Latest news about bird flu (avian influenza)

31-10-2004

World Unprepared for Avian Flu, Experts Warn

The current U.S. flu vaccine shortage shows perfectly how poorly the world is prepared to handle the next global epidemic of influenza, health experts said on Sunday.

There are few vaccines or drugs to fight the flu and it takes months to make them, so when the pandemic comes it could wreak havoc for a long time, the experts told a conference.

"We believe with the current influenza vaccine supply issues, it illustrates perfectly the message that we'd like to get across," said Dr. Kathleen Neuzil of the University of Washington School of Medicine.

To prepare for a pandemic, countries first have to be ready for the regular yearly epidemics of influenza. That means having vaccines, drugs and data on whom the disease sickens and kills, she told the joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.

Dr. Klaus Stohr, influenza coordinator for the World Health Organization, believes the world is overdue for a pandemic that could kill millions, and he believes the H5N1 virus now killing off tens of millions of birds in Asia is the most likely source.

Flu pandemics -- global epidemics of new strains of disease that kill an unusually high number of people -- come on average every 27 years. The last one was in 1968.

"We are 36 years out. We believe that we are closer to the next pandemic than we ever were," Stohr told a news conference.

"There is this new subtype in Asia circulating in poultry. It appears it is only a question of time until this subtype moves into humans."

FROM POULTRY TO PEOPLE

So far the H5N1 flu has infected 44 people and killed 32 of them, Stohr said. Other studies presented to the conference show the virus has not yet acquired the ability to move from human to human.

Once it does, experts agree, it could spread quickly and kill millions.

In an average year, influenza kills between 500,000 and a million people globally, Stohr said -- stressing that this is a low estimate. No figures are available from developing countries with poor health care.
Avian influenza could kill many more than that. Scientists believe most strains of influenza originate with ducks or poultry and mutate to move into people.

The best way to fight such a new flu would be to quickly vaccinate against it, Neuzil said. But only the United States is working on such a vaccine, through National Institutes of Health contracts to Aventis Pasteur Inc and Chiron Corp, under which 2.4 million doses will be produced.

Chiron's woes with standard influenza vaccine show just how badly wrong things can go. British regulators stopped Chiron from selling flu vaccine made at its plant in Liverpool earlier this month because of contamination.

That meant the United States did not get 48 million of an expected 100 million flu shots and forced government officials to scramble to scrape up a few million more doses.

Drugs that can fight flu are also in short supply. There are four -- Roche's oseltamivir or Tamiflu, amantadine, rimantadine and zanamivir, sold by GlaxoSmithKline under the brand name Relenza.

Stohr said WHO had just 120,000 doses of amantadine and rimantadine. Roche only has 4 million doses of Tamiflu available and there are even fewer doses of Relenza.

But there could be some good news. Widespread use of Wyeth's Prevnar pneumococcal vaccine in U.S. children has meant fewer adults, especially old people, are developing deadly infections caused by the bacteria targeted by the vaccine, another group of experts told the conference.

WHO: Ducks could transmit bird flu

The World Health Organization or WHO warns that bird flu might be transmitted from ducks to humans, even though they show no external signs of having the disease.

The UN health agency's influenza chief Dr. Klaus Stohr says experiments in the United States show that unlike chickens, seemingly healthy ducks can also infect humans, China Radio International reported on Monday.

He suggests governments urgently invest in research to discover just how widespread bird flu is in domestic ducks, adding that no human cases can be directly traced to ducks.

The deadly H5N1 strain of bird flu appeared throughout Asia early this year, ravaging poultry farms and sparking a region-wide health scare.

Authorities in Asia culled tens of millions of birds in an attempt to thwart the spread of the disease, but it resurfaced in July.

25-10-2004

Passers-by ignore car crash victims because of Thailand bird flu fears

Bird flu fears in Thailand prevented passers-by from helping four people injured in an accident between a drunk-driver and a pick-up truck full of chickens, rescue officials said on Sunday.

The four were left unattended late Saturday despite dozens of motorists stopping because up to 500 live and dead chickens were scattered around the wrecked vehicles, said rescue officials in the southern province of Nakhon Si Thammarat.

"A lot of people were watching but nobody wanted to help because they were scared of the disease," a volunteer rescue official told AFP. He said it took rescuers hours to collect the chickens after the four accident victims were taken to hospital in stable condition.

The accident happened one day after a Thai tiger zoo reported 83 of the beasts had either died or been culled after becoming infected with the deadly bird flu virus.

Six Asian nations have reported a resurgence of the virus amid fears that the disease has become endemic in the region.

Thai tigers culled over bird flu

More than 50 tigers in a Thai zoo have been put down after they showed symptoms of bird flu. The animals became sick after eating raw chicken carcasses believed to have been infected with the virus. Before the outbreak began, the Sriracha Tiger Zoo in Chonburi province housed more than 400 endangered tigers, but 80 have now died or been culled.

No keepers have succumbed to the virus, and the WHO said the outbreak among tigers had no implications for humans.

According to wildlife officials, 32 of the tigers in the zoo actually died of the H5N1 bird flu virus earlier this week, and more than 50 were put down after showing signs of the disease. "We had to perform mercy killings on those tigers because they were in critical conditions," said Preecha Ratanaporn. But he indicated that the worst of the outbreak was now over, saying: "We are monitoring four or five more of these tigers. If they show no symptoms in a week, we can declare the zoo free of bird flu."

Sriracha Zoo has been closed to the public since Tuesday, and the remaining tigers are reportedly being fed pork instead of chicken.

The Thai government - like several others in the region - has battled a string of bird flu outbreaks this year. At least 11 Thai people are known to have died after contracting a human form of the disease. More than 100 million birds have been culled across south-east Asia in an attempt to control the virus.

20-10-2004

Thailand confirms 23 tigers die of bird flu

Lab test confirmed that 23 tigers in a private zoo in eastern Thailand have died of infecting with avian influenza virus, officials said here on Tuesday. "All the 23 tigers have infected with H5N1 virus of bird flu," Charal Trinvuthipong, director of the Bird Flu Prevention and Elimination Center, told reporters.

The tigers might have infected with the virus for being fed with raw chicken in the Sri Racha Tiger Zoo, some 80 kilometers east of Bangkok, said Deputy Prime Minister Chaturon Chaisang. Tigers in the private zoo started to show flu symptoms since last Thursday and altogether 23 have died until Tuesday. Some 400 tigers kept by the private zoo are usually fed with raw chicken. Now, at least 30 tigers have fallen ill and more are feared to die of the disease, while the zoo has been closed. Five tiger caretakers at the zoo also showed symptoms of flu and have been sent to hospital for medical examinations.

Earlier this year, a clouded leopard was infected with and died of the poultry epidemic in eastern Thailand.

Having been hit by two rounds of bird flu outbreaks, the kingdom has suffered great economic loss including at least 30 million birds culled in the first outbreak and more than 100 million US dollars have been spent for compensation.

The epidemic also claimed the lives of 11 Thais during the two outbreaks and the kingdom has been fully alerted over a "probable human-to-human transmission" case.

Describing tackling the disease as the country's top priority, Thai Prime Minister Thaksin Shinawatra earlier set Oct. 31 as the deadline to eradicate bird flu from Thailand. The country is now undertaking a national campaign to switch open-field duck feeding to closed system so as to eradicate the disease.

Ducks raised in open fields are a crucial source of the H5N1 strain of bird flu and the poultry epidemic situation is feared to deteriorate in the coming cold season. Ducks can carry the flu virus and they are strong enough to remain alive, and the virus can live in water sources for up to 30 days.

The next step for the Thai government is to monitor fighting cocks and chickens raised at backyard.

In late September, the United Nations Food and Agriculture Organization (FAO) and the World Organization for Animal Health (OIE) jointly issued a statement, warning that the disease will notbe eradicated from the region in the near future and asking for more investment to solve the problem.

19-10-2004

More bird flu outbreaks in southern Vietnam

Bird flu has broken out again in four provincial areas of southern Vietnam.

An official from the Ministry of Agriculture says more than 3000 poultry died from the disease in four provinces from October 4 to 16, China Radio International reported Monday.

The Ministry of Agriculture has warned the farmers in the areas and asked the local governments to report weekly on the situation.

The Vietnam government will give out new measures to prevent new outbreak of bird flu.

Bird flu has killed or forced the cull of more than 43 million chickens in Vietnam.

The disease has killed 20 people in Vietnam and 11 in Thailand.

Thai gov't vetoes budget on bird flu vaccine research

The Thai government has vetoed a budget plan for bird flu vaccine research, local press reported on Wednesday.

Under the plan, the government was asked to set a budget of 300 million baht (about 7.5 million US dollars) to build a new laboratory on bird flu vaccine research. The proposal, put forward by the Agriculture Ministry, was rejected Tuesday by the government in line with its policy of not using or producing bird flu vaccine, said Government spokesman Jakrapob Penkair.

"It did not want to send mixed signals on the issue," he was quoted by Bangkok Post as saying, referring to the possible influence of vaccine use over trade.

Having been hit twice by avian influenza, Thailand is cautious over the topic of vaccine. In early August, the government banned the use of bird flu vaccine for fear of negative influence over public health and poultry trade.

The use of vaccine could prevent large-scale outbreaks of the poultry epidemic, but there is fear that the practice will trigger mutation that is even more difficult to deal with. The United Nations Food and Agriculture Organization earlier said it's still a problem with open answer.

Thailand, which has lost millions of orders, is also afraid that any development on the vaccine issue will deteriorate the country's poultry export. In the first bird flu outbreak lasting more than three months, Thailand, the world's fourth largest poultry exporter, suffered a loss of no less than 880 million US dollars. The major buyers such as Japan and the European Union (EU) havenot fully lifted their ban on the kingdom's poultry imports. The EU also warned it would extend its ban on Thai chickens if the country carried on vaccine experiment. The kingdom does not ban the use of human vaccine to prevent infection of the virus and the Cabinet on Tuesday approved a 900-million-baht (22.5 million dollar) budget to immediately tackle the epidemic

13-10-2004

Malaysia investigates oil platforms for possible bird flu outbreaks

Malaysia is investigating the deaths of birds on several oil platforms located off northeast Terengganu state, amid fears of a bird flu outbreak.

The veterinary services department says its officers are taking samples from the birds to test for the deadly H5N1 strain of bird flu, which has killed at least 30 people in Vietnam and Thailand this year.

Malaysia's first case of the H5N1 strain of bird flu was detected in August in a village in Kelantan, Terengganu's neighbouring state, which also borders Thailand.

It quickly spread to other areas in Kelantan, prompting the government to impose a quarantine on the state. There have been no new cases of bird flu in birds and poultry since late September.

Birds from Taiwanese ship spark Cebu bird flu scare

by Jasmin R. Uy

A regional veterinary quarantine officer had warned people who were able to acquire “marked” pigeons coming off a ship from Taiwan, which docked at the Cebu International Port yesterday morning, to be vigilant.

Port workers, while unloading cargoes from the M/V Ocean Park, were surprised to see a number of pigeons emerging from the vessel’s container vans, flying out of the ship and landing at the pier.

This caused a brief commotion among people at the pier who caught some of these birds, each of which have leg and wing bands with Chinese markings on them.

Quarantine officer Pablo Balite said his office got 16 of these, prompting him to call on those who got some of these birds to be forewarned while his office has yet to verify where these came from and what those bands are for.

Balite received reports that some of those who caught their share of the flock of birds had either brought them home or sold them to other people.

He surmised that these pigeons had flown and rested on the cargo area as the vessel left the Taiwan port then stayed there throughout the length of the voyage to Cebu.

Taiwan has been declared as free from the dreaded bird flu virus but Balite said he is not sure what those markings mean and their purpose so he would like to verify first while calling on those people who got these birds to take precaution at the moment.

Balite said his office had already taken some samples from the body of the pigeons to be sent to Manila for examinations and be certain that these are not carriers of the bird flu virus.

“We could not say that these birds are really contaminated unless we already have results of the tests from Manila,” he said.

He assured the public, however, not to take the wrong impression that the birds are infected since Taiwan is already bird flu virus-free.

“We need not worry about this. What I am trying to say is we just need to be vigilant since we are not sure yet on the background of these migrating birds,” Balite said.

Avian flu task force formed, disease returns to Indonesia

Southeast Asian nations have agreed to band together to coordinate response to the deadly avian influenza outbreak that has caused 31 human deaths and widespread poultry losses.

Agriculture ministers from the Association of South East Asian Nations (ASEAN) concluded a 2-day meeting with a statement Friday that said the H5N1 avian flu is threatening "global public health, poultry production, trade and economic development," according to a Reuters news service story. They plan to create a task force focused on the disease.

ASEAN's member countries are Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. Two of those countries have made independent announcements about bird flu this week.

Avian influenza has returned to Indonesia, where hundreds of chickens were killed last week, according to Thursday's Jakarta Post. But an Indonesian official announced that the flu strain responsible for poultry deaths there couldn't be spread to humans, according to news reports.

Agriculture Minister Tri Satya Putri Naipospos, director of animal health, said on Wednesday that tests conducted in Hong Kong found that the H5N1 flu strain in Indonesia differed from the flu that has killed people in Thailand and Vietnam this year. It was of a genotype that does not infect humans, Naipospos was reported as saying.

The World Health Organization (WHO) countered the claim.

"We know of no studies that would support that kind of contention," WHO spokesman Dick Thompson told Reuters. "A closer reading of the study would indicate that H5N1 can infect humans no matter which strain we are talking about."

A WHO expert told Agence France-Presse the situation was a case of misinterpretation. That news agency quoted the WHO's Steven Bjorge as saying that Indonesia's virus differs somewhat from the virus in Vietnam and Thailand, but it is still part of the same Z genotype that has caused deaths in the latter countries.

Also on Wednesday, Vietnam announced it had contained its latest avian flu outbreak, according Agence France-Presse.

"Basically, Vietnam has successfully controlled bird flu. Over the past 20 days, no new cases of bird flu have been reported in Vietnam," Bui Quang Anh, a spokesman for the Ministry of Agriculture and Rural Development, told Agence France-Presse.

Anh also told the agency that the Vietnamese government was not covering up avian influenza despite its refusal to release test results conducted on a 14-month-old boy who died Sep 5. Avian influenza was suspected in his death, the story said.

05-10-2004

Thai girl dies as bird flu re-emerges

A young girl has become the third person to have died from the latest wave of bird flu virus sweeping Thailand.

Our South East Asia correspondent, Peter Lloyd, says the death of the nine-year-old brings to 11 the number of people to have died from the disease in Thailand this year.

The government put the country on high alert last week after it reported an earlier bird flu victim died after probably contracting the virus from her daughter.

She was the first in this outbreak believed to have caught the disease from another human, rather than from poultry.

Tests are still continuing to try to confirm that the girl had flu and to discover if the disease has mutated into a more contagious and lethal form that could trigger a wider health crisis.

A mutated bird flu outbreak was blamed for the deaths of as many as 40 million people worldwide in 1918.

Thai Prime Minister Thaksin Shinawatra has launched a so-called "war on bird flu" and given officials until the end of the month to eradicate the disease.

The World Health Organisation has cast doubt on the deadline but praised the government's effort to send officials into all 76 provinces to detect any sign of bird flu.

04-10-2004

Not yet a nightmare: fear flutters in land of sick birds

When the chickens started dying in Ban Srisomboon, no one panicked. Birds died mysteriously in the village each year. But this was different. Every one of the 400 households lost birds, and then the children got sick.

Pranom Thongchan, 32, buried her dead birds and rang her sister Pranee to say her daughter, Sakuntala, was running a fever. "My sister came home, stayed two nights", and then went to the hospital to care for Sakuntala, Pranom said at the hospital in Kamphaeng Phet, the provincial capital.

Pranee nursed her 11-year-old daughter until the end, holding her as she coughed up blood through the mouth and nose, the English-language newspaper The Nation reported. The cause of death was listed as dengue fever and the girl's body was cremated.

Less than two weeks later, on September 20, Pranee, too, was dead, at the age of 26.

Her cause of death was listed as avian influenza, probably transmitted by her daughter.

Pranom fell ill with flu symptoms four days before her sister died. She is a confirmed case, but recovered enough to lie propped up in bed and nibble at fruit.

Her seven-year-old son, Kittipong, a suspected bird flu case, was released from hospital on Wednesday. The hospital has four other suspected cases. With the virus re-emerging in 35 of Thailand's 76 provinces, the human-to-human transmission, combined with authorities' inability to stamp out the virus in chickens, ducks, pigs
and migratory birds, is causing concern.

The World Health Organisation said it may take years to bring the virus under control in poultry. A few dead chickens in any village will lead to all its chickens being killed. Since July, more than 800,000 chickens have been killed.

"It's not yet a nightmare, because we have to continue to study this," said Dr Thraveesak Khanutwong, director of the Khanu Voraluksaburi Community Hospital, where Sakuntala was initially admitted. "We can't confirm if it is human to human transmission or not."

In Ban Srisomboon, there are stories that there are many more human deaths than the Government will admit to.

"The chickens in this area fell sick and died all over. They started dying house by house," said Taw Laempakvan, Pranom's mother-in-law.

Last week, 21 days after Sakuntala died, men in white suits and gas masks descended on Ban Srisomboon to kill the surviving chickens. It took three days to bag and bury the 2000 birds.

On a raised wooden platform under his grandparents' stilt house, Kittipong sleeps in a rough hammock. His grandmother, Taw Laempakvan, rocks the little boy, and discusses her options. "If we are [scared], what can we do? Where can we go? I have nowhere to go, so I will stay here and raise my grandson."

Thailand finds bird flu in dog for the first time

Asia's deadly bird flu has been found in a dog for the first time in Thailand, authorities said on Sunday.

Health Ministry spokeswoman Nittaya Chanruangmahaphol told Reuters that the H5N1 virus was discovered in a dog in the southeastern province of Prachinburi, where previous cases had been found in humans and poultry.

"We have found that a dog was infected by the H5N1 virus," she said, adding the case was confirmed by laboratory tests conducted at two Thai universities.

She gave no further details, but Thai newspapers reported on Sunday that the dog was still alive.

Thailand reported its first probable case of human transmission of bird flu last week.

A campaign ordered by Prime Minister Thaksin Shinawatra to wipe out the virus by the end of October started last week.

So far, 92 areas in 28 provinces are under bird flu watch, of which 50 areas were confirmed to have been hit by the virus, Livestock Department officials say.

Dutch researchers reported last month that cats can get the avian influenza virus, which means pets are at risk of getting and spreading the disease.

01-10-2004

Thai outbreak has health officials rushing to thwart a possible pandemic

A day after Thai and international officials confirmed the first probable human-to-human transmission of a virulent strain of avian influenza in this country, public health systems around the globe were scrambling to prepare for a possible pandemic.

Scientists say they cannot predict how quickly, if at all, the strain may develop the ability to spread easily among people, and whether it will remain as lethal as it has proven so far. The strain, A(H5N1), has killed 30 of the 42 Southeast Asians it infected in the past year, and millions of chickens, wild birds and other animals across wide areas of Asia.

A handful of cases of human-to-human transmission may have occurred during bird flu outbreaks in Hong Kong in 1997 and in Europe a year ago, but neither resulted in a pandemic.

Not taking any chances
Nevertheless, public health experts say it would be irresponsible not to prepare for a worst-case scenario. The so-called Spanish Flu pandemic of 1918 to 1919 — believed, like the current strain, to have been a mutant virus that jumped from animals — killed an estimated 20 million to 100 million people.

By comparison, AIDS has killed an estimated 22 million since 1981, according to the United Nations.

On Wednesday, the World Health Organization convened a meeting in Geneva of representatives of the drug industry to demand that they speed vaccine production.

In the United States, scientists with the federal Centers for Disease Control and Prevention in Atlanta are racing to complete a genetic sequence of the virus from this case to determine if it has acquired any mammalian influenza genetic material, which could make it more transmissible, and the government has ordered 2 million doses of experimental vaccine.

Untested vaccines
Health officials would normally look to vaccines and antiviral drugs to control a pandemic, but in this case, those tools have yet to be fully developed and tested.

Conventional flu vaccines are not believed to provide any protection against A(H5N1) avian influenza.

Human trials of the new vaccine ordered by the U.S. government are not expected to begin until the end of this year, at the earliest.

The United States, like governments in Australia, Japan, New Zealand and a small number of other countries, is also stockpiling the only antiviral medicine that may work against the strain, Tamiflu, but there have been too few human cases to document its effectiveness. The symptoms of human bird flu appear to be indistinguishable from severe cases of conventional flu, with fevers, sneezing, coughing and aches.

Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, said that the U.S. government is "doing everything that is technically and feasible to be done at this time — essentially, loading up and stockpiling Tamiflu to the extent of almost exhausting the manufacturer's capabilities."

But the absence of a tested vaccine and the scarcity of the antiviral underline what many health officials say a chronic mismatch of public health needs and private control of production of vaccines and drugs.

"The market has failed here to drive companies into research, and we believe that's something public health should be looking at much more closely in the future," said Klaus Stoehr, the WHO's top influenza expert, before the meeting on Wednesday.

Advanced techniques
Only Aventis Pasteur Inc. of Swiftwater, Pa., and the Chiron Corp. of Emeryville, Calif., are braving a thicket of patent issues and financial feasibility concerns to try to use advanced genetic techniques to develop vaccines against so-called bird flu. And they have proceeded only with National Institute of Health contracts to do so.

Other drug makers have given reasons for not making their own vaccines: that production is expensive and investment may not be recouped if there is no pandemic, and that intellectual property rights concerning new techniques used to make the vaccine remain unsettled.

Fears of liability
Drug makers also worry that putting out a new vaccine without lengthy safety tests could expose them to liability.

Because the clinical trials have not been done, "nobody can go into full-scale production now, nobody," Stoehr said.

When vaccines are not available, doctors can turn only to the antiviral Tamiflu, but it is expensive and may work only if it is administered in the first two days.

Drawing on lessons from past pandemics, Fauci, the federal official, said that an avian influenza pandemic might start with an initial, so-called sentinel wave of cases in one region of the world. The epidemic, if it occurs, might not become a global problem until the following year, giving drug manufacturers time to respond.

By KEITH BRADSHER and LAWRENCE K. ALTMAN

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