Avian Flu'

[CaptainK]

Warning an outbreak may be inevitable, the White House on Saturday conducted a test of its readiness for a feared bird flu pandemic and said federal agencies fared "quite well" without offering any details.

Cabinet secretaries, military leaders and other top officials took part in the four-hour tabletop drill, which officials said was designed to assess the level of federal preparedness for a possible outbreak of bird flu or another deadly virus.

"This is about being ready for what inevitably will come," Health and Human Services Secretary Michael Leavitt said.

But the White House refused to divulge details about the exercise and the test results, and officials said afterward that it was clear that state and local governments would have to assume a leading role.

"Quite frankly, I think we did quite well," White House homeland security adviser Fran Townsend said of the federal agencies that took part in the exercise.

The White House test came one day after a Thai boy became the 70th person to die of bird flu, which usually strikes those in close contact with infected fowl or their droppings.

Experts fear the deadly virus, known as H5N1, will mutate into a form that can easily infect and pass between people, causing a pandemic.

"We're quite concerned now about this H5N1 virus as scientists suggest that it could, in fact, mutate into a virus of major concern. So we need to be ready," Leavitt said.

HHS has projected that in a pandemic 92 million Americans will become sick and that as many as 2 million will die. Schools will close, businesses will be disrupted and essential services may break down.

"We currently have no evidence that a pandemic flu in this country is imminent. That said, we are fairly warned, and the time to prepare for that pandemic is now," Townsend said.

The preparedness drill was conducted in offices next to the White House.

Approximately 20 officials took part, including Townsend, Leavitt, Homeland Security Secretary Michael Chertoff and Marine Corps Gen. Peter Pace, chairman of the Joint Chiefs of Staff, White House spokesman Trent Duffy said.

U.S. President George W. Bush did not participate.

"The exercises are just that. It's a drill, it's meant to test, it's meant to push federal resources to the breaking point and to ensure that we're prepared, that we identify gaps and then we plan to fill them. We accomplished that this morning," Townsend said.

She said the biggest lesson from the test was the leading role that state and local governments would have to play in responding to a pandemic.

"This is not going to be a federal answer to the problem," she said. "The federal government has got a support role to play. But frankly, I think, really very important is the state and local efforts."

Leavitt said officials discussed at length how they would deal with limited U.S. supplies of antiviral and vaccines.

"We lack the capacity in this country to manufacture the number of courses needed to give everyone a vaccine," Leavitt said, adding that the United States also needed a surveillance system to detect the virus before it spreads.

Bush, who went for a bike ride in Maryland during the preparedness drill, has proposed a $7.1 billion bird flu plan, but Congress has yet to fund it.

The plan calls for building stockpiles of influenza drugs, which would not provide a cure but which might help make the most vulnerable patients less ill.

"We urge Congress to fully fund the president's strategy," Townsend said.

[BC Mike]

As long as they keep their hands off my pet duck " Quack " things may go smoothly. " Quack " is a sensitive girl and does not like to be bothered. " Where's the grain " is one of her favourite sayings. You have to be able to understand duck talk to decyfer this.
Michael

[GordMay]

Avian Influenza A ~ Online readings (H5N1, or ‘Bird Flu’):

Centers for Disease Control and Prevention (CDC):
http://www.cdc.gov/flu/avian/

National Institutes of Health (NIH): http://www3.niaid.nih.gov/news/newsr...vianfluvax.htm

World Health Organization (WHO):
http://www.who.int/csr/disease/influenza/pandemic/en/

UN Food and Agriculture Organization (FAO):
http://www.fao.org/ag/againfo/subjec...ial_avian.html

[CaptainK]

A third child from the same family in eastern Turkey died from bird flu on Friday and health experts plan to study the outbreak for signs the virus was passing from person to person.

Doctors were treating more than 20 other people, mostly youngsters, suspected of having the deadly virus. Some of the victims had been playing with the severed heads of infected birds, doctors said.

The H5N1 bird flu virus has killed 74 people in east Asia and has now spread to the fringes of Europe.

It has so far been hard for people to catch but there are fears it could mutate into a form easily transmitted among humans. Experts say a pandemic among humans could kill millions and cause massive economic losses.

A spokeswoman in Geneva said the World Health Organization (WHO) was sending experts to the area who would check for any signs the virus had been passed from person to person -- something that has happened in only one previous but unconfirmed case.

"It is possible that they all had common exposure to sick poultry but it is also possible there may have been human to human transmission. We don't have enough information to draw a hypothesis either way," WHO spokeswoman Maria Cheng said.

"That is certainly one of the possibilities that the team is going to be investigating," she added.

The latest child to die was Hulya Kocyigit, 11, the sister of Mehmet Ali, a 14-year-old boy who died last weekend, and of Fatma, 15, a girl who died on Thursday. She was buried alongside her brother and sister on Friday in a lime-covered grave.

Final tests at a WHO laboratory have confirmed two of the victims had bird flu. The additional tests are carried out to confirm the preliminary diagnosis and it normally takes a few days for the results to come through.

MORE CASES

Turkey's farm minister said bird flu had been detected in two wild ducks near the capital Ankara, nearly 1,000 km (700 miles) west of infected areas where the three children died.

The discovery suggests migratory birds may be spreading the disease across the large country, as experts had warned.

The dead children lived in a remote rural district of eastern Turkey near the Armenian and Iranian borders, mixing with poultry -- just like the east Asian victims. Neighboring Azerbaijan was also going to run tests on suspect dead birds.

Doctors treating victims at a hospital in the eastern city of Van said the disease had been contracted from sick birds.

"All our patients have been in close proximity to poultry. Some patients handled the infected poultry, some of them were even playing with the heads of chickens," BBC television quoted doctor Ahmet Faik Oner as saying.

A joint WHO/European Commission team is expected to arrive in eastern Turkey on Friday. Four more WHO experts will go to Turkey at the weekend.

Doctors said more than 20 people were being treated for suspected bird flu in hospital in the eastern city of Van. The patients, many of them children, come from several provinces across eastern Turkey.

Six children were being tested for suspected bird flu in the city of Diyarbakir, hundreds of kilometers southwest of the area so far affected, hospital officials said.

The dead children's six-year-old brother was also being treated for the same disease in hospital. But their parents were in good health as they received visitors paying condolences at their tiny one-room cottage in the town of Dogubayazit.

"There is no doctor here, we are very poor," Ibrahim Kocyigit, a relative, told Reuters in a tent set up near the house to accommodate the flood of visitors.

In Dogubayazit, an anxious crowd gathered outside the state agricultural offices to dump sacks of dead poultry or ask for their poultry to be culled.

"After the deaths everybody is scared. We are all getting rid of our chickens and nobody dares eat their meat," said local trader Devlet Kaya.

The WHO said in a statement dated Thursday that Turkish authorities had told it that the district had been placed under quarantine, with no people or animals allowed to move in or out. However, a Reuters reporter there on Friday saw no controls.

[mario f]

CaptainK once whispered in the wind:
On Wednesday, October 5th 2005. U.S. president George W, Bush spoke to congress about having the U.S. military to help out with controlling the Avian Flu outbreak.
Should it ever reach the shores of the United States. Bush wants the military to set up quaratine zones, around cities. Or areas, around the populated, most heavily infected with the avian flu. A plan to try, to keep the avian flu from spreading to the rest of the country.

By the folks that brought you the response to Katrina...
Now that is scary!
No politics, just reality

[ssullivan]

Somehow... I'm not at all nervous about this. Just put up the "no vacancy" sign as it pertains to charters and anchor out with a few months' supply of food and water.

Presto! No flu.

[delmarrey]

Isn't that A BIT amusing?

Not saying death is funny, but just an oxymoron.

[CaptainK]

More similarities have been found between the bird flu creeping into Eastern Europe and the 1918 Spanish flu that decimated populations worldwide, including the discovery of an entirely new way bird flu may kill human cells.

Researchers from St. Jude Children's Research Hospital in Memphis, Tenn., have found that bird flu viruses carry a gene that can latch onto many crucial proteins inside human cells, presumably disrupting their function and causing far more severe disease than human viruses.

The research provides a new hypothesis for why certain bird flu viruses are particularly lethal for humans.

Published in today's issue of the journal Science, the research comes as Canada prepares to release an updated pandemic flu plan that includes new infection control and border measures, from strategies to get people to wash their hands and cough into Kleenex, to surveillance systems in airports and emergency rooms to detect the virus's introduction into Canada.

There's no evidence so far that the H5N1 avian flu is transforming into the next human pandemic flu strain, but "we certainly are really increasing our efforts in terms of preparedness," says Dr. Theresa Tam, of the Public Health Agency of Canada.

But a SARS survivor, and infectious disease specialist, says Canada is "nowhere close" to being ready for a pandemic should it happen. Dr. Allison McGeer, of Mount Sinai Hospital in Toronto, says more money and time needs to be spent on looking for new drugs for influenza, which masks will truly protect people, how sick people will be cared for when there aren't enough health-care workers and getting Canadians to agree on "fair and reasonable" distribution of vaccines.

In what is being described as the first large-scale mapping of bird flu viruses, researchers from St. Jude mapped 2,196 bird flu genes culled from ducks, gulls, shorebirds and poultry samples collected over 30 years, looking for patterns and comparing them to human flu bugs.

They also mapped the complete genome for 169 bird flu viruses. The work doubles the amount of genetic information available on avian flu.

The team honed in on a gene called NS 1. After looking at nearly 1,200 bird, human and swine NS 1 proteins, they found a particular feature of that gene which is unique in bird viruses and different from human ones.

In bird viruses, the gene produces a protein that allows the virus to bind to "scaffolding" proteins inside human cells.

"It's like a large number of policemen being held hostage. Society falls apart," says McGeer.

In human viruses, the protein doesn't bind to certain cells, which may explain why they're not as virulent.

It hasn't been proven yet. "But, we think that if you interfere with that many proteins in cells, you're going to have a deleterious consequences," said author Dr. Clayton Naeve of St. Jude.

The finding fits with what doctors on the ground in Asia have seen: The H5N1 virus can attack not just the airways, like regular flu, but multiple organs and systems, including the kidney, liver, spleen and brain. Infection has been fatal in more than half the reported cases, and most cases occur in previously healthy children and young adults.

The H5N1 avian flu sweeping across Asia has this "bird" form of the protein. The milder pandemics of 1957 and 1968 had the "human" one.

The 1918 Spanish flu virus, which scientists now believe came from birds, had a very similar "bird" protein that the researchers believe behaves the same way. The protein could become a key target for the development of vaccines and new anti-flu drugs.

McGeer says the research answers "a big piece of the puzzle.

"Does it tell you H5N1 is going to be the next pandemic? No. What it does is add to our understanding of the evolution of influenza viruses."

Naeve says it is possible that whatever makes H5N1 so pathogenic, or toxic to humans, could persist even if the virus adapts to spread easily from humans to humans, and becomes pandemic.

If or when that happens is anyone's guess. Some virologists believe H5N1 is not going to be the next human pandemic.

The virus, which surfaced in Hong Kong in 1997, has been in contact with humans for eight years "and we haven't seen the required mutation," says Dr. James Mahony, a professor of pathology and molecular medicine at McMaster University.

The 1918 virus, by contrast, jumped from birds to humans and was quickly lethal.

On Thursday, Indonesia reported that a 22-year-old chicken seller infected with the H5N1 virus died, the country's 15th death from bird flu.

China on Wednesday confirmed the country's 10th case of human infection with H5N1, a 29-year-old woman from Chengdu City in the province of Sichuan. It's not known if she was exposed to infected birds.

The virus has infected 152 people in six countries since 2003, killing 84 of them.

At least some species of migratory birds are carrying the virus to new areas along migratory flyways, according to a report presented this week to the WHO's executive board, and the chance the virus will spread to poultry in new areas "is now high."

Health officials in Canada are monitoring the outbreak of bird flu in Turkey, where two people have died. "To date, people are still convinced there is no efficient human to human transmission," says Tam, associate director of the immunization and respiratory infections division at the Public Health Agency of Canada.

But, "we really have no idea how this virus will behave next if it undergoes some mutation."

The updated influenza pandemic plan will include recommendations for the use of masks. Droplets, or larger "blobs" of secretions primarily spread flu. General surgical masks should be enough should a pandemic happen, Tam says.

"Public health experts feel that putting a mask on an ill person when they're coughing or sneezing and have to move around ... is a sensible thing to do.

"Having well people milling about on the streets wearing masks all the time, we don't know if it's effective or not."

The public focus will be on hand hygiene, Tam says.

[CaptainK]

Medical centers in four US states are seeking volunteers for the first human testing of a bird flu vaccine made in Britain by Chiron Corporation, researchers said.

Stanford Medical Center, in Palo Alto near San Francisco, is one of four centers recruiting "healthy subjects" to be injected with "inactive influenza A/H5N1 vaccine," said research assistant Ernesto Martin Gonzalez.

"The emergence of the avian influenza virus strains in human populations outside of the US has added urgency to ongoing efforts to develop plans for responding to potential world-wide outbreak," Gonzalez said in a release calling for volunteers.

Stanford vaccine program director Cornelia Dekker told AFP it will be the first time this particular vaccine is tested in humans.

A Sanofi Pasteur bird flu vaccine was tested in human volunteers last year, with the August results showing that large doses triggered anti-body levels on par with those seen with common flu vaccines, Dekker said.

The French pharmaceutical firm's vaccine has gone on testing in people age 65 and older, a group considered more at risk of dying from bird flu, Dekker said.

Since the Chiron and Sanofi vaccines are chemically similar, the testing being launched in the United States is focused on seeing whether chemicals called "adjuvants" can boost the potency, Dekker said.

"The new study added two adjuvants in the mix to increase the immune response and make it possible to use less vaccine, and thereby have more doses for more people," Dekker said.

"It is a checkerboard mix-and-match of vaccine and adjuvants to come up with the most promising combinations."

The US National Institutes of Health (NIH) is looking to Chiron and Sanofi Pasteur to make bird flu vaccines for a US stockpile, according to Dekker. The NIH is sponsoring the new study.

Scientists fear the bird flu's H5N1 strain may mutate into a form easily transmissible between humans and trigger a pandemic that could kill millions around the world.

A total of 280 subjects are being sought for testing at Stanford and medical centers in the states of Ohio, Tennessee, and Missouri, Dekker said.

Volunteers will undergo health screening, and sound candidates will get two injections, one in each arm, about a week apart. The trials are to begin in February, according to the medical center.

There will be nine groups, eight of them given different vaccine-adjuvant combinations and the ninth a control group injected with a placebo.

"Assignment to groups will be random, like a coin toss," Dekker said. "They won't know and we won't know what group they are in."

Researchers will watch for ill effects and determine the efficacy of the vaccines by checking antibody levels.

Volunteers will be required to make seven clinic visits for shots, blood tests and check-ups during the course of about eight months. They will be paid 30 dollars per clinic visit, according to Gonzalez.

"We are doing it as fast as we can to provide results as quickly as possible so people can make decisions on what to do next," Dekker said.

"The goal is to have something, even if imperfect, rather than nothing," Dekker said. "The other option is to treat people after they become ill, and that is much more difficult in a pandemic situation."