Bird Flu news round-up in November 2005

News clippings about Bird Flu in December 2005.

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Glaxo seeks rule change to fight pandemic flu

GlaxoSmithKline Plc is seeking dispensation from international regulators to help in the fight against a future flu pandemic, its chief executive said in an interview published on Saturday.

Jean-Pierre Garnier told the Financial Times that authorities including the U.S. Federal Trade Commission needed to waive their usual rules to allow vaccine producers to work together.
"We'd like to cooperate with other manufacturers to make vaccines but the U.S. needs to clear that with the FTC and the Food and Drug Administration," he said.
Cooperation would breach current antitrust rules but could allow flu vaccine manufacturers to collaborate in order to maximize production of the best vaccine that any of them was able to produce, he said.
Glaxo is currently racing against other vaccine makers, such as Sanofi-Aventis SA and Chiron Corp, to produce a vaccine able to fight any pandemic strain of flu that might arise from bird flu.
Experts fear the H5N1 strain of bird flu will mutate just enough to allow it to pass easily from person to person. If it does so, it could cause a catastrophic pandemic, killing tens of millions of people, because humans lack immunity to it.
Garnier also told the paper that all employees at Glaxo and their families would have access to Relenza, the company's inhaled antiviral drug that can help reduce the severity of flu.

Beijing invents bird flu virus killer

A Beijing-based university has invented a water generator which can kill the H5N1 strain of bird flu completely, the university reported Thursday.

The "killer", called "HTDJ-15 acid oxidizing potential water generator", was invented by Hantong Science and Technology Company of Beijing Union University.

This new sterilizer can convert water into disinfectant which, by keeping PH scale below 2.7, can kill all the animalcules.

In addition, the used disinfectant can be deoxidized into ordinary water, causing no harm to human skin and environment.

This invention has just been approved and certified by the country's Ministry of Health, the State Drug Administration and the State Intellectual Property Office respectively.

The water generator as a sterilizer is currently in extensive use abroad, such as in hospitals, restaurants and hotels.

BULGARIA BANS POULTRY IMPORT FROM TURKEY AGAIN

For the second time in the past two months Bulgaria’s Agriculture and Forestry Minister Nihat Kabil banned poultry import from Turkey.

The ban was enforced on Thursday due to the new case of bird flu registered in Southeastern Turkey, close to the border with Armenia and Iran. Dead birds were found there two days ago and Turkish veterinarian experts immediately warned neighbouring countries.

The import of poultry products ceased as a preventive measure, Dnevnik newspaper reported.

Bulgarian border authorities will return all poultry products that have not undergone thermal processing. The bird flu virus dies when exposed to temperatures higher than 70 degrees Celsius, experts said. Two months ago the first import ban on Turkish poultry products was imposed. Bulgaria enforced a partial ban in October due to suspicion of bird flu spread in Turkey.

Clean poultry supplies sufficient for Tet

There will be a plentiful supply of clean chickens for sale during the forthcoming Tet, the traditional lunar New Year festival, that will fall in late January, said head of the Veterinary Department Bui Quang Anh.

Anh added that the avian flu vaccination campaign for around 240 million poultry in Viet Nam will be completed in the next few days. As of Jan. 10, the number of safe poultry for sale will increase considerably. Chickens will be vaccinated for the second time 14 days before being sold.

To have enough safe chicken for Tet, the Prime Minister has assigned the Trade Ministry to buy safe poultry for concentrated slaughtering and processing and to work with other concerned sectors to open more stores selling safe poultry.

According to the Veterinary Department, 15 communes in six provinces infected by avian flu have yet to pass through the 21-day period, the duration for an infected locality to be declared free from the disease.

Since early October, avian flu has broken out in 285 wards and communes in 24 provinces, leading to the culling of a total of 3,959,040 quails, chickens, geese, pigeons and other birds.

Ukraine says bird flu stopped, lifts emergency state

President Viktor Yushchenko lifted the state of emergency in Ukraine's Crimea as an outbreak of the deadly H5N1 bird flu in the region has been eliminated, a presidential decree said on Thursday.

Ukraine reported its first outbreak of the disease in a dozen villages on the peninsula, a major stopover point for migratory birds, in late November.
The president invoked a state of emergency in a half dozen villages and ordered a mass cull of domestic birds.
The number of villages affected by mass deaths of birds rose to about 30, but authorities have noted no new cases since mid-December.
"The document has been signed because the bird flu outbreak was eliminated and work to seize and destroy poultry in the Sovietsky, Nizhnyogirsky and Dzhankoi regions of Crimea have been completed," said a statement on the presidential Web site www.president.gov.ua.
Officials have said more than 62,000 birds were destroyed.
Bird flu is endemic in poultry in parts of Asia where it has killed more than 70 people. Though hard for people to catch, experts fear it could mutate into a form which passes easily from person to person.

Bad vaccines may trigger China bird flu

China is most likely using substandard poultry vaccine or not enough good vaccine, which would explain recent outbreaks of the deadly H5N1 bird flu virus in poultry, a prominent virologist said on Thursday.

Thirty-one counties in China have reported outbreaks of the H5N1 in poultry this year, although only one county remains under isolation and there have been no new outbreaks for three weeks, according to Chinese state media.
But the fear among experts is that the virus could mutate from a disease that largely affects birds to one that can pass easily between people, leading to a human pandemic.
Dr Robert Webster, of St Jude's Children's Hospital in Memphis, Tennessee, said the problem of substandard vaccines was not exclusive to China.
"If you use a good vaccine you can prevent the transmission within poultry and to humans. But if they have been using vaccines now (in China) for several years, why is there so much bird flu?" Webster told Reuters in Hong Kong.
"There is bad vaccine that stops the disease in the bird but the bird goes on pooping out virus and maintaining it and changing it. And I think this is what is going on in China.
"It has to be. Either there is not enough vaccine being used or there is substandard vaccine being used. Probably both."
Webster praised China's ambitious plan to vaccinate all its chickens, but also called for agricultural vaccines to be standardized.
"It's not just China. We cant blame China for substandard vaccines. I think there are substandard vaccines for influenza in poultry all over the world," he added.
Since late 2003, there have been 141 confirmed human cases of the deadly H5N1 strain of bird flu, all of them in Asia, including six in China. Two people have died from bird flu in China, out of 73 known fatalities in Asia.
BEAST
Webster warned against underestimating the virus, which he said has exhibited some of the worrying characteristics of the Spanish flu virus of 1918-1919, which killed an estimated 50 million people.
"If you go back to 1918, it showed that there are about 10 critical amino acids in that virus that seemed to be necessary (for the virus) to be pathogenic," Webster said.
"Many of those changes have been seen in the H5N1, but not all together. Individually, these have been out there.
"If you get all of these 10 all in together in one (H5N1) virus, to get 10 amino acids all lined up in the right order, yes the chances are very, very small that it could happen, but it could happen you see," he said.
Webster said it was not surprising that some strains of the H5N1 have been found to be resistant to Tamiflu, Roche AG's drug that is believed to be capable of reducing the symptoms and chances of complications caused by the virus.
"That's the nature of the beast, there is nothing special about this one. Flu viruses change every time they multiply, they make mistakes, these mutations occur naturally," he said.
It was now crucial to find the cure -- the right doses, duration of treatments and combining Tamiflu with a few other anti-viral drugs, such as amantadine and rimantadine.
"It is important to realize that the H5N1 cases in China recently are also sensitive to the old-fashioned drugs amantadine and rimantadine. So we need to be thinking more about combinations of these drugs, combinations of amantadine, rimantadine and Tamiflu," Webster said.

Quarantine in bird flu town

BIRD flu has been found in dead chickens in Turkey, authorities revealed today.

Officials said the chickens tested positive for an H5 variant of bird flu and placed parts of an eastern town under quarantine.

The virus was first detected on Monday following tests on samples taken from the town of Aralik, in the Igdir province bordering Armenia, where deaths of chickens have been reported in recent days, the Agriculture Ministry said.

Authorities have already culled 360 chickens to prevent it from spreading and said "all necessary measures were being taken".

The statement said samples would be sent to labs in Europe to see if the virus is H5N1, which is being tracked worldwide out of fear it could mutate into a form that is easily transmitted to humans.

Bird flu scare frightens visitors

A weekend bird flu scare at Wentworth, in southern New South Wales, has deterred some tourists from visiting the town.

A property on the Victorian border became the first to be quarantined in Australia after a chicken's death raised concerns there could be avian influenza in a backyard poultry flock.

Veterinarians cleared the flock on Saturday, saying the sick chicken that sparked the scare had died from the common Marek's disease.

Wentworth Shire Mayor Marg Thompson says the scare has led to some cancellations at the caravan park but that tourists should feel welcome to return to the town.

She says she is pleased the matter was resolved so quickly.

"I am pleased about that - probably any shire would rather not have any negative publicity but it only took a day to sort out so we're very happy about that," Ms Thompson said.

Banks provides loans to poultry slaughtering and processing

State commercial banks are required to be responsible for providing loans for concentrated poultry slaughtering and processing establishments that are allowed to develop the business.

A circular on guiding the provision of loans for the purpose, signed by Governor Le Duc Thuy of the State Bank of Viet Nam, stipulated that banks can provide loans worth VND15 million for a tonne of frozen poultry for a period of three months and VND20 million for a tonne of canned poultry products for a period of six months with interest rates of zero percent.

The Veterinary Department reported that by Dec. 24, 14 provinces had no new outbreaks of bird flu over the past three weeks, and 26 communes in seven provinces infected by avian flu have not yet passed through the 21-day period, the duration for an infected locality to be declared free from the disease.

Spain provides fund to WHO to fight bird flu

The Spanish government has agreed to give the World Health Organization (WHO) some 2.4 million U.S. dollars to help the organization's anti-bird flu programs, local media reported on Friday.

The WHO is developing international structures of support mostly to Asian and African countries to halt the spread of the disease and help them adopt measures to protect their people.

At the same time, Spain is giving some 1.2 million dollars to European Union's research program to develop anti-Human Immunodeficiency Virus (HIV) vaccines, as part of the European and Developing Country Trail Program whose activities include research and development of technologies used to fight malaria, tuberculosis and HIV.

Bird flu virus resistance not a cause for alarm: WHO

Signs that the H5N1 bird flu virus may be developing resistance to frontline drug Tamiflu in some patients are not necessarily a cause for alarm, a senior World Health Organization official said in Geneva Thursday.

Keiji Fukuda, a scientist at the WHO's global influenza programme, said some resistance was inevitable with any kind of drug.

"Whenever you use any kind of drugs, antivirals or antibiotics, you expect to see resistance develop in organs. Finding some resistance in and of itself is not surprising and is not necessarily alarming," he said.

But findings published in the New England Journal of Medicine that four of eight patients treated in Viet Nam for bird flu infections had died despite the use of Tamiflu indicated that more research was needed into how best to use the drug, Fukuda said.

"It just points out the need for more information... What really is critical is understanding whether the way we are using the drugs contributes to that (resistance)," he added.

Tamiflu, made by Swiss firm Roche, remained an "excellent choice" among a limited number of antivirals available against the deadly virus, the WHO official said.

Shanghai Pharmaceutical Group last month became the first in Asia to secure a licence from Roche to produce a generic variety of Tamiflu.
Tamiflu losing effect over H5N1, researcher
Tamiflu is losing its effect over H5N1 virus as two patients showed resistance to this famous anti-bird flu drug, researchers say.

In a report completed in the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, Menno D. de Jong, clinical medicine expert from Oxford, together with his colleagues pointed out that bird flu virus is subject to very fast variation, and four of eight N5N1-infected patients died here in spite of antiviral treatment by taking Tamiflu. Drug resistance has been found in the body of two patients. Just like against the AIDS, "cocktail" therapy is also needed in fighting bird flu, using more than one kind of medicine, the researcher said.

Two more human deaths from bird flu in Indonesia were confirmed yesterday, bringing the known global total to 73, while cases including survivors would rise to 141. All the deaths so far have been in Asia.

The H5N1 strain of bird flu has also killed hundreds of millions of chickens and ducks since it started ravaging poultry stocks across Asia in 2003.

The WHO confirmed that a 39-year-old man and an 8-year-old boy died earlier this month of bird flu, raising Indonesia's toll to 11.

No more bird flu in Russia - Agriculture Ministry

There are currently no known bird flu cases in Russian agricultural enterprises and private farms, the Russian agriculture minister told a news conference Thursday.

"Not a single industrial agricultural site or private farm is currently infected with the bird flu virus," Aleksei Gordeyev said. "There is no bird flu in the country," he said.

In November the virus affected several Russian regions, including the Altai Territory in central Siberia and the Astrakhan Region on the Caspian Sea.

Indonesia to begin bird flu surveillance in capital

Indonesia will launch house-to-house surveillance of poultry in Jakarta in a bid to halt the spread of deadly bird flu, a minister said on Tuesday.

Local communities, student volunteers and military forces will be deployed to inspect poultry across the sprawling capital of nearly 9 million people, where four of the country's confirmed nine deaths have occurred.

"For the initial stage, we will carry out mass surveillance starting on December 22 in Jakarta. It will be done door to door," Agriculture Minister Anton Apriyantono told reporters.

"However, there will be no mass culling because it is not effective. What we will do is selective culling," he said. "Culling will depend on the disease attack rate."

Apriyantono did not elaborate on the number of people such extensive monitoring would take or how much it would cost. In 2005, Indonesia allocated 107 billion rupiah ($10.86 million) to fight the disease.

Since July, Indonesia has had nine deaths from bird flu confirmed by a Hong Kong laboratory affiliated with the World Health Organization and five cases where patients have survived.

Officials are awaiting confirmation from Hong Kong of local tests which showed a 39-year-old man and an 8-year-old boy died from the H5N1 virus this month.

Millions of chickens and other fowl have died from the disease in Indonesia or been killed to prevent its spread since it first surfaced on the sprawling archipelago in late 2003.

Indonesia, with 220 million people, has many millions of chickens and ducks, the majority in the backyards of rural or urban homes.

Such a close relationship between people and livestock has helped spread the disease in humans and the virus has been found in poultry in two-thirds of the nation's 33 provinces.

The Food and Agriculture Organization has launched its own grass-roots scheme covering Java island. The U.N. agency says Indonesian efforts to control bird flu need to be stepped up and the government needs to draft an effective national strategy.

Indonesia is also preparing an early bird flu warning system that will involve local governments setting up health posts in all villages, where doctors and nurses would be on the lookout for flu cases in birds and humans.

More than 70 people have died of bird flu in Asia since the virus swept through much of the region in late 2003, almost all of them from direct contact with infected fowl.

The H5N1 virus cannot move easily between humans at the moment, but experts fear it could develop that ability and set off a global pandemic which might kill millions of people.

Bird Flu Drugs Shipped into US Counterfeit

With growing fears over a possible Avian Flu or Bird Flu pandemic, countries throughout the globe are stockpiling a drug believed to be capable of saving lives. However, a disturbing story is being told by officials from the US Customs and Border Protection directorate of the Department of Homeland Security -- counterfeit medicines.

CBP officers recently seized 51 shipments of counterfeit Tamiflu pills earmarked for several different importers in southern San Francisco, CA. Tamiflu is the drug being stockpiled throughout the world in response to the avian flu in the event of serious outbreaks. This is the first seizure of counterfeit Tamiflu pills in this nation, and each package contained approximately ten to fifty individual pills.

“Our CBP Officers are diligently working around the clock to keep our nation’s citizens and residents safe from harmful products crossing our borders. Could you imagine what could happen if counterfeit avian flu medicine is being sent around the world and people are depending on it to keep themselves healthy? This seizure is an excellent find for the nation as a whole,” said San Francisco Director of Field Operations Nat Aycox.

CBP works in conjunction with the Food and Drug Administration (FDA) on importations of food and medication. An FDA official stated, “preliminary laboratory tests conducted by the FDA have found only trace amounts of active ingredients in these pills for Tamiflu.”

The pills were allegedly shipped from Asia and had been purchased via several different Internet sites. It appears that the purchases were made for personal use. This case is still under investigation by CBP and the FDA.

Malawi in bird flu scare as thousands of birds die

Malawi was on Friday hit with the country's major scare of bird flu after thousands of birds mysteriously died in a hill in the central district of Ntchisi, some 200 km east of the capital, Lilongwe, a senior agriculture official told journalists.

Malawi's Director of Livestock and Animal Health, Wilfred Lipita, said the government had sent tissue samples of birds to a laboratory in South Africa following the mysterious mass death of the birds.

"We are sending the samples from these birds to South Africa for analysis as South Africa is the only country in the Southern Africa that has labs to detect avian flu," he said.

Lipita said several thousands of the Fork-tailed Drongo started dropping dead in Mwera Hills in the district earlier this week.

He added that local people in the area started collecting the dead birds to eat before some people informed the police.

"We sent officials to caution the people not to eat them since the dead birds might have the avian flu which has proved deadly to humans in other countries," the agriculture official said.

Lipita said Malawi has not known case of avian flu but added that although birds sometimes drop dead from unknown causes it was very unusual for birds to die in thousands in a short time.

District Commissioner for Ntchisi, Daniel Phiri, told journalists that he suspected that the birds might have traveled from a long distance.

"One of the birds had a ring with inscription numbers and the word Israel," he told a local paper, The Nation, on Friday.

The Malawi government has since set up a task force for rapid response in case bird flu is confirmed in the country.

Meanwhile the government has issued a statement advising people to avoid eating birds found dead but to report such incidences to police or veterinary authorities for investigations.

Russian Expert Predicts Bird Flu Pandemic in 2 Years

The director of the Russian Academy of Medical Sciences’ Influenza Institute, Oleg Kiselyov, said that a global epidemic of bird flu will occur in two years, Interfax reported Wednesday.

“A pandemic will occur, and it will occur in two years,” Kiselyov told journalists at a science workshop conference in the Russian Agricultural Sciences Academy.

The H5N1 virus strain that circulated in Russia this year “will probably not cause any diseases among the population,” and will not lead to a pandemic, he said.

“I can say that H5N1 will probably not be dangerous to humans on a global scale,” Kiselyov said.

Experts fear the H5N1 strain of bird flu could trigger a human flu pandemic if it mutates into a form that is easily spread between people. Since 2003, the virus has killed at least 69 people in Asia — most of them farm workers who came into close contact with infected birds.

Germany to relax bird flu restrictions on Friday

Germany will relax anti-bird flu regulations and permit poultry to be kept in the open air from Friday, the Agriculture Ministry said on Tuesday. Germany confined all poultry to their pens in mid-October after migrating birds spread bird flu close to Moscow and into Turkey and Romania.

The disease has not moved substantially westwards since then, despite fears wild birds would spread it around Europe.

"The ban will expire on December 15 and poultry will be permitted out again on December 16," a ministry spokeswoman said.

"This is as intended. The pen compulsion was limited until December 15 unless there was a change in the risk assessment."

An official announcement would be made in the next couple of days. Germany's Friedrich Loeffler scientific institute, which advises German authorities on bird diseases, has cut its assessment of the risk migratory birds will spread the disease to Germany from "high to moderate" to "low".

The main bird migration season was now over, the spokeswoman added. But some measures would remain, such as a compulsion to keep feeding areas for farm poultry segregated from wild birds, she said.

Several German states have already announced they planned to end the outdoor ban this week provided the federal government did not renew the national ban.

PM REQUESTS ASEAN MEMBERS TO STOCK UP BIRD FLU VACCINES

During 11th Asean Summit in Kuala Lumpur, Prime Minister Thaksin Shinawatra requested Asean members to stock up bird flu vaccines for emergency cases. He also emphasized on measures to prevent the deadly virus in the region.

PM Thaksin has met more than 10 leaders at the 11th Asean Summit at the Kuala Lumpur Convention Centre (KLTC) in Malaysia. The summit has started 8.30 in the morning. After an hour of high-level meeting, Government Spokesperson SURAPONG SUEBWONGLEE (สุรพงษ์ สืบวงศ์ลี) said that the premier has expressed satisfaction over the Malaysian government in repatriating all the Thai-Muslims who fled to Malaysia, back to Thailand. Dr Suebwonglee said on behalf of the Thai premire that all the Thai-Muslim refugees will receive a fair trial and in accordance with the law.

However, the premier said that in all of the ASEAN members, cooperation is still needed inorder for the ASEAN Vision to come about. This afternoon high level delegates will be discussing the contentious issue of Myanmmar.

Bird Flu Death Toll at 70

A child in Thailand is confirmed as the 70th victim to die of bird flu, as studies predict an Avian Flu pandemic could cost the US economy hundreds of billions of dollars as well as the loss millions of lives.

In addition, Chinese health officials have reported a new case of H5N1, the fifth person in the country known to have been infected with that deadly virus. However, the 31-year-old woman, who lived in Liaoning province, did recover from her illness.

There have been allegations that Chinese officials concealed bird flu outbreaks in several provinces for many months this year, according to a Friday story in Canada's Globe and Mail newspaper.

The death of the 5-year-old boy from the central province of Nakhon Nayok, about 90 miles outside of Bangkok, took Thailand's bird flu death toll to 14 out of 22 known cases since the virus first swept through large parts of Asia in late 2003.

Medical officials are not sure how the boy caught the virus. Experts believe bird flu usually strikes those who come into close contact with infected birds and fowl or their droppings. The boy, who died in hospital on Wednesday, was not known to have had direct contact with chickens.

"We believe that the boy contracted the virus from his surroundings because, although his family does not raise chickens, there are chickens raised in his neighborhood," said Thawat Suntrajarn, head of the Health Ministry's Disease Control Department.

That would follow the usual pattern of human infections of the virus, which has not yet shown signs of mutating into a form which can be contracted from person-to-person.

Experts say that mutation of the virus is the great fear. If the H5N1 virus did acquire that ability, it could set off a pandemic which could kill millions of people without immunity to the new strain.

China has reported more than 30 outbreaks of bird flu and two deaths among cases where the virus has spread to humans. Beijing has promised resources and openness in fighting bird flu after being severely criticized for an initial cover-up of the SARS virus in 2003.

China may need to shut live poultry markets nationwide to stop bird flu

The Chinese government may need to shut down traditional live poultry markets nationwide to prevent the spread of bird flu, the World Health Organization (WHO) said yesterday.

Dr Henk Bekedam, WHO's China representative, told a regular press briefing that the practice of slaughtering live animals at so-called 'wet markets' for consumers put humans at danger of catching the fatal virus.

'We need to start discussing from a public health point of view that perhaps traditional wet markets are a threat,' Bekedam said.

'That's despite many consumers' preference for fresh, live jumping animals.'

Bekedam applauded the Beijing government's recent closure of live bird markets in the nation's capital, saying it may need to be repeated around the country.

Despite his warning, Bekedam warned against panic about the virus.

He said that for now, there is no scientific proof supporting the ability of bird flu to be spread from person to person.

'There is no evidence at this time of the transmutability of the H5N1 (bird flu) between humans... and at the end of the day we do not ...yet... think the virus is very clever at infecting humans,' Bekedam said.

However, he said that there was still much preparatory work to be done in China to contain the virus to its current outbreak levels, including taking more drastic preventative measures.

'The best way to deal with bird flu is to attack it when it is still confined to poultry -- before it spreads to humans,' Bekedam said.

While the poultry industry accounted for only around three pct of China's GDP, he said it was extremely important to China's rural population with 14 bln domestic birds in the country -- 70 pct of which are raised in backyard farming.

Bekedam said communication channels must remain open among poultry farmers, between local and international organizations, and farmers and authorities to fight the disease.

China's battle with the diseased was highlighted again today by news that a 10-year-old girl in southern China is in hospital undergoing emergency treatment after contracting bird flu -- the fourth human case to be confirmed in the country.

Xinhua said the girl from Guangxi region developed fever and pneumonia-like symptoms on Nov 23, China's health ministry said.

Doctors are closely monitoring her family and friends for signs of the virus, the agency said. It was unclear how the girl contracted the virus and investigations are ongoing. The ministry of health has alerted WHO, it added.

Bird-Flu Patients May Need Higher Dose of Tamiflu

Bird-flu patients may need higher doses of the antiviral treatment Tamiflu than recommended by drugmaker Roche Holding AG, World Health Organization officials said.

Tamiflu can reduce the severity and duration of illness caused by seasonal influenza provided it is given within 48 hours of the onset of symptoms. The drug has been used in the treatment of more severe disease caused by the H5N1 strain of avian influenza, and is being stockpiled worldwide as the best protection against any pandemic flu.

Clinical trials may start as early as next month in countries including Vietnam to study whether doubling the recommended dose provides more effective treatment in H5N1 cases, Peter Horby, a Hanoi-based epidemiologist with WHO, said today.

``It's possible that increased doses of Tamiflu for treatment above the current recommended level may be more effective in H5N1 cases,'' Horby said by telephone from Bangkok. ``There are reports of some patients being treated with standard doses of Tamiflu in Vietnam and not being cured.''

Roche is working closely with the WHO and the National Institutes of Health in the U.S. to assist in the evaluation of a higher dose, company spokesman Daniel Piller said. Studies conducted during the drug's development showed higher dosages were safe. The lower dose was just as effective for seasonal flu.

``In terms of the clinical effect of the drug in people infected with H5N1, we have limited information,'' Piller said. ``We will look at longer duration of therapy and higher doses in critical case of H5N1 infected to derive the greatest benefit from Tamiflu for such patients.''

Vietnam

The ministry of Health in Vietnam has already instructed doctors to lengthen the treatment time for Tamiflu to seven days from five days for bird-flu patients, according to Tran Tinh Hien, deputy director of the Hospital for Tropical Diseases in Ho Chi Minh City, which has treated bird-flu patients in the past.

``The bird-flu virus is much more virulent, so it makes sense to double the dose for bird-flu patients,'' the doctor said in an interview. ``Given that Tamiflu has been unsuccessful in treating several cases in the north, I support that trial.''

Avian flu has infected at least 135 people the past two years in Vietnam, Thailand, Indonesia, Cambodia and China and killed 69 of them, Geneva-based WHO said on Dec. 7.

``In some cases in which people were given antiviral drugs, they died even after the treatment,'' Hitoshi Oshitani, Manila- based regional adviser in communicable disease surveillance and response with WHO, said this week. ``We don't know why the antiviral drugs didn't work in these cases. The current recommended dose of antiviral may not be enough to treat H5N1 cases.''

Too Late?

Another explanation may be that the patients began treatment more than 48 hours after their symptoms emerged, Oshitani told the Institute of Southeast Asian Studies on Dec. 6.

``This virus may be causing them more systemic infection so the usual recommended dose of antiviral is based on our experience on usual human influenza infections which only causes respiratory infection,'' he said.

Under the planned schedule for the Tamiflu trial, 150 milligrams of the medicine would be given twice a day for five days, Horby said. That compares with the recommended dose of 75 milligrams twice a day for five days, he said.

``We know that in trials using Tamiflu to treat normal influenza, you can increase the dosage safely,'' Horby said.

Details of the study are yet to be completed. The trials would be the first through a new research network established by the WHO to gather information on H5N1 cases, he said.

`Multiplying'

There are other reasons why H5N1 patients may require higher doses of Tamiflu, scientists said.

``The virus is multiplying to higher levels than normal human viruses, therefore it may take more drug to control this higher level of virus,'' said Jennifer McKimm-Breschkin, a virologist at Australia's Commonwealth Science and Industrial Research Organization (CSIRO) in Melbourne.

``Some H5N1-infected patients treated with Tamiflu have had resistant virus emerge during the treatment, hence the theory is that higher doses may prevent resistance emerging,'' McKimm- Breschkin said.

Indonesian baby tests positive for bird flu

An eight-month-old baby is the latest patient to test positive for bird flu in Indonesia.

Doctors believe the baby may have caught the disease from an infected pigeon.

A spokesman at the Sulianti Saroso hospital has told the ABC that preliminary tests, yet to be confirmed by the World Health Organisation (WHO) in Hong Kong, show that the child is suffering from the deadly H5N1 strain of avian influenza.

He was put into an isolation ward at the designated bird flu centre on Sunday, five days after contracting a high fever at his home in north Jakarta.

Six other patients are undergoing tests at the hospital.

While the official death toll from bird flu in Indonesia stands at eight, some experts believe that because of poor surveillance and reporting the number has been underestimated

Latest bird-flu cases in Thailand might be human-to-human transmission

The two latest confirmed cases of human bird flu in Thailand might be human-to-human transmissions, a senior health official has said.

Dr Charoen Chuchottaworn, a bird-flu expert at the Public Health Ministry's Department of Medical Services, said doctors concluded after reviewing the history of the past two cases that both victims presented very mild symptoms of avian influenza and neither had any physical contact with chickens or birds.

One of the victims was a boy in Bangkok and the other was an 18-year-old man from Nonthaburi province, The Nation newspaper reported Friday.

This left doctors no clues as to where the patients became infected with the H5N1 virus and showed that the avian influenza had moved from causing severe human infection to milder cases.

Charoen, who is also a member of the national committee issuing guidelines for the treatment of avian influenza, made the remarks Thursday at the Joint International Tropical Medicine Meeting 2005 in Bangkok.

Dr Kamnuan Ungchusak, director of the Epidemiology Bureau, challenged Charoen's assertion about human-to-human transmissions.

He told The Nation that while neither of the patients had direct contact with chickens, they lived in an environment where the virus was prevalent.

"Chickens were dying near their homes and chicken droppings were everywhere around their neighborhood," he said. "They might have contracted the virus through contaminated soil."

Dr Charoen said the milder the symptoms, the harder it is for doctors to diagnose. This means that a lot more advanced laboratory facilities are needed with a testing technique called RT-PCR to confirm cases and decide if patients should be treated with antiviral Tamiflu (oseltamivir phosphate).

He said this meant that avian influenza could become asymptomatic now.

The only tool available in Thailand to fight H5N1 infections atthe moment is insufficient, he said. At present, Thailand has about one million capsules for 100,000 treatments of Tamiflu, but it is estimated that about 120 million capsules of the drug will be needed.

In the past, only severe cases of human bird flu have been detected in Thailand simply because patients went to hospital for treatment. But doctors believe that there have been many cases with mild symptoms of the disease.

"We believe that this is the tip of the iceberg," he said.

Signs of possible human-to-human transmission were closely observed in Vietnam, where 10 clusters of probable human transmissions were detected in which the victims had no contact with infected poultry, Charoen said.

Thailand and Indonesia had one official cluster, he said, but the Indonesian cluster showed clear-cut evidence because a child contracted H5N1 without going to an infected area, as her father had.

X-rays show shared symptoms among bird flu victims

The lungs of avian flu victims are racked by infections, clogged with pus and surrounded by fluid, and the severity of the symptoms can predict whether the patients will survive, researchers said on Friday.

Based on chest X-rays performed on 14 Vietnamese bird flu patients admitted to Ho Chi Minh City Hospital -- nine of whom died -- researchers at the University of Oxford in England found shared abnormalities that were good predictors of whether the disease would be fatal.

The infection from the H5N1 avian flu virus caused multiple lung infections, "which usually represents pus and infection in patients with fever and a cough," radiologist Dr. Nagmi Qureshi said. "We also discovered that the severity of these findings turned out to be a good predictor of patient mortality."

The avian flu virus has infected 133 people in Asia since late 2003 and killed 68 of them. Several countries in the region are regularly reporting more suspected cases in people and outbreaks in poultry.

Scientists fear the avian flu virus H5N1 could kill millions of people if it mutates into a form that passes easily among humans. The regular flu vaccine is useless against avian flu and there is no cure, although drugs can help reduce its severity.

Three of the five surviving patients in the study, which was presented at the annual meeting of the Radiological Society of North America, underwent more detailed computed tomography (CT) exams after they left the hospital.

Those images showed that while their respiratory symptoms had subsided, scar tissue formed in their lungs similar to damage suffered by victims of severe acute respiratory syndrome, or SARS, which broke out in 30 countries in 2003 and infected 8,400 people, killing about 800 of them. "However, additional abnormalities we discovered in avian flu patients -- including fluid in the space surrounding the lungs, enlarged lymph nodes and cavities forming in the lung tissue -- were absent in patients with SARS," Qureshi said.

Ethiopia tests dead pigeons for bird flu

Ethiopia is testing pigeons found dead in the east of the country for the virulent form of avian flu, a Ministry of Agriculture official said on Friday.

Members of the public alerted authorities to the bird carcasses found in the eastern Somali region of Ethiopia, said Seleshi Zewdie, director of the animal health department in the Ministry of Agriculture.

The deadly H5N1 strain of bird flu has not yet been found in Africa and Seleshi said the tests were precautionary.

"It is unlikely that the disease is bird flu. It could be a local disease strain," Seleshi said. He added that the Somali region was not along the migratory routes which birds follow when traveling through east Africa.

Seleshi did not give a specific number of birds being tested, beyond saying there were many. Tests were being carried out in Ethiopia and results expected next week.

Experts say pigeons are generally resistant to bird flu, although it is not unknown for them to get the disease.

The H5N1 strain of bird flu is endemic in poultry in parts of Asia where it has killed almost 70 people. It has been found in birds in eastern Europe and Kuwait and there are fears migratory birds could now carry it to east Africa.

Experts warn finding and controlling the virus would be a huge task if it takes hold in Africa's rural hinterlands. Already high rates of mortality among the continent's backyard chickens would make detection hard.

The virus remains hard for people to catch, but experts fear it could mutate into a form which passes easily from person to person. That risks sparking a pandemic in which millions of people could die.

Bird flu detected in N. Carolina turkeys

Turkeys at a farm in North Carolina tested positive for a mild, low-pathogenic strain of bird flu which is common in birds and poses no threat to humans, the U.S. Agriculture Department said Thursday.

Routine tests conducted on poultry in North Carolina found the H3N2 strain of bird flu in turkeys on a farm in Sampson County, in the eastern part of the state, the USDA said.

A much more serious strain of the disease, known as H5N1, has been found in Asia and Eastern Europe and been blamed for 68 deaths.

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