Thursday, February 22, 2007

Bird Flu spreads, Possible Pandemic feared

Are you and your family prepared for a Pandemic Flu? Bird Flu? Avian Flu?

What must you do to prepare and protect yourself or family? http://www.pandemicinfosite.com/

Is your business prepared?

What must your business do to prepare and protect itself? http://www.pandemicinfosite.com/bird-flu-business.htm

Avian flu or bird flu is caused by influenza A viruses that occur naturally among birds.
Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population.

A pandemic has the following characteristics:
* It is a highly contagious global disease outbreak
* It spreads easily and rapidly
* There is little or no immunity to it
* There is no vaccine
* It is deadly and kills millions of people

Presently health professionals are concerned about a fairly new and deadly avian flu or bird flu virus known as H5N1. It is spreading across Asia, Africa and Europe and is expected to reach the Americas soon. More than half the people that contracted it have died.

There have been 10 pandemics over the past 300 years with three occurring in the past century. On average there is one every 30 years. The last pandemic was nearly 40 years ago in 1968.

Experts agree that we are overdue for the next pandemic. It is not a question of if there will be one, but when it will happen. When it hits, as many as 150 million people are expected to die.

What must you do to prepare and protect yourself or family? http://www.pandemicinfosite.com/

68% of businesses are not prepared for a pandemic.
When it hits many will go out of business or suffer devastating human and financial losses.

What must your business do to prepare and protect itself? http://www.pandemicinfosite.com/bird-flu-business.htm


NEWS
Europe is two years from being prepared for a bird flu pandemic
It will take at least two years before the European Union is fully ready to deal with a flu pandemic, the bloc's disease control agency said Thursday.While all EU countries have completed national preparedness plans for how to deal with a possible pandemic, more work is needed to make them fully operational, the European Center for Disease Prevention and Control, or ECDC, said in a report. ECDC Director Zsuzsanna Jakab said the bloc has made "considerable progress" in its preparation since 2005, when fears spread among Europeans that the deadly H5N1 strain of bird flu might mutate to a form more easily transmitted to and between humans and spark a pandemic."We need to maintain the current political climate and momentum to continue and finish this work," Jakab said. "In our estimate, we need another two to three years to respond well to a pandemic."
H5N1 Bird Flu Confirmed in Moscow
Tests have confirmed the presence of the H5N1 bird flu strain in poultry found dead in two suburban Moscow districts, an agriculture official said Saturday, in the first such outbreak to be recorded so close to the Russian capital. The virus was in the Odintsovo and Domodedovo districts, west and south of Moscow respectively, where two dozen birds died this week. Officials were still awaiting results on tests taken in a third suburban district, Podolsk, where 44 birds were reported to have died on Saturday. The H5N1 virus has killed at least 167 people worldwide, according to the World Health Organization. The concern is that it could mutate into a form that easily spreads from person to person and spark a pandemic.
Egyptian woman contracts H5N1 bird flu 2-14-07
An Egyptian woman has tested H5N1 positive, bringing the total number of persons infected with the deadly bird flu strain in the country to 21. The 37 year-old woman, from the oasis town of Fayoum, some 45 miles south of Cairo, was moved to a hospital for contagious diseases in the Egyptian capital.Twenty-one people have been infected with the deadly H5N1 strain in Egypt so far, with 12 of them dying from the disease. Since the avian influenza outbreak a year ago, Egypt has been one of the countries worst afflicted with the deadly bird flu outside Asia, where the disease originated.Also, Egypt has seen an increase in the death rate from the bird flu infection over the winter months, which sparked fears that the strain of the virus may be mutating to a more drug resistant form.Bird flu was first detected in Egypt in February 2006 and has spread to at least 19 of the country's 26 provinces. Egypt's latest fatality was a 17-year-old girl who died on Feb. 5.The H5N1 strain has hit at least 45 countries and killed more than 166 people worldwide.On Tuesday, Egypt's Health Minister, Hatem el-Gabaly, warned that health officials here must be particularly alert to the seriousness of the crisis.Speaking to an international conference on bird flu in Cairo, el-Gabaly also blamed the international community for not providing enough aid to African nations as they struggle to deal with the spread of the deadly virus.The three-day conference, hosted by the WHO, brought together officials from governments and international organizations to discuss coordinating efforts to combat bird flu, including how to inform people about the disease in case of a possible pandemic.
Bird flu kills 64th person in Indonesia 2-11-07
A twenty-year-old woman has become that country's 64th human victim of the avian influenza.The woman died in West Java, one day after being diagnosed with the H5N1 avian flu virus.The woman had direct contact with infected chickens, and two of her neighbors are hospitalized with bird flu symptoms. Bird flu has killed 64 people in Indonesia since 2005, more than anywhere else in the world. Experts fear it will mutate into a strain of flu that will pose a pandemic threat, the BBC said.
Bird flu resurfaces in Pakistan after a year
Tthe deadly H5N1 strain of bird flu has been found in a small flock of chickens near the capital, Islamabad, almost a year after the virus was found in poultry flocks.
Mohammad Afzal, Livestock Commissioner at the Ministry of Agriculture, said all the chickens in the flock of about 40 birds at a house in Rawalpindi, a city adjoining Islamabad, had died or been culled.
"They tested positive for the H5N1 strain" "It has been contained and there is no danger of the spread of this virus because there are no poultry farms near this house."
Pakistan's first reported cases of H5N1 bird flu were found in chickens in February last year in North West Frontier Province. In all, about 40,000 chickens were culled.
There have been no human cases in Pakistan.
Altogether, the virus has killed more than 160 people in 10 countries and scientists fear it could mutate into a strain that spreads easily among people, triggering a pandemic that would sweep the globe.
Britain kills 160,000 turkeys to stem bird flu spread
Feb 5, 2007 — HOLTON - Britain acted to complete a cull of 160,000 turkeys on Monday after it became the latest country hit by a major outbreak of the deadly avian flu virus.
Workers wearing white protective suits, black gloves and masks loaded the turkeys into crates to be gassed following the discovery of the highly pathogenic H5N1 strain of avian flu on a farm at Holton in eastern England run by Europe's largest turkey producer, Bernard Matthews.
Farm workers were offered anti-viral drugs and restrictions were imposed on the way birds are housed and moved.
The H5N1 virus has spread into the Middle East, Africa and Europe since it reemerged in Asia in 2003 and outbreaks have now been detected in birds in around 50 countries.
It remains largely an animal disease, but can kill people who come into close contact with infected birds. It has killed 165 people over the past four years, a 22-year-old woman in Nigeria being the latest confirmed victim.
Scientists fear the virus could spark a pandemic in which millions die if it mutates into a form that passes easily from person to person.
For the moment, the impact is likely to be mainly on Britain's poultry industry, the second largest in the European Union after France.
Russia said it would ban British poultry imports from Tuesday to prevent the spread of bird flu.
The European Union's top health official said on Monday he was optimistic the bloc would be able to control bird flu this year despite outbreaks in Britain and Hungary.
"The virus is still around. We should never feel that we are safe. Hungary is dealing with it in a very efficient way. The UK is doing the same, but we will probably have more outbreaks," EU Health and Food Safety Commissioner Markos Kyprianou told reporters in Brussels.
"Last year we managed to control the disease. I'm optimistic we will be able to do the same again this year," he said.
Hungary detected H5N1 in a flock of geese last month, the first outbreak in the 27-nation EU this year.
US to rate flu pandemic warnings like hurricane alerts 2-2-07
Should there be a global outbreak of deadly influenza, it could precipitate school closings of up to three months and cancellation of public gatherings such as sporting events and the opera, under a new federal ranking system that borrows from hurricane forecasting to gauge the severity of a flu pandemic.
The 1918 Spanish Flu, which killed half a million people in the United States alone, would be called a Category 5 pandemic under the system described Thursday for the first time by the federal Centers for Disease Control and Prevention.
If such a monster were to reappear, the new CDC plan calls for extreme measures to reduce the spread of the virus, such as lengthy school closures, cancellation of public events, and urging workers to stay home or telecommute.
A milder flu pandemic, such as the Asian Flu of 1957, which killed 70,000 Americans, would rank as a Category 1, and communities would be advised to consider much simpler prevention measures, such as encouraging the stricken to stay isolated at home, unless they need hospitalization.
The hurricane-style ranking system was chosen deliberately by pandemic preparedness planners at the CDC to help the public and local communities judge for themselves how to react to news of a global outbreak.
"Today we are better prepared than we were a year ago, but there is still much to do," Health and Human Services Secretary Mike Leavitt said at a Washington, D.C., press conference.
Leavitt acknowledged that public concern about the H5N1 strain of avian influenza has abated since the Bush administration began a nationwide pandemic preparedness program in November 2005. Fears were that the bird flu virus, deadly to chickens and to some people in close contact with poultry, could mutate into a form that spreads easily from person to person. That hasn't happened, yet.
"The media buzz may have died down, but the H5N1 virus has not," he warned. "The disease is highly pathogenic, and it continues to spread."
Pandemics are caused by rogue strains of influenza that are so different from common seasonal flu strains that the population has little or no immunity against it. There were three pandemics during the 20th century, in 1918, 1957 and 1968.
A Category 5 flu pandemic is one that can strike 30 percent of the population and kill more than 2 percent of those stricken. That's what the Spanish Flu did in 1918-19. A comparable pandemic would kill at least 1.8 million Americans today.
By contrast, a pandemic would be ranked Category 1 if it killed less than 0.1 percent, or 1 in every 1,000 persons stricken. It would still be capable of killing 90,000 Americans.
The Pandemic Flu Severity Index, as the category ranking system is called, is the newest element of an effort to prepare the country for a return of a Spanish Flu-like event. It is part of a new, 109-page planning document that the CDC released Thursday, offering guidance to state and local governments, as well as to businesses, schools and even families and individuals, in the event of a pandemic.
This document focuses on ways to buy time against a rapidly spreading epidemic in the estimated six months it would take before a vaccine might be available. So the focus is not on distributing drugs, which may not be available and may not work, but on multiple ways of tamping down the spread of the virus.
"We don't expect that we could protect everyone, but we do believe we can make a difference,'' said CDC director Dr. Julie Gerberding.
She acknowledged that lengthy school closures can bring their own sets of problems. Parents might have to quit their jobs to provide child care. Students milling about in their communities without supervision also could spread the flu. "Don't let them congregate in shopping malls," Gerberding advised.
Part of the purpose of ranking pandemics from Category 1 to 5 is to lessen public fears should a new strain of flu start to spread.
"If you give them solid advice, people are much less likely to panic," Gerberding said. "We don't want to artificially cry 'wolf' or raise the alarm ahead of the time when people need to take effective action."
But in a major pandemic, disease control experts stressed that the efforts to isolate the sick and keep the healthy away from crowded venues should be done early to be effective.
"Early, targeted and layered measures are the key," said Dr. Marty Cetron, director of the CDC's Division of Global Migration and Quarantine.
He said the interventions should be focused on areas where the flu risk is highest, and that multiple measures -- each one alone not fully effective -- can combine to reduce the number of infections and stretch the amount of time health departments will have to respond.
The various measures of social distancing -- reducing use of mass transit, closing schools, canceling public gatherings and isolating the sick -- were examples of measures that in combination can reduce risk. A study of the response to the Spanish flu in 44 American cities showed that communities that implemented such measures early fared far better than those that did not.
Dr. Howard Backer, chief of the immunization branch for the California Department of Health Services, said the latest federal plan provides welcome guidance. "We needed some guidance to think through how we would respond to various severities of a pandemic," he said.
Backer noted that, unlike an earthquake, fire or flood, a pandemic is an event that, once started, will be around for months, so state and local governments need to think carefully how to deal with it in advance.
"This will be a battle on our home turf. There will be no standing on the sidelines," he said. "No matter what your socioeconomic group, or whether you live in the city or in Modoc County, it will get to your community eventually, and everyone will be impacted."
Federal flu planners also have set up a series of "triggers" to determine when to implement pandemic recommendations. Reports from abroad of clusters of deadly flu would place the U.S. system on "alert," and reports of widespread outbreaks in multiple overseas locations would raise the preparedness level to "standby." The final stage, "activate," would be triggered at individual state or metropolitan regions, when a laboratory-confirmed case of pandemic flu is found in such jurisdictions.
Bird Flu Claims First Human In Nigeria 1-31-07
Bird flu claimed its first human victim in Africa's most-populous nation, killing a young Nigerian woman due to graduate from university and be married this year, officials and the victim's fiancé said Wednesday. The Jan. 17 death of the woman in Lagos, a teeming city where chickens and other fowl are kept in close quarters with humans, is a worrisome development in a vast nation with poor health care systems and weak government oversight. The victim, whose name was not released by the Information Ministry, was finishing her accounting degree and got engaged last month, her fiancé told The Associated Press. "She was a young girl, full of life, looking forward to this year," said the fiancé, who asked not to be named so that his loved one's family could grieve in peace. "For the last two weeks, I've been lost," the 25-year-old financial consultant said. "If they find a cure, I hope they name it after her." An outbreak of H5N1 bird flu hit Nigeria last year, but no human infections had been reported until Wednesday. Until the Nigerian report, Egypt and Djibouti were the only African countries that had confirmed infections among people. Eleven people have died in Egypt. The bird flu virus remains hard for humans to catch, but health experts fear H5N1 may mutate into a form that could spread easily among humans and possibly kill millions. The H5N1 virus has claimed at least 157 lives worldwide since it began ravaging Asian poultry in late 2003, according to the World Health Organization. In Nigeria, another female member of the deceased's household was infected, but was responding to treatment, Information Minister Frank Nweke said. Health officials earlier said 14 human samples had been taken and Nigeria's top bird-flu expert, Abdullahi Nasidi, said there may be more cases, including deaths. Nigeria lacks the sophisticated laboratory facilities to determine exactly which of the many bird flu subtypes killed the Nigerian woman. Samples taken from the infected women have been forwarded to a lab affiliated with the World Health Organization for further testing, Nweke said. International health officials said workers would be looking for signs of human-to-human transmission. "From a public health point of view, it would be most important to follow up H5N1 cases to see if there are any chains of transmission," said Gregory Hartl, a World Health Organization spokesman in Geneva. "H5N1 is an animal disease, but as long as it is widespread in poultry, we can expect to see sporadic cases in humans, as we have in Vietnam, Indonesia, and other countries," he said. Amid a new H5N1 outbreak reported in recent weeks in Nigeria's north, hundreds of kilometers (miles) from Lagos, health workers have begun a cull of poultry. The H5N1 strain has been confirmed in 15 of Nigeria's 36 states. With sub-Saharan Africa bearing the brunt of the AIDS epidemic, there is concern that millions of people with suppressed immune systems will be particularly vulnerable, especially in rural areas with little access to health facilities. Many people keep chickens for food, even in densely populated urban areas like Lagos. Most of Nigeria's 140 million people lack access to even basic health care and the government, hollowed by corruption, has little control over many parts of a nation the size of France. News of outbreaks in far-flung areas could take a long period to reach appropriate authorities. Since bird flu cases were first discovered in Nigeria last year, Cameroon, Djibouti, Niger, Ivory Coast, Sudan and Burkina Faso have also reported the H5N1 strain of bird flu in birds. There are fears that it has spread even further than is known in Africa because monitoring is difficult on a poor continent with weak infrastructure.
Third Bird Flu Outbreak This Month Confirmed in Japan 1-29-07
Tests confirmed that an outbreak of bird flu at a poultry farm in southern Japan was caused by the virulent H5N1 virus , the agriculture ministry said Saturday.
A state laboratory analyzed samples from 3,000 chickens that died at a farm in Hyuga in Miyazaki state, Japan's main chicken-producing region, and found the birds had been infected with H5N1, the Ministry of Agriculture, Forestry and Fisheries said in a statement.
Earlier this month, some 4,000 chickens died from H5N1 in another town in Miyazaki, about 560 miles southwest of Tokyo.
Authorities began slaughtering the remaining 49,000 chickens at the Hyuga farm on Friday, state official Hisao Takase said.
About 21,000 birds had been destroyed by Saturday afternoon, Takase said. Another 50,000 chickens at a neighboring farm will also be killed as a precaution.
The H5N1 virus has killed or forced the slaughter of millions of birds across Asia since late 2003, and caused the deaths of at least 163 people worldwide, according to the World Health Organization.
Japan has confirmed only one human H5N1 infection, and no human deaths.
The bird flu virus remains hard for humans to catch, but international experts fear it may mutate into a form that could spread easily among humans and possibly kill millions around the world.
Egyptian woman dies from bird flu 1-20-07
CAIRO, Jan 19 - An Egyptian woman died from bird flu on Friday after six days in hospital, the state news agency MENA said.The virus has now killed 11 people in Egypt, which has the largest cluster of human bird flu cases outside Asia. Eight other people who tested positive have recovered since the virus first surfaced in Egyptian poultry in February.
Warda Eid Ahmed, 27, from Beni Suef province, south of Cairo, was transferred to hospital in the capital on Jan. 13 suffering from pneumonia.A Health Ministry spokesman said earlier in the week she had raised hens in her house. The ministry has dispatched a team to take samples from the rest of her family, he said.MENA quoted Health Ministry spokesman Abdel Rahim Shahin on Friday as saying said she was the 11th person in Egypt to die from bird flu out of 19 human cases.
Three people from one family, including a 15-year-old girl, died of the virus in December, raising fears about the possibility of human-to-human transmission.Bird flu has killed at least 161 people worldwide since 2003, according to the most recent World Health Organisation figures.There are fears that millions could die if the virus were to mutate into a form that passes easily from person to person.
H5N1 Bird Flu Mutates, Resists Tamiflu 1-19-07
A mutation in the H5N1 Avian Flu or Bird Flu virus has been found in two humans infected with the virus located in the Gharbiyah Province of Egypt which is located about 50 miles outside of Egypt’s capital, Cairo, Egypt.

The victims, a 16 year-old girl and her 26 year-old uncle both died in December of 2006 and both patients were administered the Bird Flu treatment oseltamivir, which is distributed under the company name of Tamiflu, had shown to be less effective agianst their illnesses. The virus was also tested against the drugs zanamivir which was distributed under the name Relenza and amantadine, and is was found that drugs were less effective against the mutated form of this virus.

A sister of the 26 year-old also died of Bird Flu in December of 2006, but health officials have yet to determine if she died from the mutated form of the virus.
The World Health Organization is also stating that the three cases may be human to human transmission, but further tests are needed. The three cases are being treated as an outbreak and officials have yet to determine if the victims received the illness from chickens, or from one another.

“Based on the information we have, we can’t yet rule out human-to-human transmission. We need to better understand the dynamics of this outbreak,” said Bird Flu antivirals expert for the WHO, Doctor Fred Hayden.
If officials find that human to human transmission did occur, it would be “worrisome.”
“It would be very worrisome” if one family member passed it to another member.
The WHO; however, is not concerned that this outbreak may be the start of a world-wide pandemic and it is unknown how many times Bird Flu will need to mutate before it becomes more dangerous to humans.

“Given the information we have, we don’t see any broad public health implications,” said a spokeman for the WHO, Dick Thompson.
Egypt was added to the list of countries where the H5N1 virus has been found just last year. Since then the virus has only infected 18 people. Of those people, 10 have died so far, including these three cases in December.

The WHO reports that 267 people have been infected with Bird Flu in the entire world and that of those people, 161 have been confirmed to have died from the H5N1 virus.
Mutated Strains of Bird Flu have been found in Vietnam in 2005 and in Turkey in 2006.

Miyazaki bird flu confirmed as killer H5N1 Jan. 17, 2007
MIYAZAKI (Kyodo) The bird flu that has killed 3,500 chickens at a farm in Miyazaki Prefecture has been identified as the highly virulent H5N1 strain, which has proved fatal to humans, the Agriculture, Forestry and Fisheries Ministry announced Tuesday.
The National Institute of Animal Health conducted tests over the weekend on chickens from the Taniguchi Furanjo Kurosaka Farm in the town of Kiyotake.
Miyazaki Prefecture is the nation's largest producer of chickens.

The H5N1 strain is a subtype of the influenza A virus that can be transmitted to humans and other animal species.
It kills almost all poultry that are infected.
There have been no reports of human infection in the latest case, which is the fifth in Japan.
The last was in 2004 at farms in Yamaguchi, Kyoto and Oita prefectures.
About 100 sanitation workers from the Miyazaki Prefectural Government descended on the Kurosaka farm Tuesday to remove chicken fecal matter and disinfect the facility, where 8,300 birds had been culled to prevent the spread of the disease.
The previous day the last of the 12,000 carcasses were removed from the farm, which raises broiler chickens. The dead animals were taken to the city of Miyazaki where they were to be incinerated by Wednesday.

The prefectural government will inspect 16 poultry farms within a 10-km radius of the Kurosaka farm Wednesday and will also check all chickens being kept in small family coops.
The government has stopped all movement of chickens and eggs from the 16 farms and says it will monitor the situation for three weeks, after which it will lift the ban if there are no more infections.

The Environment Ministry announced it will monitor the movements of migratory birds in southern Kyushu to help prevent the spread of bird flu.
The ministry conducted an initial check near the Kurosaka farm over the weekend, officials said.
They reported finding no unusual wild bird deaths in the area.
The first case of humans being infected with the H5N1 virus was in Hong Kong in 1997. Eighteen people were infected, six of whom died.
That outbreak was contained but bird flu began spreading again in 2003, mostly in Asia.
According to data from the World Health Organization, H5N1 has infected 265 people in 10 countries, 159 of whom had died as of Friday.
Bird Flu Resurfaces Among Birds in Asia; Indonesia Death Toll Rises 1-16-07
Concerns over the deadly H5N1 strain of bird flu surfaced again across Asia Tuesday after scientists confirmed outbreaks among birds in Japan, Thailand and Vietnam, and a woman in Indonesia died.

The World Organization for Animal Health, or OIE, confirmed the first poultry cases in Japan since 2004. The outbreak killed about 4,000 chickens on a farm in the Miyazaki area of southwestern Japan. Authorities killed the remaining 8,000 chickens and have started to incinerate the dead birds. There were no reports of human infections.
Four provinces in southern Vietnam reported outbreaks of bird flu since the beginning of the year.
The virus is spreading closer to Vietnam's largest urban center in Ho Chi Minh City, prompting market inspectors to restrict the movement and selling of poultry in the city. The Vietnamese Agricultural Ministry moved to contain the spread by ordering additional poultry vaccinations and requesting reinforcement of animal health teams.
In Thailand, around 2,000 ducks in the Phitsanulok province were infected and killed in the first outbreak since July 2006.

The disease is believed to be spread by migrating birds and poultry smuggling. Keiji Fukuda, coordinator for the global influenza program at the World Health Organization, said the recent cases are following a seasonal pattern of increased outbreaks during the winter months in the northern hemisphere.

While human infection is still rare, health officials fear that the virus could mutate to be spread between humans and trigger a worldwide flu pandemic that could kills millions.
The potential for the H5N1 virus to become a pandemic still remains a threat though health authorities say it remains an animal disease.

"We don't have any evidence of human-to-human transmission; it is one of those things that we're always looking for. But in the recent group of cases, we don't have any evidence that that's what we're seeing," said Fukuda.

Since the first outbreak in 2003, 161 people have died worldwide, most of these in Asia.
On Monday, Indonesia's Ministry of Health confirmed that the death of a 22-year-old woman on Jan. 12 was caused by the H5N1 virus, bringing the human toll in Indonesia to 61 of the 79 confirmed cases, the highest in the world.

An investigation into the woman's death -- the fourth in Indonesia since the beginning of the year -- found reports of dead birds near her house. On Jan. 12, the disease killed a 37-year-old woman who was also believed to be exposed to dead chickens. Her son was confirmed to be infected with the H5N1 virus but her husband, suspected of being infected as well, tested negative.
Indonesia's head of national commission on avian influenza Bayu Krisnamurthi said there was no evidence of a human-to-human transmission.
General Information

Source: US Department of Health and Human Services
Avian Influenza (Bird Flu)
Avian Flu in Birds is Spreading in Asia and Other Countries
Avian influenza - commonly called "bird flu" - is an infection caused by influenza viruses that occur naturally in birds.

Wild birds can carry the viruses, but usually do not get sick from them. However, some domesticated birds, including chickens, ducks, and turkeys, can become infected, often fatally
One strain of avian influenza (bird flu), the H5N1 virus, is endemic in much of Asia and has recently spread into Europe. Avian H5N1 infections have recently killed poultry and other birds in a number of countries.

Strains of avian H5N1 influenza may infect various types of animals, including wild birds, pigs, and tigers.
Symptoms in birds and other animals vary, but virulent strains can cause death within a few days.
Avian H5N1 Flu in Humans is Currently Very Limited and Not a Pandemic
Human H5N1 influenza infection was first recognized in 1997 when this virus infected 18 people in Hong Kong, causing 6 deaths.

The World Health Organization is tracking the number of human cases of the H5N1virus. See http://www.pandemicflu.gov/#map, for a map showing the nations with confirmed human cases and the number of cases.

Currently, close contact with infected poultry has been the primary source for human infection. Though rare, there have been isolated reports of human-to-human transmission of the virus.
Genetic studies confirm that the influenza A virus H5N1 mutates rapidly. Should it adapt to allow easy human-to-human transmission, a pandemic could ensue - it has not done so to date.
At this time, it is uncertain whether the currently circulating H5N1 virus will lead to a global disease outbreak in humans - a pandemic.

The reported symptoms of avian influenza (bird flu) in humans have ranged from typical influenza-like symptoms (e.g. fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), acute respiratory distress, viral pneumonia and other severe, life-threatening complications.

Preventing and Treating Avian Flu or Bird Flu in Humans
Vaccines to protect humans against H5N1 viruses currently are under development. In addition, research is underway on methods to make large quantities of vaccine more quickly.
So far, research suggests that two antiviral medicines, Oseltamavir (Tamiflu(r)) and Zanamavir (Relenza(r)), may be useful treatments for H5N1 avian influenza. However, H5N1 viruses are generally resistant to two other available antiviral medications, amantadine and rimantadine, so they cannot be used to treat avian flu.

What's Happening Now?
A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.
It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Wherever and whenever a pandemic starts, everyone around the world is at risk. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.

Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. The H5N1 virus has raised concerns about a potential human pandemic because:
It is especially virulent
It is being spread by migratory birds
It can be transmitted from birds to mammals and in some limited circumstances to humans, and
Like other influenza viruses, it continues to evolve.
Since 2003, a growing number of human H5N1 cases have been reported in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam. More than half of the people infected with the H5N1 virus have died. Most of these cases are all believed to have been caused by exposure to infected poultry. There has been no sustained human-to-human transmission of the disease, but the concern is that H5N1 will evolve into a virus capable of human-to-human transmission.

Avian Influenza Viruses
Avian (bird) flu is caused by influenza A viruses that occur naturally among birds. There are different subtypes of these viruses because of changes in certain proteins (hemagglutinin [HA] and neuraminidase [NA]) on the surface of the influenza A virus and the way the proteins combine.

Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds. The avian flu currently of concern is the H5N1 subtype.
Avian Influenza in Birds

Wild birds worldwide carry avian influenza viruses in their intestines, but usually do not get sick from them. Avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Avian influenza or bird flu infection in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours. The H5N1 virus is highly pathogenic.

Human Infection with Avian Influenza Viruses
"Human influenza virus" usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses originally came from birds. Influenza A viruses are constantly changing, and other strains might adapt over time to infect and spread among humans.

The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. H5N1 is one of the few avian influenza viruses to have crossed the species barrier to infect humans, and it is the most deadly of those that have crossed the barrier.
Most cases of H5N1 influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds.

So far, the spread of H5N1 virus from person to person has been limited and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another.

In the current outbreaks in Asia, Europe, and Africa, more than half of those infected with the H5N1 virus have died. Most cases have occurred in previously healthy children and young adults. However, it is possible that the only cases currently being reported are those in the most severely ill people, and that the full range of illness caused by the H5N1 virus has not yet been defined.
Symptoms of avian influenza (bird flu) in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.

Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 bird flu virus were to gain the capacity to spread easily from person to person, a pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
Vaccination and Treatment for H5N1 Virus in Humans

There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia, Europe, and Africa. A pandemic vaccine cannot be produced until a new pandemic influenza virus emerges and is identified.

The U.S. Department of Health and Human Services (HHS), through its National Institute of Allergy and Infectious Diseases (NIAID), is addressing the problem in a number of ways. These include the development of pre-pandemic vaccines based on current lethal strains of H5N1, collaboration with industry to increase the Nation's vaccine production capacity, and seeking ways to expand or extend the existing supply. We are also doing research in the development of new types of influenza vaccines.

Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.

The H5N1 virus (bird flu) that has caused human illness and death in Asia is resistant to Amantadine and Rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamavir and Zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.

What would be the Impact of a Pandemic?
A pandemic may come and go in waves, each of which can last for six to eight weeks.
An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss. Everyday life would be disrupted because so many people in so many places become seriously ill at the same time. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery.
A substantial percentage of the world's population will require some form of medical care. Health care facilities can be overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies. Surge capacity at non-traditional sites such as schools may need to be created to cope with demand.

The need for vaccine is likely to outstrip supply and the supply of antiviral drugs is also likely to be inadequate early in a pandemic. Difficult decisions will need to be made regarding who gets antiviral drugs and vaccines.

Death rates are determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations and the availability and effectiveness of preventive measures.
What You Should Know About Avian Flu

Avian influenza in birds
Avian influenza is an infection caused by avian (bird) influenza (flu) viruses. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated secretions or excretions or with surfaces that are contaminated with secretions or excretions from infected birds. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100% often within 48 hours.

Human infection with avian influenza viruses
There are many different subtypes of type A influenza viruses. These subtypes differ because of changes in certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 known HA subtypes and 9 known NA subtypes of influenza A viruses. Many different combinations of HA and NA proteins are possible. Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds.

Usually, "avian influenza virus" refers to influenza A viruses found chiefly in birds, but infections with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997. Most cases of avian influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and transmission has not been observed to continue beyond one person.

"Human influenza virus" usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they might adapt over time to infect and spread among humans.
During an outbreak of avian influenza among poultry, there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with secretions or excretions from infected birds.

Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.

Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.

More information
Source: Center for Disease Control and Prevention
Avian Influenza A (H5N1)
Influenza A (H5N1) virus - also called "H5N1 virus" - is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.
Human health risks during the H5N1 outbreak

Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of detected cases of severe disease and death in humans. However, it is possible that those cases in the most severely ill people are more likely to be diagnosed and reported, while milder cases go unreported.

Of the human cases associated with the ongoing H5N1 outbreaks in poultry and wild birds in Asia and parts of Europe, the Near East and Africa, more than half of those people reported infected with the virus have died. Most cases have occurred in previously healthy children and young adults and have resulted from direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces. In general, H5N1 remains a very rare disease in people. The H5N1 virus does not infect humans easily, and if a person is infected, it is very difficult for the virus to spread to another person.

While there has been some human-to-human spread of H5N1, it has been limited, inefficient and unsustained. For example, in 2004 in Thailand, probable human-to-human spread in a family resulting from prolonged and very close contact between an ill child and her mother was reported. Most recently, in June 2006, WHO reported evidence of human-to-human spread in Indonesia. In this situation, 8 people in one family were infected. The first family member is thought to have become ill through contact with infected poultry. This person then infected six family members. One of those six people (a child) then infected another family member (his father). No further spread outside of the exposed family was documented or suspected.
Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin.

No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
Treatment and vaccination for H5N1 virus in humans

The H5N1 virus that has caused human illness and death in Asia is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamavir and Zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.
There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia and Europe. However, vaccine development efforts are taking place.
Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005, and a series of clinical trials is under way.
Ten things you need to know about pandemic influenza
Source: World Health Organization

1. Pandemic influenza is different from avian influenza
Avian influenza refers to a large group of different influenza viruses that primarily affect birds. On rare occasions, these bird viruses can infect other species, including pigs and humans. The vast majority of avian influenza viruses do not infect humans. An influenza pandemic happens when a new subtype emerges that has not previously circulated in humans.
For this reason, avian H5N1 is a strain with pandemic potential, since it might ultimately adapt into a strain that is contagious among humans. Once this adaptation occurs, it will no longer be a bird virus--it will be a human influenza virus. Influenza pandemics are caused by new influenza viruses that have adapted to humans.

2. Influenza pandemics are recurring events
An influenza pandemic is a rare but recurrent event. Three pandemics occurred in the previous century: "Spanish influenza" in 1918, "Asian influenza" in 1957, and "Hong Kong influenza" in 1968. The 1918 pandemic killed an estimated 40-50 million people worldwide. That pandemic, which was exceptional, is considered one of the deadliest disease events in human history. Subsequent pandemics were much milder, with an estimated 2 million deaths in 1957 and 1 million deaths in 1968.
A pandemic occurs when a new influenza virus emerges and starts spreading as easily as normal influenza - by coughing and sneezing. Because the virus is new, the human immune system will have no pre-existing immunity. This makes it likely that people who contract pandemic influenza will experience more serious disease than that caused by normal influenza.

3. The world may be on the brink of another pandemic
Health experts have been monitoring a new and extremely severe influenza virus - the H5N1 strain - for almost eight years. The H5N1 strain first infected humans in Hong Kong in 1997, causing 18 cases, including six deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. In December 2003, infections in people exposed to sick birds were identified.
Since then, over 100 human cases have been laboratory confirmed in four Asian countries (Cambodia, Indonesia, Thailand, and Viet Nam), and more than half of these people have died. Most cases have occurred in previously healthy children and young adults. Fortunately, the virus does not jump easily from birds to humans or spread readily and sustainably among humans. Should H5N1 evolve to a form as contagious as normal influenza, a pandemic could begin.

4. All countries will be affected
Once a fully contagious virus emerges, its global spread is considered inevitable. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it. The pandemics of the previous century encircled the globe in 6 to 9 months, even when most international travel was by ship. Given the speed and volume of international air travel today, the virus could spread more rapidly, possibly reaching all continents in less than 3 months.

5. Widespread illness will occur
Because most people will have no immunity to the pandemic virus, infection and illness rates are expected to be higher than during seasonal epidemics of normal influenza. Current projections for the next pandemic estimate that a substantial percentage of the world's population will require some form of medical care. Few countries have the staff, facilities, equipment, and hospital beds needed to cope with large numbers of people who suddenly fall ill.

6. Medical supplies will be inadequate
Supplies of vaccines and antiviral drugs - the two most important medical interventions for reducing illness and deaths during a pandemic - will be inadequate in all countries at the start of a pandemic and for many months thereafter. Inadequate supplies of vaccines are of particular concern, as vaccines are considered the first line of defence for protecting populations. On present trends, many developing countries will have no access to vaccines throughout the duration of a pandemic.

7. Large numbers of deaths will occur
Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of mortality cannot be made before the pandemic virus emerges and begins to spread. All estimates of the number of deaths are purely speculative.
WHO has used a relatively conservative estimate - from 2 million to 7.4 million deaths - because it provides a useful and plausible planning target. This estimate is based on the comparatively mild 1957 pandemic. Estimates based on a more virulent virus, closer to the one seen in 1918, have been made and are much higher. However, the 1918 pandemic was considered exceptional.
8. Economic and social disruption will be great
High rates of illness and worker absenteeism are expected, and these will contribute to social and economic disruption. Past pandemics have spread globally in two and sometimes three waves. Not all parts of the world or of a single country are expected to be severely affected at the same time. Social and economic disruptions could be temporary, but may be amplified in today's closely interrelated and interdependent systems of trade and commerce. Social disruption may be greatest when rates of absenteeism impair essential services, such as power, transportation, and communications.

9. Every country must be prepared
WHO has issued a series of recommended strategic actions for responding to the influenza pandemic threat. The actions are designed to provide different layers of defence that reflect the complexity of the evolving situation. Recommended actions are different for the present phase of pandemic alert, the emergence of a pandemic virus, and the declaration of a pandemic and its subsequent international spread.
10. WHO will alert the world when the pandemic threat increases
WHO works closely with ministries of health and various public health organizations to support countries' surveillance of circulating influenza strains. A sensitive surveillance system that can detect emerging influenza strains is essential for the rapid detection of a pandemic virus.
Six distinct phases have been defined to facilitate pandemic preparedness planning, with roles defined for governments, industry, and WHO. The present situation is categorized as phase 3: a virus new to humans is causing infections, but does not spread easily from one person to another.
General Information
Source: US Department of Health and Human Services
Avian Influenza (Bird Flu)
Avian Flu in Birds is Spreading in Asia and Other Countries
Avian influenza - commonly called "bird flu" - is an infection caused by influenza viruses that occur naturally in birds.
Wild birds can carry the viruses, but usually do not get sick from them. However, some domesticated birds, including chickens, ducks, and turkeys, can become infected, often fatally
One strain of avian influenza (bird flu), the H5N1 virus, is endemic in much of Asia and has recently spread into Europe. Avian H5N1 infections have recently killed poultry and other birds in a number of countries.
Strains of avian H5N1 influenza may infect various types of animals, including wild birds, pigs, and tigers.
Symptoms in birds and other animals vary, but virulent strains can cause death within a few days.
Avian H5N1 Flu in Humans is Currently Very Limited and Not a Pandemic
Human H5N1 influenza infection was first recognized in 1997 when this virus infected 18 people in Hong Kong, causing 6 deaths.
The World Health Organization is tracking the number of human cases of the H5N1virus. See http://www.pandemicflu.gov/#map, for a map showing the nations with confirmed human cases and the number of cases.
Currently, close contact with infected poultry has been the primary source for human infection. Though rare, there have been isolated reports of human-to-human transmission of the virus.
Genetic studies confirm that the influenza A virus H5N1 mutates rapidly. Should it adapt to allow easy human-to-human transmission, a pandemic could ensue - it has not done so to date.
At this time, it is uncertain whether the currently circulating H5N1 virus will lead to a global disease outbreak in humans - a pandemic.
The reported symptoms of avian influenza (bird flu) in humans have ranged from typical influenza-like symptoms (e.g. fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), acute respiratory distress, viral pneumonia and other severe, life-threatening complications.
Preventing and Treating Avian Flu or Bird Flu in Humans
Vaccines to protect humans against H5N1 viruses currently are under development. In addition, research is underway on methods to make large quantities of vaccine more quickly.
So far, research suggests that two antiviral medicines, Oseltamavir (Tamiflu(r)) and Zanamavir (Relenza(r)), may be useful treatments for H5N1 avian influenza. However, H5N1 viruses are generally resistant to two other available antiviral medications, amantadine and rimantadine, so they cannot be used to treat avian flu.
What's Happening Now?
A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to-person, causes serious illness, and can sweep across the country and around the world in very short time.
It is difficult to predict when the next influenza pandemic will occur or how severe it will be. Wherever and whenever a pandemic starts, everyone around the world is at risk. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it.
Health professionals are concerned that the continued spread of a highly pathogenic avian H5N1 virus across eastern Asia and other countries represents a significant threat to human health. The H5N1 virus has raised concerns about a potential human pandemic because:
It is especially virulent
It is being spread by migratory birds
It can be transmitted from birds to mammals and in some limited circumstances to humans, and
Like other influenza viruses, it continues to evolve.
Since 2003, a growing number of human H5N1 cases have been reported in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam. More than half of the people infected with the H5N1 virus have died. Most of these cases are all believed to have been caused by exposure to infected poultry. There has been no sustained human-to-human transmission of the disease, but the concern is that H5N1 will evolve into a virus capable of human-to-human transmission.
Avian Influenza Viruses
Avian (bird) flu is caused by influenza A viruses that occur naturally among birds. There are different subtypes of these viruses because of changes in certain proteins (hemagglutinin [HA] and neuraminidase [NA]) on the surface of the influenza A virus and the way the proteins combine.
Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds. The avian flu currently of concern is the H5N1 subtype.
Avian Influenza in Birds
Wild birds worldwide carry avian influenza viruses in their intestines, but usually do not get sick from them. Avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.
Avian influenza or bird flu infection in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours. The H5N1 virus is highly pathogenic.
Human Infection with Avian Influenza Viruses
"Human influenza virus" usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses originally came from birds. Influenza A viruses are constantly changing, and other strains might adapt over time to infect and spread among humans.
The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. H5N1 is one of the few avian influenza viruses to have crossed the species barrier to infect humans, and it is the most deadly of those that have crossed the barrier.
Most cases of H5N1 influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds.
So far, the spread of H5N1 virus from person to person has been limited and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another.
In the current outbreaks in Asia, Europe, and Africa, more than half of those infected with the H5N1 virus have died. Most cases have occurred in previously healthy children and young adults. However, it is possible that the only cases currently being reported are those in the most severely ill people, and that the full range of illness caused by the H5N1 virus has not yet been defined.
Symptoms of avian influenza (bird flu) in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.
Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 bird flu virus were to gain the capacity to spread easily from person to person, a pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
Vaccination and Treatment for H5N1 Virus in Humans
There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia, Europe, and Africa. A pandemic vaccine cannot be produced until a new pandemic influenza virus emerges and is identified.
The U.S. Department of Health and Human Services (HHS), through its National Institute of Allergy and Infectious Diseases (NIAID), is addressing the problem in a number of ways. These include the development of pre-pandemic vaccines based on current lethal strains of H5N1, collaboration with industry to increase the Nation's vaccine production capacity, and seeking ways to expand or extend the existing supply. We are also doing research in the development of new types of influenza vaccines.
Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.
The H5N1 virus (bird flu) that has caused human illness and death in Asia is resistant to Amantadine and Rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamavir and Zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.
What would be the Impact of a Pandemic?
A pandemic may come and go in waves, each of which can last for six to eight weeks.
An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss. Everyday life would be disrupted because so many people in so many places become seriously ill at the same time. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery.
A substantial percentage of the world's population will require some form of medical care. Health care facilities can be overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies. Surge capacity at non-traditional sites such as schools may need to be created to cope with demand.
The need for vaccine is likely to outstrip supply and the supply of antiviral drugs is also likely to be inadequate early in a pandemic. Difficult decisions will need to be made regarding who gets antiviral drugs and vaccines.
Death rates are determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations and the availability and effectiveness of preventive measures.
What You Should Know About Avian Flu
Avian influenza in birds
Avian influenza is an infection caused by avian (bird) influenza (flu) viruses. These influenza viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.
Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated secretions or excretions or with surfaces that are contaminated with secretions or excretions from infected birds. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry, or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.
Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The "low pathogenic" form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the highly pathogenic form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100% often within 48 hours.
Human infection with avian influenza viruses
There are many different subtypes of type A influenza viruses. These subtypes differ because of changes in certain proteins on the surface of the influenza A virus (hemagglutinin [HA] and neuraminidase [NA] proteins). There are 16 known HA subtypes and 9 known NA subtypes of influenza A viruses. Many different combinations of HA and NA proteins are possible. Each combination represents a different subtype. All known subtypes of influenza A viruses can be found in birds.
Usually, "avian influenza virus" refers to influenza A viruses found chiefly in birds, but infections with these viruses can occur in humans. The risk from avian influenza is generally low to most people, because the viruses do not usually infect humans. However, confirmed cases of human infection from several subtypes of avian influenza infection have been reported since 1997. Most cases of avian influenza infection in humans have resulted from contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretion/excretions from infected birds. The spread of avian influenza viruses from one ill person to another has been reported very rarely, and transmission has not been observed to continue beyond one person.
"Human influenza virus" usually refers to those subtypes that spread widely among humans. There are only three known A subtypes of influenza viruses (H1N1, H1N2, and H3N2) currently circulating among humans. It is likely that some genetic parts of current human influenza A viruses came from birds originally. Influenza A viruses are constantly changing, and they might adapt over time to infect and spread among humans.
During an outbreak of avian influenza among poultry, there is a possible risk to people who have contact with infected birds or surfaces that have been contaminated with secretions or excretions from infected birds.
Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which virus caused the infection.
Studies done in laboratories suggest that some of the prescription medicines approved in the United States for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to demonstrate the effectiveness of these medicines.
More information
Source: Center for Disease Control and Prevention
Avian Influenza A (H5N1)
Influenza A (H5N1) virus - also called "H5N1 virus" - is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them. H5N1 virus does not usually infect people, but infections with these viruses have occurred in humans. Most of these cases have resulted from people having direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces.
Human health risks during the H5N1 outbreak
Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 has caused the largest number of detected cases of severe disease and death in humans. However, it is possible that those cases in the most severely ill people are more likely to be diagnosed and reported, while milder cases go unreported.
Of the human cases associated with the ongoing H5N1 outbreaks in poultry and wild birds in Asia and parts of Europe, the Near East and Africa, more than half of those people reported infected with the virus have died. Most cases have occurred in previously healthy children and young adults and have resulted from direct or close contact with H5N1-infected poultry or H5N1-contaminated surfaces. In general, H5N1 remains a very rare disease in people. The H5N1 virus does not infect humans easily, and if a person is infected, it is very difficult for the virus to spread to another person.
While there has been some human-to-human spread of H5N1, it has been limited, inefficient and unsustained. For example, in 2004 in Thailand, probable human-to-human spread in a family resulting from prolonged and very close contact between an ill child and her mother was reported. Most recently, in June 2006, WHO reported evidence of human-to-human spread in Indonesia. In this situation, 8 people in one family were infected. The first family member is thought to have become ill through contact with infected poultry. This person then infected six family members. One of those six people (a child) then infected another family member (his father). No further spread outside of the exposed family was documented or suspected.
Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population. If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin.
No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily and widely from person to person.
Treatment and vaccination for H5N1 virus in humans
The H5N1 virus that has caused human illness and death in Asia is resistant to amantadine and rimantadine, two antiviral medications commonly used for influenza. Two other antiviral medications, Oseltamavir and Zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies still need to be done to demonstrate their effectiveness.
There currently is no commercially available vaccine to protect humans against H5N1 virus that is being seen in Asia and Europe. However, vaccine development efforts are taking place. Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005, and a series of clinical trials is under way.
Ten things you need to know about pandemic influenza
Source: World Health Organization
1. Pandemic influenza is different from avian influenza
Avian influenza refers to a large group of different influenza viruses that primarily affect birds. On rare occasions, these bird viruses can infect other species, including pigs and humans. The vast majority of avian influenza viruses do not infect humans. An influenza pandemic happens when a new subtype emerges that has not previously circulated in humans.
For this reason, avian H5N1 is a strain with pandemic potential, since it might ultimately adapt into a strain that is contagious among humans. Once this adaptation occurs, it will no longer be a bird virus--it will be a human influenza virus. Influenza pandemics are caused by new influenza viruses that have adapted to humans.
2. Influenza pandemics are recurring events
An influenza pandemic is a rare but recurrent event. Three pandemics occurred in the previous century: "Spanish influenza" in 1918, "Asian influenza" in 1957, and "Hong Kong influenza" in 1968. The 1918 pandemic killed an estimated 40-50 million people worldwide. That pandemic, which was exceptional, is considered one of the deadliest disease events in human history. Subsequent pandemics were much milder, with an estimated 2 million deaths in 1957 and 1 million deaths in 1968.
A pandemic occurs when a new influenza virus emerges and starts spreading as easily as normal influenza - by coughing and sneezing. Because the virus is new, the human immune system will have no pre-existing immunity. This makes it likely that people who contract pandemic influenza will experience more serious disease than that caused by normal influenza.
3. The world may be on the brink of another pandemic
Health experts have been monitoring a new and extremely severe influenza virus - the H5N1 strain - for almost eight years. The H5N1 strain first infected humans in Hong Kong in 1997, causing 18 cases, including six deaths. Since mid-2003, this virus has caused the largest and most severe outbreaks in poultry on record. In December 2003, infections in people exposed to sick birds were identified.
Since then, over 100 human cases have been laboratory confirmed in four Asian countries (Cambodia, Indonesia, Thailand, and Viet Nam), and more than half of these people have died. Most cases have occurred in previously healthy children and young adults. Fortunately, the virus does not jump easily from birds to humans or spread readily and sustainably among humans. Should H5N1 evolve to a form as contagious as normal influenza, a pandemic could begin.
4. All countries will be affected
Once a fully contagious virus emerges, its global spread is considered inevitable. Countries might, through measures such as border closures and travel restrictions, delay arrival of the virus, but cannot stop it. The pandemics of the previous century encircled the globe in 6 to 9 months, even when most international travel was by ship. Given the speed and volume of international air travel today, the virus could spread more rapidly, possibly reaching all continents in less than 3 months.
5. Widespread illness will occur
Because most people will have no immunity to the pandemic virus, infection and illness rates are expected to be higher than during seasonal epidemics of normal influenza. Current projections for the next pandemic estimate that a substantial percentage of the world's population will require some form of medical care. Few countries have the staff, facilities, equipment, and hospital beds needed to cope with large numbers of people who suddenly fall ill.
6. Medical supplies will be inadequate
Supplies of vaccines and antiviral drugs - the two most important medical interventions for reducing illness and deaths during a pandemic - will be inadequate in all countries at the start of a pandemic and for many months thereafter. Inadequate supplies of vaccines are of particular concern, as vaccines are considered the first line of defence for protecting populations. On present trends, many developing countries will have no access to vaccines throughout the duration of a pandemic.
7. Large numbers of deaths will occur
Historically, the number of deaths during a pandemic has varied greatly. Death rates are largely determined by four factors: the number of people who become infected, the virulence of the virus, the underlying characteristics and vulnerability of affected populations, and the effectiveness of preventive measures. Accurate predictions of mortality cannot be made before the pandemic virus emerges and begins to spread. All estimates of the number of deaths are purely speculative.
WHO has used a relatively conservative estimate - from 2 million to 7.4 million deaths - because it provides a useful and plausible planning target. This estimate is based on the comparatively mild 1957 pandemic. Estimates based on a more virulent virus, closer to the one seen in 1918, have been made and are much higher. However, the 1918 pandemic was considered exceptional.
8. Economic and social disruption will be great
High rates of illness and worker absenteeism are expected, and these will contribute to social and economic disruption. Past pandemics have spread globally in two and sometimes three waves. Not all parts of the world or of a single country are expected to be severely affected at the same time. Social and economic disruptions could be temporary, but may be amplified in today's closely interrelated and interdependent systems of trade and commerce. Social disruption may be greatest when rates of absenteeism impair essential services, such as power, transportation, and communications.
9. Every country must be prepared
WHO has issued a series of recommended strategic actions for responding to the influenza pandemic threat. The actions are designed to provide different layers of defence that reflect the complexity of the evolving situation. Recommended actions are different for the present phase of pandemic alert, the emergence of a pandemic virus, and the declaration of a pandemic and its subsequent international spread.
10. WHO will alert the world when the pandemic threat increases
WHO works closely with ministries of health and various public health organizations to support countries' surveillance of circulating influenza strains. A sensitive surveillance system that can detect emerging influenza strains is essential for the rapid detection of a pandemic virus.
Six distinct phases have been defined to facilitate pandemic preparedness planning, with roles defined for governments, industry, and WHO. The present situation is categorized as phase 3: a virus new to humans is causing infections, but does not spread easily from one person to another.

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