UPDATE: Avian influenza outbreaks/Crossover to humans/Avian influenza as a biological weapon

February 6, 2004

KD Weber <wvadreamin

Undisclosed-Recipient:; <Undisclosed-Recipient:;>

Sunday, 1 February 2004 5:46

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Bird Flu Vaccine in Development BEFORE Virus Mutated

http://www.stevequayle.com/News.alert/04_Disease/040130.bird.flu.vacc.html

January 29, 2004

Hello Steve:

(Vaccine Researchers Read Tea Leaves or Remote View the need for (human)

bird flu vaccine, almost a year before the mutated virus breaks out in

Asia.)

This gets even better. The WHO released an article that stated they hoped to

have a prototype of Avian Influenza vaccine ready in (now get this) ONE

WEEK. It is estimated to be ready for public marketing in months.

Now, here is where it gets even better:

I had to rub my eyes and read again. Yep, they stated ONE WEEK to prototype

vaccine against H5N1 avian influenza.

We have been hearing that the avian influenza virus has just mutated this

season and has taken a giant leap foward in mutation prompting researchers

to worry about a pandemic that would mutate again thus spreading person to

person. Normally, bird flu spreads from bird to human via droplet

transmission.

So, are the news articles simply paranoia. I thought so. Till now. Bird flu

in 2003 only killed ONE person in Hong Kong and two in China. Even now that

cases are low, too low for the paranoia being perpertrated on our TV sets

each evening during the network news shows.

Well, I read the WHO article about their reverse genetic vaccine and

wondered, ONE WEEK to prototype? I know it can take 7 -10 years to get a

vaccine to market. Months?

Well, I dug a little deeper and guess what I found? You got it, April 9,

2003 a reverse genetic vaccine for H5N1 was in the works. This is BEFORE we

even heard about a mutated bird flu. What gives?

Well, in reading, the article stated that the vaccine had to be developed

using P4 also known as BSL 4 containment because if not employed, it would

KILL the research staff. I wonder how they knew this would occur? Probably

lost a researcher or two to this bird flu due to vaccine manipulation of the

virus. My guess is that they probably took bird flu, and took some material

from human flu, combined it to enable the human body to develop antibodies.

Again, it gets better. They developed this style of reverse genetics not for

avian influenza, but for SARS. This was part of SARS research specifically

an attempt to develop a SARS vaccine.

Normally, working with influenza virus is done at BSL 2. Even the Pasteur

Influenza lab uses BSL 2. This is the first time I have heard of using BSL 4

or known as P 4 for flu.

In any event, Steve, here are the articles. The first dated Jan. 29, 2004 re

H5N1 vaccine via reverse genetics. It also describes the process. I think

that part of the process is recombination with (probably) fujian flu. The

second article, is the obscure website at biomedcentral that discusses the

April 9, 2003 development of bird flu vaccine via reverse genetic

manipulation.

This is amazing. So, we see that bird flu was manipulated BEFORE it took its

giant leap foward in evolution to mutate more virulent. Think it had help

mutating from this experiment? BTW, I did not know that St. Jude's

Children's Research had a BSL 4 lab in Tennesse? If they are researching

this vaccine there, they must be at P 4.

So, it appears that they knew bird flu did mutate and anticipate it to

mutate even more. Dr. Frankenstein does know his monster and recognizes that

the monster is dangerous.

Again, it looks like we were lied to.

Patricia Doyle

Jan. 29, 2004 Three WHO collaborating centers-The US Centers for Disease

Control and Prevention, St Jude's Children's Research Hospital in Memphis,

and the UK's NIBSC-are now using the technology to create a prototype H5N1

vaccine virus. The focus of attention in vaccine strain production is the

hemagglutinin gene, said Stohr.

Wood says work with the virus sample from Vietnam is being done under strict

P4 conditions, " or it would kill the staff. " His team will remove a stretch

of 4 or 5 basic amino acids at the hemagglutinin cleavage site that allows

the virus to replicate in every organ of a chicken's body, rather than

respiratory and gut tissue normally infected. " We are making a jump to guess

this is also important in humans, " he said. The NIBSC team extracted the

viral RNA last week, said Wood, and is now growing the appropriate plasmids

in the laboratory. Using other lab strain flu plasmids containing the other

components of the viral genome, the team will then reassort the pieces into

a nonpathogenic vaccine strain. " We hope to 'rescue' the reassortment virus

next week, " said Wood. After that comes amplification in embryonated hen's

eggs, followed by safety testing in chickens and in ferrets. Sufficient

amounts of safety-tested prototype vaccine virus will probably be available

for the necessary 1 to 2 months of clinical trials in the next 4 weeks,

Stohr told The Scientist. Large-scale commercial production requires

negotiation with MedImmune, the US company that holds the patent for the

technique, he added, but the company indicated to the WHO in April last year

that it would be willing to do this " and that they would charge very

moderate licensing fees, and consider special conditions for developing

countries. They';ve told us they would not want any country to be unable to

produce an affordable vaccine. " WHO would probably help coordinate the

trials to assess what the antigen concentration will be, how many doses

should be given, what adjuvants may help, or how each human age group will

react. " And they could be done in parallel with the production of clinical

batches, so production could begin immediately, " he said. The next hurdle

would be regulatory approval. " As the European Union may consider this to be

a genetically modified organism, that would impose much higher safety

standards during manufacture, until inactivation, " Stohr believes. " But the

potential danger of not having a vaccine ready might influence their

decision. They will have to look at the losses and benefits. " The reason

such urgency is being given to the vaccine production is the fact that the

eight genes of the H5N1 avian influenza could shuffle with the eight genes

of human flu in a coinfected individual, with the potential to create a

human pandemic. " But we don';t want to create panic, " Stohr told The

Scientist. " We have a window of opportunity to keep this in the box, " by

slaughtering the infected animals, he said. In cells infected with

influenza, the viral genome dissociates and the separate genes multiply and

recombine to make new virus particles. If both human and avian viruses are

present in a cell, all possible recombinations can be made, potentially

uniting the pathogenicity of the current H5N1 virus with the infectivity and

transmissibility of normal human flu. WHO is unwilling to estimate the

global mortality if the H5N1 virus recombines to make a human form. In 1918,

there were 20 to 40 million deaths in the infamous flu pandemic, but it is

argued that many of those were caused by secondary bacterial infections,

which could nowadays be more easily handled with antibiotics. On the other

hand, says Mike Ryan, director of WHO's Global Outbreak Alert and Response

Network, the argument is contentious. " One of the striking facts about that

pandemic is the number of perfectly healthy individuals who died within 2 to

3 days of getting sick, " he said. According to the WHO's most recent update,

only two countries, Vietnam and Thailand, have reported laboratory-confirmed

cases of H5N1 infection in humans. Vietnam has reported eight cases, six of

them fatal. Thailand has reported three cases, two of them fatal. Links for

this article " Bird flu summit urged to act, " BBC News, January 28, 2004.

http://news.bbc.co.uk/1/hi/world/asia-pacific/3436143.stm

T.M. Powledge, " Quick custom flu vaccines, " The Scientist, April 9, 2003.

http://www.biomedcentral.com/news/20030409/01

" Annex D: Influenza vaccine, " In Influenza Pandemic Preparedness Plan: The

Role of WHO and Guidelines for National and Regional Planning, Geneva,

Switzerland: World Health Organization, April 1999.

http://www.who.int/emc-documents/influenza/docs/index.htm/sec10.htm

" Avian influenza A(H5N1) in humans-Update 9, " World Health Organization

Disease Outbreak News, January 27, 2004.

http://www.who.int/csr/don/2004_01_27a/en/

Now for the April 9, 2003 article:

http://www.biomedcentral.com/news/20030409/01

Quick custom flu vaccines Technique used to craft new H5N1 vaccine could

speed development for all new strains. | By Tabitha M Powledge

A genetic technique that accelerates development of vaccines against some

emerging viruses has resulted in an experimental vaccine designed to fight a

new form of avian influenza that killed at least one person in Hong Kong in

February. Researchers at St. Jude Children's Research Hospital in Memphis,

Tennessee, say their approach, based on reverse genetics, means much

speedier creation of influenza vaccines. Other researchers agree, and expect

that eventually the method can be applied to additional diseases. SARS,

however, is probably not one of them because the genome of its suspected

agent, a novel coronavirus, is far too big. The National Institute of

Allergy and Infectious Disease announced Friday that it had begun working on

a SARS vaccine, but director Anthony Fauci warned the effort would take at

least a year or more. " The particular system we used was one developed here

at St. Jude, the so-called eight-plasmid reverse genetic system, " said

Richard Webby, who developed the new flu vaccine with colleague Daniel

Perez. " What this allows us to do is custom-make an influenza virus. We can

remove bits, we can add bits, and we can swap and change. " Influenza vaccine

is usually made via classical reassortment between two influenza viruses.

That is followed by antibody selection for the particular combination of

genes desired. Researchers attempt to zero in on a combination that melds

RNA sequences for the two surface glycoproteins from the target strain with

six other sequences from a harmless " master " strain. Checking each

reassorted virus to identify one with the desired RNA sequences takes a lot

of time, however, Webby explained. From the moment a new strain is

identified, it can take two-to-three months before the vaccine production

process in eggs can even begin. Reverse genetics cuts down on that time

dramatically. Researchers clone individual gene sequences of the virus,

hand-selecting the sequences for the two target glycoproteins to combine

with master strain sequences. " The only thing we will get out at the other

end is that particular combination. We don't have to go through a lot of

selection of individual viruses, " Webby said. The technique also gets around

another hurdle. H5N1 is so pathogenic that it kills chicken eggs, making it

impossible to grow it to the titers necessary for vaccine development. " What

reverse genetics allows you to do is to remove the molecular features that

are responsible for that pathogenicity, " he added. The reverse genetic

technique certainly does speed up the process of developing a vaccine, said

Yoshihiro Kawaoka, who holds joint appointments at the University of

Wisconsin and the University of Tokyo. In 1999, Kawaoka and his colleagues

showed that reverse genetics could be used to build flu viruses one RNA

segment at a time (PNAS, 96[16]:9345-9350). " You can make vaccine strains in

one week, " Kawaoka said. He and his colleagues are attempting to extend the

method to other viral diseases. " The use of plasmid-based reverse genetics

methods to generate influenza virus vaccine strains not only is a faster

methodology, but also allows the insertion of novel safety markers in the

vaccine strains, an important consideration when dealing with highly

pathogenic influenza viruses, such as the potential pandemic H5N1 virus, "

said Adolfo Garcia-Sastre, RNA virus researcher at the Mount Sinai School of

Medicine. " This facilitates the handling of the vaccine strains before their

inactivation to be used as killed vaccines. " Links for this article TM

Powledge, " Genetic analysis of bird flu, " The Scientist, February 27, 2003.

http://www.biomedcentral.com/news/20030227/04/

St. Jude Children's Research Hospital http://www.stjude.org/

R. Walgate, " Latest SARS evidence, " The Scientist, April 4, 2003.

http://www.biomedcentral.com/news/20030404/03

WHO, " Influenza Pandemic Preparedness Plan, Index A: Influenza Vaccine, "

April 1999.

http://www.who.int/emc-documents/influenza/docs/index.htm/sec10.htm

Patricia A. Doyle, PhD Please visit my " Emerging Diseases " message board at:

http://www.clickitnews.com/ubbthreads/postlist.php?Cat= & Board=emergingdiseas

es Zhan le Devlesa tai sastimasa Go with God and in Good Health

-

KD Weber

Friday, January 30, 2004 4:10 PM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Ed note> See also

http://news.bbc.co.uk/1/hi/sci/tech/280198.stm

Monday, February 15, 1999 : First genetic secrets of killer flu

Haemorrhaged lung tissue from an corpse dug out of the Alaskan tundra

The first gene has been sequenced from the devastating influenza virus

which killed at least 20m people in 1918.

http://millennium-debate.org/indsun7oct2.htm

7 October 2001 : Bodies to be dug up in war on killer flu

Scientists have applied to exhume the corpses of 10 Londoners buried

more than 80 years ago to discover the genetic make-up of the world´s most

deadly virus. The bodies, says Britain´s leading flu expert, could help

explain why 40 million people died in the 1918 outbreak of " Spanish flu " .

Research on them could help to combat future global epidemics.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1918 flu victim may hold clues to [bIRD FLU] outbreak

http://news.scotsman.com/topics.cfm?tid=161 & id=115862004

JOHN VON RADOWITZ

A VICTIM of the world's worst flu epidemic is to be exhumed to help

scientists trying to avert the spread of bird flu, it was revealed

yesterday.

Scientists plan to remove lung samples from the body of 20-year-old

Phyllis Burn, who was buried 85 years ago.

The army officer's daughter, from Strawberry Hill, London, was one of

50 million people killed by a devastating strain of influenza that swept

across the world in 1918.

Evidence points to the 1918 virus being a type of bird flu similar to

the one which is now claiming human lives in Asia.

Scientists are desperate to know more about what caused the pandemic,

in order to avoid another disaster on a similar scale.

The investigation leader, Professor John Oxford, from Queen Mary's

School of Medicine in London, said: " The big question is: was there

something special about this virus that enabled it to kill 50 million

people, was there something special about the people that led them to die so

quickly, or was it a combination of the two?

" No-one expects the 1918 virus to come back again, but there is the

possibility of a new virus arising in the same way today. "

Miss Burn was buried in a lead coffin, which, if properly sealed,

would have been airtight.

Prof Oxford hopes that even after more than 80 years her internal

organs will be sufficiently preserved to allow tissue samples to be taken

from her lungs.

The scientists are looking for a " genetic footprint " - fragments of

RNA - left by the 1918 virus that could yield important clues.

Prof Oxford said although he did not believe there was any way the

virus could come back to life, his team was taking no chances.

The researchers would wear special containment suits as they extracted

tissue samples from the body in situ. They would work within a tent erected

over the grave.

Back at the laboratory, the first job would be to screen the samples

for any sign of dangerous virus.

" I don't think there is any chance of finding an infectious virus, but

you never know, " said Prof Oxford. " We are treading into the unknown a

little bit. "

Only a handful of samples from the 1918 pandemic exists in Britain and

the United States. They consist of small lung " blocks " about half the size

of a sugar cube.

Scientists have already managed to identify half a dozen of the

virus's genes. The clues point to an avian, or bird, virus - but not the

same strain as the one currently worrying health officials in Vietnam and

Thailand.

The 1918 virus was an H1 strain, whereas the virus responsible for the

new outbreaks is categorised as H5.

In Vietnam, at least six people have been killed by the infection and

two other cases have been confirmed.

The World Health Organisation said yesterday that two other deaths

being investigated in Vietnam had been prematurely blamed on the virus.

At present, the bird virus does not seem capable of passing from

person to person, as happened in the 1918 pandemic.

The greatest fear of experts is that it will genetically combine with

normal human flu to produce an infection that can sweep through populations.

" That's the Armageddon scenario - that the two will mix together, "

said Prof Oxford.

A key question that scientists want answered is whether such a

combination triggered the 1918 pandemic.

Prof Oxford has spent a year clearing obstacles in the way of the

exhumation, but believes he is now " 95 per cent there " .

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

http://ap.tbo.com/ap/breaking/MGAR0K9L2QD.html

WHO Says Bird Flu Virus Has Infected Chickens in Asia Since April

BANGKOK, Thailand (AP) - The bird flu sweeping across Asia has been in

chickens in the region since at least April, tests conducted by the World

Health Organization revealed, giving reassurance the virus has not been very

successful at jumping to humans so far.

Experts say it is just a matter of time before the world is hit with

the next flu pandemic - something that could happen if the bird flu virus

swaps genes with a human variety inside someone infected with both. However,

no human genes have been found in the virus creating the current outbreak.

" If the virus has been around for so long, there may have been dozens,

hundreds or thousands of exposures to humans and nothing has happened so far

when it comes to genetic recombination. That's good news, absolutely, " Klaus

Stohr, WHO's chief flu scientist, said Friday.

Bird flu has been reported in 10 Asian countries and tens of millions

of chickens have been killed by the virus or destroyed to prevent its

spread. Eight people have died in Vietnam and two in Thailand.

Researchers have always suspected the strain of bird flu now hitting

Asia has been around for a while, but say it is probably impossible to tell

exactly when it emerged.

Stohr would not say which country provided the samples, but said it

was one of the poorer countries in Asia that does not have the facilities to

do its own tests. It is not China, he said.

The examination was done on samples from chicken carcasses that were

taken in April for reasons unrelated to the bird flu. When the disease broke

out in Asia, the country sent the frozen samples to WHO to see if they were

infected with the H5N1 bird flu strain. The tests were positive.

However, finding the virus in the April samples does not mean the

current outbreak was flourishing back then.

" It just says the virus was there already. How widespread it was we

have no clue, " Stohr said. " It could have been the first transmission of the

virus from migratory birds to domestic poultry, or it could have been

lingering in poultry for several months already. "

" It's perfectly possible that (the outbreak) could have been around

then, but not on a large scale because the bomb would have exploded

earlier, " Stohr said.

What researchers can conclude from the finding is the virus has been

in the region for some time, it hasn't mutated much since then and the

disease has not spread to humans to a large extent since it emerged, he

said.

In the absence of proper surveillance that can pick up the disease as

soon as it surfaces, the examination of preserved carcasses is an important

way for scientists to understand the evolution of an outbreak.

" If any countries have frozen samples of diseased chickens from two or

three years ago, it would be great to look into that, " Stohr said.

WHO said Friday that all countries should at least be investigating

whether it is worth stockpiling drugs thought to work against the avian flu

strain in case it turns into a pandemic.

" Without any doubt there will be very little vaccine available during

the beginning phase of a pandemic. In some countries, they many never see

one syringe for vaccine because the vaccine production will not suffice for

the whole world and it will take time before the vaccine is available, "

Stohr said.

" There will be a gap and that initial gap can only be filled by

antivirals, " Stohr said.

John Oxford, an influenza expert from Queen Mary's School of Medicine

in London, went further, saying it was " beyond comprehension " why those who

can afford it are not stockpiling the drugs, Tamiflu and Relenza.

" If there is an outbreak there's going to be a mad panic. It will be

chaos. Just like with smallpox, we should take the same attitude with

influenza, where we know there's going to be an outbreak sooner or later, "

he said.

To date, more than 25 million birds have been destroyed in the

campaign against avian flu, according to the U.N. Food and Agriculture

Organization.

Governments battling the disease include China, Thailand, Vietnam,

Indonesia, Cambodia, Japan, South Korea, Laos, Taiwan and Pakistan. However,

the strain of bird flu striking Taiwan and Pakistan is different from the

one hitting the other countries and is not considered a serious threat to

humans.

http://news.scotsman.com/topics.cfm?tid=161 & id=116482004

China denies causing bird flu virus epidemic with cover-up

MARGARET NEIGHBOUR

CHINA yesterday vehemently denied any government cover-up was responsible

for the bird flu virus rampaging through Asia.

China's foreign ministry spokeswoman, Zhang Qiyue, said the accusation, made

in New Scientist magazine, " is completely inaccurate, is without proof and

moreover does not respect science " .

The New Scientist quoted experts as saying they suspected the new strain of

bird flu began in China, probably in the first half of 2003.

" A combination of official cover-up and questionable farming practices

allowed it to turn into the epidemic now under way, " the magazine said.

http://news.scotsman.com/topics.cfm?tid=161 & id=103682004

WHO demands cash to fight bird flu

FOREIGN STAFF

THE bird flu rampaging through Asia made the leap into China yesterday,

while a second boy in Thailand died of the disease.

The rapid spread of the virus, which has now erupted in ten Asian countries

and killed eight people in Vietnam and Thailand, prompted the World Health

Organisation to ask for money and expertise to fight an all-out war against

it.

" This is a serious global threat to human health, " said the WHO chief Lee

Jong-Wook. " We must begin this hard, costly work now. "

China's Xinhua news agency said the H5N1 strain of the bird flu had killed

ducks in the southern province of Guangxi.

About 14,000 poultry within a two-mile radius of the Guangxi farm had been

culled, the agency said, adding that poultry three miles from the site had

been quarantined.

" Clearly it is of concern now that there is an outbreak here in China. The

opportunity to interact with human beings is obviously very apparent, " said

Dr Julie Hall, a WHO co-ordinator in Beijing. " It is urgent that the matter

is dealt with quickly. "

Culls and quarantining of poultry should be implemented and human contact

with animals limited in order to prevent the opportunity for the virus to

transmit to humans, she said.

The fear is that the virus might mate with human influenza and unleash a

pandemic among people with no immunity to it.

China's huge population and the number of people living in close proximity

to livestock in farms across the country have alarmed epidemiologists, who

are worried that they will be cauldrons for the next big flu epidemic.

Guangxi province also borders Laos, where a senior agriculture ministry

official said the disease had struck in an area around the capital,

Vientiane.

Health officials say that the country's poor infrastructure may not be able

to cope with containing the flu.

Vets suspected that the death of chickens at a farm in the central Chinese

province of Hubei and of ducks at a farm in the southern province of Hunan

were also caused by bird flu, Xinhua said.

Japan, which banned Thai chicken imports before the Bangkok government

confirmed it was fighting an outbreak, promptly shut its doors to chicken

from China's massive poultry farms. Japan imports about a third of all the

chicken it consumes from China.

Japan and Singapore have banned imports of birds other than chickens,

including ostriches and parrots, shipped from countries reporting bird flu

outbreaks.

Other countries are also taking measures to try to keep out the disease.

Australia has tightened surveillance at sea, restricted public access to

poultry farms, and deployed sniffer dogs and X-ray machines at airports to

stop people from bringing in potentially tainted gourmet food and souvenirs.

Meanwhile, Singapore is shielding its bird farms with netting. It is also

doubling farm inspections to twice a day and stepping up checks on fowl

shipments from Malaysia.

-

KD Weber

Friday, January 30, 2004 2:13 PM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Ed note> Shucks. Ain't that nice? A vaccine all ready for us in one week!

www.biomedcentral.com/news/20040129/05

H5N1 vaccine strain in a week

Using reverse genetics, WHO thinks a prototype bird flu strain likely to be

ready in a week | By Robert Walgate

GENEVA-A prototype vaccine strain of the H5N1 flu virus causing havoc in

Asia will probably be ready next week, John Wood of the UK National

Institute for Biological Standards and Control (NIBSC) told The Scientist

today (January 29). However, months of other hurdles remain before it may be

ready for public health use.

As leaders of the countries worst hit by the avian flu met in Bangkok at an

emergency summit on Wednesday (January 2 , World Health Organization (WHO)

labs were working to formulate a vaccine against the virus.

The H5N1 virus kills chicken eggs, the normal medium for growing flu vaccine

viruses, so the WHO laboratories are using reverse genetics to lower the

pathogenicity of the virus to chickens and to get a high yield in the egg

cultures, said Klaus Stöhr, project leader of the influenza surveillance and

scientific groups for the H5N1 outbreak team. Reverse genetics also cuts

down the normal time required for flu vaccine production.

Three WHO collaborating centers-The US Centers for Disease Control and

Prevention, St Jude's Children's Research Hospital in Memphis, and the UK's

NIBSC-are now using the technology to create a prototype H5N1 vaccine virus.

The focus of attention in vaccine strain production is the hemagglutinin

gene, said Stöhr.

Wood says work with the virus sample from Vietnam is being done under strict

P4 conditions, " or it would kill the staff. " His team will remove a stretch

of 4 or 5 basic amino acids at the hemagglutinin cleavage site that allows

the virus to replicate in every organ of a chicken's body, rather than

respiratory and gut tissue normally infected. " We are making a jump to guess

this is also important in humans, " he said.

The NIBSC team extracted the viral RNA last week, said Wood, and is now

growing the appropriate plasmids in the laboratory. Using other lab strain

flu plasmids containing the other components of the viral genome, the team

will then reassort the pieces into a nonpathogenic vaccine strain. " We hope

to 'rescue' the reassortment virus next week, " said Wood.

After that comes amplification in embryonated hen's eggs, followed by safety

testing in chickens and in ferrets.

Sufficient amounts of safety-tested prototype vaccine virus will probably be

available for the necessary 1 to 2 months of clinical trials in the next 4

weeks, Stöhr told The Scientist.

Large-scale commercial production requires negotiation with MedImmune, the

US company that holds the patent for the technique, he added, but the

company indicated to the WHO in April last year that it would be willing to

do this " and that they would charge very moderate licensing fees, and

consider special conditions for developing countries. They';ve told us they

would not want any country to be unable to produce an affordable vaccine. "

WHO would probably help coordinate the trials to assess what the antigen

concentration will be, how many doses should be given, what adjuvants may

help, or how each human age group will react. " And they could be done in

parallel with the production of clinical batches, so production could begin

immediately, " he said.

The next hurdle would be regulatory approval. " As the European Union may

consider this to be a genetically modified organism, that would impose much

higher safety standards during manufacture, until inactivation, " Stöhr

believes. " But the potential danger of not having a vaccine ready might

influence their decision. They will have to look at the losses and

benefits. "

The reason such urgency is being given to the vaccine production is the fact

that the eight genes of the H5N1 avian influenza could shuffle with the

eight genes of human flu in a coinfected individual, with the potential to

create a human pandemic.

" But we don';t want to create panic, " Stöhr told The Scientist. " We have a

window of opportunity to keep this in the box, " by slaughtering the infected

animals, he said.

In cells infected with influenza, the viral genome dissociates and the

separate genes multiply and recombine to make new virus particles. If both

human and avian viruses are present in a cell, all possible recombinations

can be made, potentially uniting the pathogenicity of the current H5N1 virus

with the infectivity and transmissibility of normal human flu.

WHO is unwilling to estimate the global mortality if the H5N1 virus

recombines to make a human form. In 1918, there were 20 to 40 million deaths

in the infamous flu pandemic, but it is argued that many of those were

caused by secondary bacterial infections, which could nowadays be more

easily handled with antibiotics.

On the other hand, says Mike Ryan, director of WHO's Global Outbreak Alert

and Response Network, the argument is contentious. " One of the striking

facts about that pandemic is the number of perfectly healthy individuals who

died within 2 to 3 days of getting sick, " he said.

According to the WHO';s most recent update, only two countries, Vietnam and

Thailand, have reported laboratory-confirmed cases of H5N1 infection in

humans. Vietnam has reported eight cases, six of them fatal. Thailand has

reported three cases, two of them fatal.

Links for this article

" Bird flu summit urged to act, " BBC News, January 28, 2004.

news.bbc.co.uk/1/hi/world...436143.stm

T.M. Powledge, " Quick custom flu vaccines, " The Scientist, April 9, 2003.

www.biomedcentral.com/news/20030409/01

" Annex D: Influenza vaccine, " In Influenza Pandemic Preparedness Plan: The

Role of WHO and Guidelines for National and Regional Planning, Geneva,

Switzerland: World Health Organization, April 1999.

www.who.int/emc-documents....htm/sec10 .htm

" Avian influenza A(H5N1) in humans-Update 9, " World Health Organization

Disease Outbreak News, January 27, 2004.

www.who.int/csr/don/2004_01_27a/en/

-

KD Weber

Friday, January 30, 2004 1:51 PM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Virulent Bird Flu Spreads in China

http://news.myway.com/top/article/id/380613|top|01-30-2004::10:08|reuters..h

tml

Jan 30, 9:59 AM (ET)

By Brian Rhoads and Vissuta Pothong

BEIJING/BANGKOK (Reuters) - China, home to a vast poultry industry, said on

Friday the deadly bird flu virus which has killed eight Asians had struck in

three provinces, possibly two more and perhaps the sprawling financial

capital of Shanghai.

It said tests confirmed the H5N1 virus had got into chickens in Hubei and

Hunan provinces as well as the southern region of Guanxi. Outbreaks were

also suspected in Anhui and Guangdong, the southern province where SARS was

born.

Another suspected outbreak was reported in a Shanghai suburb and a mass

slaughter of domestic fowl was under way around all three new outbreaks, the

official Xinhua news agency said.

Outbreaks in China -- widely condemned for covering up SARS for several

months -- were the nightmare health officials had prayed they would not have

to face.

Experts fear the world's most populous country could become a huge incubator

for the virus if the new cases are confirmed.

Especially in Guangdong, people live cheek by jowl with their chickens and

other farm animals, raising the possibility the virus may combine with human

flu to produce a strain that could sweep through a world where people have

no immunity to it.

The fresh outbreaks prompted Hong Kong, just south of Guangdong, to

immediately ban imports of live birds and poultry meat from mainland China.

So far, all eight people -- seven of them children -- known to have died

from bird flu have caught it directly from infected chickens, victims of a

virus probably spread by migrating birds.

But the generation of a new flu virus that can pass from person to person is

the overwhelming fear, and while the possibility is small, every outbreak

shortens the odds of a pandemic a little.

TURNING CORNER IN THAILAND?

Thailand reported on Friday its first outbreak of birdflu in the southern

part of the country. A provincial government official said test results

confirmed the outbreak on Thursday in Phang Nga province, 56 miles northeast

of the popular tourist resort Phuket. Thousands of chickens were being

slaughtered there, he said.

The virus has now spread across more than a third of Thailand, so far the

worst hit of 10 Asian countries struck by bird flu.

Thai officials had earlier expressed hope the country may be turning the

corner in the war against a disease that has seen governments accused of

cover-ups and incompetence.

" I'm confident the cull is nearly finished, " Agriculture Minister Somsak

Thepsuthin told reporters at Bangkok's Chatuchak market, the world's

biggest, where infected fighting cockerels were found this week.

" On Sunday, we should have some good news. We'll rub out areas which have

been red areas, " he added, referring to zones around outbreaks.

But the U.N. Food and Agricultural Organization said mass slaughters, which

it says are the most effective way of stamping the virus out and preventing

a human flu pandemic, were not happening fast enough.

Senior FAO official Hans Wagner said in a statement that although more than

25 million birds had been killed, it was " concerned that mass cullings are

not taking place at a speed we consider absolutely necessary to contain the

virus H5N1. "

Nor were some governments doing enough to convince small farmers, many

looking at the destruction of their livelihoods and hiding their stock, of

the need to cull.

" As long as small farmers and commercial producers, especially in poorer

countries, do not receive an adequate financial incentive for killing their

chickens, they will probably not apply suggested emergency measures, " Wagner

said.

" There is a real threat that the virus may linger on in poorer countries

which are without adequate resources to apply control measures. "

MORE OUTBREAKS THAN REPORTED

The World Health Organization said it was possible there were more outbreaks

than had been reported due to weak surveillance.

" If your system is not strong enough to identify that chickens and ducks are

dying, then you still have a problem, " WHO representative in China Hank

Bekedam said on Friday.

The WHO also was concerned that Chinese farmers were culling poultry in an

irresponsible manner, failing to wear protective gear and goggles, he said.

But where and when the H5N1 avian flu virus first appeared is still a

mystery, at least to the public.

Geneva-based WHO spokesman Dick Thompson said samples taken " several months

ago " in a country he would not name proved to be the H5N1 virus.

" The country where it occurred didn't have the capacity to determine whether

it was H5N1, " he said.

The WHO said on its Web site at www.who.int that test results from countries

which have the disease indicated the virus " has been circulating in parts of

Asia for longer than presumed. "

But, it said, these studies did not point to where it had originated.

China denied vehemently suggestions in the British weekly New Scientist

magazine that it was the source.

And another mystery still lingers.

The WHO has asked Beijing for further clarification on a baffling case of

bird flu that killed a Hong Kong man and infected his family after a visit

to China a year ago.

The man died and his son fell sick with the H5N1 strain in early 2003 in

Hong Kong after returning from a visit to Guangdong and the neighboring

province of Fujian. (Additional reporting by Benjamin Kang Lim, Kevin Yao

and John Ruwitch in Beijing and Stephanie Nebehay in Geneva)

-

KD Weber

Thursday, January 29, 2004 11:14 AM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Bird flu outbreak started a year ago

http://www.newscientist.com/news/news.jsp?id=ns99994614

In the past week, country after country has admitted that millions of birds

and a few people have succumbed to bird flu, and it has become clear that we

are facing the worst ever outbreak of the disease.

So how have things got so out of control? After strenuous denials, Indonesia

has admitted the H5N1 virus has been spreading there since August. Thailand

admits it had it in November. China says the disease was first detected this

week.

In fact, the outbreak began as early as the first half of 2003, probably in

China, health experts have told New Scientist. A combination of official

cover-up and questionable farming practices allowed it to turn into the

epidemic now under way.

Asia's growing prosperity has been accompanied by a boom in intensive

poultry production. After 1997, when all the chickens in Hong Kong were

destroyed after H5N1 bird flu killed six people, Chinese producers decided

to take no chances, and started vaccinating birds with inactivated H5N1

virus.

This may have been a mistake. If the vaccine is not a good match for the

virus - as is the case with the H5N1 strain now sweeping Asia - it can still

replicate but most animals do not show signs of disease. In this way, the

intensive vaccination schemes in south China may have allowed the virus to

spread widely without being spotted.

" We don't like vaccination, " says Hans Wagner of the UN Food and Agriculture

Organization in Bangkok. This is also why the World Health Organization has

reacted with dismay to Indonesia's announcement that it will tackle its

outbreak with vaccination instead of culling. Vaccination may even have

contributed to the origin of the latest variant of H5N1, as it would put

strains that could evade the vaccine at an advantage.

Single strain

The current strain resembles one first spotted late in 2002 in Penfold Park,

Hong Kong. It appears to replicate more successfully than usual in ducks,

infects a wide range of wild birds and is shed orally as well as in faeces -

all characteristics that help it spread.

The strains now causing the outbreaks in Korea and Vietnam are very similar.

While samples from other countries are still being analysed, it looks as if

all the outbreaks started with the large-scale distribution of one strain,

says Klaus Stöhr, WHO head of influenza. " We are aware of samples taken

early last year that turned out to be this strain exactly. " He will not

divulge their origin, but comments from other experts suggest it was China.

The pattern of spread strongly suggests that the virus has been carried by

people smuggling poultry, a practice reportedly widespread in south-east

Asia. Some experts blame migratory birds, but there is no evidence of this.

It is certainly true that in regions with big outbreaks in poultry, local

wild birds are being affected. There are reports of mass die-offs of rare

birds in zoos in Thailand, and pigeons are said to be piling up in the

streets of Bangkok. However, regular monitoring of migratory birds in

Thailand has not revealed any signs of the virus.

Hopeful sign

For the WHO, the priority is now to prevent the epidemic triggering a human

disaster. So far, fewer than a dozen human cases of bird flu have been

confirmed in Thailand, Vietnam and Cambodia, though there could well be many

more unrecognised cases. " It is a hopeful sign that with all the heavy

exposure of people across such a large area, only a few are known to be

infected, " Stohr says.

So far at least, the virus seems incapable of human-to-human transmission.

The great fear is that someone infected with both human flu and bird flu

will give rise to a lethal hybrid that can spread from person to person.

At a meeting in Geneva this week, the WHO asked pharmaceutical companies and

governments for more antiviral drugs and ordinary flu vaccine to prevent

chicken handlers being infected by human flu at the same time as bird flu.

But the scale is daunting. " We have 100,000 tablets of Tamiflu in Vietnam, "

says Stöhr. " That's just a drop in the bucket. " The story is similar with

the human flu vaccine.

http://www.foxnews.com/story/0,2933,109586,00.html

Experts: Bird Flu Could Kill Millions

January 27, 2004

With luck, the world will escape the latest outbreak of bird flu with no

more than the six human deaths already blamed on it and the loss of millions

of chickens. But public health experts worry of a much greater disaster: A

catastrophe they say is among the worst imaginable, a global outbreak of an

entirely new form of human flu.

There is no clear sign that will happen. Nevertheless, avian influenza's

sudden sweep through Asia, along with its tendency for wholesale mutation,

leave many wondering about the bug's potential for rampant spread among

humans. It is a possibility the medical journal The Lancet calls " massively

frightening. "

" The question everybody is asking is, 'Is this the progenitor to a

pandemic?' " says Dr. Gregory Poland, chief of vaccine research at the Mayo

Clinic.

Influenza pandemics typically strike three or four times a century. The

worst in the past 100 years, the 1918-19 Spanish flu, caused an estimated 40

million to 50 million deaths. Another is considered inevitable and perhaps

overdue, but when it will happen and how bad it will be are almost totally

unpredictable.

The nightmare this time would be a flu virus leaping from birds to people

and spreading, introducing a disease for which humans have no natural

defense.

The potential source is the strain of bird flu that has moved rapidly

through parts of Asia since December, infecting chickens in at least six

countries.

Millions of birds have died of the flu or were destroyed by workers trying

to contain the outbreak. The World Health Organization says eliminating this

" animal reservoir " is urgent.

Avian flu is naturally carried by wild ducks, and it ordinarily does not

attack creatures other than birds or pigs, so experts are especially

concerned that this bird flu is occasionally infecting people.

Human cases have been reported in Vietnam and Thailand, including six deaths

as of Saturday in Vietnam, the WHO said, and one suspected death in

Thailand. Experts believe all caught the virus from chickens, not other

people.

" We know there are two possible ways a new pandemic strain can emerge, " said

Dr. Steve Ostroff, deputy director of the National Center for Infectious

Diseases at the Centers for Disease Control and Prevention. One is a human

flu virus that resurfaces after years of dormancy, so people have no defense

built up from earlier bouts. The other is a non-human variety acquiring the

ability to infect people and spread.

The latter may happen if somebody already infected with a human flu virus

also catches the bird virus. Inside the body, these two may recombine into a

new mutant, part-human virus, part-bird.

The more people are around infected chickens and other birds, experts say,

the more chances there are for such a disaster to occur.

" If the virus continues to spread in chickens, it may adapt itself so it can

grow in humans, " says Dr. Arnold Monto, a University of Michigan

epidemiologist. " If it is transmitted human to human, then we are concerned

this is the start of the great pandemic. "

The first time an avian flu virus was found to have infected people was in

Hong Kong in 1997. At least 18 people fell severely ill and six died.

Experts believe a pandemic may have been averted that time by the rapid

slaughter of Hong Kong's entire poultry supply - an estimated 1.5 million

birds killed in three days.

That flu virus was the H5N1 variety, one of 15 known subtypes of avian flu.

The WHO calls it worrisome for several reason: It mutates rapidly and tends

to acquire genes from flu viruses in other animal species; it is clearly

dangerous to people; and it spreads quickly. Infected birds give off the

virus for at least 10 days in their feces and oral secretions.

H5N1 appeared again last February, when two members of a family returning to

Hong Kong from China became ill. One died and the other recovered. How and

where they got infected was never learned.

The disease now circulating in Asia is the same H5N1, but it is so

widespread that a quick purging, like Hong Kong accomplished seven years

ago, is unlikely. Testing shows it has mutated but has not yet picked up any

genes from human flu viruses.

If a bird flu pandemic occurs, could it be stopped? Many experts fear not.

Flu is so contagious that quarantining victims, a method that eventually

contained SARS last year, is unlikely to work.

Studies suggest that prescription drugs used to treat human flu strains

could also keep people from catching the bird flu. However, spot shortages

were reported during this winter's U.S. flu outbreak, and supplies would

quickly run out during a pandemic. No country has stockpiled the drugs,

Tamiflu, Relenza and the older amantadine and rimantadine.

The WHO is already working on a prototype vaccine against the bird flu. But

even the standard annual flu shot takes six months to manufacture, and

experts doubt a new vaccine could be ready in time.

If there is evidence the bird flu is producing significant illness in

humans, " there would be a full-bore effort to produce a vaccine, " says the

CDC's Ostroff. " It's hard to predict the timeliness of it and how widely it

could be put into people's arms. "

Scientists Say Bird Flu More

Virulent, Can Live For Years

http://www.rense.com/general48/scientistssaybirdflu.htm

HONG KONG (Reuters) -- The unusually large number of ducks dying from bird

flu in southern China indicates the bug has become more virulent, which will

put more people at risk of contracting it, Hong Kong scientists said on

Wednesday.

They also raised the alarm about chilled and frozen poultry meat, saying

the deadly H5N1 virus could survive for years in temperatures as low as

minus 70 degrees Celsius (-94 F), but repeated that it can be killed if meat

is cooked properly.

China confirmed on Tuesday that H5N1 had killed ducks in southern Guangxi

province, making it the tenth place in Asia to be afflicted with a disease

that has killed eight people in the region in the last few weeks.

" H5 viruses are generally less fatal to ducks, so it is uncommon for so

many ducks to die. This means this particular H5N1 strain has become more

virulent, " said virologist Leo Poon from the University of Hong Kong.

" This means it can cause extensive deaths in poultry and this may in turn

increase the chance of more people contracting it (if they come in direct

contact with sick birds). "

The flu has devastated poultry populations wherever it has appeared, and

the greatest fear is that the H5N1 avian flu virus might latch onto human

influenza and unleash a pandemic among people with no immunity to it.

The avian flu strain first jumped from chicken to human in 1997 in Hong

Kong, infecting 18 people and killing six of them. Then, experts considered

ducks to be the original host of the H5N1, although the waterfowl were

usually not taken ill by the bug.

Scientists said they could not rule out the possibility that the new, more

powerful bird flu strain might make the jump from human to human less

difficult. So far, most of those infected were in close contact with

chickens at home or on farms.

" If virulence goes up, it would trigger larger outbreaks and more poultry

deaths...and this increases the chance of human to human transmission, " Poon

said.

SIGNS VIRUS HAS MUTATED

Hong Kong has already banned the import of chicken from places affected by

the bird flu, and Poon urged the government to begin stringent checks on

chilled and frozen chicken and ducks in stores and warehouses and on future

imports.

" We must check the source of chilled and frozen chicken and we must do it

at once, " Poon said.

Although the virulence of the current strain indicates the virus has

mutated, experts were divided over whether the vaccine used in Hong Kong and

parts of mainland China to inoculate chickens against the bird flu is still

useful.

The vaccine was cultured from the milder H5N2 virus.

" It still serves to prevent H5N1, " Poon said.

But Frederick Leung, dean of science at the University of Hong Kong, was

more circumspect.

" This H5N2 vaccine provides cross-protection and effectiveness in 80

percent of chickens. But it is based on the 1997 strain. If there has been a

mutation, any scientist will tell you the protection will be less than 80

percent, or even none, " Leung said.

redistribution of Reuters content is expressly prohibited without the prior

written consent of Reuters. Reuters shall not be liable for any errors or

delays in the content, or for any actions taken in reliance thereon.

http://story.news./news?tmpl=story & cid=570 & ncid=570 & ;e=

2 & u=/nm/20040128/sc_nm/birdflu_hongkong_dc_2

-

KD Weber

Wednesday, January 28, 2004 1:05 PM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

U.S. Issues First Warning About Asian Bird Flu

http://www.newsmax.com/archives/articles/2004/1/27/193748.shtml

In the first warning to U.S. citizens about bird flu, the government urged

doctors Tuesday to ask patients with flu-like symptoms if they have traveled

to places in Asia where bird flu has broken out.

The goal is to prevent the possible human spread of the virus, although

there have been no documented cases of this occurring during the Asian

outbreak.

" We are taking this very seriously right now, " said Dr. Julie Gerberding,

head of the Centers for Disease Control and Prevention in Atlanta.

No cases of bird flu in either people or birds have been seen so far in the

United States.

Gerberding said if doctors find that patients with flu symptoms have been in

Vietnam or other places with bird flu, they should test for the virus. If it

turns out they have influenza A, then state and local health departments

working with CDC can check further to see if it is the H5N1 bird flu strain.

Gerberding said people who might have the flu should voluntarily tell

doctors about their Asian travels if no one asks them about it.

" I want to emphasize that right now it appears to be very unlikely, but we

want to be very vigilant and to make sure we are doing everything we can to

detect any possible introduction here, " Gerberding said.

She urged people who travel to areas with outbreaks to stay away from

poultry farms, live animal markets or any surfaces contaminated with bird

droppings.

So far, H5N1 bird flu has been found in eight Asian countries, and eight

people are known to have died from the infection. While all appear to have

caught the virus from chickens, experts suspect the disease can be passed

person to person, since that occurred during a similar outbreak in Hong Kong

in 1997.

The ultimate fear, though, is that someone will catch the bird flu while

already infected with the ordinary human flu virus. The two viruses might

swap genes, creating a mutant that could spread easily with disastrous

results.

Considering the millions of chickens infected with the virus, spread to

humans appears to be rare. Gerberding said there is no indication so far for

a travel alert or advisory for Americans going to areas affected by the

outbreak.

Last year's SARS outbreak was the last time U.S. doctors were told to be on

special alert for the introduction of a contagious respiratory virus from

abroad. Typically flu is much more contagious than SARS, so containing a

human outbreak might be much more difficult than stopping SARS, which health

officials did by isolating infected people.

Gerberding said the CDC is reviewing its infection control guidelines to be

used " in the worst case scenario if we should have a patient with this

disease and there is any suggestion of person-to-person transmission. " She

said these would be similar to measures for containing regular flu and SARS.

Countries with H5N1 bird flu so far are Cambodia, China, Indonesia, Japan,

Laos, South Korea, Thailand and Vietnam. Pakistan and Taiwan have a

different strain of bird flu that has not infected people.

~~~~~~~~~~~~~~~~~~~~~~~

http://www.msnbc.msn.com/id/4079876/

CDC Issues First Bird Flu Warning

U.S. doctors should watch for possible cases from abroad

only a brief window of opportunity to eliminate the threat

Jan. 28, 2004

Lisa Schlein

Geneva

Graphic: Graphic showing the spread of bird flu across Asia (AFP/Martin

Megino)

In the first warning to U.S. citizens about bird flu, the government urged

doctors Tuesday to ask patients with flu-like symptoms if they have traveled

to places in Asia where bird flu has broken out.

The goal is to prevent the possible human spread of the virus, although

there have been no documented cases of this occurring during the Asian

outbreak.

" We are taking this very seriously right now, " said Dr. Julie Gerberding,

head of the Centers for Disease Control and Prevention in Atlanta.

No cases of bird flu in either people or birds have been seen so far in the

United States.

Gerberding said if doctors find that patients with flu symptoms have been in

Vietnam or other places with bird flu, they should test for the virus. If it

turns out they have influenza A, then state and local health departments

working with CDC can check further to see if it is the H5N1 bird flu strain.

Tell doctors about overseas travel

Gerberding said people who might have the flu should voluntarily tell

doctors about their Asian travels if no one asks them about it.

Bird flu basics

... Introduction

The rapid spread of bird flu, which is not uncommon among chickens and other

fowl, has caught the attention of global health authorities. Click on the

topics to learn more about the illness and why scientists are so

concerned.There are at least 15 different types of avian influenza that

routinely infect birds around the world. The current outbreak is caused by a

strain known as H5N1, which is highly contagious among birds and rapidly

fatal. Unlike many other strains of avian influenza, it can be transmitted

to humans, causing severe illness and death.

... What is it?

Bird flu is not the same as SARS (severe acute respiratory syndrome).

Although their symptoms are similar, SARS is caused by completely different

viruses. Influenza viruses also are more contagious and cannot be as readily

contained as SARS by isolating people who have the infection.Influenza

viruses are highly unstable and have the ability to mutate rapidly,

potentially jumping from one animal species to another. Scientists fear the

bird flu virus could evolve into a form that is easily spread between

people, resulting in an extremely contagious and lethal disease. This could

happen if someone already infected with the human flu virus catches the bird

flu. The two viruses could recombine inside the victim's body, producing a

hybrid that could readily spread from person to person.

Photo: Chickens look out from their cage in a poultry farm in Crevedia (25km

north of Bucharest), January 27, 2004. Romania has joined other states in

banning the import of poultry, eggs and other related products from

Thailand, Taiwan, Vietnam and Japan on fears of the deadly bird flu virus,

and imposed tougher hygiene measures at poultry farms. (REUTERS/Bogdan

Cristel)

... Why the concern?

The resulting virus likely would be something humans have never been exposed

to before. With no immune defenses, the infection could cause devastating

illness, such as occurred in the 1918-19 Spanish flu pandemic, which killed

an estimated 40 million to 50 million worldwide.In rural areas, the H5N1

virus is easily spread from farm to farm among domestic poultry through the

feces of wild birds. The virus can survive for up to four days at 71 F (22

C) and more than 30 days at 32 F (0 C). If frozen, it can survive

indefinitely.

... Transmission

So far in this outbreak, human cases have been blamed on direct contact with

infected chickens and their droppings. People who catch the virus from birds

can pass it on to other humans, although the disease is generally milder in

those who caught it from an infected person rather than from birds.

... History

If the virus mutates and combines with a human influenza virus, it could be

spread through person-to-person transmission in the same way the ordinary

human flu virus is spread. The current outbreak of bird flu is different

from earlier ones in that officials have been unable to contain its spread.

An outbreak in 1997 in Hong Kong was the first time the virus had spread to

people, but it was much more quickly contained. A total of 18 people were

hospitalized with six reported deaths. About 1.5 million chickens were

killed in an effort to remove the source of the virus.

... Symptoms

Unlike the 1997 scare, this outbreak has spread more rapidly to other

countries, increasing its exposure to people in varied locations and raising

the likelihood that the strain will combine with a human influenza virus.

Bird flu can cause a range of symptoms in humans. Some patients report

fever, cough, sore throat and muscle aches. Others suffer from eye

infections, pneumonia, acute respiratory distress and other severe and

life-threatening complications. Flu drugs exist that may be used both to

prevent people from catching bird flu and to treat those who have it. The

virus appears to be resistant to two older generic flu drugs, amantadine and

rimantadine. However, the newer flu drugs Tamiflu and Relenza are expected

to work - though supplies could run out quickly if an outbreak occurs.

... Treatment

Currently there is no vaccine, although scientists are working to develop

one. It probably will take several months to complete and may not be ready

in time to stop a widespread human outbreak, if one occurs.Rapid elimination

of the H5N1 virus among infected birds and other animals is essential to

preventing a major outbreak. The World Health Organization recommends that

infected or exposed flocks of chickens and other birds be killed in order to

help prevent further spread of the virus and reduce opportunities for human

infection. However, the agency warns that safety measures must be taken to

prevent exposure to the virus among workers involved in culling. Sources:

AP, CDC & WHO

... Prevention

" I want to emphasize that right now it appears to be very unlikely, but we

want to be very vigilant and to make sure we are doing everything we can to

detect any possible introduction here, " Gerberding said.

She urged people who travel to areas with outbreaks to stay away from

poultry farms, live animal markets or any surfaces contaminated with bird

droppings.

So far, H5N1 bird flu has been found in eight Asian countries, and eight

people are known to have died from the infection. While all appear to have

caught the virus from chickens, experts suspect the disease can be passed

person to person, since that occurred during a similar outbreak in Hong Kong

in 1997.

Photo: A Chinese man holds feathers near chickens at a market in Guangzhou,

southern China, Saturday, Jan. 17, 2004. China on Thursday banned all

chicken imports from Vietnam, Japan and South Korea over fears of a bird flu

spreading rapidly as its health ministry issued an urgent notice for

vigilance against the disease. (AP Photo/Ng Han Guan)

The ultimate fear, though, is that someone will catch the bird flu while

already infected with the ordinary human flu virus. The two viruses might

swap genes, creating a mutant that could spread easily with disastrous

results.

No travel alert or advisory yet

Considering the millions of chickens infected with the virus, spread to

humans appears to be rare. Gerberding said there is no indication so far for

a travel alert or advisory for Americans going to areas affected by the

outbreak.

Last year's SARS outbreak was the last time U.S. doctors were told to be on

special alert for the introduction of a contagious respiratory virus from

abroad. Typically flu is much more contagious than SARS, so containing a

human outbreak might be much more difficult than stopping SARS, which health

officials did by isolating infected people.

Gerberding said the CDC is reviewing its infection control guidelines to be

used " in the worst case scenario if we should have a patient with this

disease and there is any suggestion of person-to-person transmission. " She

said these would be similar to measures for containing regular flu and SARS.

According to the CDC, outbreaks of H5N1 flu have been reported among poultry

in Cambodia, China, Indonesia, Japan, Myanmar, South Korea, Thailand and

Vietnam. Another strain of the disease has been seen in wild flocks or

poultry in Laos, Pakistan and Taiwan.

~~~~~~~~~~~~~~~~~~~~~~

World health alert over disease

http://www.news.com.au/common/story_page/0,4057,8515045%255E401,00.html

By Paul Colgan and wires

January 28, 2004

MILLIONS of people around the world could die if the H5N1 strain of bird flu

in Asia combines with another human influenza virus that is moving towards

the region, the World Health Organisation said today.

Dr Shigeru Omi, director of the health agency's Western Pacific office, said

there was a chance the two viruses could meet and mutate, triggering a

global pandemic.

" In my judgement it is possible and so that's why we have to work very hard

today, not tomorrow, to contain this, to prevent that mutation at the

molecular level happening, " he said in Hanoi.

" There is always potential that this kind of outbreak will result in serious

global pandemic which will involve not just hundreds, but will kill millions

of people globally if this mutation happens in the virus, " he said.

Foreign Minister Alexander Downer said this morning the flu was unlikely to

enter Australia.

" We can be confident it won't (affect Australia), but nevertheless it's

pretty serious in South-East Asia, " Mr Downer told Melbourne radio 3AW.

" It's conceivable it could come to Australia, but I think that's frankly a

little unlikely. I haven't been advised that it's really a threat. " (Q & A:

Bird flu basics)

Today it emerged the virus has spread to the Thai capital Bangkok, where

delegates were gathering for an international conference to find ways of

halting its gallop across the Asian continent.

Bangkok's Deputy Mayor Prapan Kitisin said the city was declared a " danger

zone " after detection of the avian disease in a fighting cock, chickens and

ducks.

Meanwhile, Hong Kong has slapped a ban on the import of poultry from

south-western Guangxi, in neighbouring China, where 14,000 ducks have been

slaughtered following the emergence of the virus, as well as from Hunan and

Hubei provinces, where infections are suspected.

Overnight China announced it had found the virus in ducks, while a

three-year-old boy is thought to have contracted the disease in Bali,

Indonesia.

The Balinese boy was diagnosed with symptoms similar to bird flu, an

official said overnight.

Dr Made Molin Yudiasa, head of Bali's health agency, said the boy, whose

mother worked at a chicken farm in Tabanan district, had been diagnosed with

symptoms of " a flu that seems to indicate bird flu " .

Tests are underway to establish the exact cause of the illness of the woman

and her son.

Australian quarantine officials have introduced extra screening of

passengers and cargo from Asia to prevent the virus from arriving on

Australian soil.

The nation's $3.6 billion chicken meat industry and exports would be

jeopardised if the virus arrived here.

The most direct threat is from migratory birds, which might arrive from

Indonesia carrying the virus. It can live in the gut of most wildfowl and is

highly contagious. (Backyard chooks may harbour virus)

China's announcement yesterday represented the first official confirmation

by the government that avian influenza had surfaced there during the current

outbreak that has killed eight people in other parts of Asia.

Some 14,000 birds within a 3km radius of the farm in southern China's

Guangxi region were slaughtered, and all poultry for 5km around the duck

farm was immediately quarantined, Xinhua said.

Chinese quarantine officials also said they would impose poultry bans on

Pakistan and Indonesia, bringing to eight the number of countries whose bird

products have been banned from the region's largest economy.

" Fowl, birds and related products arriving in China from these countries

will be destroyed under the supervision of the quarantine bureau, " the

Beijing Youth Daily newspaper said, citing an unnamed official from the

Ministry of Agriculture.

China's openly aggressive campaign to combat the disease starkly contrasts

with the government's initial secretive response last year to the outbreak

of Severe Acute Respiratory Syndrome, which killed 349 people on the

mainland before subsiding in June.

-

KD Weber

Tuesday, January 27, 2004 1:12 PM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Bird Flu Found in Ducks in China

Thailand confirms Asia's 8th human victim; 10 countries now affected

http://www.foxnews.com/story/0,2933,109560,00.html

BANGKOK, Thailand - China confirmed Thursday that it had found bird flu in

ducks discovered dead on a southern farm, but the government emphasized that

the virus sweeping Asia had not been found in human beings.

Authorities also said two other provinces in central China had " suspect "

cases of dead poultry believed to be bird flu.

Elsewhere, Thailand confirmed Asia's eighth human victim of the avian flu

virus, while the number of affected countries rose to 10 with Laos and China

reporting cases.

In China, the official Xinhua News Agency's dispatch was the first official

confirmation by the government that avian influenza has surfaced in China

during the current outbreak that has killed eight people and forced the

slaughter of millions of birds in other parts of Asia.

Authorities immediately isolated the area around the farm in the Guangxi

region of south China, which abuts Vietnam. Some 14,000 birds within a

two-mile radius of the farm were slaughtered, and all poultry for three

miles around it was quarantined, Xinhua said. Latest News

" Local governments have made necessary measures of slaughter or quarantine

to prevent a spread, " Xinhua said. " No people have been found infected so

far and the epidemic has been in control. "

The farm is located in Dingdang, a town in Long'an County in southern

China's Guangxi region. Though region borders Vietnam and has been the site

of increased scrutiny of poultry in recent days, the town is roughly 60

miles from the border.

Roy Wadia, a spokesman for the World Health Organization in Beijing, said

China's Health Ministry had informed the U.N. agency of the bird flu cases.

" There are no cases known in people so far, " he added.

Bob Dietz, a WHO spokesman in Hanoi, said that, because Guangxi borders

Vietnam, it " wouldn't be surprising " that bird flu could travel across the

border.

" We're seeing it in other countries in southeast Asia, " Dietz said. " There's

no reason to assume China would be immune. "

Xinhua also said reports of bird deaths in a " chicken-raising household " in

the central province of Hubei and a " duck-raising household " in the nearby

province of Hunan had been diagnosed as " suspect " bird flu. It emphasized

that those diagnoses were preliminary.

China's openly aggressive campaign to combat the disease starkly contrasts

with the government's initial secretive response last year to the SARS

outbreak. Severe acute respiratory syndrome killed 349 people on the

mainland before retreating in June.

Still, there were contradictions in the government's account. While Xinhua

said anti-flu efforts had been going on at the duck farm since Friday, Yan

Qibin, an official with the Food Quarantine Bureau of the Ministry of

Agriculture, said Tuesday that his agency was investigating whether any

ducks had actually died there.

Also Tuesday, other Chinese quarantine officials said they would impose

poultry bans on Pakistan and Indonesia, bringing to eight the number of

countries whose bird products have been banned from the region's largest

economy.

China has already stopped such shipments from Cambodia, Thailand, Japan,

South Korea and Vietnam to prevent the disease from spreading to its poultry

stocks - an unsuccessful effort, given the announcement Tuesday night. Laos

and Taiwan have also reported the virus but the mainland has not said

anything about poultry bans from those areas.

In Thailand, the Public Health Ministry confirmed that a six-year-old boy

died from the disease Tuesday, becoming the country's second fatality and

the region's eighth, following six deaths in Vietnam. Thai officials awaited

lab results on five other deaths believed linked to the virus.

Thailand's first death, announced Monday, also was a six-year-old boy, who

had carried a dying chicken to a butcher.

The scope of this year's outbreak has widened alarmingly, with countries

reporting new outbreaks in poultry stocks for each of the past three days.

So far, 10 governments have reported some strain of bird flu: China,

Cambodia, Indonesia, Japan, Laos, Pakistan, South Korea, Taiwan, Thailand

and Vietnam. Some countries claim their version of bird flu is milder than

the one that has jumped to humans.

The World Health Organization believes the virus can be transmitted across

regions by migratory water fowl.

Tens of millions of chicken and other poultry have been infected in recent

weeks, prompting the slaughter of chickens at farms across the region to

contain the virus. South Korea alone has killed 24 million chickens and

ducks.

WHO said the virus has mutated since an outbreak in Hong Kong in 1997, when

six people were killed in the first documented case of the virus jumping to

humans and the deadliest episode until this year's outbreak.

The mutations complicate the search for a vaccine. The virus strain isolated

from the 1997 outbreak can no longer be used to produce the medicine, the

health organization said.

Scientists believe people get the disease through contact with sick birds.

Although there has been no evidence of human-to-human transmission in the

latest outbreak, health officials are concerned the disease might mutate

further and link with regular influenza to create a form that could trigger

the next human flu pandemic.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Bird Flu Outbreak Is Deadliest Ever

http://apnews.myway.com/article/20040127/D80B1BMO6.html

BANGKOK, Thailand (AP) - Thailand confirmed Asia's eighth human victim of

the bird flu Tuesday in the deadliest outbreak on record, while the map of

affected areas widened with Laos becoming the ninth government to report

infections in its poultry.

Australia, which remains free of the virus, urged other countries to

immediately reveal bird-flu cases, following allegations that Thailand and

Indonesia initially covered up outbreaks.

" Countries in the region must learn from the SARS experience, and that is:

'Fess up as soon as you find a case, as quickly as possible, " Australian

Foreign Minister Alexander Downer told Australian Broadcasting Corp. radio.

" Make sure everybody knows about it and deal with it. "

The virus has jumped to humans in two countries.

Thailand's Public Health Ministry confirmed that a six-year-old boy died

from the disease Tuesday, becoming the country's second fatality and the

region's eighth, following six deaths in Vietnam. Thai officials awaited lab

results on five other deaths believed linked to the virus.

Thailand's first death, announced Monday, also was a six-year-old boy, who

had carried a dying chicken to a butcher.

Thai officials planned an international meeting Wednesday in Bangkok to

discuss strategies for combatting the illness. Nearly a dozen governments,

including China, United States and the European Union, were expected to send

representatives, Thai officials said.

The scope of this year's outbreak has widened alarmingly, with countries

reporting new outbreaks in poultry stocks for each of the past three days.

Indonesia joined the list of affected countries on Sunday, Pakistan on

Monday and Laos on Tuesday. The Laos Livestock Department director Singkham

Phounvisay said tests confirmed the virus there after reports of hundreds of

chickens being sickened.

So far, nine governments have reported some strain of bird flu: Cambodia,

Indonesia, Japan, Laos, Pakistan, South Korea, Taiwan, Thailand and Vietnam.

Some countries claim their version of bird flu is milder than the one that

has jumped to humans.

The World Health Organization believes the virus can be transmitted across

regions by migratory water fowl.

Tens of millions of chicken and other poultry have been infected in recent

weeks, prompting the slaughter of chickens at farms across the region to

contain the virus, and tight controls on poultry imports. South Korea alone

has killed 24 million chickens and ducks since its outbreak surfaced in

December.

WHO said the virus has mutated since an outbreak in Hong Kong in 1997, when

six people were killed in the first documented case of the virus jumping to

humans and the deadliest episode until this year's outbreak.

The mutations complicate the search for a vaccine. The virus strain isolated

from the 1997 outbreak can no longer be used to produce the medicine, the

health organization said.

Scientists believe people get the disease through contact with sick birds.

Although there has been no evidence of human-to-human transmission in the

latest outbreak, health officials are concerned the disease might mutate

further and link with regular influenza to create a form that could trigger

the next human flu pandemic.

Following weeks of denials in Thailand, the government confirmed on Friday

that the disease had struck the Thai countryside, sparking allegations of a

cover-up.

" The government knew, so why didn't they tell the public so that we could

protect ourselves? " said farmer Chamnan Boonmanut, whose 6-year-old son

Captan Boonmanut died from the disease after being sickened in early

January.

Other farmers had alleged for weeks that the government was hushing up

Thailand's outbreak to protect poultry exports, and said flu vaccines for

chickens might have stemmed the problem.

The European Union criticized Thailand for " non-transparency " in dealing

with the outbreak and said it would demand independent verification that

bird flu had been eradicated in Thailand before it lifts the ban on chicken

imports imposed last week.

Indonesian officials have denied reports alleging that the government

initially covered up an outbreak at the behest of companies with poultry

export interests.

The allegations have led to comparisons with last year's worldwide outbreak

of severe acute respiratory syndrome, which emerged in late 2002 in southern

China. Critics faulted China for not being forthcoming enough about the

disease during the early stages.

~~~~~~~~~~~~~~~~~~~~~~~~

Bird Flu Global Response Sought

http://www.cnn.com/2004/WORLD/asiapcf/01/27/bird.flu/index.html

BANGKOK, Thailand (CNN) -- World health experts have called for a SARS-like

response to a bird flu pandemic as two more Asian nations reported outbreaks

of the disease.

Laos and China are the latest to have reported instances of the rapidly

spreading virus that has now killed at least eight people and forced the

slaughter of tens of millions of chickens.

Thailand confirmed its second fatality from bird flu, local television

reported. A 6-year-old boy confirmed to be infected with the virus in

northern Sukhothai province died Tuesday at a hospital in Phitsanulok

province.

The boy had been hospitalized since mid-January, the iTV television station

reported.

In Europe, three global agencies called for international economic and

technical help -- similar to the worldwide response to SARS -- to combat the

spread of the disease.

" With SARS, we learned that only by working together can we control emerging

global public health threats, " said Dr. Lee Jong-wook, director-general of

the World Health Organization in Geneva.

The Food and Agriculture Organization (FAO) in Rome and the Organization for

Animal Health (OIE) in Paris joined WHO in the call for a global response.

Unlike SARS, Lee said, diagnostic tests for bird flu already exist, as do

effective, although costly, antivirals for humans.

" This is a serious global threat to human health, " he said. " We must begin

this hard, costly work now. "

The victims have all been people who handled infected birds. There has been

no evidence of human-to-human transmission. The disease cannot be passed by

eating cooked birds, experts say.

In addition to the human health threat, the flu would be an economic

disaster for the poultry industry and poultry farmers who must now kill

infected and exposed birds, said Dr. Jacques Diouf, director-general of the

FAO.

Those people, he said, will " require support to compensate for such losses. "

" This will represent a huge cost, especially to struggling economies and

small farmers, " he said. " The international community has a stake in the

success of these efforts and poorer nations will need help. "

Laotian health and agriculture officials said Tuesday the infection has been

detected in chickens in and around the capital of Vientiane but not in

humans.

Local authorities in China reported detecting the disease on private farms

in the Guangxi and Hubei provinces, the official Xinhua News Agency said,

adding that labs in Beijing were still testing the dead birds.

Ducks that died on January 23 in Guangxi province were examined by local

veterinarians, and authorities concluded they died of bird flu, the agency

reported. Authorities sealed the farm and slaughtered 14,000 fowl within a 3

kilometer radius of the farm.

On Monday, authorities in Hubei province found cases on private poultry

farms and slaughtered and disinfected the farms according to " proper "

methods, the agency said.

The Chinese government reported these cases to WHO and FAO, but neither

agency has confirmed them.

The flu also has been discovered in Pakistan, Japan, South Korea, Vietnam,

Cambodia and Indonesia. A different strain of bird flu has been detected in

Taiwan.

Humans have been infected only in Vietnam and Thailand so far, although

officials in Cambodia said Monday that two boys who played with chickens are

suspected of having the virus.

If the disease mutated enough to allow human-to-human transmission, health

experts warn the virus could become a bigger health crisis than SARS. That

virus killed nearly 800 people worldwide last year.

WHO said a vaccine for bird flu is at least six months away because the

disease keeps mutating. The agency also is highly concerned because the

virus appears resistant to cheaper antiviral drugs used to treat regular

influenza.

" This is now spreading too quickly for anybody to ignore it, " WHO spokesman

Peter Cordingley said.

A conference starting Wednesday in Bangkok, Thailand, will try to come up

with an coordinated global approach to the bird flu threat.

Attending the meeting will be the 10 ASEAN countries -- Brunei, Cambodia,

Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and

Vietnam -- as well as China, South Korea and Hong Kong.

" We are looking to this conference for a return, if you like, to the spirit

of SARS, " Cordingley told CNN.

The latest outbreak of a strain of H5N1 avian influenza has been marred by

accusations of cover-ups by government officials in Thailand and Indonesia.

Thai officials only confirmed the presence of the flu on Friday after days

of denying accusations from farmers and opposition legislators that the

nation had been hit by the disease.

Indonesia also has been under pressure to explain its actions after

researchers there said signs of the flu had been in the republic since

September. Indonesia revealed it had an outbreak on its hands on Sunday.

Singapore, meanwhile, has banned the public from visiting any poultry farms

or slaughterhouses and stepped up monitoring of Malaysian imports to keep

the bird flu out of the island state.

-

KD Weber

Monday, January 26, 2004 11:19 AM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

Bird flu resistant to basic drugs

Indonesia 7th country in Asia to confirm outbreak of deadly human virus

Thai Boy Is Bird Flu's Seventh Fatality

http://apnews.myway.com/article/20040126/D80AGG580.html

BANGKOK, Thailand (AP) - A 6-year-old Thai boy became Asia's seventh

confirmed bird flu fatality, and Pakistan on Monday joined the list of

countries affected by the disease that has sparked mass chicken culls across

the region.

The World Health Organization pleaded Monday with the global scientific

community to accelerate the search for a cure. Attempts to tackle the virus

are being frustrated by its fast rate of mutation as well as its spread

across at least eight countries.

Pakistan said it had detected a form of bird flu in its chicken population.

The commissioner for livestock husbandry said it was not a strain of bird

flu that can spread to humans - something that has happened in other parts

of Asia.

" We have confirmed this. The strand that jumps to humans is not in them, "

commissioner Rafaqat Hussain Raja said.

(AP) A Cambodian woman buys chicken in a market in Phnom

Penh, Cambodia Saturday, Jan. 24, 2004. ...

Full Image

Faizullah Kakar, an official at the WHO office in Pakistan, said it had no

confirmation of an outbreak of bird flu in the South Asian nation.

Laos, meanwhile, fears it might also be hit by the bird flu and is awaiting

test results on the nature of an illness killing its fowl, the U.N. Food and

Agriculture Organization said.

Other Asian governments frantically slaughtered chicken flocks in a

desperate bid to contain the disease, as well as the growing political

fallout from accusations that officials in two countries - Thailand and

Indonesia - initially covered up outbreaks.

Dr. Prasert Phongcharoen, a WHO adviser and viral disease expert, urged

caution in the disposal of the chicken carcasses. If infected chickens are

thrown in rivers, " the virus could spread to open pig farms and this could

result in transmission from pigs to humans, " he said.

Officials in Bangkok said they were investigating whether the virus might be

being carried by migratory birds.

(AP) A Chinese man unloads chickens at a market in

Guangzhou, southern China, Saturday, Jan. 17, 2004....

Full Image

The Thai boy, Captan Boonmanut, became infected after he played with

chickens in his village a in the central Kanchanaburi province. He died

Sunday night in a Bangkok hospital, Thailand's first confirmed death from

the virus.

Six people have died in neighboring Vietnam and Thai officials are trying to

determine whether bird flu was also the cause of last week's death of a

56-year-old man who had bred fighting cocks.

Thailand's Public Health Ministry also said Monday that four other people

suspected of having bird flu had died in the northern Sukhothai province,

but it was awaiting lab results to confirm whether they had the avian

influenza virus.

The WHO said a search for a cure had been set back because the virus had

mutated. A previous strain detected in Hong Kong in 1997 can no longer be

used as the key to producing a vaccine. It said an international effort was

needed.

Scientists believe people get the disease through contact with sick birds.

Although there has been no evidence yet of human-to-human transmission,

health officials are concerned it might mutate further and link with regular

influenza to create a form that could be transmitted from person to person,

triggering the next human flu pandemic.

(AP) A Chinese man holds feathers near chickens at a

market in Guangzhou, southern China, Saturday, Jan....

Full Image

" This is now spreading too quickly for anybody to ignore it, " said WHO

spokesman Peter Cordingley in Manila.

So far eight countries have reported bird flu - Thailand, Cambodia, South

Korea, Japan and Taiwan are also affected and Indonesia admitted it had a

problem on Sunday.

Indonesian officials had earlier denied the disease's presence, but the

country's veterinarian association said independent investigations had

revealed that bird flu had killed millions of chickens over recent months.

The Jakarta Post reported Monday that Indonesian officials may have covered

the outbreak there at the behest of politically connected businessmen who

feared it would harm their interests. Indonesian officials denied the

allegations.

" It's not true. We have zero tolerance for pressure from businessmen. We are

talking about the lives of people, " Agriculture Department spokesman Hari

Priyono said.

The Thai prime minister, Thaksin Shinawatra, faced similar allegations that

he covered up his country's outbreak.

Thaksin has said that his government had suspected " a couple of weeks " ago

that bird flu had struck his nation but that he didn't tell the public

because he feared mass panic.

Thailand has killed some 9 million chickens so far.

The outbreak has devastated Thailand's chicken export industry - the world's

fourth largest. Thailand shipped about 500,000 tons of chicken worth $1.3

billion in 2003.

Vietnam has slaughtered more than 3 million chickens.

-

KD Weber

Sunday, January 25, 2004 9:42 PM

UPDATE: Avian influenza outbreaks/Crossover to humans/Avian

influenza as a biological weapon

http://news.ft.com/servlet/ContentServer?pagename=FT.com/StoryFT/FullStory & c

=StoryFT & cid=1073281281191 & p=1012571727085

Thailand brings in troops to fight bird flu

By Amy Kazmin in Bangkok

Published: January 25 2004 11:09 | Last Updated: January 25 2004 11:09

The Thai government on Sunday sent soldiers and prisoners to slaughter

millions of chickens, as it struggled to control the damage caused by its

belated admission that its poultry industry had been hit by the deadly bird

flu.

The Thai move to cull chickens came as fears mounted that the virus,

which has already killed six people in Vietnam, was spreading across the

region. Indonesia became the seventh Asian country to reveal cases of flu

among its chickens.

Confronting allegations that the government had covered up the illness

sweeping Thai poultry farms for months, Prime Minister Thaksin Shinawatra

acknowledged that officials had suspected the bird flu outbreak for weeks -

but said they wanted to avoid public panic in the absence of hard evidence.

" I couldn't have said it was bird flu as long as lab results didn't

come out, " the premier said in his weekly radio address. " I didn't want to

create panic. "

Thailand, the world's fourth-largest poultry exporter, has invited

senior Asian health and agricultural officials and representatives from

international agencies to discuss how to stop the spread of the epidemic now

affecting Thailand, Taiwan, Japan, South Korea, Cambodia, Vietnam and

Indonesia.

At the meeting, scheduled for Wednesday, Bangkok is likely to be

heavily criticised for its role in allowing the deadly disease to spread.

International food safety experts say the test to determine whether

chickens are infected with the H5N1 virus, which causes bird flu, takes less

than a day, undermining Bangkok's claims that it had no proof of the virus.

" The government's efforts to sweep the problem under the carpet have

exploded in its face, leaving the poultry industry in tatters and the very

safety of the public in jeopardy, " the Bangkok Post newspaper said in a

weekend editorial.

The World Health Organization on Saturday confirmed that a 13-year-old

Vietnamese boy who died on Thursday was the sixth confirmed bird flu

casualty in the country. An 8-year-old girl who had tested positive for the

virus is also critically ill.

On Friday, Thailand acknowledged that two Thai children were infected

with the virus and that a 56-year-old chicken farmer was also suspected to

have died from the disease. It said it had already slaughtered an estimated

7m chickens last week prior to its public admission of the outbreak.

The WHO has expressed deep concern about the threat posed by the bird

flu, calling the extent of its current simultaneous spread " historically

unprecedented. "

While the disease - usually confined only to fowl - has so far only

infected people in direct contact with chickens, health experts fear that

the virus could mutate into a form that could be transmitted through human

contact, potentially creating a deadly pandemic that could kill millions of

people.

" The opportunity for the virus to reform itself into something even

more aggressive and dangerous to humans has most likely never been higher, "

Robert Dietz, a WHO spokesman in Hanoi said yesterday.

The WHO also warned that those people carrying out the mass cull of

chickens in Thailand were at risk of infection unless they wore protective

clothing, including respiratory masks.

-

KD Weber

Sunday, January 25, 2004 4:32 PM

Avian influenza outbreaks/Crossover to humans/Avian influenza as a

biological weapon

Workers throw bags containing chickens into a dump site in Soong Peenong

district, Supanburi province, Thailand Sunday, Jan. 25, 2004.

Thailand's prime minister said Sunday that the government suspected for 'a

couple of weeks' that the country was facing an outbreak of bird flu, but

decided not to tell the public to avoid causing panic. (AP Photo/Apichart

Weerawong)

Bird Flu Vaccine Not Likely for 6 Months

By DANIEL LOVERING, Associated Press Writer

BANGKOK, Thailand - Asia's bird flu virus is resistant to key anti-influenza

drugs, and an effective vaccine is probably more than six months away, the

World Health Organization (news - web sites) said Sunday, as Indonesia

confirmed it had become the seventh country in the region with an outbreak.

The WHO said it would launch a massive funding appeal to help Asian nations

destroy millions of chickens in an attempt to stem the disease. Experts

warned that if the mass slaughter is improperly carried out, it might only

help the virus' jump from fowl to humans.

In Indonesia, bird flu has affected millions of chickes, said Sofjan

Sudardjat, a senior Indonesian Department of Agriculture official. But the

virus has not crossed over to humans, he said.

Vietnam and Thailand are the only countries this year where humans have

caught the avian flu, with six confirmed deaths in Vietnam and one suspected

fatality in Thailand.

But the virus has hit millions of chickens in five other countries as well -

raising concerns it might mutate, link with regular influenza to create a

form that can be transmitted from human to human, fostering the next human

flu pandemic.

World Health Organization spokesman Dick Thompson warned that the H5N1 virus

in humans appears to be resistant to amantadine and rimantadine, the cheaper

anti-viral drugs used to treat regular influenza.

" This is a disease that's appearing in the developing world. So what you

want is affordable drugs, " said Thompson in Geneva. " Should this move from

human to human - and it hasn't yet, I want to stress that - then it's going

to be a real challenge. "

Last week, WHO influenza chief Dr. Klaus Stohr said other anti-viral drugs

still appeared to work against the bird flu virus in humans.

WHO also reported that the virus, thought to be highly adaptable, had

already mutated - setting back hopes for creating a vaccine, which the

organization had said might be ready within four weeks.

" I don't think we're looking at a workable vaccine within six months. That's

too late for the influenza season in Asia but it would be available, "

regional WHO spokesman Peter Cordingley told The Associated Press in the

Philippines.

" It could be available for next winter's flu season ... It's not promising

this year, " he added.

On its Web site, a WHO statement said new strains that haved appeared were

" significantly different from other H5N1 strains isolated in Asia in the

recent past, thus necessitating the development of a new prototype strain

for use in vaccine manufacturing. "

Asia is on a region-wide health alert, with governments slaughtering

millions of chickens to contain outbreaks in Thailand, Vietnam, Cambodia,

South Korea (news - web sites), Japan and Taiwan.

On Sunday, China - which has so far reported no cases of bird flu - banned

all poultry from Thailand and Cambodia, two days after cases of the virus

were confirmed in both Southeast Asian nations.

China is eager to show its resolve in proactively battling bird flu,

particularly after last year's severe acute respiratory syndrome epidemic

brought the communist government under criticism for its initial guarded

response.

Hundreds of Thai soldiers, wearing rubber gloves, boots, colorful shower

caps and safety masks, helped clear farms of chickens in Thailand's

Suphanburi province - the area hardest hit by an outbreak of bird flu.

" It's not dangerous, but don't be neglectful, " Deputy Agriculture Minister

Newin Chidchob said as he briefed soldiers lined up at the village hall.

" The safety masks may be uncomfortable because you're not used to them, but

don't even think of taking them off. "

Some 450 troops were joined in the operation by 60 prisoners from the

provincial jail. In Thailand, prisoners are sometimes called out to dig

ditches, repair sewage works and perform other manual public service labor.

WHO backs a poultry cull in affected countries as the best way to wipe out

the disease. But Thompson said that if the mass slaughter is not funded and

handled properly it could make things worse, so the U.N. organization will

appeal for international donations to ensure it's carried out correctly.

" Safety's the key. You don't want the virus to start mixing in humans. If

you send a lot of humans in to do culling you'd be exposing them, unless

they wear protective clothing and goggles - something many poor nations can

ill-afford, Thompson said.

" It's going to be an enormous burden on the developing world to do safe

culling, " he said. " We're also going to be asking for assistance for

reimbursement to pay backyard farmers when we ask them to kill off their

investment in their poultry stock and give them a reasonable incentive to do

that. "

Thai officials, following weeks of denial, acknowledged the virus' presence

this week after poultry farmers claimed not enough was being done to stop

the disease from spreading from nearby countries.

In a weekly radio address, Thai Prime Minister Thaksin Shinawatra

acknowledged Saturday that the onset of the virus in Thailand could

devastate the country's chicken export sector - the world's fourth largest.

Thailand shipped about 500,000 tons of chicken worth $1.3 billion in 2003.

But the 15-nation European Union (news - web sites) and Japan - Thailand's

biggest markets for poultry - and several other countries also have

announced poultry bans.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Thaksin admits human bird flu cases 'highly likely' - JAN 23, 2004

..... call several weeks ago to import bird-flu vaccine, much of ... of a

government cover-up

over bird flu, said on ... H5N1 swops genes with a common flu virus,

creating a ...

http://straitstimes.asia1.com/latest/story/0,4390,231395,00.html - Cached

Bird Flu Hits Indonesia, WHO Concerned Over Drug Resistance

Thailand admits hiding avian flu

Concealed outbreak for 'a few weeks' to avoid public panic

--New York Times

Nations Ban Poultry Imports to Contain Avian Flu Reported in Six Asian

Countries

WHO Suggests Quarantine for Bird Flu

GENEVA (AP) -- The World Health Organization said Friday that people hit by

the bird flu outbreak sweeping Asia should be quarantined to avoid contact

with sufferers of regular influenza, because a combination of the two

viruses may accelerate the spread of the disease....

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Avian influenza H5N1 infection in humans: urgent need to eliminate the

animal reservoir - update 5

www.who.int/csr/don/2004_01_22/en/

22 January 2004

Epidemics of highly pathogenic avian influenza, caused by various H5N1

strains, have been reported in parts of Asia since mid-December 2003.

Millions of domestic poultry have either died or been destroyed as a result.

Thousands of workers have been involved in the culling operations.

The current situation is of serious concern for human health as well as for

agriculture and the poultry industry. Rapid elimination of the H5N1 virus in

bird populations should be given high priority as a matter of international

public health importance.

WHO is collaborating closely, at high levels, with FAO and the World

Organisation for Animal Health (OIE) to ensure that appropriate measures in

the agricultural sector are introduced as a matter of urgency, and in the

interest of protecting public health at the international level. Joint

investigations are currently under way in Viet Nam.

Of all the avian influenza viruses, which normally cause infection in birds

and pigs only, the H5N1 strain may have a unique capacity to cause severe

disease, with high mortality, in humans.

The simultaneous occurrence in several countries of large epidemics of

highly pathogenic H5N1 influenza in domestic poultry is historically

unprecedented. The present situation may grow worse. In bird populations,

the disease is highly contagious and rapidly fatal, and spreads easily from

farm to farm. Wild migratory waterfowl can spread infection to domestic

flocks. The potential for further spread of ongoing poultry epidemics, both

within affected countries and to other countries, is therefore great.

For all these reasons, the H5N1 strain may be more widely established in

bird populations and in the environment in this part of the world than

presently appreciated. Studies have shown that infected birds can shed large

amounts of the virus in their faeces. The virus can survive for long periods

in the tissues and faeces of diseased birds and in water, especially when

temperatures are low. In water, the virus can survive for up to four days at

22oC and more than 30 days at 0oC. The virus survives in frozen material

indefinitely.

The large epidemics of highly pathogenic avian influenza currently seen in

poultry, and possible widespread presence of the virus in the environment,

increase opportunities for human exposure and infection. They also increase

opportunities for human and avian influenza viruses to exchange genes This

can occur when humans are simultaneously infected by human and avian

influenza viruses. The frequency of such co-infections increases the

likelihood that a completely new influenza virus subtype might emerge,

carrying sufficient human genes to allow efficient and sustainable

person-to-person transmission.

Research has shown that the risk of direct transmission of H5N1 infection

from birds to humans is greatest in persons having close contact with live

infected poultry. Contact with poultry kept in live markets is considered

the source of infection for 17 of the 18 human cases of H5N1 infection that

occurred in Hong Kong in 1997. The additional case - the first in the

outbreak - has been linked to contact with poultry at farms experiencing

epidemics of highly pathogenic avian H5N1 influenza. Six of the 18 cases

were fatal.

Occupational exposure can occur among poultry workers, and among workers

involved in culling operations.

Rapid elimination of the H5N1 virus in animal populations is an essential

measure to prevent the emergence of a new influenza virus subtype with

pandemic potential. This measure not only helps prevent further spread in

bird populations, but also reduces opportunities for human infection.

However, in the present situation, the problem of controlling all human

exposures is compounded by the large number of " back yard " farms where

chickens are kept in rural areas.

While rapid culling of infected or exposed flocks is strongly recommended,

prevention of infection during culling operations must also be given high

priority. Culling operations can place large numbers of workers at risk of

brief but intensive exposure to the virus.

In 1997, Hong Kong authorities culled the entire poultry population, an

estimated 1.5 million birds, within three days. This rapid and comprehensive

action is thought by many experts to have averted an influenza pandemic.

Culling operations were performed by trained government workers, most of

whom wore protective masks, gloves, and gowns. Although subsequent

investigation detected H5 antibodies, indicating exposure to the virus, in

around 3% of persons involved in the culling of infected poultry, no case of

severe respiratory disease was detected as a result of this exposure.

In the Netherlands in 2003, an outbreak of highly pathogenic H7N7 avian

influenza in poultry caused infection, with mild illness, in 83 persons, and

fatal illness in a veterinarian. An estimated 30 million poultry were culled

within a week.

Further information about highly pathogenic avian influenza is available in

a WHO fact sheet, at the FAO web site , and the OIE web site . Information

on safety precautions during culling operations will be issued soon by the

WHO Regional Office for the Western Pacific.

Laboratory characterization of the 2004 H5N1 viruses

Laboratories in the WHO Global Influenza Surveillance Network have today

discussed results from the sequencing and antigenic characterization of H5N1

strains isolated from humans and poultry in Viet Nam. Initial results show

significant differences between these viruses and strains obtained during

outbreaks of H5N1 avian influenza in Hong Kong, in 1997 and 2003, indicating

that the virus has mutated.

Work continues on the updating of WHO diagnostic kits for the rapid

detection of H5N1 infection in humans, and on the development of a prototype

virus for use in vaccine manufacturing. Viruses from birds in other

currently affected countries are urgently needed in order to conduct

additional laboratory investigations. Such investigations are part of the

information needed by WHO to recommend and develop a vaccine strain that can

protect humans against circulating H5N1 strains.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

CDC

Influenza A (H5N1) Outbreak in Vietnam

www.cdc.gov/flu/about/h5n1outbreak.htm

Recent Influenza A (H5N1) Cases

The Government of Vietnam has reported hospitalized cases of severe

respiratory illness in people from provinces surrounding Hanoi beginning in

October 2003. Avian influenza A (H5N1) virus infections have been confirmed

is some of these patients. Deaths have been reported. (Visit www.who.int/en/

for updated case counts.)

Influenza A (H5N1) viruses normally circulate among wild birds but can

infect poultry and rarely have infected people in the past. In 1997, 18

persons in Hong Kong were hospitalized because of influenza A (H5N1)

infections and six of them died. In 2003, two residents of Hong Kong who

traveled to China developed influenza A (H5N1) virus infections and one of

them died. In Vietnam, large outbreaks of influenza A (H5N1) have been

reported among poultry in the southern and northern regions of the country.

WHO has reported that the H5N1 strain implicated in the outbreak has now

been sequenced. All genes are of avian origin, indicating that the virus

that caused death in the three confirmed cases had not yet acquired human

genes. The acquisition of human genes increases the likelihood that a virus

of avian origin can be readily transmitted from one human to another.

H5N1 Outbreak Investigation

The World Health Organization (WHO) is coordinating an investigation in

Vietnam. Staff from CDC have traveled to Vietnam to work with WHO and

Vietnam's human and animal health authorities to evaluate the situation,

including patterns of transmission of the influenza A (H5N1) viruses. The

investigation will focus on determining specific characteristics of

influenza A (H5N1) viruses isolated from human cases and poultry and on

determining how people became infected. In addition, increased surveillance

will help investigators determine how many people in Vietnam already have

been infected with the influenza A (H5N1) virus and whether other people are

continuing to be infected.

During December 2003, an outbreak of avian influenza A (H5N1) was reported

among poultry in South Korea. In the second week of January, Japan reported

the deaths of 6,000 chickens on a single farm in the western part of Honshu

due to influenza A (H5N1) virus infection. No human cases of infection with

the avian influenza virus have been reported in either of these outbreaks.

CDC Recommendations

U.S. residents who are traveling outside the United States should consult

their physician for advice about which vaccines they should obtain. In

Vietnam and in other tropical regions, influenza can occur at any time

during the year. Thus, persons who are at increased risk of developing

influenza-related complications and healthy persons who wish to decrease

their risk of becoming ill with influenza should receive the 2003-04

trivalent influenza vaccine. The vaccine will protect against three viruses

and offers some protection against variants of them as well.

At this time CDC and WHO have not issued any travel alerts or advisories for

Vietnam. However, travelers to Vietnam are advised to avoid contact with

animals in live food markets and any surfaces that appear to be contaminated

with feces from poultry or other animals. For more information about topics

related to travelers' health, visit www.cdc.gov/travel/.

Enhanced U.S. Influenza Surveillance

At this time, CDC recommends enhanced surveillance efforts by state and

local health departments, hospitals, and clinicians to identify patients who

have been hospitalized with unexplained pneumonia, ARDS, or severe

respiratory illness AND who have traveled to Vietnam, South Korea, and Japan

within 10 days from onset of symptoms.

CDC will make additional recommendations on enhanced surveillance if

influenza A (H5N1) activity continues to evolve.

More Information About Influenza

For further details about the reported cases of influenza A (H5N1) in

Vietnam, see the WHO Web site www.who.int/en/. Additional information about

influenza is available on the CDC Web site at www.cdc.gov.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Experts Fear Global Bird Flu Outbreak

story.news./news...he_big_one

By DANIEL Q. HANEY, AP Medical Editor

With luck, the world will escape the latest outbreak of bird flu with no

more than the six human deaths already blamed on it and the loss of millions

of chickens. But public health experts worry of a much greater disaster: A

catastrophe they say is among the worst imaginable, a global outbreak of an

entirely new form of human flu.

There is no clear sign that will happen. Nevertheless, avian influenza's

sudden sweep through Asia, along with its tendency for wholesale mutation,

leave many wondering about the bug's potential for rampant spread among

humans. It is a possibility the medical journal The Lancet calls " massively

frightening. "

" The question everybody is asking is, 'Is this the progenitor to a

pandemic?' " says Dr. Gregory Poland, chief of vaccine research at the Mayo

Clinic.

Influenza pandemics typically strike three or four times a century. The

worst in the past 100 years, the 1918-19 Spanish flu, caused an estimated 40

million to 50 million deaths. Another is considered inevitable and perhaps

overdue, but when it will happen and how bad it will be are almost totally

unpredictable.

The nightmare this time would be a flu virus leaping from birds to people

and spreading, introducing a disease for which humans have no natural

defense.

The potential source is the strain of bird flu that has moved rapidly

through parts of Asia since December, infecting chickens in at least six

countries.

Millions of birds have died of the flu or were destroyed by workers trying

to contain the outbreak. The World Health Organization (news - web sites)

says eliminating this " animal reservoir " is urgent.

Avian flu is naturally carried by wild ducks, and it ordinarily does not

attack creatures other than birds or pigs, so experts are especially

concerned that this bird flu is occasionally infecting people. (ED NOTE:

See

LAKEPORT, CALIFORNIA: Massive avian cholera kill

http://www.record-bee.com/Stories/0,1413,255~26901~1912220,00.html

The effort to pick up hundreds of ruddy ducks killed by avian cholera

continues. )

Human cases have been reported in Vietnam and Thailand, including six deaths

as of Saturday in Vietnam, the WHO said, and one suspected death in

Thailand. Experts believe all caught the virus from chickens, not other

people.

" We know there are two possible ways a new pandemic strain can emerge, " said

Dr. Steve Ostroff, deputy director of the National Center for Infectious

Diseases at the Centers for Disease Control and Prevention (news - web

sites). One is a human flu virus that resurfaces after years of dormancy, so

people have no defense built up from earlier bouts. The other is a non-human

variety acquiring the ability to infect people and spread.

The latter may happen if somebody already infected with a human flu virus

also catches the bird virus. Inside the body, these two may recombine into a

new mutant, part-human virus, part-bird.

The more people are around infected chickens and other birds, experts say,

the more chances there are for such a disaster to occur.

" If the virus continues to spread in chickens, it may adapt itself so it can

grow in humans, " says Dr. Arnold Monto, a University of Michigan

epidemiologist. " If it is transmitted human to human, then we are concerned

this is the start of the great pandemic. "

The first time an avian flu virus was found to have infected people was in

Hong Kong in 1997. At least 18 people fell severely ill and six died.

Experts believe a pandemic may have been averted that time by the rapid

slaughter of Hong Kong's entire poultry supply - an estimated 1.5 million

birds killed in three days.

That flu virus was the H5N1 variety, one of 15 known subtypes of avian flu.

The WHO calls it worrisome for several reason: It mutates rapidly and tends

to acquire genes from flu viruses in other animal species; it is clearly

dangerous to people; and it spreads quickly. Infected birds give off the

virus for at least 10 days in their feces and oral secretions.

H5N1 appeared again last February, when two members of a family returning to

Hong Kong from China became ill. One died and the other recovered. How and

where they got infected was never learned.

The disease now circulating in Asia is the same H5N1, but it is so

widespread that a quick purging, like Hong Kong accomplished seven years

ago, is unlikely. Testing shows it has mutated but has not yet picked up any

genes from human flu viruses.

If a bird flu pandemic occurs, could it be stopped? Many experts fear not.

Flu is so contagious that quarantining victims, a method that eventually

contained SARS (news - web sites) last year, is unlikely to work.

Studies suggest that prescription drugs used to treat human flu strains

could also keep people from catching the bird flu. However, spot shortages

were reported during this winter's U.S. flu outbreak, and supplies would

quickly run out during a pandemic. No country has stockpiled the drugs,

Tamiflu, Relenza and the older amantadine and rimantadine.

The WHO is already working on a prototype vaccine against the bird flu. But

even the standard annual flu shot takes six months to manufacture, and

experts doubt a new vaccine could be ready in time.

If there is evidence the bird flu is producing significant illness in

humans, " there would be a full-bore effort to produce a vaccine, " says the

CDC's Ostroff. " It's hard to predict the timeliness of it and how widely it

could be put into people's arms. "

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Highly Pathogenic Avian Influenza (Fowl Plague)

Last updated January 23, 2004

http://www.cidrap.umn.edu/cidrap/content/biosecurity/ag-biosec/anim-disease/

avianflu.html

Agent

Hosts

Epidemiology

HPAI As a Biological Weapon

Clinical Features

Differential Diagnosis

Laboratory Diagnosis

Treatment

Prevention

Outbreak Control

Public Health Issues

References

Agent

Avian influenza can occur in two forms: highly pathogenic avian influenza

(HPAI), also known as fowl plague, and low-pathogenic avian influenza

(LPAI). Both forms are caused by influenza type A virus. HPAI spreads

rapidly among flocks and often is highly fatal. Conversely, LPAI generally

does not cause severe disease and is more commonly seen in US poultry

flocks.

Viral classification and genetic composition

a.. Family: Orthomyxoviridae

b.. Genus: Influenza

a.. Virions 80 to 120 nm in diameter

b.. May be filamentous

c.. Eight different segments of negative-stranded RNA; allows for

genetic reassortments in single cells infected with more than one virus and

may result in multiple strains that are different from the initial ones (see

References: PHS, Voyles 2002)

c.. Types: A, B, and C

a.. Type designation is based on the antigenic character of the M

protein located in the virus envelope and the nucleoprotein within the virus

particle.

b.. Influenza A virus causes human, swine, equine, avian, and marine

mammal influenza and is the type associated with pandemic disease in humans.

c.. Influenza B virus causes disease in humans only.

d.. Influenza C virus causes a relatively mild illness in both humans

and swine and occurs uncommonly.

e.. HPAI and LPAI are caused by influenza A viruses.

d.. The virus envelope glycoproteins have hemagglutinin (HA) and

neuraminidase (NA) activity; these characteristics are used to subtype the

A, B, and C viruses.

a.. For influenza A viruses, there are 15 different HA antigens (H1 to

H15) and nine different NA antigens (N1 to N9).

b.. Only subtypes H5 and H7 of influenza A virus have caused HPAI.

c.. The H5 and H7 strains also are identifiable according to a nucleic

acid sequence at the hemagglutinin cleavage site (see References: PHS).

Environmental Survival of HPAI Virus

a.. Influenza A virus remains viable at moderate temperatures for long

periods in the environment and can survive indefinitely in frozen material.

It can survive for 4 days in water at 22°C and for over 30 days at 0°C (see

References: PHS).

b.. Inactivation of the virus occurs under the following conditions (see

References: OIE 2002, PHS):

a.. Temperatures of 56°C for 3 hours or 60°C or more for 30 minutes

b.. Acidic pH conditions

c.. Presence of oxidizing agents such as sodium dodecyl sulfate, lipid

solvents, and B-propiolactone

d.. Exposure to disinfectants: formalin, iodine compounds

Back to top

Hosts

It is likely that all birds are susceptible to HPAI. Species that have been

shown to be susceptible either experimentally or naturally include:

a.. Chickens

b.. Turkeys

c.. Ducks

d.. Partridges

e.. Pheasants

f.. Quail

g.. Pigeons

h.. Ostriches and other ratites

i.. Geese

j.. Guinea fowl

Migratory waterfowl, sea birds, shore birds, and imported pet birds have

been found to be carriers of highly-pathogenic influenza A viruses without

clinical signs.

As noted above, influenza A viruses also cause illness in humans and other

animal hosts (pigs, horses, sea mammals, and mustelids).

Back to top

Epidemiology

Transmission

a.. Routes of infection include:

a.. Oral

b.. Conjunctival

c.. Respiratory

b.. Vertical transmission is not known to occur

c.. Common modes of infection include:

a.. Direct transmission through secretions (feces, respiratory

secretions) of infected birds

b.. Broken contaminated eggs in incubators infecting healthy chicks (see

References: OIE 2002)

c.. Movement of infected birds between flocks

d.. Fomites such as contaminated equipment, egg flats, feed trucks, and

clothing and shoes of employees and service crews (see References: APHIS,

Beard 1998)

e.. Contact with wild birds and waterfowl, which appear to be natural

reservoirs for the virus

f.. Fecal contamination of drinking water

g.. Garbage flies (suspected of transmitting the virus during the

1983-1984 epidemic in Pennsylvania) (see References: Beard 1998)

h.. Airborne transmission if birds are in close proximity

The disease is highly contagious. One gram of contaminated manure can

contain enough HPAI virus to infect 1 million birds (see References: APHIS).

As stated above, waterfowl, ostriches and other ratites, shore birds, sea

birds, and other wild birds can act as carriers of the virus. These birds

may not show clinical signs but shed the virus.

Occurrence

Because HPAI usually arises from an LPAI virus that has mutated at its

hemagglutinin surface proteins, it is difficult to define specific areas

where the disease is endemic. HPAI types of virus have been isolated from

free-living birds in Europe and other regions; however, there is no

recognized wild bird reservoir for the HPAI subtypes of the virus.

a.. Apathogenic and mildly pathogenic influenza A viruses occur worldwide.

b.. Some H5 and H7 viruses are of low pathogenicity.

c.. Because of a lack of appropriate laboratory facilities in many parts

of the world, it is difficult to accurately determine the actual incidence

of HPAI in the world's poultry flocks (see References: Beard 1998).

Outbreaks of HPAI have occurred throughout the world:

a.. An H5 strain affected Pennsylvania in 1983 and caused severe clinical

disease and high mortality rates in chickens, turkeys, and guinea fowl (see

References: Beard 1998).

a.. A serologically identical but apparently mild virus had been

circulating in poultry in the area for 6 months (see References: Beard

1998).

b.. A total of 17 million birds were culled.

c.. Retail egg prices increased by 30 cents (see References: APHIS).

b.. An H5N1 strain of AI was responsible for a significant outbreak of

influenza in humans and domestic poultry in 1997 in Hong Kong.

a.. Prior to this outbreak, H5N1 was not known to infect humans.

b.. Six human deaths were attributed to this strain.

c.. The virus was isolated from chickens, and mortality rates were high.

d.. A total of 1.5 million birds were culled in 3 days.

e.. A monitoring system was instituted for birds in live markets.

c.. An H7N1 strain occurred in the Veneto region of Italy in December

1999.

a.. A total of 30,000 turkeys died or were destroyed to contain the

outbreak.

b.. In 1998, H5N2 strains of the virus were responsible for at least

eight outbreaks on Italian farms (see References: APHIS).

d.. Other countries that have had outbreaks include Australia (H7),

England (H7), South Africa (H5), Scotland (H5), Ireland (H5), Mexico (H5),

and Pakistan (H7).

e.. A Hong Kong man died in February 2003 from bird flu (H5N1), the first

human case reported since 1997 (see below), and his son contracted the

disease as well. Health officials are working to develop a vaccine to H5N1

in humans (see References: Cyranoski 2003).

f.. An outbreak of HPAI occurred in the Netherlands in 2003. Over 28

million birds out of a total 100 million birds in the country were killed.

There were reports of over 80 human cases, and one veterinarian died. The

disease spread to Belgium but was quite rapidly contained.

g.. An outbreak in Asia started in January 2004 and continues to spread.

So far, it involves South Korea, Vietnam, Japan, Thailand, and Cambodia. Of

special concern is that fact that in Vietnam and Thailand, the avian strain

(H5N1) has now been confirmed in several cases of fatal human respiratory

disease. Low-pathogenic avian influenza (H5N2) has been identified in

Taiwan.

Back to top

HPAI As a Biological Weapon

HPAI is considered a potential biological weapon because of the following

factors:

a.. Extremely contagious

b.. High mortality rate

c.. Severe economic consequences of an outbreak:

a.. Large numbers of birds are destroyed or die.

b.. Control measures disrupt trade of poultry products from affected

areas.

c.. Prices of retail poultry products may increase significantly.

d.. Virus has a high potential for genetic mutations and for new strains

to arise and affect new species

a.. The Hong Kong epidemic of 1997 and the associated human cases

demonstrate the ability of the virus to affect humans and birds.

Back to top

Clinical Features

The clinical signs of HPAI are severe and result in high mortality rates in

many species of birds, especially domestic fowl. As mentioned above,

waterfowl, ratites, and other birds may not be as susceptible to clinical

signs, but can act as carriers for the virus.

Clinical Features of Highly Pathogenic Avian Influenza in Animals

Feature

Characteristics

CHICKENS

Incubation Period

3-7 days

Clinical signs

-Sudden death

-Severe depression with ruffled feathers

-Inappetence

-Drastic decline in egg production

-Edema of head and neck

-Swollen and cyanotic combs and wattles (see Gray Book figure 25 and

figure 26 [References: Beard 1998])

-Petechial hemorrhages on internal membrane surfaces

-Excessive thirst

-Watery diarrhea that begins as bright green and progresses to white

-Swollen and congested conjunctiva with occasional hemorrhage

-Diffuse hemorrhage between hocks and feet (see Gray Book figure 27

[References: Beard 1998])

-Respiratory signs are dependent on tracheal involvement

-Nasal and ocular discharge

-Mucus accumulation (varies)

-Lack of energy

-Coughing/sneezing

-Incoordination

-Nervous system signs such as paralysis

Complications

-Cessation of egg production, and eggs laid immediately prior to

infection often soft-shelled and misshapen

-Surviving birds are in poor condition and resume laying only after a

period of several weeks

Case-fatality rate

-Can be as high as 100%

-Death may occur prior to any symptoms or as late as a week after

symptoms, though it is frequently within 48 hr

TURKEYS

Incubation period

3-7 days

Clinical signs

-Sudden death

-Severe depression with ruffled feathers

-Inappetence

-Drastic decline in egg production

-Edema of the head and neck

-Swollen and cyanotic combs and wattles

-Petechial hemorrhages on internal membrane surfaces

-Excessive thirst and evidence of dehydration

-Watery diarrhea that begins as bright green and progresses to white

-Swollen and congested conjunctivae with occasional hemorrhage

-Diffuse hemorrhage between hocks and feet

-Respiratory signs are dependent on tracheal involvement

-Nasal and ocular discharge

-Mucus accumulation (varies)

-Lack of energy

-Coughing/sneezing

-Incoordination

-Nervous system signs such as paralysis

-Sinusitis

-Dehydration

Complications

-Decrease in egg production

-Sudden death

-Surviving birds are in poor condition and resume laying only after a

period of several weeks

Case-fatality rate

-Can be as high as 100%

-Most turkeys die within 3 to 10 days

DOMESTIC DUCKS AND GEESE

Incubation period

3-7 days

Clinical signs

-Signs of depression, inappetence, and diarrhea similar to those seen

in layers

-Swollen sinuses

-Neurologic signs in younger birds

-Sinusitis

Complications

-Decrease in egg production

-Sudden death

-Surviving birds are in poor condition and resume laying only after a

period of several weeks

Case-fatality rate

As high as 100%

Adapted from Aeillo 1998, APHIS, Beard 1998, Capua 2001, OIE 2002,

PHS) (see References).

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UPDATE: Avian influenza outbreaks/Crossover to humans/Avian influenza as a biological weapon

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