Risk of bird flu pandemic remains substantial/probably growing

Two numbers of interest....

The article indicates that the current form of the bird flu has a kill
rate of 63%.

Another article I read recently indicates that the current flu vaccine
that was used this winter in the United States less than 40%
effective.

The two numbers together indicate that even with the best medical
care, the death rate will be substantial.

I guess one good point is that the bird flu doesn't care if you a
Republican or Democrat.

I would also expect more deaths due to the collapse of infrastructure
that will result when vital services fail.

TMT

Pandemic flu threat remains substantial, health experts say By ELIANE
ENGELER, Associated Press Writer
Tue May 6

The world still faces a substantial threat of a flu pandemic and
countries need to speed up preparations for a global outbreak, health
experts said Tuesday.

"We can't delude ourselves. The threat of a pandemic influenza has not
diminished," said Keiji Fukuda, coordinator for the World Health
Organization's Global Influenza Program.

Fukuda spoke to a meeting of around 150 health experts from
governments, WHO and other agencies to update WHO's pandemic influenza
preparedness plan.

Scientists fear that the H5N1 strain of bird flu virus — which began
ravaging Asian poultry stocks in late 2003 — could mutate into a form
that spreads easily among humans, potentially sparking a pandemic that
kills millions. So far, most human cases have been linked to contact
with infected birds.

Fukuda said more than 150 countries had some kind of national
preparedness plans but some of them were merely a piece of paper
acknowledging the risk.

He said it was crucial that all levels of society were involved in the
preparations and that everyone knows where to go for information.

"If somebody is sick in the family for example and it's difficult to
get to hospital, they need to know what sort of advice might be
available," Fukuda told The Associated Press.

WHO says 382 people have come down with bird flu since 2003, and that
241 of them have died. Indonesia, with 108 of the deaths, is seen by
experts as a potential hotspot for a pandemic.

WHO is updating its 2005 preparedness plan to include progress in
research on flu viruses, stronger international cooperation and
experience with human cases of bird flu.

"Our understanding of the virus, the effects on people, the
epidemiology how viruses move around the world, is much greater than
it was a few years ago and this continues," Fukuda said.

Stockpiles of antivirals have been built since 2005, he said. WHO has
stockpiled a total of 5 million antiviral treatment courses ready to
be handed out if a pandemic breaks out.

He said the development of a possible pandemic vaccine have made
significant strides.

"A few years ago it would not have been possible to talk about
pandemic vaccines," he said. "All of a sudden we have new things to
work with."

Experience and research over the last few years have led experts to
believe that it is possible to stop a pandemic influenza right at the
beginning of the outbreak, said Fukuda, adding that they recognized it
will be difficult.

Fukuda said WHO will take into account the revised International
Health Regulations in updating its pandemic preparedness plan, which
is expected to be published by the end of the year.

Max Hardiman from WHO's secretariat for the health regulations said
the agreement, which took effect in 2007, should help the world to
know about a pandemic outbreak as soon as possible.

The health regulations oblige countries to report new disease threats
with global public health significance, such as new flu subtypes. They
also allow the WHO to act on credible information sources, rather than
being reliant strictly on official government channels.

Hardiman said measures to contain a pandemic should avoid unnecessary
travel restrictions.

Under the health regulations countries are putting in place measures
to curb the spread of a pandemic, he said. These include assuring
access to medical centers, control of airports and other points of
entry and preparations to isolate sick people and quarantine
contacts.

"One day we will face a pandemic but we don't know when," Fukuda said.

===

Risk of bird flu pandemic probably growing: experts By Stephanie
Nebehay
Tue May 6

The risk of a human influenza pandemic remains real and is probably
growing as the bird flu virus becomes entrenched in poultry in more
countries, health officials warned on Tuesday.

Some 150 experts are attending a meeting hosted by the World Health
Organization (WHO) to update its guidance to countries on how to boost
their defenses against a deadly global epidemic.

The H5N1 avian flu virus has infected flocks in much of Asia, Africa
and parts of Europe. Experts fear it could mutate into a form that
passes easily from person to person, sparking an influenza pandemic
that could kill millions.

"The risk of a pandemic remains and is probably expanding," said Dr.
Supamit Chunsuttiwat, a disease control expert at Thailand's health
ministry who is chairing the four-day meeting.

Supamit noted the highly pathogenic H5N1 virus persisted on three
continents and had caused human cases in Indonesia, Egypt and China
this year.

"We are concerned that the spread through migratory birds hasn't
stopped. Once the virus is established in birds, it is difficult to
get rid of the virus and the risk (to humans) remains unless countries
develop good control of transmission in birds," he told Reuters.

The avian flu virus rarely infects people, but there have been 382
human cases worldwide since 2003, 241 of them fatal, according to the
WHO, a United Nations agency.

Keiji Fukuda, coordinator of WHO's global influenza program, told the
talks: "We can't delude ourselves about the threat of pandemic
influenza -- it has not diminished."

The timing of a pandemic "remains speculative," he said.

OVERWHELMING EFFECT OF PANDEMIC

A pandemic could shut down businesses and schools and overwhelm
healthcare systems, particularly in poor countries.

Infected people can shed the virus before symptoms appear, and this
increases the risk of international spread through asymptomatic air
travelers, the WHO says.

Most countries have drawn up pandemic plans, but the level of
preparedness varies. The WHO aims to revise its 2005 guidance to its
193 member states by year-end.

"We are going to improve our guidance and give people and countries
better tools to deal with," Fukuda said. "Pandemic preparedness is not
just a health sector effort, it is something that requires the whole
of society's perspective."

The WHO has set up two global stockpiles of the antiviral Tamiflu,
containing 5 million treatment courses donated by the Swiss drugmaker
Roche, for use in a pandemic.

It is also developing a vaccine stockpile which -- when a vaccine has
been produced -- should initially contain 150 million doses, Fukuda
said.

At least 16 companies are working on vaccines to prevent bird flu
infection in people, including GlaxoSmithKline and Sanofi-Aventis.

"Some are very close to regulatory approval. These are the newer
generation vaccines which use less antigen and contain adjuvant but
still stimulate an immune response," Fukuda said.

Antigens are substances like toxins, viruses and bacteria that
stimulate the production of antibodies. They can be difficult to
culture, and scientists have been trying to fix that by using
adjuvants, which boost a vaccine's effectiveness.

Large-scale commercial production of a vaccine will not start until a
pandemic virus has emerged, because the vaccine must closely match the
strain.

The WHO uses six phases of pandemic alert to gauge levels of threat.
The world is currently in phase 3, meaning that a new influenza virus
sub-type is causing disease in humans but is not yet spreading
efficiently.

"The risk is as great as it has ever been. We hope to send out a very
clear message that this effort needs to continue and the threat has
not gone away," Fukuda told Reuters.



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