lose some of its present virulence (potency) - something experts think it very likely.


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Article Information

Title: Avian Flu
Author: Luisetta Mudie
Article Id: 85
Date Added: 4th Mar 2006


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