HANOI, June 27 (Xinhuanet) -- Laboratory tests in Vietnam and abroad have indicated that the antigen structure of bird flu virus strain H5N1 in the country is changing, local newspaper Labor Monday quoted a Vietnamese Health Ministry report as saying.
The change, which might increase the possibility of bird flu infections on human, explains why people in Vietnam have still been infected with H5N1 in recent months, although it has detected no major outbreaks.
The mutation also makes it more difficultfor health agencies to identify high-risk areas, since poultry infected with H5N1 with a change in the antigen structure do not exhibit the disease's symptoms, said the report.
An international team, consisting of top virologists and epidemiologists from Chinese Hong Kong, Japan, the United Kingdom and the United States, is studying the possibility of more widespread H5N1 human transmission, changes in the virus strain, and the likelihood of increased person-to-person transmission. The experts are expected to make initial conclusions on the virus's mutation late this month.
To minimize infections on poultry as well as humans, Vietnam will start vaccinating fowls against bird flu viruses in northern Nam Dinh province and southern Tien Giang province on a trial basis in early August, and then do the same in other localities with high risks of outbreaks in October if the vaccination proves effective.
The country's Veterinary Department is asking localities to reduce the number of poultry flocks, raise and slaughter them on large scale in concentrated areas, and cull infected poultry as well as flocks of less than 30 fowls which are raised freely in gardens or fields, regardless they contract H5N1 or not.
The total of bird flu patients confirmed in Vietnam since mid-December 2004 has increased to 59 cases, of which 18 were fatal.
Sickening Prospect U.S. readiness for avian flu worrisome
10:10 PM CDT on Sunday, June 26, 2005
If the staggeringly lethal H5N1 strain of avian flu jumps into the human population and ignites theapocalyptic global pandemic scientists fear, a fateful decision by the Chinese government will likely prove of world-historical importance.
The Washington Post reported that during the late 1990s, in violation of basic health protocols, China advised its farmers to dose their poultry with the antiviral drug amantadine as an anti-flu precaution. Amantadine is meant for humans only, and its use in treating livestock may have given rise to the new flu strain, which is resistant to the drug.
In the event of a global pandemic, the folly of the Chinese (who, implausibly, deny the well-sourced report) might result in the agonizing deaths of up to 350 million people worldwide, according to a recent estimate by Dr. Michael Osterholm, a top flu expert who advises the U.S. Department of Homeland Security. With a nightmare scenario breathing down our collective necks, the world cannot afford such bureaucratic fearfulness or stupidity.
The signs of impending pandemic grow more worrisome by the day. In May, the Indonesian government discovered the virus in pigs – a major leap to mammals, and particularly to a species of mammal that, pathologically speaking, is close to humans. A week ago, Indonesia confirmed its first case in a human being, a farmer. Meanwhile, public health officials report that the virus seems to be mutating in Vietnam to make itself more easily transmissible between humans.
If pandemic comes, a virus with such an astronomical mortality rate – more than half of all cases so far have been fatal – will present far more than a public health problem. It stands to cause massive economic dislocation worldwide and even civil unrest here, sparked by fear and panic in the face of food shortages and an overwhelmed health system. Said Dr. Osterholm, commenting on America's current lack of readiness: "We're pretty much screwed right now."
Our country stands a better chance of withstanding a flu catastrophe if the public has been well informed and prepared in advance by its leaders. America is not China. And this is not Chicken Little.
Summit of EU influenza experts discusses coordinated response to possible pandemic
Influenza experts from the 25 Member States and other European countries are meeting in Luxembourg today to discuss the threats of avian and human influenza, and possible responses to a pandemic, as part of the integrated zoonoses strategy. The workshop, which was organised by the European Commission and also attended by experts from the ECDC, EFSA, WHO, FAO and OIE, is being held in light of the current avian flu situation in Asia and growing concerns that a mutant virus could lead to a worldwide pandemic amongst humans. Among thetopics on the workshop agenda are how to improve coordination between avian and human influenza networks, and the role of various bodies in the fight against the disease.
Markos Kyprianou, Commissioner for Health and Consumer Protection, said: “The threat of a global influenza pandemic with serious human and economic losses is a very real one that must be addressed. In today’s globalised society, unilateral responses to such possible outbreaks are not a viable option. There must be a coordinated EU approach to prevent and control diseases such as influenza, and today’s workshop is a significant step forward in this direction.”
The current avian influenza epidemic in Asia is unprecedented. It is caused by a particular strain of virus that has already caused the death or killing and destruction of more than 125 million birds, major economic losses to the countries concerned which have been estimated at € 8-12 billion and the death of more than 50 people. Even more worryingly, it has given rise to grave concerns that an influenza pandemic is imminent.
This would originate in case of the emergence of a “new” influenza virus, fully adapted to humans, which could rapidly spread worldwide due to human-to-human transmission. The social and economic consequences of pandemics can be devastating, as was the case with the 1918-19 Spanish flu pandemic which led to the death of approximately 60 million people. International health experts have warned that increased movement of people and goods around the globe, changes in theeco-systems, new animal husbandry practices and large-scale epidemics such as the avian flu in Asia, all create the conditions from which a new influenza virus may emerge and a pandemic breaking out.
Networks of veterinary and human health laboratories are already in place in the EU to address the threat of Influenza viruses. The exchange of information, virus strains and laboratory reagents amongst the various EU surveillance networks, and the provision of adequate technical support to national veterinary and human health authorities, are of fundamental importance in order to properly tackle influenza viruses.
The Commission is now working to establish improved co-operation between the avian and human influenza surveillance networks, as well as the relevant European and international organisations dealing with animal and human health, to ensure better preparation in case of a pandemic.
This is only one of the many actions undertaken by the Commission in relation to this major health threat.
A vaccine probably would not be available in the early stages of a pandemic  (http://www.cdc.gov/flu/avian/gen-info/pandemics.htm).
Once a potential virus is identified, it normally takes at least several months before a vaccine becomes widely available, as it must be developed, tested and authorised. The capability to produce vaccines varies widely from country to country; in fact, only 15 countries are listed as "Influenza vaccine manufacturers" according to the World Health Organisation  (http://www.who.int/csr/disease/infl...t/en/index.html).
It is estimated that, in a best scenario situation, 750 million doses could be produced each year, whereas it is likely that each individual would need two doses of the vaccine in order to become inmuno-competent. Distribution to and inside countries would probably be problematic  (http://www.phacilitate.co.uk/pages/...cle_fedson.html).
Several countries, however, have well-developed plans for producing large quantities of vaccine. For example, Canadian health authorities say that they are developing the capacity to produce 32 million doses within four months, enough vaccine to inoculate every person in the country.  (http://www.ctv.ca/servlet/ArticleNe...809/?hub=Canada)
* Anti-viral drugs. Several new anti-viral drugs have been developed in recent years. A number of governments are working to stockpile anti-viral drugs but the work is complicated by the constant mutation of the virus, which might become somewhat resistant to some anti-viral drugs, making these drugs less effective.
* Non-pharmaceutical means:
o "Social distance". By travelling less, working from home or closing schools there is less opportunity forthe virus to spread.
o Respiratory etiquette. Placing one's hand in front of the mouth when coughing or sneezing can somewhat limit the dispersal of droplets.
o Masks. No mask can provide a perfect barrier but products that meet or exceed the NIOSH N95 standard recommended by the World Health Organization are thought to provide good protection. Other well-fitting masks can be helpful but much less effective.
o Hygiene. Frequent handwashing, especially when there has been contact with other people or with potentially contaminated surfaces can be very helpful.
UN health agency maintains current level of pandemic alert forbird flu
Avian Influenza 30 June 2005 – Although there is no laboratory evidence that human infection with bird flu in Vietnam is occurring more frequently or that the virus is spreading readily among humans, the UN health agency today maintained its current level of alert over a potential pandemic, which in a worst case scenario could kill tens of millions of people worldwide.
The World Health Organization (WHO) said reports that it had downgraded its assessment of the pandemic threat, first made at the start of the current outbreak in South-East Asia in January 2004, were unfounded.
WHO issued its statement following the visit to Vietnam of an agency team of international experts sent at the Government’s request to search for evidence that the H5N1 virus had changed its behaviour in ways consistent with an improved, though not yet efficient, ability to spread directly from one human to another. In its preliminary findings theteam did not confirm such a change.
Firm evidence of improved transmissibility would be grounds for moving to a higher level of pandemic alert. Because of the huge consequences of such a change, WHO said it was following a cautious approach that combines heightened vigilance for new cases with immediate international verification of any suggestive findings.
WHO has repeatedly stressed the need for scientists to determine possible changes in the behaviour of H5N1 to assess the risk of a human pandemic. The so-called Spanish flu pandemic of 1918-1920, unrelated to the present virus, is estimated to have killed between 20 million and 40 million people worldwide.
WHO is concerned that continuing transmission from birds to humans might give avian and human influenza viruses an opportunity to exchange genes, facilitating a pandemic.
Overall there have been more than 100 reported human infections, about 50 of them fatal, since the first case linked to widespread poultry outbreaks in Viet Nam and Thailand was reported in January last year. Nearly 140 million domestic birds have died or been culled over the past year in South-East Asia in an effort to curb the spread of the disease.
>> Scientists believe that if Tamiflu is quickly supplied at the site of an initial pandemic outbreak, it could help to contain the bug for as long as six months or even eliminate it. Six months is about what researchers would need to develop a vaccine based on the pandemic strain that emerges. <<
Although Tamiflu could contain H5N1, the available evidence suggests that this strategy is much more wishful thinking than a approach likely to succeed. Assuming the H5N1 infections in people could be quickly identified, which is a major assumption because H5N1 has been endemic to Vietnam for at least several years and there is no comprehensive survey of where it is and is not in humans, there would still be major bird flu containment issues.. A recent survey of ducks and chickens indicated H5N1 was in 71% of ducks and 21% if chickens in the Mekong Delta. Most of these infections were in asymptomatic birds and now evidence is emerging that pigs in Indonesia may be asymptomatically infected. It seems likely that pigs in Vietnam and Thailand are similarly infected,
In addition, Tamiflu was used to try to contain an H5N1 outbreak in tigers in a Sri Racha zoo in Thailand. Prophylactic treatment, combined with culling, failed to stop H5N1 and 147 tigers died or were euthanized, even though Tamiflu was used at double the recommended dose.
Possible H5N1 problems were forecast in in vitro assays. Tests of Tamiflu against all 9 N serotypes indicated that the drug could inhibit spread of the virus, but N1 was among the most resistant serotypes. Recent data with H5N1 again showed that Tamiflu could inhibit the virus, but even more drug was required. However, the supply of Tamiflu is limited.
However, it is the most recent report on treating humans known to be infected with H5N1 that raises a major red flag on use of Tamiflu to control or eliminate H5N1. Media reports suggest that Tamiflu resistance developed in one patient being treated with Tamiflu. The number of reported H5N1 human infections has been exceedingly low, so resistance in this group indicates antiviral resistance will be common. However, because it is possible that the number of non-hospitalized patients infected with H5N1 may be markedly higher than the reported cases, Tamiflu resistance in H5N1 may already be much more common than the one cited case.
Thus, stockpiling Tamiflu may make stockpilers feel that the supplies may limit or eliminated H5N1, but real data, although limited, suggest the containment plan, like the surveillance plan, is not reality based.
probegallo Скажите честно вы боитесь умереть? Я например нет. И вам того желаю. Все мы когдато умрем. Во время пандемии умереть это ж даже интересно. Вокруг куча трупов, а ты как дурак живой. И вот бах ты тоже заразился. И умер. Нет ничего более чудесного чем умереть во время пандемии!
Я для этого не буду учить английский язык чтоб не читать ваши опусы, а то еще передумаю умирать.
U.N.: Bird flu at tipping point Health official calls for mass vaccination of Asian poultry
Monday, July 4, 2005 Posted: 0549 GMT (1349 HKT)
KUALA LUMPUR, Malaysia (AP) -- The outbreak of bird flu in Asia has reached a critical stage and the disease could easily become a human pandemic if it isn't quickly controlled, a U.N. health expert warned Monday.
Dr. Shigeru Omi of the World Health Organization and other specialists who addressed the opening of a three-day U.N. conference on bird flu called for mass vaccination of poultry, saying the virus has "tightened its grip" on Asia and is capable of springing major surprises.
"We believe we are at the tipping point. Either we ... reverse this trend or things will get out of hand," Omi said.
"We must have an all out war against this virus," he told reporters after opening a three-day U.N. conference on bird flu virus, which has killed 54 people in Asia.
The virus currently appears to spread only by close association of humans and poultry. But medical experts fear it could mutate into a form which can easily pass among people, triggering a global pandemic especially since humans have not developed resistance to the virulent H5N1 strain.
"The virus has behaved in ways that suggests it remains as unstable, unpredictable and versatile as ever," said Omi. "Judging by its performance today we need to be on constant alert for surprises," he said in a speech earlier.
The U.N. meeting is co-organized by the WHO, the Food and Agriculture Organization and the World Organization for Animal Health, known by its French acronym OIE.
Omi said the virus poses the threat of a pandemic, especially after re-emerging in China where the virus killed 6,000 wild migratory birds last month in the remote Qinghai province.
He said wild birds had previously been considered "reasonably resilient" to H5N1, and their deaths in such large number shows the virus can have unexpected consequences.
Omi noted that there have been 64 human cases in Asia this year, mainly in Vietnam, compared to 44 cases in 2004. Of the 64, 22 died, compared to 32 fatalities for all of last year, he said.
Vietnam is now "chronically infected," while Cambodia and possibly Indonesia have also reported their first human cases, he said.
The prevention of human pandemic relies on efficient control of infection in animals, said Joseph Domenech, the FAO's chief veterinary officer, in his speech.
The only way to control it is by imposing mass vaccination of poultry and speeding up efforts to develop new poultry vaccines, he said.
"Avian influenza is not just an Asian problem. No poultry producing country is safe from the occurrence of the avian influenza as long as there are pockets of infections in Asia," Domenech said.
At the news conference, Domenech said the region needs about US$100 million (euro83 million) over the next two years to fund a viable program to fight bird flu, but so far only one-tenth that amount has been raised.
Donations from international donors such as the EU and the U.S. were "still not enough and still not coming quick enough," he said.
The meeting's objectives include identifying practices in the production and marketing of live animals in Asia that might endanger human health. In most of rural Asia, poultry, domestic animals and farmers live in close proximity, often sharing the same room, increasing the chances of the virus jumping species.
Countries must tighten regulations in the production, transport and marketing of poultry and poultry products, especially since live bird markets in Asia have played a role in the spread of virus to humans, said T. Fujita, OIE's regional representative for Asia and the Pacific.
He said efficient inspection service is needed to detect and eliminate sick birds from live markets and to ensure that different animal species are sold in different premises, he said.
Avian Dis. 1990 Apr-Jun;34(2):406-11. Related Articles, Links
Persistence of avian influenza viruses in water.
Stallknecht DE, Shane SM, Kearney MT, Zwank PJ.
Department of Epidemiology and Community Health, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803.
Persistence of five avian influenza viruses (AIVs) derived from four waterfowl species in Louisiana and representing five hemagglutinin and neuraminidase subtypes was determined in distilled water at 17 C and 28 C. Infectivity was determined over 60 days by microtiter endpoint titration. One AIV was tested over 91 days at 4 C. Linear regression models forthese viruses predicted that an initial concentration of 1 x 10(6) TCID50/ml water could remain infective forup to 207 days at 17 C and up to 102 days at 28 C. Significant differences in slopes for AIV persistence models were detected between treatment temperatures and among viruses. Results suggest that these viruses are adapted to transmission on waterfowl wintering habitats. Results also suggest a potential risk associated with waterfowl and domestic poultry sharing a common water source.
The avian influenza that killed 1000 or more migratory birds at Lake Qinghai in western China in mid-May may represent a new and more lethal form of the HN51 virus, Chinese researchers report. The results suggest the virus is evolving and raise the possibility that surviving birds could spread it over an even wider area, endangering more poultry and increasing the chances of further genetic changes that could spark a deadly human pandemic.
Jinhua Liu of the College of Veterinary Medicine in Beijing and colleagues fully sequenced four isolates recovered from various Lake Qinghai bird species and found them all to be very similar to each other but distinct from any H5N1 sequences posted in GenBank. The researchers also tested the pathogenicity of the virus by using it to infect mice, which succumbed more quickly than mice infected with other H5N1 strains. Theteam publishes its results 8 July in Science. Similar findings, from other groups, are presented today in Nature. But some questions remain unresolved, such as how the virus reached this sparsely populated corner of China. Since H5N1 appeared, researchers have debated whether migratory birds can spread it. Some aquatic birds are known to host strains of the virus with no or minimal symptoms. But the United Nations' Food and Agriculture Organization says there is no evidence tying outbreaks in poultry to wild birds.
A more pressing question is where these migratory birds might carry the virus next. A priority, says David Melville, an ornithologist in New Zealand, should be determining if surviving birds are carrying a weakened strain of the virus, or if some species or individual birds are carrying the same variant with minimal health effects.
"These are the important questions," says George Gao, a virologist at the Chinese Academy of Sciences' Institute of Microbiology and the study's corresponding author. To answer them, Gao and colleagues will begin collecting additional samples from healthy birds over the next couple months.
Are more cases of H5N1 cropping up in Vietnam? FAO
The world last week seemed to edge closer to the brink of a flu pandemic. On 30 June, officials at the World Health Organization (WHO) revealed that they recently considered raising the threat level of a global pandemic, from the current 3 on a six-point scale, to 4 or even 5.
The scare was triggered a few weeks ago when several research groups visiting Vietnam filed preliminary reports that many people with mild cases of influenza — and those in contact with them — were testing positive forthe deadly avian flu strain H5N1. This suggested that there was widespread human-to-human transmission of the virus.
Subsequent tests have so far failed to confirm this, and WHO spokesman Dick Thompson is keen to play down the incident. “It was just unpublished information provided to us in preliminary form that spurred an investigation,” he says. “We thought about upgrading the alert. We looked at it fast and strongly, and based on that decided not to upgrade.”
But take a closer look, and the picture in Vietnam is one of confusion rather than reassurance. The first signs of trouble came in May, with reports of small clusters of human cases of H5N1, including a rise in the infection of older people and an increase in milder cases — all signs consistent with the possibility that the virus had mutated to achieve improved, although still inefficient, human-to-human spread (see Nature 435, 390; 2005.
Concern mounted in subsequent weeks as several international groups investigated the clusters using different methods, including the polymerase chain reaction (PCR), which amplifies DNA sequences, and western blots, which use antibodies to detect proteins. Despite using different tests, each of theteams reported that “substantial proportions” of the hundreds of people it had tested seemed to be infected with H5N1.
That led the WHO to consider upgrading the pandemic threat level to 4 (small, localized clusters of human infection) or 5 (large clusters of infection) — just one step away from a full-blown global pandemic. But first it asked an international team of experts, including Masato Tashiro, a virologist at the National Institute of Infectious Diseases in Tokyo, to retest many of the samples and some new ones, using the WHO's own PCR tests.
They found no evidence of clusters of human-to-human transmission. “This is good news,” Tashiro says, relieved that his worst suspicions weren't confirmed. But it remains unclear why the various groups got different results.
Samples have now been sent to a WHO laboratory in Hong Kong forthe last word in confirmation: antibody neutralization assays. These take time as they involve growing large amounts of the virus for analysis, but a firm conclusion is expected by the end of the month.
In the meantime, the WHO is holding off raising the alarm. “Because of the consequences of such a change, the WHO is following a cautious approach,” it said in a statement last week. Pushing the level to 4 forthe first time would mean deploying the international stockpile of antiviral drugs to try to contain or stamp out the spread, and would probably result in countries restricting travel to Vietnam.
But Tashiro remains concerned that he and his colleagues didn't have enough time to check all of the clinical and epidemiological information associated with the initial lab samples. Follow-up work is also complicated by the fact that recovered patients have now returned home, making it hard to track down people they might have infected. “We still have a big problem collecting enough good data,” he says.
Jeremy Farrar, director of the Wellcome Trust Clinical Research Unit at the Hospital for Tropical Diseases in Ho Chi Minh City, says that much of the uncertainty over the prevalence of H5N1 could be avoided if Vietnam had better facilities for testing samples locally. “The international community continues to suggest that countries ship samples out somewhere else,” he says, “while doing absolutely nothing to invest in enhancing the scientific capacity of the Vietnamese to respond to the epidemics themselves.”
In the meantime, Tashiro adds that even if final tests confirm his negative results, “the fundamental situation has not changed”. Many are concerned that July and August will bring a new and bigger wave of flu cases in Vietnam, as happened last year during the hot rainy season. And recent events in China bode just as ill. Scientists investigating migratory birds infected with H5N1 in western China are now warning that these pose an explosive risk of spreading the virus alongtheir migration routes as they fly south in September (see ‘Infected birds poised to take flu virus south’).
At a UN meeting on bird flu held this week in Kuala Lumpur, Malaysia, the WHO's western Pacific regional director, Shigeru Omi, warned that H5N1 remains at a “tipping point”.
World Health Organisation scientist Hitoshi Oshitani spends his days planning for a nightmare scenario -- a bird flu pandemic among humans that would kill millions and bring nations to their knees. . There is much that experts still don not know aboutthe deadly H5N1 strain of avian influenza -- exactly how humans contract it from infected poultry, and why so many of its victims are healthy youngsters. . But Oshitani says they do know vulnerable countries are ill-prepared and that if the virus mutates and erupts among humans in one of Asia's crowded mega-cities, it will be impossible to prevent it from becoming a pandemic. . "If a pandemic starts we cannot do anything to stop it. What we can do, once a pandemic starts, is just to reduce the negative impact by being better prepared," said the Manila-based WHO policy-maker. . "It's probably just a matter of time. Every 30 to 40 years we have had a pandemic," he told AFP on the sidelines of an international conference on bird flu held this week in the Malaysian capital. . After working on the front line of the SARS crisis, which struck terror into the region and beyond in 2003, he says the deadly pneumonia was in retrospect an "easy disease to control" because it was only spread by people who had fevers. . "Usually for influenza, it's almost impossible to control. That's why we have huge outbreaks every year." . To date, most bird flu victims have caught the disease from animals, but the fear is it will mutate into a form that can spread easily among humans, triggering a contagion that could kill tens of millions of people. . Oshitani, who specializes in communicable disease surveillance and response, says WHO experts are working on models to prevent a pandemic if an outbreak of the mutated virus was detected in time, but figuring out how to contain such a virulent disease is baffling them. . "It's not simple and we don't have any experience. (With) polio control or measles control we have a lot of experience ... but for this particular case it's extremely difficult to come up with a good plan," he says. . Measures being contemplated are to treat infected people and surrounding communities with antiviral drugs, and restrict their movement to prevent others from the disease. . But if a deadly flu virus was being spread by people with no symptoms, whose movements were not able to be controlled, in a country that could not afford expensive medicines, halting an outbreak would be almost impossible, he says. . Oshitani says the WHO has a stockpile of 60,000-70,000 doses of antiviral drugs in its Manila regional office, but the logistics of getting them to a remote community in time to stop the disease would be difficult. . "Our window of opportunity will be just two or three weeks," he says. After that the virus would almost certainly have moved on. . And in teeming cities like the Thai capital Bangkok or Vietnam's Ho Chi Minh City, the sheer mass and movement of people would mean the virus would have to be allowed to run its course through thepopulation. . "There are no other alternative tools to stop the spread," Oshitani said. . What would happen then is the stuff of nightmares. . Water and electricity supplies could be disrupted because utility workers are too sick to maintain them, the public transportation system could be abandoned for fear of infection, and those who cannot afford drugs would succumb in huge numbers. . "If more than 20 percent of thepopulation is affected, it could affect a whole range of social activities," Oshitani said, adding the crisis would no longer be just a health issue, but one which could damage entire economies. . "People do not want to get infected in a bus or the train. People may not want to go to the supermarket. So how to maintain that social life is a big challenge, particularly in urban areas." . Oshitani said there were worrying signs a mutation is looming. Growing numbers of people are being infected with bird flu -- 64 cases have emerged in Asia so far this year, compared with 44 forthe whole of 2004. . The disease is still circulating widely in the region, and the virus has continued to change and mutate since jumping to humans in 1997, when it killed six people in Hong Kong. . Since resurfacing in 2003, it has killed 55 people in Asia including 39 in Vietnam, 12 in Thailand and four in Cambodia. . "These are all bad indicators in terms of the risk of a pandemic," he said. . Experts from the World Organisation for Animal Health and the United Nations' Food and Agriculture Organisation this week unveiled a 100 million dollar plan to rein in bird flu within a decade. . But as a backup measure, the WHO is urging countries to prepare by stockpiling antiviral drugs and readying hospitals to deal with large numbers of sick people. . While some developing countries have started to work on a strategy, others with less resources such as Cambodia and Laos have barely begun, Oshitani said. . "If you start thinking of what you should do after a pandemic starts, it will be too late," he warned. — AFP
Добавлено в 07:26 H5N1 in Russia Kazakhstan and Mongolia?
The global economy could be profoundly disrupted as tens of millions of people die
The avian influenza spreading throughout Asia has so far confined its economic harm largely to farmers, who have had to slaughter tens of millions of their chickens and ducks.
But scientists and economists fear that if the virus were to mutate in such a way as to spread easily among humans, the global economy could be profoundly disrupted as tens of millions of people die.
Even if the deaths were largely limited to Asia, U.S. companies, particularly airlines, could suffer, said economist Eric Graber, president of the National Economists Club, which held a meeting Thursday to explore the financial ramifications of global epidemics.
In Asian countries, massive deaths would reduce productivity and slash output, he said. Even worse, "the fear factor" could spread up the globalized supply chain of manufactured goods, he said.
"People here could become afraid of buying products originating in those countries," he said. That could harm major importers such as Wal-Mart Stores Inc. "And people will be afraid of traveling in those countries," hurting U.S. airlines, he said.
A far bigger concern may be that Americans will continue to travel to Asia, and inadvertently bring back the deadly flu, said another meeting participant, Martin Apple, president of the Council of Scientific Society Presidents, an organization of the leaders of about 60 scientific federations and societies.
Apple said that in a "worst-case scenario," in which bird flu was easily passed from human to human, millions of Americans could die. World Health Organization officials have said the global death toll could reach 100 million. In a typical year, 36,000 Americans die from regular flu, according to the Centers for Disease Control and Prevention.
So far, bird flu, caused by a strain calledtheH5N1 avian influenza virus, has spread to at least eight countries in Asia, killing about 55 people. But those deaths appear to have been caused by direct contact with infected fowl.
"Once we have human-to-human transmission, which is apparently just beginning, it becomes an extremely serious issue, unless it's contained," Apple said.
The virus is not yet out of control, he noted. "If we took a lot of concerted action in the next 100 days, we could have a big impact," he said. "If we fail to act in the next 180 days, I think we will pay the consequences."
Even if the virus never mutates, it could have a devastating economic impact if it were to reach this country and begin killing masses of animals, he said. This virus "has the potential for eliminating, at least for some period of time, the American poultry industry" as well as the pork industry, he said.
This week, scientists reported in the journals Nature and Science that, despite efforts to cull domesticated flocks of fowl, migratory geese that can fly far beyond China may be spreading bird flu.
The epidemic of severe acute respiratory syndrome in Asia in 2002- 03 was limited in economic impact, said Maureen Lewis, senior fellow at the Center for Global Development. Even so, SARS did serious harm to certain economic sectors.
According to Lewis' study, over the course of the crisis, scheduled flight arrivals declined by about two-thirds in Southeast Asia, causing a sharp drop in business at hotels, restaurants and stores.
In Hong Kong, retail sales fell 50 percent. At the peak of the epidemic, the number of visitors and tourists dropped 80 percent in Taiwan and nearly as much in Singapore.
Monday, Jul. 11, 2005 Shortly after health experts met last week in Kuala Lumpur to craft a plan to control avian flu, Dr. Shigeru Omi, Regional Director forthe World Health Organization's (WHO) Western Pacific region, spoke with TIME's Bryan Walsh aboutthe challenge of fighting a highly unpredictable virus, the need to harness international resources, and the terrible toll a human pandemic would take.
Are we closer to a flu pandemic than ever before?
The virus is already entrenched in this part of the world, number one. Second, the number of human cases is on the rise, particularly in Vietnam. And third, the virus continues to be unpredictable and unstable. That's why we have to remain constantly on alert.
Do we havethe ability to prevent a pandemic?
This is not an easy battle. The virus is everywhere and very changeable. We are dealing with billions of animals, not just human beings. But I still believe there is a window of opportunity. That's why we should implement all the necessary strategies—cleaning up backyard farms, improving surveillance—not just on a piecemeal basis but comprehensively and thoroughly. There is no single panacea.
Are developed countries providing sufficient aid to carry out these measures?
The international community has already provided a lot of support, and I'm very grateful. But we need an additional $250 million altogether. This sounds like a big figure, but this is a lot less than the magnitude of theeconomic loss that a pandemic would cause.
Studies published last week showed that the virus is now circulating in migratory birds in western China. Could these birds spread the virus?
The findings certainly confirm that the virus is very unstable. Migratory birds used to be regarded as reasonably resistant to the virus, but now we find that's not the case. We cannot rule out the possibility that these birds will carry it to other areas. The most important thing is to test more samples from animals and humans in the area, so that we know how far the virus has spread.
Are you happy with the cooperation you've received from Beijing?
Overall, I am quite happy. We found they had aggressively culled poultry, and had restricted the movement of poultry and people. That's good, but we strongly recommend that the Chinese government get more samples from humans and animals. We need to know whether the virus is spreading among asymptomatic birds and humans.
How do you respond to charges that Chinese farmers have been using the flu drug Amantadine on their chickens?
The Chinese government has officially told the WHO that the government has never encouraged [use of] this drug for prevention purposes. We're waiting formore information. It's a very serious blow to our fight against this virus if amantadine has been used in an inappropriate manner, because this drug would normally play an important role in treating influenza.
Does the WHO support Vietnam's efforts to develop its own bird-flu vaccine?
We understand why Vietnam wants to produce its own vaccine—because there may not be enough vaccine from the West for developing countries. [But] if the vaccine quality is not well controlled, the vaccine will cause more problems than it solves. Our job is not to stop the Vietnamese but to make sure the vaccine produced will be safe and effective.
Vietnam has seen rising case numbers with a lower mortality rate. What does this mean forthe virus?
Our investigations have concluded that, so far, there's no evidence of efficient human-to-human transmission there. But given the unpredictable nature of the virus, the longer the current situation persists, themore chance the virus will achieve efficient human-to-human transmission.
Are there any genetic changes in the virus?
TheH5N1 virus has undergone significant genetic changes over the past several years, but there's no evidence so far of a specific change that makes the virus more transmissible to humans.
You've said that 100 million people could die in a worst-case pandemic. Do you still believe that?
If [a pandemic] happens, the consequences could be very serious, and the magnitude of human casualties could be in the order of millions of deaths. One hundred million is just one of so many possible figures. What's important is to understand the serious potential consequences and prepare forthem.
From the Jul. 18, 2005 issue of TIME Asia Magazine
Headlines: Influenza News June 10, 2005, CIDRAP Foreign Affairs Magazine to Feature "The Next Pandemic" Excerpt from the article:
The influential journal Foreign Affairs is adding its voice to the warnings about a potential influenza pandemic by publishing a special section on pandemics in its forthcoming July/August issue. Titled "The Next Pandemic," the section includes four articles by a panel of experts. They focus on the evidence that theH5N1 flu virus may spark a pandemic, the challenges of preparing for a pandemic, the need to integrate disease-control efforts for people and animals, and the lessons of the HIV/AIDS pandemic. Foreign Affairs is the second well-known journal in less than three weeks to publish a sizable collection of articles on the threat of a pandemic.
Foreign Affairs is the second well-known journal in less than three weeks to publish a sizable collection of articles on the threat of a pandemic. The British journal Nature published 10 articles on the subject in its May 26 issue.
Foreign Affairs has also scheduled a special press briefing on the pandemic issue for Jun 16 in Washington, DC. The briefing will feature two of the article authors, Laurie Garrett and Michael T. Osterholm, along with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and James F. Hoge Jr., editor of the journal.
Following are summaries of theForeign Affairs articles.
'The next pandemic?'
TheH5N1 flu virus is showing potential to cause the next flu pandemic. It is impossible to predict when a pandemic might hit—the swine flu of 1976, which failed to materialize, is a notable example of the risks of such predictions—but author Laurie Garrett is certain that the world is currently unready to address such a threat. Garrett is a senior fellow for global health at the Council on Foreign Relations.
The imbalance of wealth, the weakness of public health systems in countries worldwide, and the numerous hurdles to fast, efficient vaccine production are just a few of the issues that will affect how the world copes with a pandemic, Garrett says. She recommends that national policymakers prepare now "for worst-case scenarios involving quarantines, weakened armed services, dwindling hospital space and vaccine supplie." Further, it is in every government's interest to bolster the funding and authority of the World Health Organization and theFood and Agriculture Organization so they can offer timely, impartial assessments of an epidemic's progress.
People engaged in policy and security worldwide "cannot afford to ignore the warning" of a possible pandemic, Garrett writes.
'Preparing forthe Next Pandemic'
The next flu pandemic could well cause hundreds of millions of deaths around the world and bring the global economy to a standstill, writes Michael T. Osterholm, PhD, MPH, director of the University of Minnesota Center for Infectious Disease Research and Policy, publisher of this Web site.
Recent evidence suggests that theH5N1 strain of influenza A could trigger a pandemic like that of 1918-19, which probably killed between 50 million and 100 million people, Osterholm writes. In today's world, that could mean up to 360 million deaths. The SARS (severe acute respiratory syndrome) epidemic gave a hint of the kind of economic disruption a pandemic could cause. Though only about 8,000 of SARS cases occurred, the disease cost the Asia-Pacific region an estimated $40 billion.
If a major pandemic began today, the global economy would shut down, Osterholm predicts. The disease would trigger shortages of food and other essential commodities. No vaccine would be available in the first several months, and in the first year the world could produce only enough vaccine forabout 14% of thepopulation. The antiviral drug oseltamivir could help countries that have stockpiled it, but in most of the world it would be unavailable. Other medical supplies such as masks and ventilators would be in short supply.
As he has done in other recent writings, Osterholm calls for detailed operational planning to get through a pandemic. He also advocates an international project to develop the ability to produce a vaccine forthe entire world population within several months of the start of a pandemic. If there isn't enough vaccine to go around, economic disaster will overtake all countries, regardless of their vaccine supplies. "No one can truly be isolated from a pandemic," he writes.
'One World, One Health'
Many diseases that have scared the public and disrupted global commerce in recent years have been zoonoses — diseases that originated in animals and crossed into humans. The emergence of diseases like avian flu, SARS, and Ebola tell us that it's time to knock down the walls between the agencies and groups that deal with diseases in humans, domestic animals, and wildlife, according to William B. Karesh and Robert A. Cook. Karesh directs the field veterinary program at the Wildlife Conservation Society (WCS) and co-chairs the World Conservation Union's veterinary specialist group; Cook is vice-president of the WCS and its chief veterinarian.
Burgeoning international travel, population growth, the global trade in animals and animal products, and a growing dependence on intensified livestock production have made humanity more vulnerable to cross-species diseases, Karesh and Cook write. But "no government agency or multilateral organization today focuses on the numerous diseases that threaten people, domestic animals, and wildlife alike."
The authors observe that the eradication of smallpox — the only major infectious disease that has been eradicated — was possible largely because smallpox, at least under natural conditions, affects only humans. When a pathogen can infect a range of hosts, controlling it becomes far more difficult and requires an integrated approach, they write.
They call for a number of steps to integrate efforts to deal with human and animal diseases. Examples include better surveillance of wildlife diseases, requiring animal traders to pay more of the cost of preventing and controlling outbreaks, and inducing governments to improve the regulation of trade in animals.
"Bridges must be built between different scientific disciplines, and trade in wildlife must be dramatically reduced and, like the livestock industry, properly regulated," Karesh and Cook argue.
'The lessons of HIV/AIDS'
To understand the impact of a potential avian flu pandemic, author Laurie Garrett suggests, one should first examine a slower-moving global pandemic: HIV/AIDS. Garrett details the massive destabilization of countries acrossthe world as soldiers, teachers, and political leaders die and countless children are orphaned.
Donor states should spend heavily on HIV/AIDS prevention, care, and treatment, but also emphasize development to usher thepoorest countries into the global economy, Garrett contends. Donor states also should step up international programs that prevent high-risk sex and drug use while providing condoms and sterile needles, she adds. Thesurvival of some developing countries may rest on risking tension over unequal treatment to provide antiretroviral therapy to important people and workers in key sectors of society.
In addition, science and global security interests must recognize the importance of developing more sophisticated methods to identify and track specific strains of HIV and factors, such as drug smuggling, that contribute to the spread of the disease.
Formore information, seethe links to the three articles in Foreign Affairs.