News about the bird flu (avian influenza) in March 2005.
Bird Flu Hits N. Korea in Sore Spot
In recent years, North Korea's Kim Jong Il ordered his army to build chicken farms to fight the country's chronic food shortage and sell poultry abroad for hard currency. Just this month, North Korean-raised chickens were due to be exported for the first time — to South Korea.
Hai Phong family recovers from recent bird flu infection
Five members of a Hai Phong family, including both parents and three children, are recovering and are in stable condition after initial tests showed they were infected with bird flu, doctors from Hai Phong’s Viet-Tiep Hospital said yesterday.
Vu Van Son, 39, his wife, and their three children, aged from four months to 10 years old, were hospitalised last Tuesday with symptoms of coughing, fever and difficulty breathing.
Their initial tests taken at the National Institute of Hygiene and Epidemiology showed that they had contracted the H5N1 virus.
Three days later, their 41-year-old neighbour was hospitalised with less severe but similar symptoms.
Avian flu has been reported as an epidemic in Hung Dao Village of Kien Thuy Commune where Son lives. Son’s family raised an estimated 400 poultry, more than 200 of which have died and were subsequently eaten.
According to Hue Central Hospital, other patients who are currently infected with and receiving treatment for virus H5N1 include Hoang Dong Duong, 5, of Quang Binh Province’s Tuyen Hoa District and Nguyen Tien Dung of Chau Hoa District and Cao Lu Uy, 30, from Dong Ha Town of Quang Tri Province.
Bui Quang Anh, director of the Animal Health Department of the Ministry of Agriculture and Rural Development, said there have been no reported outbreaks of bird flu anywhere in the country since last Saturday and Bac Lieu Province has been bird flu-free for 21 days, increasing the total provinces free from the disease to 26.
The remaining infected provinces include An Giang, Ben Tre, Can Tho, Dong Thap, Hau Giang, Tra Vinh, Vinh Long and Hai Duong.
North Korea Must Tell the Truth About Bird Flu
The (south korean) government on Monday said it would provide North Korea with medical and technical aid and quarantine equipment in combating its latest bird flu outbreak, but asked Pyongyang to provide accurate information about the damage done.
What is known thus far is only a report by the state-run Korea Central News Agency that with the outbreak of avian influenza in two or three chicken farms near Pyongyang, hundreds and thousands of birds have been buried or burned. There are 135 confirmed bird flu strains, and the methods of diagnosing and combating them differ from strain to strain. If the wrong drugs are used, it fosters resistance. Depending on how far the flu has spread, disinfection methods and the scope of the slaughter vary. South Korea cannot offer medicine and equipment at random.
Avian influenza has broken out at massive chicken farms near Pyongyang directly managed by the authorities. Many experts think chances are high that the flu has spread to a many other areas where quarantine and sanitary conditions are poor. North Korea admitted the outbreak as late as Sunday; the outbreak was rumored among experts here for over a month.
Since we have suffered nationwide bird flu outbreaks, we do have experience of combating it. In Asia, Korea and Japan have the technology for diagnosing the deadly disease. But if we are to provide adequate technology, facilities and equipment, North Korea must give us accurate information about bird flu strains, the process by which it is spreading and the preventive measures taken so far. Only then will we be able to help effectively.
Since this is not a migration season for birds, experts say, chances are slim of the bird flu in the North spreading to the South. But we should not become complacent. In only three months after our first avian flu broke out in December 2003, we had to slaughter as many as 5.2 million birds. Thorough precautions must be taken with the people, goods and vehicles traveling to the North. In the restricted area along the de-militarized zone, blissfully free from people, there live many resident birds that fly to and fro between the two Koreas.
Vietnam, Cambodia confirm additional bird flu deaths, raising Asia's total to 48
Vietnam and Cambodia on Friday each confirmed an additional death from bird flu, raising Southeast Asia's death toll to 48 from a disease that has become entrenched in the region's poultry and raised fears of a global pandemic.
Most human cases have been traced to contact with sick poultry, but experts fear the virus could mutate into a form that is easily transmissible among people, sparking a pandemic.
The latest deaths were a 26-year-old man from Cambodia's southern province of Kampot and a 17-year-old woman from Vietnam's northern Nam Dinh province.
The man died of the severe H5N1 strain, according to test results from Phnom Penh's Pasteur Institute, Deputy Agriculture Minister Yim Voeun Tharn said.
That strain of bird flu began ravaging Asian poultry farms in December 2003, and also has claimed 48 human lives – two of them Cambodians, 12 from Thailand and 34 from Vietnam.
In Vietnam, the teenager, who died Thursday, was one of two new bird flu cases reported Friday. In addition, a 40-year-old woman was hospitalized in stable condition in Hanoi, health officials said.
An epidemiologist for the World Health Organization in Cambodia, Megge Miller, said this week's Cambodian victim, Meas Ran, was believed to have contracted the disease from poultry that died near his house. Villagers did not immediately tell authorities about the sick chickens for fear that their remaining stock would be slaughtered, Miller said.
The 40-year-old woman and her family ate chicken March 10 and she began developing the disease's typical symptoms of fever, coughing and labored breathing four days later, said Nguyen Van Thich with Quang Ninh province's medical center said.
In Vietnam, where 14 people have died of bird flu since December, the latest cases follow a string of infections that have had health experts worried about the spread of the virus now acknowledged to be endemic in the region.
Officials are unsure how the teenager contracted the disease because there had been no outbreaks among poultry in her village, said Vu Huu Viet, head of Nam Dinh's provincial medical center.
A 28-year-old man has become Cambodia's second person to die of avian influenza, health authorities there announced today.
The man, named Meas Ran, fell ill earlier this week and died late Mar 22, Cambodian Health Minister Nuth Sokhom told Agence France-Presse (AFP) today. The virus has been confirmed as H5, and a sample was being sent to France as a formality to confirm it is H5N1, said Jean-Louis Sarthou, director of the Pasteur Institute in Phnom Penh.
Second Cambodian dies of avian flu
Cambodia's second victim lived in the village of Tram Sasor in Kampot province, only about 20 kilometers from the first victim, a 25-year-old woman who died Jan. 30, AFP reported.
More than 600 chickens have died in half a dozen villages in Kampot during the past 3 weeks, and another 120 were culled yesterday, said Yim Voeunthan, secretary of state at the ministry of agriculture, in an AFP story. Villagers hadn't revealed the outbreak because they didn't want their remaining chickens to be culled, he added. Now that fear is being realized.
"Many people have cooked the sick or dead birds to eat because they are very poor, but no one fell sick," The Standard of Hong Kong quoted Voeunthan as saying. He was quoted by AFP as also saying, "Villagers were eating the dead chickens even though we warned them not to . . . now the villagers are afraid. They dare not eat chicken anymore."
It's not clear whether Ran had been in contact with poultry. Media reports described him variously as a traveling businessman who sometimes worked in Vietnam and as a man who owned chickens. Dr. Heng Taykry, director of the Calmette hospital in Phnom Penh, where Ran died, said Ran appeared to have been infected after eating dead chickens, according to a Reuters story today. Several of his relatives have tested negative for avian flu, the doctor added.
Sarthou said there are no other suspected human cases of avian flu in Cambodia, according to AFP.
Suspected cases in Vietnam still under investigation
A senior provincial health official in Quang Binh, Truong Dinh Dinh, challenged state media reports, telling Reuters that no one was in serious condition and nobody had symptoms requiring medical care.
A doctor in central Vietnam said tests on several residents in Quang Binh's Chau Hoa commune have all been negative, AFP reported today. A Reuters story indicated several people were being monitored, including a 41-year-old man from Chau Hoa who walked out of a hospital on Wednesday.
Peter Horby, a World Health Organization (WHO) epidemiologist in Hanoi, told AFP there was "no serious information so far to substantiate media reports."
At least one case occurred in Chau Hoa recently: A 5-year-old boy was hospitalized Mar 15 and tested positive for H5N1. His condition was described today as stable. His sister had died Mar 9 of a similar illness, but she was not tested.
Hong Kong takes precautions
In addition, Hong Kong's Centre for Health Protection has been collaborating with the WHO and the Vietnamese consulate to keep current on the situation in Vietnam, according to a government news release yesterday.
In other developments, this week brought rumors of a flu outbreak among poultry in Myanmar, but the government has denied the reports. Myanmar authorities responded to a United Nations Food and Agriculture Organization (FAO) request for information today by assuring the FAO the country had no cases of avian flu.
Elsewhere in Southeast Asia, the Indonesian government announced this week it will spend 1 billion Indonesian rupiahs (about US $106,100) to compensate small poultry producers for recent losses due to avian flu, according to a story yesterday in the Jakarta Post online. More than 12,000 birds died of avian flu in January and February on the island of Java, although that outbreak that didn't come to light until early this month.
Compensation was capped at US 21 cents (2000 Indonesian Rupiahs) per chicken and 5,000 chickens per producer. Each Indonesian farmer who is reimbursed will receive roughly US $1,050, under today's exchange rate.
U.S. to create a bird flu virus mutation
The U.S. Centers for Disease Control and Prevention has begun a series of experiments to see how likely the bird flu virus could result in a human pandemic.
Burma’s Livestock Agency Denies Bird Flu Report
Burma’s government livestock agency told the United Nations on Wednesday that a recent spate of poultry deaths in the country’s southeast was not caused by bird flu, denying reports by a Burmese-language foreign radio station.
The Livestock Breeding and Veterinary Department blamed the poultry deaths on other causes after the UN Food and Agriculture Organization, or FAO, officially asked about the matter Tuesday.
The FAO had asked the department to check a report of a possible bird flu outbreak among thousands of chickens in the Mon State capital, Moulmein, FAO resident representative Dr Tang Zheng Ping told The Associated Press.
“We received a reply from the livestock and veterinary department today confirming that there was no outbreak of bird flu,” he said. “The government’s survey found that 300 chickens died in Moulmein, but they died of normal poultry disease.”
The veterinary department said 300 chickens died of Newcastle disease, a common poultry sickness that poses no threat to humans.
The Norway-based Democratic Voice of Burma, a shortwave radio station critical of the military government, reported Sunday that thousands of chickens died suddenly in Moulmein last week of what residents suspected could be bird flu.
A severe form of bird flu has killed a total of 46 people from Vietnam, Thailand and Cambodia since it began ravaging poultry farms across Asia in December 2003. Burma has reported no cases among birds or humans.
The Burma’s livestock agency’s director, Than Tun, confirmed he had told the FAO there had been no bird flu outbreak.
He had said earlier that bird flu was unlikely to break out in Burma because only about 15 percent of the country’s chickens are grown commercially. The disease often breaks out in crowded conditions such as those on commercial farms.
In January last year, Burma banned poultry imports from countries where bird flu has been detected. Officials are monitoring the country’s poultry farms.
The FAO recently provided US$350,000 (€271,000), to be shared by Burma and seven other Asian countries for fighting bird flu.
The funds are intended for administrative support, veterinarian training and equipment for disease diagnosis.
Hunting Bird Flu on the Cheap in Cambodia
The man who might save the world from a devastating bird flu pandemic makes $38 a month.
As Cambodia's chief of disease surveillance, Ly Sovann is responsible for spotting the stirrings of an epidemic in a country where the public health and veterinary systems are so impoverished that experts acknowledge they are probably failing to detect most of the human cases and have no idea how rampant the virus is among poultry.
That poses a profound danger well beyond Cambodia's borders. International health specialists warn that avian influenza could kill millions of people worldwide if it has a chance to develop into a form easily spread among humans.
Ly Sovann, 36, a physician, is a full-faced man with dark, playful eyes and sloping shoulders. He heads a team of 10 Cambodian flu hunters struggling to head off an epidemic from their 12-by-10-foot office on the third floor of the Health Ministry. They share one Internet line and even at times of crisis have to go home by 7 p.m., when the power in the building is switched off.
Ly Sovann's epidemic alert system is nothing more than a network of personal cell phones. But through his wide-ranging contacts and charisma, he has cobbled together a national network of informants. Cambodia is seeking $10,000 from foreign donors to purchase prepaid phone cards to allow local health workers to report on suspicious respiratory cases.
But the monitoring effort has stumbled. Cambodia's one confirmed human case of bird flu was not recognized by local doctors two months ago and was diagnosed only after the victim's family took her across the border for treatment in Vietnam, where the health system is more advanced.
So far, international health specialists report that the disease is less prevalent in Cambodia than in Vietnam and Thailand, another neighbor, where a total of 45 people have died since early last year. But health specialists are concerned about the rudimentary level of medical and veterinary care in Cambodia and its destitute neighbor Laos. They fear that those countries' primitive health care systems may not be able to diagnose or report human cases of bird flu, allowing the virus to spread.
The avian strain now has difficulty infecting people. However, each new human case gives the virus an opportunity to undergo genetic changes that could eventually allow it to be transmitted easily from person to person.
"The chain is as strong as the weakest link," said Klaus Stohr, director of the World Health Organization's global influenza program. "Cambodia and Laos are certainly the ones that need beefing up."
Bird flu was first confirmed in Cambodian chickens in January 2004. Since then, international health officials have speculated that human cases have probably gone unreported. Nevertheless, Jim Tulloch, WHO's top representative in Phnom Penh, said he was confident that a concentrated outbreak would be spotted. The question is how fast.
"If we start seeing the disease spread more quickly, speed will be everything to contain it," he said. "It's a matter of chance if we know about it as quickly as we like."
Still struggling to recover from decades of war and political instability, Cambodia's government spends only $3 per person on health care each year despite high rates of HIV/AIDS, tuberculosis, and infant and maternal mortality, according to Tulloch. Foreign donors contribute twice that amount for specific health programs, but because the money is earmarked, it cannot be used for tracking new diseases, such as bird flu.
Cambodia lacks trained doctors and clinicians, laboratory facilities, referral wards, epidemiologists and an overall health system tying them together for the fight against avian influenza, experts said. The government cannot even afford to produce warnings about the disease for radio and television.
"We've had over 30 years of war. We need time to build up our system of public health," Ly Sovann said from behind his modest metal desk while a small air conditioner whined in the window. He said he had secured his lone Internet connection only after prevailing on the health minister to seek help from the prime minister's office.
"We try our best to build up the system for detecting avian flu in Cambodia," Ly Sovann continued. "Five years ago, it was nothing. Now I have computers, paper and stationery. It's better."
Ly Sovann received his undergraduate medical degree from a college in Phnom Penh and a master's in clinical tropical medicine from a Thai university. He was promoted to his current post after distinguishing himself by crafting an aggressive national response during the 2003 outbreak in Asia of SARS, or severe acute respiratory syndrome.
Ly Sovann said that was when he realized he could make use of the country's extensive cell phone coverage.
Reaching behind him to a bulletin board, Ly Sovann showed the worn and smudged list of names and phone numbers he began assembling during the SARS program, covering scores of health care workers in Cambodia's cities and all 24 provinces.
Compared with Vietnam and Thailand, Cambodia is fortunate because it has fewer chickens and ducks to spread the disease, and its dense commercial farms, which could offer the virus a welcome roost, are few and well-monitored, according to international agriculture experts.
But the paucity of commercial farms also makes it difficult to track the disease. Large farms serve as a bellwether for bird flu outbreaks, because the death overnight of hundreds of chickens on a single farm is easy to detect. The vast majority of Cambodian chickens, however, live in the back yards of peasants, where the death of a few dozen birds typically goes unnoted, especially because many die of fowl cholera, Newcastle disease and other common poultry maladies.
Ly Sovann set out before dawn one day this month on a three-hour drive to Cambodia's southern Kampot province, the home of Tit Sukhan, a 24-year-old woman who had died of bird flu on Jan. 30. His goal was to repeat his frequent public plea that suspicious illnesses be reported.
Arriving at the local community hall, he set up his laptop computer for a visual presentation, fished his personal digital assistant from the breast pocket of his white dress shirt and waited his turn beneath the humming ceiling fans. The reception from officials, activists and farmers proved skeptical. Several approached the microphone to question whether the virus had even entered the province.
A week before Ly Sovann's visit, the father of the dead woman had said in an interview that he still doubted that bird flu had killed her, even though most of his 40 chickens had died without warning shortly before she and several other family members became ill.
Uy Ngoy said his 14-year-old son was the first to develop a fever, diarrhea, breathing problems and a bad cough. The family took the boy to a private clinic that provides basic care in the local town of Kompong Trach. A clinician took the boy's temperature and blood pressure. Two days later, after the boy's condition worsened, the clinician sent him home so family members could pray to their ancestors in case the illness was caused by an affront to the spirits. The boy died soon afterward and his body was cremated.
No tests were run, but WHO officials now suspect the cause of death was bird flu.
After embracing the boy's body at his funeral, Tit Sukhan, his sister, developed the same symptoms, Uy Ngoy recounted. The family took her to another, slightly better-equipped clinic, where an ultrasound test revealed lung damage. Then they took her across the border for medical care in Vietnam. Doctors there diagnosed bird flu, and she died soon thereafter.
The health workers who ran the two Cambodian clinics said in separate interviews that they had believed the siblings were suffering from pneumonia, extremely common among villagers, and never thought to report the cases to Ly Sovann's department or any other official.
After Ly Sovann learned about Tit Sukhan's case from news reports nearly two months ago, he rushed to Kampot province with his team and remained for a week. Blood samples were taken from family members, villagers were canvassed and health warnings were broadcast from loudspeakers mounted on motorbikes. Ly Sovann's mobile phone rang relentlessly, he recounted.
Even after that, until he was confident the outbreak had been contained, Ly Sovann said, he worked in his Phnom Penh office from daybreak until 7 p.m., when the power was cut. Every night, he found his way out of the darkened building by the light of his mobile phone.
Staff writer David Brown in Washington contributed to this report
Myanmar Asked to Check Bird Flu Report
The United Nations food agency has asked Myanmar authorities to check a report of a possible outbreak of Asia's deadly bird flu in the military-ruled country, a U.N. official said on Wednesday.
Dr. Tang Zhengping, resident representative of the Food and Agriculture Organization (FAO), said he contacted Myanmar's livestock and veterinary departments after an opposition Web Site reported thousands of chickens had suddenly died in southern Myanmar last week.
"We are waiting for their reply," Tang told Reuters.
"They are a member of FAO and we have good relations with the veterinary department. If they knew of a bird flu outbreak, I'm sure they would report to FAO," he added.
The avian influenza, which has killed 47 people in Asia, has ravaged poultry flocks in neighboring Thailand and other countries in the region for more than a year.
But Myanmar has insisted it is free of bird flu.
The Norway-based Democratic Voice of Burma reported on Sunday that thousands of chickens had suddenly died at Moulmein in Mon State last week and local residents feared it could be bird flu.
"There have been reports that the state authorities have been trying to cover up the news, making the people suspect that these chickens died from avian flu," the Web Site said.
It quoted an unnamed veterinary official in Mon State as saying some birds had died due to extreme heat, but "no massive death in the thousands."
"There have been flu outbreaks in other countries. It still hasn't happened in our country," the official said.
Most of Myanmar's 63 million chickens are raised in rural backyard farms, a traditional way of farming across much of Asia where chickens are allowed to wander freely, mixing with wild birds and other animals and spreading disease.
"If the bird flu came to Myanmar, it would be difficult to control because it could spread among the small farms," Tang said.
He said Myanmar had a good veterinary service, but the FAO was providing training, technical services and lab equipment worth about $350,000 to the southeast Asian nation.
The assistance is part of a broader program to help 7 countries in the region fight trans-boundary diseases such as bird flu, he said.
Vietnam province unaware of bird flu outbreak until media report
Authorities in central Quang Binh province became aware of a serious bird flu outbreak only after media recently uncovered a bird flu death and hundreds of suspected cases in one of the province’s communes.
Provincial authorities learnt of the outbreak after Thanh Nien newspaper carried a news report on Sunday, March 20 saying that 195 people in Chau Hoa commune had symptoms of the bird flu – a disease that had killed at least a dozen people in Vietnam since late last year.
In addition, two children in the commune fell ill and were taken to a hospital in Dong Hoi town in March. The 13-year-old girl died at the hospital on March 9, testing positive for the deadly H5N1 strain of the avian influenza, according to health authorities.
However, the Dong Hoi hospital never reported the case to provincial leaders, a Thanh Nien investigation showed.
Local residents said families in the Chau Hoa commune continued to eat dead chickens throughout the Lunar New Year, which started Feb. 9, while poultry in the rest of the country was being culled and destroyed en masse and health authorities were ordered to stay on guard around the clock to prevent spread of the disease.
An interagency task force has now arrived at the commune to take immediate necessary actions to stabilize the situation and fend off the spread of the epidemic, a Thanh Nien source said.
Tests are being carried out with all 195 suspected patients to determine whether they are infected with bird flu.
Meanwhile, patients with unusual symptoms have been transferred to a special hospital in the central city of Hue for quarantine treatment.
Bird flu outbreak feared as thousands of chickens die in Burma
During last week, thousands of chickens died suddenly at Moulmein, Mon State in southern Burma and local worried residents suspect that there could be an outbreak of bird flu.The chickens are said to be from a farm at 6-mile Hill near Moulmein University, but Veterinary Department of Mon State said these chickens died from ordinary diseases. There have been reports that the state authorities have been trying to cover up the news making the people suspect that these chickens died from avian flu. “There have been some deaths from the extreme heat. There is no massive death in their thousands,” a local veterinary official told DVB. “There have been flu outbreaks in other countries. It still hasn’t happened in our country. There is no report of the outbreak in Burma. If there is a problem or something suspicious, we check it straight away. We have no cover-up from our part. If there is an outbreak in a neighbour country, we just close the border down from this side if need be. We could not allow it to spread it to our country”. At the same time, some of the pigeons in Rangoon look as if they are suffering from a kind of illness causing worries to those who live in building blocks in the town centre, according to the local resident. When DVB asked a retired vet if there could be an outbreak of bird flu in Burma as there had been in some Asian countries in the past, he said: “I am still investigating. Around Moumein and Burma border areas, the condition is ripe for an outbreak,” he remarked. He added that laboratories in Burma won’t be able to spot such a strange disease like the bird flu. “Some of them haven’t got enough instruments and the like. Due to their situation, I haven’t seen them do things systematically…whatever it is, I don’t trust them,” he said. According to latest reports, there have been some deaths of chickens in Sagaing and Mandalay Division in central Burma, and the local authorities are imposing news blackout on the matter. According to a report from Rangoon by AP on 20 March, the UN Food and Agriculture Organisation (FAO) donated US$ 350,000 to Burma to prevent the outbreak of bird flu. The director in chief of Veterinary Department Dr. Than Tun told DVB that he hadn’t received reports of the deaths of chickens and he also denied news blackout on the matter. “We recently mentioned in Kumudra magazine that we are continuing to take action on bird flu,” he insisted. When DVB asked why the FAO donated money to Burma if the situation is not critical, Dr. Than Tun said: “They give money to non-infected countries: there must be about five or six in all. In my opinion, even China is included”. When DVB pointed out that bird flu epidemic started in China, therefore it could not be called a “non-infected” country, Dr. Than Tun insisted that the money was given as technical cooperation and suggested DVB to ask the FAO for details. “We have to be more alert than before…so that there is no out break here,” he rambled on.
Bird flu hits central province, 195 locals show symptoms
A commune in central Vietnam has been severely hit by the bird flu, with 195 patients showing symptoms and two children testing positive with the virus, reported a top provincial official.
Two siblings from the province’s Chau Hoa commune of Quang Binh province had tested positive for the H5N1 strain of bird flu, said Mai Xuan Thu, vice chairman of the provincial People’s Committee on March 20.
The older sister, Hoang Lan Huong, 13, died from the bird flu on March 9, while the brother, Hoang Trong Duong, 5, is in serious condition at the Hue Central Hospital.
Meanwhile, there are 195 other local residents who have shown symptoms of the flu, said Ms. Thu.
It is not yet clear whether these people, some of who had reportedly eaten sick chickens, have the symptoms of the deadly bird flu or the normal flu.
Of the 195 patients showing symptoms, 108 are from Kinh Chau village while the rest live in other villages in Chau Hoa commune.
The outbreak hit the province’s Kinh Chau village in Chau Hoa commune just ahead of the Lunar New Year holidays which started Feb. 9.
The province is currently trying to stop the spread of the influenza by culling all poultry in the commune.
Bird Flu Fears Halt North Korean Poultry Exports
The World Health Organization is investigating a possible outbreak of avian influenza in North Korea. The suspected outbreak is already affecting North Korean export plans.
South Korea has decided to delay planned imports of North Korean poultry following a suspected outbreak of bird flu at a farm near the North Korean capital. The Japanese government also says it will not allow any North Korean poultry imports.
For South Korea, Thursday's planned shipment would have been the first import of North Korean poultry in almost 50 years.
North Korean officials have not confirmed the outbreak of the bird flu. South Korean media are attributing reports of the outbreak to unnamed sources, and also point to a report from Pyongyang's central news agency last week saying veterinary activity had been intensified at poultry farms.
Dr. Samad Abdullah represents the World Health Organization in New Delhi - the regional office responsible for North Korea, also called the DPRK. He says the WHO's knowledge is still at the rumor stage:
"We have a WHO representative there in DPR Korea," he said. " Verification takes some time. It depends on the distance from the capital, the communications distance in terms of physical communication, or telephone communication and so on."
A strain of avian flu known as H5N1 has swept across much of Asia in the past 18 months, forcing governments to cull millions of chickens and ducks. The disease has killed more than 40 people in Southeast Asia since late 2003 - most victims caught the virus from sick poultry.
Human victims in North Korea could be particularly vulnerable to the disease because of the poor state of the health system.
Health experts say dealing with a bird flu outbreak in North Korea would be difficult. Under Pyongyang's Stalinist system, international organizations are given very little access to the country, so agencies such as the WHO may not be able to visit poultry farms to identify disease outbreaks or to monitor containment efforts.
Impoverished North Korea has experienced severe food shortages since the mid-1990s. That means it may try to avoid the standard response to a bird flu outbreak - a thorough cull of chickens.
WHO researchers have repeatedly warned of the possibility the virus could mutate into a form transmissible from human to human, which they say could spark a global pandemic.
Psst, want the latest on bird flu?
The Australian government has set up a rumour surveillance program as part of its response to the threat of an avian influenza pandemic.
Second Nurse Suspected to Have Bird Flu in Vietnam
A Vietnamese nurse who tended a bird flu patient with a colleague who has since tested positive for the deadly virus has been hospitalized after showing symptoms of the disease, health officials said on Saturday.
It was not clear yet if the 41-year-old female nurse caught the sickness from the patient or in another way, said an official at the health center of Thuy Luong commune, northern Thai Binh province, 70 miles southeast of Hanoi.
"She has all the symptoms of having bird flu including fever and lung infection," said another official from Thuy Luong commune health center. "Test for bird flu is being conducted but results are not available yet."
The nurse had provided care for a 21-year-old man who caught the virus last month after drinking raw duck blood, a local delicacy. Her colleague, a 26-year-old male nurse who also tended the young man, tested positive for bird flu last week.
The patient, whose 14-year-old sister and grandfather were also infected after coming into contact with sick poultry, remained in critical condition, said health officials.
His sister was recovering while the grandfather did not show any symptom and remained healthy despite having the virus.
The Thai Binh bird flu cluster has prompted an investigation into whether relatives and health workers caught the virus directly from infected patients.
However, there is no evidence yet that the virus, which has killed 47 people in Asia, has mutated into a form that could pass easily between humans. Experts say if the virus did mutate in such a way, it could set off a pandemic that could kill millions.
The H5N1 virus has killed 34 Vietnamese, 12 Thais and one Cambodian since it swept across large parts of Asia in late 2003.
It has recurred several times despite the slaughter of millions of poultry and has spread across about half of Vietnam since the latest outbreak began in the Mekong Delta of southern Vietnam.
Thailand Stockpiles Anti-Flu Drugs for Bird Flu Fight
Thailand, a country on the frontline of the war against Asia's bird flu, is stockpiling Tamiflu and considering producing a generic version of the antiviral drug, health officials said.
Thailand, the latest country to increase stocks of the drug to meet World Health Organization guidelines for fighting the deadly virus, began limited use of Tamiflu last year on patients suspected of contracting the H5N1 bird flu virus.
"We have started a stockpile of Tamiflu. This is just a backup measure," senior Health Ministry official Supamit Chunsutiwat told reporters late on Thursday.
Tamiflu, made by Switzerland's Roche Ag and also known as oseltamivir, has been singled out by the WHO as its drug of choice to protect against bird flu and in case of a human flu pandemic.
The WHO says bird flu -- which has killed 47 people in Asia -- could mutate into a form that spreads easily between humans and trigger a global pandemic that could kill millions.
Tamiflu belongs to a drug class that blocks the action of viral enzymes. It proved effective in managing an outbreak of the H7N7 avian strain in the Netherlands in 2003, which infected about 1,000 people.
Hong Kong announced plans on Wednesday to beef up its stocks of the drug, and other countries such as France, Britain, New Zealand, Sweden and Canada have also placed significant orders.
But the high cost has prompted Thailand to consider producing its own supply of oseltamivir, said Suwit Wibulpolprasert, a senior adviser on health economics at the Health Ministry.
"Hopefully, if the active ingredient which we are importing from India proves to be good quality, we will be able to produce the drug in an emergency case in six months," Suwit said.
Thailand, like other developing countries with established pharmaceutical factories, has the right to issue a compulsory license and make generic copies of patented drugs in the event of a medical emergency. It already makes generic anti-AIDS drugs.
Health experts say improving detection and reporting of the virus in countries with poor health care systems is as crucial as stockpiling the drug.
Tamiflu is most effective when taken within two days of the onset of symptoms and Thailand has increased its surveillance and reporting of suspected cases since it reported its first outbreaks in January last year.
But in poor neighboring countries like Cambodia and Vietnam, surveillance systems are still inadequate, due partly to a lack of public awareness.
"You have to give the drug to them in the first 48 hours and this is very challenging. After that, the effectiveness is very low," said Dr. Somchai Peerapakorn of the WHO office in Bangkok.
"It's still not a very good tool, but it's the only tool."
Relatives of avian flu patients have asymptomatic cases
Two relatives of avian influenza patients in northern Vietnam have tested positive for the virus without being sick, according to reports from Vietnam today.
The 61-year-old widow of a man who died of avian flu in late February and the 80-year-old grandfather of two patients currently under treatment in a hospital have tested positive, the Associated Press (AP) and other news services reported. Both are apparently healthy.
Both people live in Thai Binh province, where five other avian flu cases have been reported in the past 2 weeks.
The AP said Nguyen Tran Hien, director of the National Institute for Hygiene and Epidemiology in Hanoi, confirmed that the 61-year-old woman had tested positive for the H5N1 virus. The director of a district medical center in Thai Binh, Nguyen Van Thieu, said the woman remained in good health but was isolated at home, the story said.
Her 69-year-old husband fell ill Feb 19 and died Feb 23, Thieu said. He said the family had raised some chickens, but they remained healthy, and the source of the woman's infection was unclear.
The 80-year-old is the grandfather of a 21-year-old man and a 14-year-old girl who have avian flu. The young man has been in critical condition for 2 weeks, while the girl is in good condition though still hospitalized, Agence France-Presse (AFP) reported today.
Testing completed yesterday at the National Institute of Hygiene and Epidemiology showed that the grandfather had the H5N1 virus, the AP reported, quoting Pham Van Diu, director of the province's Preventive Medicine Center. Diu said the man was at home and in good health.
A Reuters report today quoted health officials in the man's village as saying he had drunk raw duck blood during the Lunar New Year festivities in February. But the AFP story said it was unclear whether he had caught the virus from infected poultry or from his grandchildren. None of 12 other relatives tested positive for the virus, the AP reported.
The two new cases are not the first sign that people can contract the H5N1 virus without getting ill or seriously ill. Mild and asymptomatic cases were seen when the virus first jumped to humans in Hong Kong in 1997, Dick Thompson, infectious disease spokesman for the World Health Organization (WHO) in Geneva, told CIDRAP News via e-mail today. (Six of 18 people infected in that outbreak died.)
In addition, a Japanese man was found to have been infected while working at a farm where a poultry outbreak of H5N1 avian flu occurred in February 2003, though he never got sick, according to news reports in December 2004.
The confirmation of asymptomatic cases implies that infections may be more common than previously thought and that the case-fatality rate may be lower. The fatality rate for officially confirmed cases has hovered in the 70% range.
Thompson commented, "The CFR [case-fatality rate] had to be overstated. The cases we were sure of were those which were sick enough to go to a hospital and these extreme cases have very poor outcomes. Surely others were infected and either not getting sick or not getting sick enough to seek treatment at a hospital. Factoring those into the CFR has been impossible. We simply don't know the denominator."
Dr. Arlene King of the Public Health Agency of Canada told CIDRAP News that researchers in Asia have conducted serologic surveys in an effort to find asymptomatic cases, but full results have not been released yet. In a newspaper report yesterday, she said, the WHO's Peter Horby reported that a serologic survey of Asian healthcare workers who had cared for avian flu patients found no evidence of infection among the workers. King is director of the agency's Immunization and Respiratory Infections Division in Ottawa.
King said mild and asymptomatic cases of avian flu could go undetected even if people are tested, depending on test sensitivity. "The sensitivity of tests may be higher in sick patients," she said. "If you're swabbing patients who are less sick, maybe your tests are less sensitive."
If avian flu cases are more common than suspected, it raises the question whether the virus has more opportunities to mix, or "re-assort," with human-adapted flu viruses. Reassortment could lead to a mutated virus that could spread easily from person to person, potentially triggering a flu pandemic in a world population with little or no resistance to the virus.
Thompson said the WHO is assessing the implications of asymptomatic cases for viral reassortment. "We hope to have something soon," he wrote.
King commented, "I think we know so little about the conditions in which that [reassortment] occurs that it's really difficult to speculate on that."
King said it would not surprise her if the two latest cases are found to involve person-to-person transmission, given that some possible cases of human transmission have been seen previously in the past year. "The two settings you're going to see them [cases involving human transmission] in are households and healthcare settings, because that's where infection gets amplified," she said.
Several family clusters of cases have occurred since H5N1 avian flu began spreading in Southeast Asia in late 2003, but human-to-human transmission has been described as probable in only one instance so far. Researchers concluded that the mother and an aunt of an 11-year-old girl probably acquired the virus from her when they cared for her in a hospital in Thailand in September 2004.
Vietnam reported 4 new bird flu cases
Vietnam has reported four new cases of human avian influenza! After a 26-year-old nurse admitted to a hospital in Hanoi last week developed avian influenza, the grandfather of two siblings infected with the bird flu in Vietnam has also contracted the virus according to Vietnamese health officials.
Military intelligence warns that avian flu could be used as weapon
The military's intelligence arm has warned the federal government that avian influenza could be used as a weapon of bioterrorism, a heavily censored report suggests.
It also reveals that military planners believe a naturally occurring flu pandemic may be imminent. The report, entitled Recent Human Outbreaks of Avian Influenza and Potential Biological Warfare Implications, was obtained under the Access to Information Act by The Canadian Press.
It was prepared by the J2 Directorate of Strategic Intelligence, a secretive branch of National Defence charged with producing intelligence for the government.
The report outlines in broad terms the methods that could be used to develop a manmade strain of influenza capable of triggering a human flu pandemic.
It notes a method called "passaging," while not entirely predictable, could be a "potentially highly effective" way to push a virus to develop virulence.
"Such forced antigenic shifts could be attempted in a biological weapons program," says the 15-page report, dated Dec. 8, 2004.
Passaging involves the repeated cycling of strains of a virus through generations of a species of animals or through cell culture. The process can be used to either ratchet up or dial down the virulence of a virus, depending on which of the ensuing offspring - the mild or the severe - are selected in each cycle for the next passage.
There is debate in the community of infectious disease experts whether influenza would make a good bioterrorism agent. For one thing, once released, the virus would not discriminate between friend or foe. Terrorists and their supporters would be as likely to fall ill and die as those they hoped to target.
But if the ultimate goal is panic, social disruption and economic losses, influenza would be a good choice, says Dr. Brian Ward, a virologist at McGill University in Montreal.
"To me it's one of the most logical viruses to use. It doesn't have to be a really bad one to throw a huge wrench," Ward said.
"I mean, if you want to hurt the world's economy, that's an awfully good way."
Canada estimates the direct and indirect health-care costs alone of a mild flu pandemic would range from $10 billion to $24 billion. That doesn't start to count societal costs such as lost productivity because of mass illness or the impact on vulnerable industries such as airlines and tourism or the insurance sector that would be hit with business losses and death claims.
But influenza expert Dr. Earl Brown suggests that while flu makes a good theoretical bioterror agent, the reality of these "delicate" viruses is that the task would be harder than it appears.
"Flu is a wimpy virus, which I think is the one knock against it. It doesn't persist in the environment (outside a human) very long," says Brown, a University of Ottawa scientist who specializes in the evolution of influenza viruses.
"You have to infect people sort of straight away, otherwise it's going to die sitting around the environment."
Brown, who has done expensive work on reassorting or mating flu viruses, says any virus bred to spread would have to meet several key criteria: it would need to jump the species barrier and have the ability both to transmit easily and cause severe disease if it did.
"If you want to see chaos and mayhem and you're not concerned about the backlash, then you just have to get to the biology. And right now nobody can do it," Brown says.
"There's a good chance that you'd make something that just would burn out. It just wouldn't spread very well."
The report also raises the spectre of a pandemic strain engineered in a laboratory using reverse genetics. That technically challenging process allows scientists to custom tailor a flu virus, taking genes from a virulent but not highly transmissible strain, for instance, and melding them with genes from a virus that transmits well from person to person.
The report notes this is a technique scientists have been using to try to decipher why the virus that caused the Spanish flu of 1918-1919 was so deadly. That pandemic, which may have claimed upwards of 50 million lives worldwide, was the worst in known history.
"It is feared that this process could be copied . . . to produce a human viral strain similar to the 1918-1919 pandemic," the report says.
It also theorizes that a naturally occurring pandemic may be imminent, unless rigorous measures are taken to contain the spread of the H5N1 avian flu strain that has been responsible for more than 45 deaths in Southeast Asia in the last 14 months.
The report says factors such as the region's inability to eradicate the virus and influenza's propensity to mutate rapidly "raises the possibility that a novel strain capable of efficient human-to-human transmission may arise in the near future, threatening Canadian operations worldwide."
Second opinion turns up bird flu
SEVEN Vietnamese patients who had initially tested negative for bird flu had been found to have carried the virus, the World Health Organisation said yesterday after further tests by a laboratory in Tokyo.
All seven had since recovered, officials said.
"The results were positive in Tokyo in a WHO reference laboratory," Hanoi-based WHO epidemiologist Peter Horby said.
Earlier this year, WHO staff at Japan's National Institute of Infectious Diseases in Tokyo and the Centres for Disease Control and Prevention in Atlanta, Georgia, began working with health authorities in Vietnam to improve reliability of laboratory tests.
"Retesting detected H5N1 in specimens from seven persons," WHO said in a statement on its website.
WHO said it was awaiting further details about these cases, including outcomes. Upon receipt of this information, it would also include these cases in Vietnam's cumulative total.
A Vietnamese doctor in Ho Chi Minh City confirmed yesterday "some" samples originally tested negative were found positive in Japan, without saying precisely how many. "There are some differences in the tests between Vietnamese labs and others abroad," the doctor added, asking not to be named.
All the patients had recovered, he said. "WHO has not issued any standards for testing. Therefore, differences are understandable."
Dr Horby said more information was expected in the next few days.
Feather pillows may carry Asian bird flu
Poultry feathers imported from China to make products such as pillows could carry the avian flu virus, says a British microbiologist who is urging the British Government to consider banning them.
Thailand undecided on bird flu vaccine trial on human
Thailand is yet to decide whether to carry out vaccine trial on human to prevent bird flu infection,said the government amid local media speculations about the possibility.
"There are still several stages of the consideration process," the state-run Thai News Agency (TNA) on Saturday quoted Deputy Prime Minister Chaturon Chaisaeng as saying.
Human safety was listed as the top priority when considering such trial.
"We need to determine whether the procedures, stages and methods follow the same standards as those used in developed countries and how, and what the level of safety is," said Chaturon,who chairs the kingdom's bird flu prevention and control committee.
The deputy prime minister also confirmed that one US institution has contacted Thailand's Public Health Ministry on thepossibility of the vaccine trial.
The news of possible US-Thai cooperation on human vaccine trialagainst bird flu grabbed headlines of Thai press on Friday, while Chaturon was holding a meeting with concerned Thai agencies to discuss the issue.
However, he noted that it is only an e-mail on the subject sentfrom the US Disease Control Center in Atlanta to the Thai ministry,no official bilateral discussions on the issue so far.
Chaturon said related government institutions would consider the possibility and the decision would be made later in March.
Since the first bird flu outbreak at the beginning of last year,altogether 12 people have died of infecting with the disease in Thailand.
A case of two victims in last September also raised the fear ofthe virus' possible transmission between humans.
On the other hand, the Thai government in last month shot a national anti-bird flu plan, citing the proposal of culling 2.7 million free-ranged ducks might raise unnecessary panic.
Bird flu has cost the country about 4.3 billion baht (107.5 million US dollars) in economic damage in addition to 2.2 billion baht (55 million dollars) compensation that the government paid tofarmers for the mass chicken cull in January 2004, reported Bangkok Post.
Avian flu reported again in Indonesia
More than 12,000 chickens and quail have died in the past 2 months in an outbreak of avian influenza on the Indonesian island of Java, according to an Associated Press (AP) report published today.
The viruses involved are H5N1 and H7N1, said an Indonesian official who spoke to the AP on condition of anonymity. Avian flu killed about 1.6 million chickens in the same region in West Java province last year, the official said.
H5N1 avian flu has occurred in at least eight Asian countries since late 2003 and has caused 66 human illness cases, 46 of them fatal. No human cases have been reported in Indonesia, the AP report said.
Although the official told the AP that Indonesia has been dealing with the outbreak for 2 months, the country's most recent report on avian flu to the World Organization for Animal Health (OIE) was filed in October 2004.
Meanwhile, Vietnam has reported that its poultry outbreaks are subsiding. More than 1.5 million birds have been culled in Vietnam since January. However, 14 of 35 affected areas have detected no new outbreaks for at least 3 weeks, China's Xinhua news agency reported today, citing Vietnam's Department of Animal Health.
Avian flu has continued to spread in Ben Tre, Long An, and Dong Thap provinces, according to a Vietnam News Service report yesterday.
Thailand's most recent report to OIE indicated the country still has sporadic outbreaks, with fewer than 200 chickens and ducks fatally infected or culled in the week that ended Feb 24.
14-year-old girl has bird flu
A 35-year-old Vietnamese poultry market cleaner and a 14-year-old girl, both in the north of the country, have contracted bird flu, which has killed 47 people in Asia.
The Lao Dong newspaper said today the woman was taken to hospital on February 24 and tests confirmed yesterday she had the virus, which experts fear could mutate into a form that could pass between people and unleash a global flu pandemic that might kill millions.
The woman, from a district of the capital, Hanoi, is the latest bird flu patient detected in northern Vietnam, where fewer outbreaks have been reported in recent weeks, but where cool spring weather still favours the spread of the H5N1 virus.
A laboratory researcher said tests on the other patient, the 14-year-old girl, also confirmed she had the virus that had also infected her 21-year-old brother.
"The girl also has the virus," said the researcher at Hanoi's National Institute of Hygiene and Epidemiology which conducts bird flu tests.
Her brother has been in critical condition and on a respirator after a traditional drink of duck blood before the Lunar New Year festival last month, officials said.
The siblings and a 36-year-old infected man are from the northern province of Thai Binh, 110km south-east of Hanoi and far from the southern Mekong Delta where the outbreaks began in December.
Officials said the H5N1 virus killed a 69-year-old man last week in Thai Binh, taking the toll to 14 people in Vietnam since December and the total to 47 since the virus erupted across large parts of Asia at the end of 2003.
Almost all the victims - 34 Vietnamese, 12 Thais and a Cambodian - have caught it directly from poultry.
The Agriculture Ministry said poultry infections occurred this year only on small farms.
It has ordered a halt until June 30 to the hatching and raising of waterfowl such as ducks and geese, which experts said can carry the virus without showing symptoms.
But state-run Voice of Vietnam radio said on today farmers in several bird flu-hit Mekong Delta provinces had tried to avoid the ministry's order by letting their ducks wander off into rice fields to hide from inspectors.
Nearly Current overview from AP / WHO / CDC
Back to the homepage Poultry in the News Poultry News in 2004 how to cook poultry safely top of the current page Poultry slaughtering and religion Manual (Home) slaughering of poultry poultry recipes Health and poultry archived bird flu news June 04 archived bird flu news July 04 archived bird flu news August 04 archived bird flu news September 04 archived bird flu news October 04 archived bird flu news November 04 archived bird flu news December 04 archived bird flu news January 05 archived bird flu news February 05 archived bird flu news March 05 archived bird flu news April 05 archived bird flu news May 05 archived bird flu news June 05 archived bird flu news July 05 archived bird flu news August 05 archived bird flu news September 05 archived bird flu news October 05 Choosing the red or the white meat
Site of the Month: about jeans