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September 17th, 2005, 12:56 PM
Avian Flu: Is the Government Ready for an Epidemic?
Virus Poses Risk of Massive Casualties Around the World

Brian Ross
ABC News Chief investigative Correspondent


Sept. 15, 2005 — It could kill a billion people worldwide, make ghost towns out of parts of major cities, and there is not enough medicine to fight it. It is called the avian flu.

This week, the U.S. government agreed to stockpile $100 million worth of a still-experimental vaccine, while at the United Nations Summit in New York, both the head of the U.N. World Health Organization and President Bush warned of the virus' deadly potential.

"We must also remain on the offensive against new threats to public health, such as the Avian influenza," Bush said in his speech to world leaders. "If left unchallenged, the virus could become the first pandemic of the 21st century."

According to Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, Bush's call to remain on the offensive has come too late.

"If we had a significant worldwide epidemic of this particular avian flu, the H5N1 virus, and it hit the United States and the world, because it would be everywhere at once, I think we would see outcomes that would be virtually impossible to imagine," he warns.

Already, officials in London are quietly looking for extra morgue space to house the victims of the H5N1 virus, a never-before-seen strain of flu. Scientists say this virus could pose a far greater threat than smallpox, AIDS or anthrax.

"Right now in human beings, it kills 55 percent of the people it infects," says Laurie Garrett, a senior fellow on global health policy at the Council on Foreign Relations. "That makes it the most lethal flu we know of that has ever been on planet Earth affecting human beings."

No Natural Immunity

The Council on Foreign Relations devoted its most recent issue of the prestigious journal, Foreign Affairs, to what it called the coming global epidemic, a pandemic.

"Each year different flus come, but your immune system says, 'Ah, I've seen that guy before. No problem. Crank out some antibodies, and I might not feel great for a couple of days, but I'll recover,'" Garrett says. "Now what's scaring us is that this constellation of H number 5 and N number 1, to our knowledge, has never in history been in our species. So absolutely nobody watching this has any natural immunity to this form of flu."

Like most flu viruses, this form started in wild birds — such as geese, ducks and swans — in Asia.

"They die of a pneumonia, just like people," says William Karesh, the lead veterinarian for the Wildlife Conservation Society. "When you open them up, you do a post-mortem exam. Their lungs are just full of fluid and full of blood."

Karesh has been tracking this flu strain for the last several years as it has gained strength, spreading from wild birds to chickens to humans.

"We start at a market somewhere in Guangdong Province in China," explains Karesh. "And it's packed with cages, and you'll have chickens, and you'll have ducks. You might have some other animals — cats, dogs, turtles, snakes — and they're all stacked in cages, and they're all spreading their germs to each other."

In response, Asian governments have killed millions of chickens in futile attempts to stop the flu's spread to humans.

"The tipping point, the place where it becomes something of an immediate concern, is where that virus changes, we call it mutates, to something that is able to go from human to human," says Redlener, director of the National Center for Disaster Preparedness.

Scientists in Asia and around the world are now working around the clock as they wait for that tipping point.

"Unlike the normal human flu, where the virus is predominantly in the upper respiratory tract so you get a runny nose, sore throat, the H5N1 virus seems to go directly deep into the lungs so it goes down into the lung tissue and causes severe pneumonia," says Dr. Malik Peiris, the scientist who first discovered the so-called SARS virus, which killed 700 people and drew worldwide attention.

To date, there have been 57 confirmed human deaths, and another suspected one last week in Indonesia. Scientists say the humans have only been infected by birds. However, they add, every infected person represents one step closer to the tipping point.

"Once that virus is capable of not needing the birds to infect humans, then we have the beginnings of what can turn out to be this worldwide epidemic problem that the experts call 'pandemics,'" Redlener says.

That is exactly what happened in 1918 when the global epidemic called the Spanish flu struck.

"The Spanish flu was killing people in two or three days once they got sick," said Bill Karesh of the Wildlife Conservation Society.

"In 1918, my now-quite-elderly uncle was a young boy, living in Baltimore, Maryland," says Garrett of the Council on Foreign Relations. "And the flu came through, and his family insisted that he could not go outside for any reason until the whole epidemic was over. He spent afternoons looking out the window and counting the hearses going up and down the neighborhood and trying to guess which of his schoolmates had died."

Disaster Would Require Massive Quarantines

Unlike the avian flu, the Spanish flu spread long before the international air travel routes of today. At that time, there were no nonstop flights from flu ground zero to the United States. But not anymore.

Karesh believes the avian flu could travel from China to Japan to New York to San Francisco within the first week.

"It's on people's hands. You shake hands. You touch a doorknob that somebody recently touched," Garrett says, referring to how the flu is spread.

Redlener, who is stationed at Mailman School of Public Health at Columbia University, has been working with New York City officials to get ready for the deadly epidemic.

"The city would look like a science fiction movie," according to him. "It's extremely possible we'd have to quarantine hospitals. We'd have to quarantine sections of the city."

"I could imagine that you could look at Grand Central Station and not see much of anybody wandering around at all," Garrett agrees. "People would be afraid to take the subways, because who wants to be in an enclosed air space with a whole lot of strangers, never knowing which ones are carrying the flu?"

As for the hospitals, there would be scenes like the ones this past month in the stadiums of New Orleans and Houston after Hurricane Katrina.

"There wouldn't be equipment and personnel to staff them adequately that you could really call them a hospital," Garrett predicts. "You might more or less call them warehouses for the ailing."

And, as happened in New Orleans, there would be no place for the dead.

"If you look at the expected number of deaths that could occur in cities across the United States, we are wholly unprepared to process those bodies in a dignified and respectful way," asserts Michael Osterholm, director of the Center for Infectious Disease Research and Policy. "We will run out of caskets literally within days."

The prospects have become so bleak that in planning meetings held in New York City, veteran emergency responders have walked away.

"They just don't know how we're going to get through," says Osterholm of those responders. "If we have a repeat of the 1918 life experience, I can't imagine anything to be closer to a living hell than that experience of 12 to 24 months of pandemic influenza."

If the flu does strike, victims at first would not know if it is the kind of easily treated flu that comes every year or the killer flu, known as H5N1.

The man in charge of making sure Americans are prepared in the event of a killer flu epidemic is the secretary of Health and Human Services.

"We would do all we could to quarantine," says Secretary Michael Leavitt. "It's not a happy thought. It's something that keeps the president of the United States awake. It keeps me awake."

The preparedness plan calls for Leavitt to run operations out of a crisis room in Washington.

When pressed as to how ready the country actually is, Leavitt replied, "Not as prepared as we need to be. We're better prepared than we were yesterday; we'll be better prepared tomorrow than we are today."

The draft report of the federal government's emergency plan, obtained and examined by ABC News' "Primetime," predicts as many as 200,000 Americans will die within a few months. This is considered a conservative estimate.

"The first thing is everybody in America's going to say, 'Where's the vaccine?' And they're going to find out that it's really darned hard to make a vaccine. It takes a really long time," said Garrett of the Council on Foreign Relations.

In fact, the draft report says it will not be until six months after the first outbreak that any vaccine will be available, and then only in a limited supply.

"I imagine that not a lot of poor people will get vaccinated," Garrett says. "If you think about New Orleans, this is a similar situation."

'Inadequate' Stockpile of Medicine

While there is no vaccine to stop the flu, there is one medicine to treat it. Called Tamiflu, it is made by the Roche pharmaceutical company in Switzerland. Roche has been selling Tamiflu for years.

Only recently, however, did scientists learn of its potential to work against the killer flu, H5N1. That has since created a huge demand and a critical shortage.

"All of the wealthiest countries in the world are trying to purchase stockpiles of Tamiflu," says Garrett. "Our current stockpile is around 2.5 million courses of treatment."

According to Leavitt, that is a long way from the country's ideal stockpile. "Our objective is to have 20 million doses of Tamiflu or enough for 20 million people," he says.

He later admitted that only 2 million are currently on hand, but asserted that no other country is in a better position.

Officials in Australia, however, have 3.5 million courses of treatment, and in Great Britain, officials say they have ordered enough to cover a quarter of their population.

"I think at the moment, with 2.5 million doses, you are pretty vulnerable," warns professor John Oxford of the Royal London Hospital.

"The lack of advanced planning up until the moment in the United States, in the sense of not having a huge stockpile I think your citizens deserve, has surprised me and has dismayed me," he admits.

Faced with worldwide demand, the Roche company, which produces Tamiflu, has organized a first-come, first-served waiting list. The United States is nowhere near the top.

"The way we are approaching the discussions with governments is that we are operating on a first-come, first-serve basis," says Dr. David Reddy, head of the pandemic task force at Roche.

"Do we wish we had ordered it sooner and more of it? I suspect one could say yes," admits Leavitt. "Are we moving rapidly to assure that we have it? The answer is also yes."

When asked why the United States did not place its orders for Tamiflu sooner, Leavitt replied, "I can't answer that. I don't know the answer to that."

Even leading Republicans in Congress say the Bush administration has not handled the planning for a possible flu epidemic well.

Senate Majority Leader Bill Frist, R-Tenn., says the current Tamiflu stockpile of 2 million could spell disaster.

"That's totally inadequate. Totally inadequate today," says Frist, who is also a physician. "The Tamiflu is what people would go after. It's what you're going to ask for, I'm going to ask for, immediately."

Leavitt says deciding who gets the 2.5 million doses of Tamiflu currently on hand in the United States is part of the federal government's response plan. However, he also admits that thought has motivated the government to move rapidly in securing more doses of the medicine.

"It isn't going to happen tomorrow, but if it happened the day after that, we would not be in as good as a position as we will be in six months," he says.

However, in the end, even the country's top health officials concede that a killer flu epidemic this winter would make the scenes of Katrina pale in comparison.

"You know, I was down in New Orleans in that crowded airport now a couple weeks ago," Frist says. "And this could be not just equal to that, but many multiple times that. Hundreds of people laid out, all dying, because there was no therapy. And a lot of people don't realize for this avian flu virus, there will be very little effective therapy available early on."

ABC News' Rhonda Schwartz, Michael Bicks, Samantha Chapman, Maddy Sauer, Simon Surowicz, Jill Rackmill, Steve Baker, Monica DelaRosa and Jennifer Needleman contributed to this report.

September 17th, 2005, 03:35 PM
U.S. Buys $100 Million of Bird Flu Vaccine

September 15, 2005


WASHINGTON (AP) - Mass production of a new vaccine that promises to protect against bird flu is poised to begin, as the government on Thursday agreed to stockpile $100 million worth of inoculations.

The new contract with French vaccine maker Sanofi-Pasteur marks a major scale-up in U.S. preparation for the possibility that the worrisome virus could spark an influenza pandemic.

While the vaccine is still experimental, preliminary results from the National Institutes of Health's first testing in people suggest the inoculations spur an immune response that would be strong enough to protect against known strains of the avian influenza, sparking the new investment.

But just how many doses the $100 million will buy isn't yet clear.

That's because there is contrasting research on just how much antigen much be in each dose to provide protection, explained Sanofi spokesman Len Lavenda. The range is huge - from 15 micrograms of antigen per dose to 90 - and the protective amount likely will wind up somewhere in between, he said.

Previously, the government has said it has stockpiled 2 million doses of bird flu vaccine.

Sanofi stored that vaccine in bulk, and the 2 million estimate assumed a single 15-microgram dose per person, Lavenda said. In contrast, the preliminary NIH research suggested it may take two 90-microgram shots to provide protection.

Simple math suggests that means the $100 million purchase could provide enough doses to protect anywhere from 1.7 million people - "we're quite sure it's going to be a lot more than that," Lavenda said - to a maximum of 20 million people.

A study now under way in France pairs the vaccine with an immune booster, called an adjuvant, that may help stretch doses. Sanofi expects results later in the year.

Regardless of the ultimate number, clearing the way for mass production now is a big step. Sanofi's factory in Swiftwater, Penn., can produce bird flu vaccine in September and October - months not occupied making vaccine for regular winter flu - and separate bulk lots into agreed-upon doses later.

The government's ultimate goal is to stockpile 20 million vaccine doses, a first wave of protection if the H5N1 bird flu strain eventually sparks a pandemic.

It's a quest gaining urgency. The virus has now killed or led to the slaughter of millions of birds, mostly in Asia but in parts of Europe, too. Although it has killed only about 60 people, mostly poultry workers, that's because so far it doesn't spread easily from person to person. If that changes - and flu viruses mutate regularly - it could trigger a deadly worldwide outbreak, because H5N1 is so different from the flu strains that circulate each winter that people have no residual immunity.

The nation also plans to stockpile 20 million doses of anti-flu medication, and the government announced Thursday it was purchasing enough of the drug Relenza, from maker GlaxoSmithKline, to treat 84,300 people.

Already in stock is enough of a competing drug, Tamiflu, to treat 4.3 million. Tamiflu is a pill, while Relenza must be inhaled, a drawback. The government still is planning additional Tamiflu purchases.

"These counter-measures provide us with tools that we have never had prior to previous influenza pandemics," said Health and Human Services Secretary Mike Leavitt. --

TLOZ Link5
September 17th, 2005, 04:59 PM
Anyone care to predict a culling of pigeons in New York?

Sorry to seem like I'm making light of this, but it's important to keep a positive attitude.

September 18th, 2005, 10:20 AM
Avian Flu: Is the Government Ready for an Epidemic?...

We can only hope the highest levels of government become infected with it.

September 18th, 2005, 10:29 AM
From: http://www.andrewsullivan.com/ (http://www.andrewsullivan.com/) (Saturday, September 17, 2005)

AVIAN FLU: Some more details on what might be done. Right now, we have a not-too-great experimental vaccine and insufficient supplies of Tamiflu to try and limit the viral impact if you get infected. But there are other options. A specialist emailed me to point out the following:
Tamiflu is mentioned because it's the only drug that works against both influenza A and influenza B strains. However, pandemic influenza is type A and the current "bird flu" H5N1 is also type A. For this we have two other drugs which are approved for treating type A infleunza - amantadine and rimandatine. Both are available as generic and are much cheaper/ should be easier to get.Where are the feds on that one? Amantadine will not help avian flu as it now is - but a single new mutation could make the flu vulnerable to it; and it cannot hurt to have big supplies of it ready to go. Small things can cause big shifts in an epidemic's reach. The Canadian government has stockpiled a big supply - which may save many lives in the early days of a pandemic. So have many other countries (http://www.recombinomics.com/News/08240504/Sweden_Flu_Stockpile.html). Other possible drugs - to ward off flu in the uninfected and weaken it in the infected - include oseltamivir and zanamivir (the side-effects suck). According to this article (http://www.newsleader.com/apps/pbcs.dll/article?AID=/20050828/LIFESTYLE/508280319/1024), "The United States is doing nothing to assure an adequate supply of these drugs." Given what we know of the Bush administration's competence, why am I not surprised? At my next doctor's visit, I'm going to request my own supply of all these drugs, just in case. You might think about it as well. In a national emergency in the U.S. under Bush, you're on your own. Next time, we shouldn't be shocked by federal ineptitude. We should just prepare to save ourselves.

From the link to "this article" cited above:

"Prevention would be infinitely better than having to deal with treatments. Development of a vaccine is a priority, but there are major concerns about a vaccine.

"First, there isn't a vaccine already proven. Second, production of an effective avian flu vaccine would require three or more times the current world capacity for vaccine production, even if we started now. Third, and worst of all, since the virus is changing rapidly, a vaccine developed with today's avian flu virus might not be useful if the virus changes enough to adapt to human infection.

"The shortage last year of flu vaccine unmasked how inadequate vaccine production capacity is worldwide. Even though plans are now in progress for building a new plant, it will take until 2008.

"...Some countries are buying up stockpiles of these drugs, including China, Japan, and Canada. The United States is doing nothing to assure an adequate supply of these drugs."

September 20th, 2005, 09:48 AM
World has slim chance to stop flu pandemic


By Michael Perry
Sep 20 1:48 AM US/Eastern

NOUMEA, New Caledonia (Reuters) - The initial outbreak of what could explode into a bird flu pandemic may affect only a few people, but the world will have just weeks to contain the deadly virus before it spreads and kills millions.

Chances of containment are limited because the potentially catastrophic infection may not be detected until it has already spread to several countries, like the SARS virus in 2003. Avian flu vaccines developed in advance will have little impact on the pandemic virus.

It will take scientists four to six months to develop a vaccine that protects against the pandemic virus, by which time thousands could have died. There is little likelihood a vaccine will even reach the country where the pandemic starts.

That is the scenario outlined on Tuesday by Dr Hitoshi Oshitani, the man who was on the frontline in the battle against SARS and now leads the fight against avian flu in Asia.

"SARS in retrospect was an easy virus to contain," said Oshitani, the World Health Organization's Asian communicable diseases expert.

"The pandemic virus is much more difficult, maybe impossible, to contain once it starts," he told Reuters at a WHO conference in Noumea, capital of the French Pacific territory of New Caledonia. "The geographic spread is historically unprecedented."

Oshitani said nobody knew when a pandemic would occur, it could be within weeks or years, but all the conditions were in place, save one -- a virus that transmitted from human to human.

The contagious H5N1 virus, which has killed 64 people in four Asian countries since it was first detected in 2003, might not be the one to trigger the pandemic, he said. Instead a genetically different strain could develop that passes between humans.

While bird flu cases continued to spread throughout Asia, with Indonesia this week placed on alert after reporting four deaths, Oshitani said the winter months of December, January and February would see an acceleration in cases, and the more human cases the greater risk that the virus would mutate.

Vietnam, Indonesia and Cambodia were most vulnerable due to the large domestic poultry populations, he said.


When a pandemic is first detected, health authorities will need to carry out a massive anti-viral inoculation campaign within two to three weeks to have any chance of containment, said Oshitani.

"Theoretically it is possible to contain the virus if we have early signs of a pandemic detected at the source," he said.

Scientists estimate that between 300,000 and one million people will immediately need anti-virals, but there are only limited stocks. WHO will receive one million doses by the end of 2005 and a further two million by mid-2006.

Even when an avian flu vaccine is fully developed, production limitations will mean there will not be enough vaccine.

"Right now we have a timeframe of four to six months to develop and produce a certain quantity of vaccine and that may not be fast enough," said Oshitani.

Last week French drug maker Sanofi-Aventis won a $100 million contract to supply the United States a vaccine against H5N1. The United States has also awarded a $2.8 million contract to Britain's GlaxoSmithKline for 84,300 courses of an antiviral. The purchases are part of a U.S. plan to buy vaccine for 20 million people and antivirals for another 20 million.

Oshitani said the early vaccines were unlikely to protect against the pandemic virus. "The vaccine should match the pandemic strain. So a vaccine developed for the virus in Vietnam now may not protect you from another virus," he said.

But Oshitani fears that once a pandemic occurs, the world's rich nations may dominate vaccine supply.

"The distribution of a vaccine will be a major issue when a pandemic starts. There is no mechanism for distribution," he said. Asked whether poorer Asian nations such as Cambodia and Vietnam would get a vaccine, Oshitani said "probably not."

Avian flu has moved west from Asia and into Russia, with many fearing migratory wild birds will spread the virus to Europe and possibly the United States via Alaska.

But Oshitani casts doubt on the impact migratory birds are having on the spread of avian flu, saying different sub-types of the H5N1 virus are in Asia and Russia.

"There are so many uncertainties about the pandemic. We don't know how it will start. We don't know exactly how it is spreading," he said.

Oshitani said that the successful containment measures used against SARS, such as quarantining those infected and cross-border checks, would fail against an avian pandemic, as people spreading bird flu may not show early symptoms.

"The pandemic is likely to be like the seasonal influenza, which is much more infectious than the SARS virus," he said.

(c) Reuters 2005

September 21st, 2005, 12:24 AM
Your best bet is to get a perscription for Tamiflu and keep it on hand. If you take it up to two days after symptoms appear, it can reduce the flu's severity, even the bird flu.

September 22nd, 2005, 09:04 AM
No transparency at CDC on flu data
Wednesday, September 21, 2005

http://effectmeasure.blogspot.com/2005/09/no-transparency-at-cdc-on-flu-data.html (go to link for full post)

Nature magazine, one of the world's premier scientific journals, just blew CDC and the Bush Administration out of the water. Specifically, in a detailed story by Declan Butler we learn of CDC's abysmal record of data sharing with the world scientific community. Despite Bush’s call at the UN last week that the international community share sequences, samples and information about influenza, CDC has not done so, even with the US’s top scientists.
“Many in the influenza field are displeased with the CDC’s practice of refusing to deposit sequences of most of the strains that they sequence,” says Michael Deem, a physicist at Rice University in Houston, who works on predicting flu vaccine efficiency. Policy decisions, such as which vaccine to produce ahead of each flu season, are being made without the full data being available to the scientific community, he says. “The quality of their decisions, which can affect millions of people, cannot be checked.” (Nature, online now (http://www.nature.com/nature/journal/v437/n7058/full/437458a.html), print issue of 9/22/05)Apparently flu researchers don't know what sequences and samples CDC has or even how many. While thought to be in the thousands, less than 10% of sequences deposited in national and international databases come from the agency, according to a Nature search. An NIH consortium has deposited almost 2800 this year alone.
“No other US laboratory receives thousands of influenza samples and sequences from around the globe,” points out one [scientist]. “They say it’s in [their weekly report],” says another. “Give me a break. I want the database.” CDC's response?
“The advancement of public health and science is generally best served when data are shared in an open, timely and appropriate manner, and the CDC Influenza Branch is committed to accomplishing this objective,” says James LeDuc, director of the CDC’s division of viral and rickettsial diseases. But he adds: “This must be balanced against the needs for maintaining high standards for data quality and for protecting sensitive information when the situation warrants.”Do they know how to spell Bullshit? Because it's a much shorter way of saying the same thing.

September 22nd, 2005, 09:58 AM
Like this administration response to Katrina, the response from the CDC confrms that Bush and Co. are just trying to thin the American herds.

Gregory Tenenbaum
September 24th, 2005, 06:49 PM
To all those fat retarded middle-aged men who like travelling to Southeast Asia to exploit the women there and five dollars and ninety-nine cents for some Ding Dang Wally Bang action -

Watcha Gonna Do??

Watcha Gonna Do when the Flu comes for You??

Its wrong to exploit these people, I wonder what these men are going to do in the next few weeks? maybe they'll have to actually get a girlfriend.

I do feel sorry for the people who contract this in Asia.


September 28th, 2005, 10:01 PM
The October 2005 issue of National Geographic is devoted to the Avian Flu:



Gregory Tenenbaum
September 29th, 2005, 09:54 AM

Sitting in our sofas behind our large television sets, we forget that we are a lucky generation (most of whom are) untouched by war, famine or disease like this flu.

Very scary. Read a little about WWI, then the influenza epidemic, then WWII, then Korea, then Nam to see just why we are lucky.

September 29th, 2005, 10:15 AM
I don't think this generation is lucky (as compared to others). There are soldiers fighting and dying in the Middle East.

It is no different than when I was in Vietnam. Most of the country went about its business. At least like that era, people are beginning to wake up and protest.

Even during the intensely focused WWII: My father left as a teenager to fight in the Pacific. Returning home after 3 years in a POW camp and witnessing the devastation in Japan, he was shocked to see how the U.S. had prospered.

American civilians, except those who sent their young to fight, have had it easy since the Civil War.

September 29th, 2005, 12:54 PM
The October 2005 issue of National Geographic is devoted solely to the Avian Flu:

Solely? In my issue it's just one of the half-dozen features, though the article is indeed a real wake-up call.

September 30th, 2005, 10:07 AM
^ Thanks, I fixed the post. (My info was based on a web posting.)

September 30th, 2005, 10:10 AM
New Flu Pandemic Could Kill 150 Million

By EDITH M. LEDERER Associated Press Writer
The Associated Press

http://abcnews.go.com/Health/Flu/wireStory?id=1171638 (http://abcnews.go.com/Health/Flu/wireStory?id=1171638)

UNITED NATIONS Sep 29, 2005 — A top U.N. public health expert warned Thursday that a new influenza pandemic could come anytime and claim millions of lives unless officials to take action now to control an epidemic in Asia.

Dr. David Nabarro of the World Health Organization called on governments to take immediate steps to address the threat at a news conference following his appointment as the new U.N. coordinator to lead a global drive to counter a human flu pandemic.
"We expect the next influenza pandemic to come at any time now, and it's likely to be caused by a mutant of the virus that is currently causing bird flu in Asia," he said.

The H5N1 strain of bird flu has swept through poultry populations in Asia since 2003, infecting humans and killing at least 65 people, mostly poultry workers, and resulting in the deaths of tens of millions of birds. The virus does not pass from person to person easily, but experts believe this could change if the virus mutates.

Nabarro said with the almost certainty of another influenza pandemic soon, and with experts saying there is a high likelihood of the H5N1 virus mutating, it would be "extremely wrong" to ignore the serious possibility of a global outbreak.

"The avian flu epidemic has to be controlled if we are to prevent a human influenza pandemic," Nabarro said.

The 1918 influenza pandemic killed more than 40 million people, and there were subsequent pandemics in 1957 and 1968 which had lower death rates but caused great disruption, he said.

In a new pandemic, Nabarro said, "the range of deaths could be anything between 5 and 150 million."

"The work we're doing over the next few months on prevention and preparedness will make the difference between, for example, whether the next pandemic leads us in the direction of 150 (million) or in the direction of 5 (million)," he said.

He said Asian leaders met with Secretary-General Kofi Annan during the recent U.N. summit and asked for U.N. assistance in coordinating the response to the bird flu epidemic.

Annan asked Nabarro to take a leave from his current post as WHO's executive director for sustainable development and health environments to become the U.N. system's coordinator for avian and human influenza.

Copyright 2005 The Associated Press

October 3rd, 2005, 01:17 PM
CDC locks up flu data
Critics call policy too restrictive

By REBECCA CARR (rcarr@ajc.com)
The Atlanta Journal-Constitution
Published on: 10/03/05


Washington — Amid growing concerns that avian influenza will develop into a deadly pandemic, the Centers for Disease Control and Prevention is under fire by some in the scientific community for hoarding data crucial for vaccine development. The allegations come as CDC has issued new and controversial rules on what data, documents and other information it will — and will not — share with the public.

Open government advocates are critical of the CDC's "Information Security" manual, the 34-page document that gives officials 19 categories to shield data from public scrutiny without obtaining a "secret" classification.

That runs counter to CDC's mission, says Steven Aftergood, director of the Federation of American Scientists' project on government secrecy, which first published the leaked manual on its Web site.

"The CDC is not the CIA," Aftergood said. "Withholding data is not just bad public policy, it is bad science," he said, because it impedes the processes of peer review and the scientific replication of results. He called the CDC's policies "just baffling."

Tom Skinner, spokesman for CDC Director Dr. Julie Gerberding, could not respond when asked about the manual on handling "sensitive but unclassified" information, which was released July 22, because he had not seen it. He asked a reporter to e-mail a copy to him.

National security concerns

Upon further questioning, CDC spokesman Von Roebuck cited national security concerns. He said the agency has programs that require protection from disclosure, such as the locations and work of laboratories with such biological agents as smallpox or anthrax.

In its Sept. 22 issue, the journal Nature reported widespread concern among influenza researchers that too little flu data collected by the CDC are being made available for research, hindering their efforts to develop flu vaccines.

Dr. Nancy J. Cox, chief of CDC's influenza branch, said the increasing focus on influenza worldwide has brought a deluge of requests for information that the CDC cannot easily accommodate.

"Given the sheer volume of such requests, we have had to make hard choices about how to respond because we do not have the capacity to comply with all requests while also meeting our other public health responsibilities," she said in a written response to questions.

One unnamed National Institutes of Health researcher told Nature that, other than the occasional large deposits of data required by journals to accompany published papers, information from CDC is "coming through an eye dropper."
Influenza researchers said their work would progress faster if they could access the disease control agency's databases of virus sequences and immunological and epidemiological data.

Nature quoted Michael Deem, a physicist at Rice University in Houston, as saying: "Many in the influenza field are displeased with the CDC's practice of refusing to deposit sequences of most of the strains that they sequence."
Nature's own analyses found that the CDC deposited less than a tenth of the 15,000 influenza A sequences in the gene database Genbank and the influenza sequence database at the Los Alamos National Laboratory in New Mexico. By comparison, a consortium led by the U.S. National Institute of Allergy and Infectious Diseases deposited more than 2,800 sequences this year alone.

Flu vaccine concerns

CDC's Cox said the agency collaborates with international health officials on influenza control and prevention policies and strategies. She said CDC does recognize that the advancement of public health and science is generally best served when information is shared in an open, timely and appropriate manner. But she added the effort must be "balanced against the needs for maintaining high standards for data quality and for protecting sensitive information when the situation warrants."

Cox said the agency wants to improve its data-sharing efforts and recently revised its policy to meet its goal of sharing information in a timely way.

"The purpose of this new policy is to ensure that CDC routinely provides data to its partners for appropriate public health purposes and that all data are released and/or shared as soon as feasible without compromising privacy, federal and state confidentiality agreements, propriety issues, national security interests, or law enforcement activities."

Nearly all of the scientific associations and scientists interviewed for this report declined to comment on the record. The issue is "delicate," one person explained, because the CDC controls funding for their research.

There could be other reasons for the CDC's actions, some experts said.

One potential concern that the CDC may have about sharing data is how it would affect any partnership it might now have with vaccine manufacturers, said David Webster, president of Webster Consulting Group, a health industry consulting firm based in Pennsylvania. The CDC might be concerned that those manufacturers might not be able to recoup their investment if the information is made widely available, he said.

"The CDC views partnerships with vaccine manufacturers as an indispensable skill set to get vaccinations manufactured and distributed on extremely short notice," Webster said. "If you don't provide strong commercial incentives for research and development, then public health will suffer enormously because a vaccine will not be developed."

Assumption of 'secrecy'

The CDC manual on keeping a lid on information is surprising to see at a federal agency charged with dispensing health information, said Rick Blum, executive director of OpenTheGovernment.org, an umbrella group of more than 40 conservative and liberal groups concerned about government secrecy.

"I think it's a perfect example of how out of control our policies on the free flow of information have become," Blum said. "You have many different, confusing, overlapping repetitive names designed to keep information from the public."

The CDC states that the manual's purpose is to "allow for the accomplishment of our public health service mission while safeguarding the various categories of unclassified data and document information that, for legitimate government purposes and good reason shall be withheld from distribution or to which access shall be denied or restricted."

Given the threat of a biological attack by a terrorist group, there may be sound reasoning for securing certain information, said Meredith Fuchs, general counsel at the National Security Archive at George Washington University.

However, the CDC manual shows a "shift in the agency mind-set from one that assumes openness to one that assumes secrecy," Fuchs said.
"It's worth understanding that secrecy is not necessarily going to advance the public's health," Fuchs said. "It's troubling and causes one to pause."

•ON THE WEB: The CDC manual posted at the American Federation of Scientists project on government secrecy:

www.fas.org/sgp/othergov/cdc-sbu.pdf (http://www.fas.org/sgp/othergov/cdc-sbu.pdf)

October 5th, 2005, 04:43 PM
Scientists resurrect 1918 flu, study deadliness

Wed Oct. 5


Scientists who resurrected the 1918 "Spanish flu" virus that killed as many as 50 million people said on Wednesday they are beginning to understand why it caused such a deadly pandemic and say it could happen again.

They have begun comparing the genetic mutations in the 1918 flu to those being seen in the H5N1 avian flu virus killing tens of millions of poultry and some people in Asia, in the hope of being able to predict and perhaps even prevent a similar pandemic.

"We felt we had to recreate the virus and run these experiments to understand the biological properties that made the 1918 virus so exceptionally deadly," said Terrence Tumpey of the U.S. Centers for Disease Control and Prevention in Atlanta, who helped write the reports published jointly this week in the journals Nature and Science.

The experiment, in which the virus was recreated employing a process called reverse genetics using preserved samples of the 1918 virus, allowed the researchers to test it in the laboratory and in several animals.

It will help answer important questions, said Dr. Jeffery Taubenberger of the Armed Forces Institute of Pathology in Rockville, Maryland.

"How did the virus get into humans and how did the pandemic start? Second is to understand how this particular virus was so virulent," Taubenberger told reporters in a telephone briefing.

"What can we learn from the lessons of 1918 to prepare for and mitigate against a future influenza pandemic?" he asked.

Drugs and vaccines could be designed to target the mutations found in the research, Taubenberger said.

Taubenberger's team used pieces of virus taken from preserved samples from 1918 victims, as well as from the corpse of a victim dug up from a frozen grave in Alaska in 1998.


They used these pieces to make a replica of the 1918 virus, and brought it back to "life" -- viruses are not truly alive like other microbes -- by combining it with modern influenza virus pieces and growing it in bacteria.

"We now think that the best interpretation of the data available to us is that the 1918 virus was an entirely avian-like virus that adapted to humans," Taubenberger said.

This, he said, was different from the two other 20th century flu pandemics, in 1958 and 1967, in which different flu viruses actually swapped genes to become especially virulent. "It suggests that pandemics can form in more than one way," Taubenberger said.

There were several changes in each gene of the 1918 flu, Taubenberger said. The H5N1 flu is beginning to show some of the same changes, he said, but appears to be early on in the process.

The findings reinforce the fears of health officials about H5N1 avian flu, which now does not easily infect humans but which has killed more than 60 people in four Asian nations. It will take only a few mutations for a virus that has killed tens of millions of birds to become just as infectious and deadly in people.

But now the scientists are beginning to understand what the mutations are and perhaps start work on drugs and vaccines that can fight them.

"We identified a number of virus proteins that were essential for the development of severe pulmonary (lung) disease," Tumpey said.

In particular, he said, a protein called hemagglutinin -- the "H" in flu names -- was key. When the 1918 hemagglutinin was replaced with a modern influenza hemagglutinin, the resulting virus was not very deadly at all.

Also, another protein called neuraminidase was mutated in the 1918 virus in such a way that it could replicate itself under unusual conditions, perhaps deeper in the lung than other flu viruses. Neuraminidase is another key flu gene that makes up the "N" in flu designations.

The 1918 flu was an H1N1 flu and very different from H5N1, the researchers stress. They also said there was no danger to the public from their experiments, which are conducted in biosafety level 3 labs designed to contain the virus.

And today's human flu viruses are all descendants of the 1918 flu, which means people have some immunity to them, CDC director Dr. Julie Gerberding said. What is frightening about H5N1 is that people do not have any immunity to it.

If not H5N1, then some other influenza virus is certain to cause a pandemic that could be much worse than the 1918 flu, Gerberding said.

"Most experts agree it is not a question of if -- it is a question of when," she said. "This important science creates new information and new clues that does help us prepare for the pandemic."

Copyright © 2005 Reuters

October 5th, 2005, 10:34 PM
:eek: Time to load up on whiskey and freeze-dried food!

October 5th, 2005, 11:03 PM
That would be "extinct."

Last year we had the panic over no flu vaccine. Now, we have this anticipated pandemic. Are we sure the pharmaceutical companies aren't just trying to recoup lost revenue from last year?

The news that the army would enforce quarantines was interesting. The conditioning toward a police state just doesn't relent.

Time to go out and rent Stephen King's "The Stand."

It has become impossible to separate hype from news anymore. We know the US health agencies are owned by big pharma. Why wouldn't the U.N. health agencies be? I wonder if this flu will be as bad, dangerous and deadly as WMDs in Iraq?

Here's a good place to review your vaccine options


October 8th, 2005, 08:18 AM
Well, it took them "many years" but at least the Bushie Bureaucrats have almost finished their Report ...

Bush Plan Shows U.S. Is Not Ready for Deadly Flu

By GARDINER HARRIS (http://query.nytimes.com/search/query?ppds=bylL&v1=GARDINER HARRIS&fdq=19960101&td=sysdate&sort=newest&ac=GARDINER HARRIS&inline=nyt-per)
October 8, 2005


WASHINGTON, Oct. 7 - A plan developed by the Bush administration to deal with any possible outbreak of pandemic (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/epidemics/index.html?inline=nyt-classifier)flu (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/influenza/index.html?inline=nyt-classifier) shows that the United States (http://topics.nytimes.com/top/news/international/countriesandterritories/unitedstates/index.html?inline=nyt-geo) is woefully unprepared for what could become the worst disaster in the nation's history.

A draft of the final plan, which has been years in the making and is expected to be released later this month, says a large outbreak that began in Asia would be likely, because of modern travel patterns, to reach the United States within "a few months or even weeks."

If such an outbreak occurred, hospitals would become overwhelmed, riots would engulf vaccination (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/vaccinationandimmunization/index.html?inline=nyt-classifier) clinics, and even power and food would be in short supply, according to the plan, which was obtained by The New York Times.

The 381-page plan calls for quarantine and travel restrictions but concedes that such measures "are unlikely to delay introduction of pandemic disease into the U.S. by more than a month or two."

The plan's 10 supplements suggest specific ways that local and state governments should prepare now for an eventual pandemic by, for instance, drafting legal documents that would justify quarantines. Written by health officials, the plan does yet address responses by the military or other governmental departments.

The plan outlines a worst-case scenario in which more than 1.9 million Americans would die and 8.5 million would be hospitalized with costs exceeding $450 billion.

It also calls for a domestic vaccine production capacity of 600 million doses within six months, more than 10 times the present capacity.

On Friday, President Bush invited the leaders of the nation's top six vaccine producers to the White House to cajole them into increasing their domestic vaccine capacity, and the flu plan demonstrates just how monumental a task these companies have before them.

In the wake of Hurricane Katrina, the Bush administration's efforts to plan for a possible pandemic flu have become controversial, with many Democrats in Congress charging that the administration has not done enough. Many have pointed to the lengthy writing process of the flu plan as evidence of this.

But while the administration's flu plan, officially called the Pandemic Influenza Strategic Plan, closely outlines how the Health and Human Services Department may react during a pandemic, it skirts many essential decisions, like how the military may be deployed.

"The real shortcoming of the plan is that it doesn't say who's in charge," said a top health official who provided the plan to The Times. "We don't want to have a FEMA-like response, where it's not clear who's running what."

Still, the official, who asked for anonymity because the plan was not supposed to be distributed, called the plan a "major milestone" that was "very comprehensive" and sorely needed.

The draft provided to The Times is dated Sept. 30, and is stamped "for internal H.H.S. use only." The plan asks government officials to clear it by Oct. 6.

Christina Pearson, a spokeswoman for Health and Human Services Secretary Michael O. Leavitt, responded, "We recognize that the H.H.S. plan will be a foundation for a governmentwide plan, and that process has already begun."

Ms. Pearson said that Mr. Leavitt has already had one-on-one meetings with other cabinet secretaries to begin the coordination process across the federal government. But she emphasized that the plan given to The Times was a draft and had not been finalized.

Mr. Leavitt is leaving Saturday for a 10-day trip to at least four Asian nations, where he will meet with health and agriculture officials to discuss planning for a pandemic flu. He said at a briefing on Friday that the administration's flu plan would be officially released soon. He was not aware at the briefing that The Times had a copy of the plan. And he emphasized that the chances that the virus (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/viruses/index.html?inline=nyt-classifier) now killing birds in Asia would become a human pandemic were unknown but probably low. A pandemic is global epidemic of disease.

"It may be a while longer, but pandemic will likely occur in the future," he said.

And he said that flu planning would soon become a national exercise.

"It will require school districts to have a plan on how they will deal with school opening and closing," he said. "It will require the mayor to have a plan on whether or not they're going to ask the theaters not to have a movie."

"Over the next couple of months you will see a great deal of activity asking metropolitan areas, 'Are you ready?' If not, here is what must be done," he said.

A key point of contention if an epidemic strikes is who will get vaccines first. The administration's plan suggests a triage distribution for these essential medicines. Groups like the military, National Guard and other national security groups were left out.

Beyond the military, however, the first in line for essential medicines are workers in plants making the vaccines and drugs as well as medical personnel working directly with those sickened by the disease. Next are the elderly and severely ill. Then come pregnant women, transplant and AIDS (http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/aids/index.html?inline=nyt-classifier) patients, and parents of infants. Finally, the police, firefighters and government leaders are next.

The plan also calls for a national stockpile of 133 million courses of antiviral treatment. The administration has bought 4.3 million.

The plan details the responsibilities of top health officials in each phase of a spreading pandemic, starting with planning and surveillance efforts and ending with coordination with the Department of Defense.

Much of the plan is a dry recitation of the science and basic bureaucratic steps that must be followed as a virus races around the globe. But the plan has the feel of a television movie-of-the-week when it describes a possible pandemic situation that begins, "In April of the current year, an outbreak of severe respiratory illness is identified in a small village."

"Twenty patients have required hospitalization at the local provincial hospital, five of whom have died from pneumonia and respiratory failure," the plan states.

The flu spreads and begins to make headlines around the world. Top health officials swing into action and isolate the new viral strain in laboratories. The scientists discover that "the vaccine developed previously for the avian strain will only provide partial protection," the plan states.

In June, federal health officials find airline passengers infected with the virus "arriving in four major U.S. cities," the plan states. By July, small outbreaks are being reported around the nation. It spreads.

As the outbreak peaks, about a quarter of workers stay home because they are sick or afraid of becoming sick. Hospitals are overwhelmed.

"Social unrest occurs," the plan states. "Public anxiety heightens mistrust of government, diminishing compliance with public health advisories." Mortuaries and funeral homes are overwhelmed.

Presently, an avian virus has decimated chicken and other bird flocks in 11 countries. It has infected more than 100 people, about 60 of whom have died, but nearly all of these victims got the disease directly from birds. An epidemic is only possible when a virus begins to pass easily among humans.

Lawrence K. Altman contributed reporting for this article.

Copyright 2005 (http://www.nytimes.com/ref/membercenter/help/copyright.html)The New York Times Company (http://www.nytco.com/)

October 8th, 2005, 08:50 AM
^^ Where to start with this one?

First, are we in good hands with the gang at HHS???

How about this guy Michael O. Leavitt, Head of HHS, appointed by Bush less than one year ago?

His bio here: http://www.hhs.gov/about/bios/dhhssec.html

Before entering politics Leavitt worked in the private sector ( http://usinfo.state.gov/special/transition/transition_nominees/leavitt.html ) :
" ... he eventually became president and chief executive officer of a regional insurance firm, establishing it as one of the top insurance brokers in America."

Then: 3 term governor of Utah. Leavitt left that job when Bush appointed him to head the EPA, and then got bumped up to HHS.

But his experience in the Health field: Little to none.

Here's what Planned Parenthood had to say ( http://www.plannedparenthood.org/pp2/portal/files/portal/webzine/newspoliticsactivism/fean-041230-leavitt.xml ) :

Though Leavitt has been praised for his managerial skills, some have grumbled that he lacks the right experience to head one of the government's largest agencies. Georges Benjamin, executive director of the American Public Health Association, was among the critics: "You don't have to be a doctor," he said, "but health care experience is essential."


Frank O'Donnell, executive director of Clean Air Watch, describes Leavitt's tenure as EPA head: "When push came to shove, the key decisions on clean air were being made at the White House and he was a loyal soldier going along with those decisions."

What were Leavitt's big accomplishments before he became a Federal employee? Let's look back to his time in the world of insurance ( http://www.cmwf.org/healthpolicyweek/healthpolicyweek_show.htm?doc_id=253524 ) :

Leavitt's exposure to health care issues began in the business world. He started out as an insurance agent and was president and CEO of a regional insurance firm called The Leavitt Group from 1984 to 1992. About 7 percent of its revenues came from long-term care and other health insurance plans. But it was as Utah governor and in Medicaid where Leavitt made his biggest health care splash.

Whatever heat Leavitt is likely to get on health care in his confirmation hearings is likely to come on the waiver he obtained in 2002 to change the state's Medicaid program. The criticism won't block confirmation, even his critics said. But changes in that area alarm advocates for the poor.

They fear the Utah waiver will be a blueprint for changes in Medicaid in the second Bush administration, and that Leavitt's "primary care network" model will be paired with a new effort to block grant Medicaid.

"There was a really positive track record" on health care under Leavitt when he was governor, said Judi Hilman, health policy director for Utah Issues, a program of the nonprofit Center for Poverty Research and Action. But there was also a downside, she said. "We think the PCN is a dress rehearsal for a Medicaid block grant."

Hilman credits Leavitt with developing an ambitious health care reform plan called HealthPrint during the heyday of the state health reform movement in the early 1990s. An ambitious effort to cover the uninsured, it relied on savings from managed care as a funding mechanism. But the premise that managed care would deliver Medicaid savings used to fund coverage expansions "had a lot of problems. It did not deliver, as we know," Hilman said...

The state budget crisis of the recent recession shelved ambitious coverage expansion ideas, but Leavitt pushed ahead in 2002 with a different approach—a first-of-its kind waiver program that funded Medicaid expansion by reducing benefits for certain Utah residents already in the program. "We call this incrementalism in reverse," said Hilman...

The Utah philosophy was to offer some working people—those making up to 150 percent of the poverty line—some coverage while reducing dental and vision benefits to other beneficiaries. "We believe this is far better than offering no coverage at all," said the official...

Hilman and others emphasize the extreme poverty of those who lost dental and vision care under the waiver—people whose incomes are at half the poverty line. And the Primary Care Network opened up to those low-income workers offers only primary care. It does not pay for visits to specialists or to the hospital. "We would say yes, it has value, but it has value only for healthy people," said Hilman. "That's not coverage."

October 8th, 2005, 09:43 AM
Bush Plan Shows U.S. Is Not Ready for Deadly Flu

The plan outlines a worst-case scenario in which more than 1.9 million Americans would die and 8.5 million would be hospitalized with costs exceeding $450 billion...

The plan also calls for a national stockpile of 133 million courses of antiviral treatment. The administration has bought 4.3 million.

Let's see...

8.5 Million people are in hospitals for treatment (where are these big hospitals?), each seeking "courses of antiviral treatment".

So far the US has purchased 4.3 M courses, which are only 3.2 % of the amount determined as necessary to be stockpiled for use.

Glad to hear that just this week "President Bush invited the leaders of the nation's top six vaccine producers to the White House to cajole them into increasing their domestic vaccine capacity".

Hoping a little cajoling does the trick...

October 13th, 2005, 04:19 PM
October 13, 2005
Airports With Quarantine Stations
Filed at 4:04 p.m. ET

Airports with Centers for Disease Control and Prevention quarantine stations:

Atlanta Hartsfield-Jackson International Airport

Miami International Airport

Chicago O'Hare International Airport

New York John F. Kennedy International Airport

Honolulu International Airport

San Francisco International Airport

Los Angeles Tom Bradley International Airport

Seattle-Tacoma International Airport

Newark Liberty International Airport

Washington Dulles International Airport

Houston George Bush Intercontinental Airport

Anchorage International Airport

Boston Logan International Airport

Detroit Metropolitan International Airport

Minneapolis-St. Paul International Airport

San Diego International Airport

San Juan Luis Munoz Marin International Airport

Copyright 2005 The Associated Press

October 13th, 2005, 04:29 PM
There they go "thinking" again.

October 14th, 2005, 09:09 AM
Flu drug maker won't share patent; (http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/10/13/MNG39F7MNG1.DTL)
Roche rejects calls to allow production of generic versions (http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/10/13/MNG39F7MNG1.DTL)

Sabin Russell, Chronicle Medical Writer (srussell@sfchronicle.com)
Thursday, October 13, 2005

Tamiflu ( http://www.tamiflu.com/ ), a pricey antiviral pill invented in a Bay Area lab and made in part from a spice used in Chinese cookery, has emerged as the world's first line of defense against bird flu should the deadly strain begin its feared spread among human beings.

As nations begin to stockpile the drug in anticipation of a flu pandemic, calls are mounting for countries to sidestep patents on the drug -- as Brazil first did for AIDS medications -- and make their own generic versions.

But Swiss pharmaceuticals giant Roche, which acquired rights to the drug from Gilead Sciences Inc. of Foster City in 1996, said Wednesday it had no intention of letting others make it.

"Roche ... fully intends to remain the sole manufacturer of Tamiflu,'' said company spokesman Terry Hurley.

The immediate problem is not the cost of Tamiflu, which runs about $60 for a 10-pill course of treatment, but a staggering gap between the sudden demand for it and the capacity of its sole manufacturer to produce it.

Although Roche has increased production of Tamiflu eightfold in the past two years, it will take $16 billion and 10 years to make enough of the drug for 20 percent of the world's population, said Klaus Stohr, director of the World Health Organization's Global Influenza Program, in comments to reporters in San Francisco last week.

"Something has to be done,'' said Ira Longini, an Emory University professor whose computer model of a potential avian flu pandemic shows that an outbreak could be snuffed out within a month by rushing antiviral drugs to the place where it started. "When you think of the potential damage a pandemic flu could do, and how little drug we have, the situation is quite absurd.

"It makes sense to do something along the lines of what was done with AIDS drugs.''

James Love, director of the Consumer Project on Technology in Washington, D.C., said that during the anthrax bioterrorism scare in 2001, both the United States and Canada had threatened to bypass the patent of Bayer Corp.'s antibiotic Cipro to assure a sufficient supply of the drug. The Tamiflu problem is similar.

"The WHO should buy stockpiles from generic suppliers,'' he said. "If patents are in the way, the WHO should ask the manufacturing country to issue the appropriate compulsory licenses. The patent owner will receive royalties, but we will have the stockpiles."

U.N. Secretary-General Kofi Annan has signaled a willingness to consider generic production of flu drugs and vaccines. During remarks at the World Health Organization headquarters in Geneva last week, he said drug companies should be "helpful" by not letting their patent claims interfere with access to medicines. "I wouldn't want to hear the kind of debate we got into when it came to the HIV anti-retrovirals,'' he said.

Roche will not release its Tamiflu production figures, deeming it "commercially sensitive" information, said Hurley, the company spokesman. However, he said the company produced "many hundreds of millions" of the pills annually. In response to WHO concerns about bird flu this summer, the company agreed to donate enough Tamiflu to treat 3 million people.

Although public awareness of the pandemic threat posed by the bird flu has blossomed in recent weeks, scientists have been warning since 1997 that the rogue influenza strain known as H5N1 could be the one that triggers a pandemic rivaling the devastating Spanish flu of 1918 -- which killed 50 million.

Tests on laboratory mice strongly suggest that Tamiflu -- and a lesser-known inhaled antiviral, Relenza -- are the only medications that can treat infection with the H5N1 strain.

Tamiflu has not been effective in the treatment of the small number of people who've contracted the H5N1 virus in Asia. Of 116 people infected since 2003, half have died. However, most of those patients were admitted to hospitals days or weeks after they became ill. Tamiflu is thought to work best within 36 hours of symptoms.

"Late treatment is clearly ineffective,'' said Dr. Frederick Hayden, a University of Virginia expert on flu drugs.

As a treatment for ordinary flu, Tamiflu has been effective, but in a Japanese study of children treated with the drug, about 1 in 6 patients developed strains of flu resistant to the drug, though the new flu strains were much weaker, causing less illness.

At WHO's urging, 40 nations last year began building stockpiles of Tamiflu. The United Kingdom, for example, has ordered enough for 14.6 million people, a quarter of its population. The U.S. stockpile goal for this year is 4.3 million 10-pill treatments, enough to cover less than 2 percent of the population.

Secretary of Health and Human Services Michael Leavitt has said the U.S. government plans to buy 20 million courses of Tamiflu, although no timeframe for the purchase has been revealed. To accommodate U.S. demand for the drug, Roche is building Tamiflu production capacity in the United States, and spokesman Hurley said the plant -- actually a series of facilities owned by the company and subcontractors -- would be "up and running"

TLOZ Link5
October 14th, 2005, 09:35 PM
The U.S. stockpile goal for this year is 4.3 million 10-pill treatments, enough to cover less than 2 percent of the population.

Most of it for the military and government officials, I would assume.

October 14th, 2005, 10:36 PM
Most of it for the military and government officials, I would assume.
Yep. And medical personnel.

Odd, but I heard that "first responders" are NOT on the top of the list!

October 15th, 2005, 04:56 AM
A Vietnamese patient has become partially resistant to the antiviral drug experts plan to use to tackle a human bird flu outbreak.

The UK government has ordered 14.6m doses of Tamiflu, but the Nature report suggests this may not be effective enough if an outbreak does happen.

However British authorities said the study did not obviate the need to stockpile Tamiflu.

It may be that using Tamiflu (oseltamivir) for too little time or at too low a dose could contribute to the emergence of resistant virus, Yoshihiro Kawaoka from the University of Tokyo and colleagues say.

"Further investigation is necessary to determine the prevalence of oseltamivir-resistant H5N1 viruses among patients treated with this drug," they warn.

The 14-year-old Vietnamese girl they describe had been given the drug in February as a preventative measure.

It might be useful to stockpile zanamivir as well as oseltamivir in the event of an H5N1 influenza pandemic

Although she had not had any known direct contact with infected poultry, she had been caring for her 21-year-old brother who was thought to have caught bird flu.

The virus detected in the girl resembled that found in her brother. The girl recovered without any problems, but her case raises the possibility that she could have been infected by her brother, rather than directly by birds.

Also, oseltamivir on its own may not be sufficient to fight a potential H5N1 pandemic and other drugs from the same family such as Relenza (zanamivir) may be needed too, say the researchers.

"Although our findings are based on a virus from only a single patient, they raise the possibility that it might be useful to stockpile zanamivir as well as oseltamivir in the event of an H5N1 influenza pandemic," they said.

Professor Ian Jones, microbiologist at the University of Reading, said: "It's worthwhile noting but it is not unexpected."

He said past studies had shown viruses could become resistant to Tamiflu. He said such resistant strains appeared to be less able to cause harm than the original virus, which was reassuring.

It does not mean that resistant viruses will emerge and transmit effectively
A spokeswoman from the Health Protection Agency

"They don't grow as well so whilst the mutation does arise there is no reason to suppose that [the mutant] virus is going to be a very successful infectious agent."

He added that antiviral drugs did not cure someone of the virus, but merely keep down the levels of infection to allow the body to mount its own response.

"I don't think it obviates the need for stockpiling Tamiflu, but I do agree that it might be useful to have Relenza as well."

* I googled Relenza and it appears to be the flu medicine that you inhale. *

October 15th, 2005, 11:19 AM
They have found also a virus in another city in Romania!

October 16th, 2005, 04:53 AM
How many birds were killed in Romainia when they thought there was a case of the bird flu there? Turns out there wasnt.


October 16th, 2005, 07:46 AM
To clarify, there have been no confirmed cases of the flu in humans, but it has been detected in migrating birds.

Avian flu strain confirmed in Romania

Officials appeal for calm in Europe

By Colin Nickerson, Globe Staff | October 16, 2005

BERLIN -- As lab tests confirmed yesterday that the most lethal strain of bird flu has reached mainland Europe for the first time, people across the continent sought to protect themselves against a disease for which there is no existing vaccine. Officials, meanwhile, urged calm after a week of issuing dire forecasts
Germans streamed to doctors' offices demanding flu shots; Belgians descended upon pharmacies in search of fast-dwindling stocks of antiflu medication, while Serbians snapped up tens of thousands of surgical face masks.

From Portugal to Poland, a poultry disease that until recently was confined to distant Asia suddenly seemed disconcertingly near as public health agencies, after a series of conflicting reports, confirmed that the H5N1 strain of bird flu had arrived in Europe by way of Romania.

The disease was carried by migrating birds and may now be spreading through poultry and pigeon flocks. Of far greater concern is the prospect of the fast- mutating virus transforming into a strain contagious to humans, as some epidemiologists predict.

''The virus has the potential to change and mutate, and thus spark a terrible pandemic of the kind that has occurred every once and a while over past centuries," Klaus Stoehr, head of the World Health Organization's influenza program, told German NDR radio. ''There is no question that if such a pandemic occurs, we'll be looking at hundreds of thousands or even millions of deaths worldwide."

No human cases of the disease have emerged in Europe, and virologists say Asia remains the continent most likely to spawn an epidemic.

Health officials in Romania said yesterday that tests by a British laboratory have clinically established the presence of the H5N1 virus in dead ducks found a week ago in the Danube delta, Europe's largest wetland.

European national leaders urged their citizens not to become unduly alarmed. But some news media took an opposite tack: ''Panic!" read the front-page headline in 24 Chasa, one of the leading newspapers in Bulgaria.

Poultry sales plummeted across Europe and in Turkey, where presence of the H5N1 strain was confirmed last week, even as top leaders made a show of dining on chicken for the benefit of press and television cameras. ''We are not in a situation of pandemic," said Prime Minister Dominique de Villepin of France. ''We must not give in to panic."

International health agency officials stressed that the H5N1 strain of avian influenza, in its existing form, infects humans only in rare instances and with great difficulty.

Europeans, they said, have little to fear for the moment. Yet the officials also warned that H521 shows extraordinary capacity to mutate and could rapidly turn into a virus able to spread from human to human.

Stoehr said countries need to wake up to the reality of a fast-moving bird disease and prepare for a pandemic. ''It's about getting ready for an outbreak to occur, even in Europe," he said. Pandemic refers to an outbreak of disease spread over huge areas.

Many epidemiologists say they think bird flu poses the single most dangerous disease threat to humanity.

The World Health Organization, the US Department of Health, and some of the world's most prominent virologists have warned in recent days that the altered H5N1 virus could spawn an influenza pandemic that could spread around the world in weeks, killing millions. Health agencies and epidemiologists have also warned that the world is woefully unprepared to meet such an outbreak.

''Bird flu is a disease among animals; it's very difficult for this virus to move from poultry into humans," WHO spokesman Dick Thompson said from the UN body's headquarters in Rome. ''Our concern is that it will change in a way that will allow it to easily move between humans, and that will trigger a pandemic."

Since 2003, when the dormant disease reemerged, at least 65 people have died of bird flu, all in Asia. Vietnam has been hardest hit -- 44 dead -- with the other deaths occurring in Thailand, Indonesia, and Cambodia. So far, most victims have contracted the disease from poultry, including farmers, slaughterhouse workers, and at least one person who drank raw duck's blood, a delicacy in some Asian cultures.

Millions of chickens, ducks, and geese have been slaughtered in an effort to bring the disease under control. H5N1 is the most virulent of avian flu strains because it is capable of acquiring genes from other viruses, so it may acquire the ''code" of another virus that is infectious to humans. If that occurs, it would spread among population centers at jet speed, carried by travelers to every continent in hours or days.

In Vietnam yesterday, a top American government scientist said a worldwide outbreak of deadly influenza is certain -- if not from H5N1, then from a different flu virus. ''It's a matter of 'when,' not 'if,' " Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said. ''Inevitably we're going to have a pandemic."

The deadliest pandemic of modern times occurred in 1918 when the so-called Spanish flu hurtled around the planet in a few months, killing at least 20 million people and perhaps as many as 50 million, according to medical historians. http://cache.boston.com/bonzai-fba/File-Based_Image_Resource/dingbat_story_end_icon.gif

© Copyright (http://www.boston.com/help/bostoncom_info/copyright) 2005 The New York Times Company

TLOZ Link5
October 31st, 2005, 10:16 PM
Bloomberg Canada

Canada Finds Avian Flu in Wild Birds; Risk 'Low'

Oct. 31 (Bloomberg) -- Canada found 33 cases of avian influenza, a lethal strain of which has spread through Asia and Europe, in a survey of wild ducks conducted this summer, a government health agency said.

The infected ducks were healthy, suggesting they don't carry the virulent H5N1 strain, the Canadian Food Inspection Agency in a statement today. Tests to identify the strain will be completed next week. Canada has had no cases of H5N1, Agriculture Minister Andy Mitchell told reporters in Ottawa today.

Concern about bird flu's spread to humans has increased since Oct. 5, when U.S. scientists reported finding similarities between the H5N1 strain in Asia and the Spanish flu that killed as many as 50 million people in 1918 and 1919. There have been 121 confirmed cases of bird flu in humans and 62 people have died, according to the World Health Organization.

Strains of H5 influenza that don't kill ducks can still be dangerous to other species such as chickens, said Terrence Tumpey, a senior microbiologist in the U.S. Centers for Disease Control and Prevention's influenza branch. Testing will be needed to rule out the H5N1 strain in the infected ducks, he said.

"You can get H5N1 out of healthy ducks,'' he said in a telephone interview today. "You can get all kinds of subtypes out of migratory ducks.''

Twenty-eight infected ducks were found in Quebec and five in Manitoba, according to the Canadian Food Inspection Agency. The agency said the risk to humans is 'low' and that it made the results public to be transparent.


The study is the first national survey of influenza in migratory birds in Canada and will serve as a benchmark in future years, the agency said.

Canadian pharmacists today halted cross-border sales of the Tamiflu flu drug to relieve public concern there may be a shortage in the country if there's an outbreak, the Canadian International Pharmacy Association said in a statement today. There's no evidence of a shortage of the drug, made by Roche Holding AG, the group said.

Tamiflu, approved for the treatment and prevention of flu, has been shown to fight the H5N1 avian and human virus strains in test-tube and animal tests. The World Health Organization recommends that governments stockpile antiviral drugs should an outbreak occur.

To contact the reporter on this story:
Alexandre Deslongchamps in Ottawa at adeslongcham@bloomberg.net.

Last Updated: October 31, 2005 16:56 EST

October 31st, 2005, 10:35 PM
Is this guy well connected, or what ???

Rumsfeld's growing stake in Tamiflu

Defense Secretary, ex-chairman of flu treatment rights holder, sees portfolio value growing

October 31, 2005
By Nelson D. Schwartz
Fortune senior writer


NEW YORK (Fortune) - The prospect of a bird flu outbreak may be panicking people around the globe, but it's proving to be very good news for Defense Secretary Donald Rumsfeld and other politically connected investors in Gilead Sciences, the California biotech company that owns the rights to Tamiflu, the influenza remedy that's now the most-sought after drug in the world.

Rumsfeld served as Gilead (http://money.cnn.com/quote/quote.html?shownav=true&symb=GILD) (Research (http://cnnfn.investor.reuters.com/Reports.aspx?ticker=GILD))'s chairman from 1997 until he joined the Bush administration in 2001, and he still holds a Gilead stake valued at between $5 million and $25 million, according to federal financial disclosures filed by Rumsfeld.

The forms don't reveal the exact number of shares Rumsfeld owns, but in the past six months fears of a pandemic and the ensuing scramble for Tamiflu have sent Gilead's stock from $35 to $47. That's made the Pentagon chief, already one of the wealthiest members of the Bush cabinet, at least $1 million richer.

Rumsfeld isn't the only political heavyweight benefiting from demand for Tamiflu, which is manufactured and marketed by Swiss pharma giant Roche. (Gilead receives a royalty from Roche equaling about 10% of sales.) Former Secretary of State George Shultz, who is on Gilead's board, has sold more than $7 million worth of Gilead since the beginning of 2005.

Another board member is the wife of former California Gov. Pete Wilson.
"I don't know of any biotech company that's so politically well-connected," says analyst Andrew McDonald of Think Equity Partners in San Francisco.
What's more, the federal government is emerging as one of the world's biggest customers for Tamiflu. In July, the Pentagon ordered $58 million worth of the treatment for U.S. troops around the world, and Congress is considering a multi-billion dollar purchase. Roche expects 2005 sales for Tamiflu to be about $1 billion, compared with $258 million in 2004.

Rumsfeld recused himself from any decisions involving Gilead when he left Gilead and became Secretary of Defense in early 2001. And late last month, notes a senior Pentagon official, Rumsfeld went even further and had the Pentagon's general counsel issue additional instructions outlining what he could and could not be involved in if there were an avian flu pandemic and the Pentagon had to respond.

As the flu issue heated up early this year, according to the Pentagon official, Rumsfeld considered unloading his entire Gilead stake and sought the advice of the Department of Justice, the SEC and the federal Office of Government Ethics.

Those agencies didn't offer an opinion so Rumsfeld consulted a private securities lawyer, who advised him that it was safer to hold on to the stock and be quite public about his recusal rather than sell and run the risk of being accused of trading on insider information, something Rumsfeld doesn't believe he possesses. So he's keeping his shares for the time being.

November 1st, 2005, 11:01 AM
Yeah, he made a ton of money by pushing aspartame through the FDA process too.

November 2nd, 2005, 08:57 AM
Lofter whats going on now? I missed a few hours of the news today and I heard the president is going to talk about the bird flue. Does he has his kill all thought going through his head? Kill all birds that might be infected using more harmly chemicals?

Dude, what have you been drinking?

This does not seem like your usual posting....

Anyway, back on subject, nothing like bringing up a pandemic and a billion dollar price-tag to get peoples attention. It was a trump card the admin was holding in case of fire. And the senate closed session announcement yesterday was the fire that burnt the Alito appointment to a crisp.

It may or may not be enough. Lets see if he can get enough "concern" going (that is what he is calling paranoia, right) about this to refocus our attention away from such inconsequential things like lying about the reasons for war and all that....

November 2nd, 2005, 12:59 PM
Bush Orders Mass Bald Eagle Slaughter To Stop Spread Of Bird Flu

November 2, 2005

WASHINGTON, DC—As experts issue increasingly dire warnings of an avian flu epidemic, President Bush signed an executive order Tuesday authorizing the mass slaughter of "all bald eagles found anywhere within our borders."

"As president, my first duty is to protect the American people, whether the threat is terrorists or deadly, fast-mutating bird viruses," said Bush, standing on the lawn of the National Mall before a specially built pyre stacked with recently killed bald eagles. "This proactive initiative will rid our nation of this potentially disease-ridden winged animal."

Bush added: "I want these birds rounded up, tied down, and their throats slit."


In a photo opportunity, President Bush blow-torches
several pinned-down eagles.

Executive Order 1342A, which calls for the annihilation of the bald eagle, specifies that each carcass shall be wrapped in a single American flag, doused with gasoline, and burned.

The order, written by members of Bush's Council of Advisers on Science and Technology, nullifies the 1973 Endangered Species Act and the 1940 Bald Eagle Protection Act. It will be overseen by the Department of the Interior, which will work closely with state natural-resource agencies and National Guard units to ensure that the bald eagle threat is eliminated.

"This order was developed with the help of my top science advisers," Bush said. "We can all trust that their wisdom, manifested by this bold, eagle-killing initiative, will protect us from any deadly bird-related diseases."

Secretary of State Condoleezza Rice will meet with the Canadian prime minister and Mexican president next week to discuss eradication efforts for bald eagle populations in their countries. The Department of the Interior's deadline for bald eagle annihilation is July 4, 2006.

According to White House sources, Bush is adopting a hands-off attitude regarding the methodology of eagle slaughtering. Telling advisers that he would prefer that the eagles have their throats slit for "humane purposes," the president said he is willing to allow wildlife officials to exercise their own judgment. According U.S. Fish and Wildlife Service Director "Whooping" Dale Hall, the killing strategies are many and varied.

"Bald eagles may not be as imposing as, say, bears or wolves, but they are surprisingly difficult to kill," Hall said. "We can blow them off their perches with air rifles, stun them with ball-peen hammers, or break their wings, beaks, and necks, but still, some survive."

Hall continued: "I'm encouraging officials on the local level to utilize 'certain kill' methods, such as wrapping the eagle in radioactive waste and burying it upside-down in an old-growth forest."

Hall urged Boy Scout troops to join in the effort by ferreting out eagle nests and smashing the eggs underfoot.

The FWS estimates the population of the bald eagle, which the Second Continental Congress designated as the national bird in 1782, to be roughly 20,000 in the lower 48 states, with an additional 35,000 in Alaska. Tuesday afternoon, the FWS elevated the bald eagle's endangered-species status from "stable" to "severely threatened," its most serious designation.

Administration critics have suggested that the president's plan is too narrow in scope, and leaves Americans susceptible to contact with a wide variety of other dangerous birds.

"What about less prominent but far more abundant fowl common to residential areas, such as bluebirds, cardinals, or geese—shouldn't they die, too?" said Democratic Party strategist Elaine Quigley, appearing on MSNBC's Hardball. "Benjamin Franklin once said that the wild turkey, not the bald eagle, should be the emblematic bird of America. Why aren't we executing those, too?"

The Office Of The White House Counsel, which oversees the usage of all executive-branch insignias, is expected to approve a new eagle-free presidential seal as early as next week.© Copyright 2005, Onion, Inc.


November 3rd, 2005, 08:09 PM
Law, I have noticed this on your postings lately as well. If you are not drinking, I would seriously suggest seeing a doctor. Best wishes -

November 3rd, 2005, 11:36 PM
^ L&O: Clearly you underestimate the Pres. No nasty chemicals for him!

Just a good old blow torch and ... ZZZZOOOOOOOOmmmBAAAAAAAAA ... Flu Be Gone !!

November 4th, 2005, 10:55 AM
The president has a much more insidious epidemic in his administration to deal with.

November 4th, 2005, 11:16 AM
^ L&O: Clearly you underestimate the Pres. No nasty chemicals for him!

Just a good old blow torch and ... ZZZZOOOOOOOOmmmBAAAAAAAAA ... Flu Be Gone !!

Don't you mean....


November 4th, 2005, 12:25 PM
^^ SCARY :eek: :eek:

November 7th, 2005, 01:33 AM
New Wave of Bird Flu Breaks out in Northeast China

High-resolution image (2464 x 1648 px, 72 dpi) Bird flu was once again confirmed to be spreading in China. This is the fourth confirmation within three weeks.


Ecology, Immunity, and Bird Flu

The Center For Disease Control (CDC) reports that “[the] H5N1 virus circulates among birds worldwide, is very contagious among birds and can be deadly...In 1997...the first case of spread from a bird to a human was seen during an outbreak of bird flu in poultry in Hong Kong, Special Administrative Region. The virus caused severe respiratory illness in 18 people, 6 of whom died. Since that time, there have been other cases of H5N1 infection among humans. Recent human cases of H5N1 infection that have occurred in Cambodia, Thailand, and Vietnam have coincided with large H5N1 outbreaks in poultry.” With currently no commercially available vaccine to protect humans against the H5N1, the looming threat of a bird-flu pandemic spreads over the globe. Many wonder what conditions could have lead to such a catastrophe.


Gregory Tenenbaum
November 7th, 2005, 04:50 AM
Asia-Sex-pats, Sex-pats,

Watcha Gonna Do??

Watcha Gonna Do when the Flu comes for You??

Ya gonna die a horrible death for visiting the Land of Shangri La for the five dollar ninety-nine hookers and thats your fault for exploiting people.

I think that we should come off ok compared to Europe and Asia, at least we are surrounded by water and its easier to control human migration.

TLOZ Link5
November 7th, 2005, 01:53 PM
Asia-Sex-pats, Sex-pats,

Watcha Gonna Do??

Watcha Gonna Do when the Flu comes for You??

Ya gonna die a horrible death for visiting the Land of Shangri La for the five dollar ninety-nine hookers and thats your fault for exploiting people.

I think that we should come off ok compared to Europe and Asia, at least we are surrounded by water and its easier to control human migration.

What if it ends up in Latin America first?

November 13th, 2005, 09:20 PM
Tamiflu Cited in 2 Teen Deaths, Report Says

Associated Press

TOKYO (Nov. 12) - Two teenage boys who took the antiviral drug Tamiflu exhibited abnormal behavior that lead to their deaths -- one jumped in front of an oncoming truck and the other apparently fell from a building, the Mainichi Shimbun reported Saturday.

Following the first incident, which took place last year, the prescription drug in Japan began carrying a warning that says possible side effects include "abnormal behavior" and "hallucinations," the major Japanese newspaper said.

This is the first time that deaths have been linked to the drug.

The Ministry of Health, Labor and Welfare is aware of one of the cases. "As a result of abnormal behavior, it could lead to an accidental death," a ministry official said.

Rokuro Hama, the doctor who heads the Japan Institute of Pharmacovigilance for Evidence-Based Healthcare, will present the cases at a meeting of the Japanese Society for Pediatric Infectious Diseases on Saturday in Tsu, Mie Prefecture, the Mainichi said.

Hama, who runs the Osaka-based nonprofit group, was consulted by the boys' families, according to the newspaper.

The first case occurred in February last year when a 17-year-old male high school student in Gifu Prefecture was diagnosed with influenza and took a regular dose, one capsule, of Tamiflu at home at around noon, the newspaper said.

When no one else was there, the teen, wearing pajamas and barefoot, left the house, jumped over a fence around the house and ran in the snow, it said.

He then crossed over a guard rail near his home, jumped in front of a big truck and died at around 3:45 p.m., it said.

Chugai Pharmaceutical Co., the Japanese distributor of Tamiflu, produced by Swiss drug giant Roche, reported the incident in July that year to the health ministry as "a case where a causal link to the drug cannot be denied," the Mainichi said.

In the second case, a 14-year-old male junior high school student in Aichi Prefecture was diagnosed with flu on Feb. 5 this year and took one capsule at around 4 p.m.

He went to his bedroom around 5:30 p.m. About 30 minutes later, the boy was found lying barefoot in front of his condominium building, and later died, the newspaper said.

Police said his fingerprints were found on a handrail on the ninth floor of the building, and the boy is believed to have fallen after hanging onto the handrail, according to the Mainichi.

Neither of them had exhibited any psychological abnormalities before taking the drug, the newspaper said.

The government is planning to boost its stockpile of Tamiflu, generically known as oseltamivir phosphate, amid growing fears about a possible pandemic of a new type of influenza as bird flu deaths rise across Asia, health ministry sources said earlier.

Tamiflu is used to inhibit the growth of a flu virus in humans.

Copyright 2005 The Associated Press.

November 16th, 2005, 04:54 PM
URL: http://sfgate.com/cgi-bin/article.cg...NG88FOTT01.DTL (http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/11/16/MNG88FOTT01.DTL)

China to vaccinate poultry for flu

All birds included in effort to prevent human pandemic

- Keith Bradsher, Elisabeth Rosenthal, New York Times
Wednesday, November 16, 2005

Beijing -- China's Agriculture Ministry said late Tuesday that it would vaccinate all of the nation's billions of chickens and other poultry against bird flu.

The campaign, disclosed by the official Xinhua News Agency, would be the largest single vaccination effort ever for any species, according to the U.N. Food and Agriculture Organization in Rome. It will also be logistically complicated because billions of free-range birds will have to be caught and injected one by one. The Agriculture Ministry did not provide a timetable for the vaccination program.

About 14 billion domestically grown chickens, ducks and geese are consumed every year in China, experts say.

Dr. Qi Xiaoqiu, director general of the department for disease prevention and control at China's Health Ministry, said at a conference Tuesday that three-fifths of the poultry in China were kept by families, who let the birds and other domesticated animals wander around the neighborhood and the yard and often through the house. Constant close contact between animals and people is worrisome because birds and pigs can carry the H5N1 bird flu virus and may transmit it to people.

"People raise pigs, and people keep birds, just like Americans keep dogs -- those pigs and birds are part of the family," Qi said. "It is a kind of self-sufficient, outmoded production method."

Qi also said it was "highly probable" that a boy and a girl who suffered high fevers last month -- the girl died -- had been the country's first human cases of bird flu. Prime Minister Wen Jiabao warned last week that China faced a "very serious situation" as it sought to control bird flu.

Qi and Roy Wadia, a World Health Organization spokesman here, said there had been no sign of human-to-human transmission of bird flu, a critical capability the virus needs if it is to develop the ability to cause a human pandemic. But Qi warned, "It is very possible that people will catch the bird flu virus."

In an interview at the conference, an American official, who insisted on anonymity because he had not received permission to give an interview on the issue, said the United States had begun stockpiling bird flu vaccine for poultry but would find it logistically difficult to inoculate all poultry nationwide.

China reported 50 outbreaks of bird flu in 16 provinces last year and has reported 11 more to international health agencies this autumn, including two more small outbreaks reported Tuesday.

Poultry infections have been especially severe this autumn in Liaoning province. Xinhua reported last week that a fake flu vaccine, possibly including active virus, might have actually spread the disease instead of preventing it, although there has been no suggestion that this occurred elsewhere.

China has also developed its own version of Tamiflu, an antiviral drug, and is preparing to produce it in large quantities if a human pandemic occurs, official media said.

Bird vaccine has been widely available for several years. Costing just 10 cents a dose and produced by a dozen manufacturers, it is nearly 100 percent effective at protecting poultry from the disease.

The Food and Agriculture Organization normally recommends such massive vaccination programs only in areas where the H5N1 bird flu virus has become endemic -- places where it persists in the environment and where culls and quarantines have proved unable to eliminate it.

Parts of Vietnam and Indonesia fall into this category, and widespread vaccination programs have successfully controlled bird flu among poultry in some areas. Joseph Domenech, chief of veterinary services at the Food and Agriculture Organization's headquarters in Rome said he had seen no evidence that this was true for all of China.

"billions of free-range birds..."

I have this image of doctors with hypos chasing chickens all over the China countryside.

November 16th, 2005, 06:13 PM
Suicide or not, I got some Tamiflu last week. I absolutely do not trust the government to handle a deadly flu situation with any kind of positive result. Sounds like a case of Tamiflu in warehouses while the public dies.

November 27th, 2005, 01:30 AM
The bird flu has killed 100 times more people than Chinese officials admit, said an unofficial report presented by a World Health Organisation (WHO) avian influenza expert on November 20.

WHO bird flu consultant Dr. Masato Tashiro presented this unverified information, received from China via "private channels," to a room of the world's top virologists, while speaking at the University of Marburg in Germany.

According to the data, at least 300 people have died from H5N1 bird flu in China and 3000 have been infected including seven cases of human-to-human transmission, reported the German newspaper Frankfurter Allgemeine Zeitung (FAZ).

CCP is cheating the world again!

November 27th, 2005, 07:27 AM
I really like the Epoch Times. We started getting it in my building recently. :)

November 27th, 2005, 10:07 AM
unverified information....seven cases of human-to-human transmission,
Human to human infection would indicate a mutation of H5N1 virus, and would be major news on the possible outbreak of a pandemic, but I have found no corroborating news article.

Some info on the influenza virus:

Type A and type B influenza virus are capable of antigenic drift (http://www.medterms.com/script/main/art.asp?articlekey=26116). Type A virus can also undergo antigenic shift (http://www.medterms.com/script/main/art.asp?articlekey=26115).

Antigenic shift is what worries health organizations. It was the cause of the Asian Flu (1957) and the Hong Kong Flu (1968) epidemics.

H3N2 virus: commonly infects humans
H5N1 virus: commonly infects birds
Both are type A.

There is a considerable "species barrier" between birds and humans that makes infection difficult. However, there are variations in cell structure within species that could allow for direct bird to human infection. The relatively low human infection rate of the highly virulent H5N1 virus indicate that this is the case, rather than a mutation of H5N1.

The feared scenario is the simultaneous infection of a pig by both the human and avian flu viruses. While present within the host cell, the two strains could re-assort genetic material, and a new strain could be created that transmits as easily between humans as H3N2, but with a much higher mortality rate.

The first documented case of H5N1 infection of a human was the 1997 death of a 3 year old boy in Hong Kong.

Good explanation from Cornell University

If you wanna get technical


December 18th, 2005, 10:02 PM
Customs Agents Seize Counterfeit Tamiflu

Associated Press Writer
December 18, 2005

http://news.yahoo.com/s/ap/20051219/ap_on_he_me/counterfeit_tamiflu;_ylt=AqSzL98g.TH9GbeKc04GBv2s0 NUE;_ylu=X3oDMTA3MjBwMWtkBHNlYwM3MTg

Customs agents have intercepted more than 50 shipments of counterfeit Tamiflu, the antiviral drug being stockpiled in anticipation of a bird flu pandemic, marking the first such seizures in the U.S., authorities said Sunday.

The first package was intercepted Nov. 26 at an air mail facility near San Francisco International Airport, said Roxanne Hercules, a spokeswoman for U.S. Customs and Border Protection.

Since then, agents have seized 51 separate packages, each containing up to 50 counterfeit capsules labeled generic Tamiflu.

The fake drugs had none of Tamiflu's active ingredients, and officials were running tests to determine what the capsules did contain. Initial tests indicated some vitamin C in the capsules, said David Elder, director of the Food and Drug Administration Office of Enforcement.

Information on the packages was written in Chinese, but it is unclear where the drugs originated, Elder said.

They were sent by Asian suppliers to individuals who placed orders over the Internet, Hercules said. She said none of the shipments intercepted so far was bound for doctors or hospitals.

Agents became suspicious because Tamiflu is produced by Swiss pharmaceutical manufacturer Roche, and there is no generic version available.

"What we're trying to do is alert the American public that they shouldn't be buying this product because we may never be able to track down the manufacturers," Elder said Sunday. "We've anticipated the likelihood of counterfeits from the very beginning. People are trying to profit on the heightened concerns of the American public."

The H5N1 strain of the bird flu virus has ravaged poultry stocks in Asia and killed at least 71 people since 2003. Tamiflu is one of two drugs found to be effective against it.

Fears of a bird flu pandemic have increased as the virus has spread into poultry in Europe. While bird flu has not yet appeared in the United States, or been found to transmit from person to person, officials worry it could mutate and, because humans have no immunity to it, become contagious globally.

President Bush has requested $7.1 billion in emergency flu preparedness funds.

Roche declined to comment Sunday. Its Web site says the company "does not advocate the purchase of Tamiflu via the Internet. Patients should always gain a diagnosis from a health care professional before buying Tamiflu and ensure they obtain it from a reliable source."

The FDA will seek criminal charges if it finds any U.S. businesses were involved in the fake drug shipments, Elder said.

On the Net: CDC information on bird flu: http://www.cdc.gov/flu/avian/ (http://www.cdc.gov/flu/avian/)

Copyright © 2005 The Associated Press

December 19th, 2005, 09:46 PM
Local tests show Indonesian boy died of bird flu

Mon Dec 19, 2005 7:16 AM GMT

JAKARTA (Reuters) - An eight-year-old Indonesian boy has died from the H5N1 strain of bird flu according to local tests, a Health Ministry official said on Monday.

Hariadi Wibisono, head of a department charged with eradicating animal-borne diseases, said the local test results had yet to be confirmed by a Hong Kong laboratory affiliated with the World Health Organization.

"Based on the results, local tests show he is positive for bird flu," Wibisono told Reuters.

Indonesia has had nine deaths from bird flu confirmed by the Hong Kong laboratory and five cases where patients have survived.

Besides the boy, Indonesia is also awaiting confirmation from Hong Kong of local tests which showed a 39-year-old man died of bird flu last week.

It was unclear if the boy, who died in Jakarta last week, had contact with infected chickens, Wibisono said.

Since late 2003, the H5N1 virus is known to have killed 71 people in five Asian countries -- Indonesia, Thailand, Vietnam, China and Cambodia -- and almost all are believed to have caught it from infected fowl.

The highly pathogenic H5N1 strain is hard for humans to catch and remains essentially a virus in birds. However, scientists fear it could mutate into a form that could pass easily from human to human.

The United Nations urged Jakarta to take steps to halt the spread of the disease.

"We are losing the battle against this particular avian influenza outbreak. It is a very nasty bird flu virus," David Nabarro, the U.N. coordinator for avian influenza, told Indonesian officials at a meeting in Jakarta.

"Act as though a pandemic influenza will start tomorrow. Don't think we can wait around and not worry it won't start for six months or one year," Nabarro said. "Once, it starts it is too late to prepare."

Children would be the most vulnerable group, he said.

Jakarta has designated dozens of hospitals across the country for treating patients with bird flu symptoms, set out plans to produce the anti-viral drug Tamiflu and vaccinate poultry in a bid to stop the spread of the disease.

A bird flu committee with powers to bypass the bureaucracy would be up and running soon, Welfare Minister Aburizal Bakrie said in the same Jakarta meeting.

"Political, financial, logistical, security and bureaucratic constraints are among the biggest threats to an effective response to a pandemic threat. I invite the best brains and expertise to join this committee," he said.

The virus is endemic in poultry in parts of Asia and has affected birds in two-thirds of the provinces in Indonesia, a sprawling archipelago of 17,000 islands and 220 million people.

Indonesia has millions of chickens and ducks, many in the backyards of rural or urban homes. Since August 2003, 10 million poultry have died from the H5N1 strain or been culled.

© Reuters 2005. All rights reserved.

January 11th, 2006, 08:00 AM
anuary 11, 2006

A Scientific Puzzle: Some Turks Have Bird Flu Virus but Aren't Sick

International Herald Tribune

ANKARA, Turkey, Jan. 10 - Two young brothers, ages 4 and 5, who have tested positive for the dreaded A(H5N1) avian virus but shown no symptoms of the disease were being closely watched at Kecioren Hospital here on Tuesday. Doctors are unsure whether they are for the first time seeing human bird flu in its earliest stages or if they are discovering that infection with the A(H5N1) virus does not always lead to illness.

In any case, the highly unusual cluster of five cases detected here in Turkey's capital over the last three days - all traceable to contact with sick birds - is challenging some of the doctors' assumptions about bird flu and giving them new insights into how it spreads and causes disease. Since none of the five have died, it is raising the possibility that human bird flu is not as deadly as currently thought, and that many mild cases in Asian countries may have gone unreported.

"The two brothers are a very interesting finding that may for the first time give us a chance to monitor the human response to the disease," said Dr. Guénaël Rodier, who is leading a World Health Organization Team now in Turkey.

The bird flu outbreaks and infections in this country in the last week have perplexed international scientists on many fronts. Turkey is the first country outside eastern Asia to have human cases, and the first one anywhere to have so many separate animal outbreaks simultaneously.

In one week, Turkey announced 15 confirmed human cases of A(H5N1); Asia has seen only about 140 in the space of five years. In that same week, Turkish agriculture authorities announced bird outbreaks in 16 cities, from Aydin on the West coast to Van in the far east; in Asia outbreaks have occurred more sporadically.

"We are not yet sure of the mechanism," said Keith Sumption, an expert with the United Nations Food and Agriculture Organization in Rome. A senior scientist from that group is scheduled to arrive here tomorrow.

On the human side, the five cases in Ankara hospitals are different from those elsewhere in Asia. Four of the five display only mild symptoms, or no symptoms at all. Also, although all five have had some recent contact with birds, Dr. Rodier said, they are people who live on the fringes of a major city, not farmers or people who keep birds in their backyards.

The group includes two sets of brothers: the two who show no symptoms at all, and a set from the distant suburbs who developed mild symptoms after contact with gloves that had been used to dispose of a dead duck. The fifth is a 65-year-old man from inside the city itself, who the Turkish health ministry says had "close contact with a chicken," without elaborating on the details.

The Turkish Health Ministry and the World Health Organization team refused to give further details. Nor would a hospital administrator allow reporters into the hospital on Tuesday, the public holiday of Id al-Adha, on which families slaughter livestock.

In addition to observing the boys, who are all being treated with antiviral medicines, scientists are struggling with other issues, particularly the possibility that bird flu might not be so deadly as previously thought.

A study released Tuesday in the Archives of Internal Medicine suggested that the A(H5N1) virus might cause a wide spectrum of disease, but that doctors in in other parts of Asia might detect only the severest cases, the ones that went to the hospital. The four children in Ankara bolster that suggestion.

In Ankara, where the government has been sending out vans with loudspeakers urging people to report symptoms and avoid contact with animals, even people with mild symptoms are being checked for bird flu, meaning that milder cases are more likely to be detected than they are in other parts of Asia. "I'm sure that part of the explanation for the high number of case in Turkey is better surveillance," said Maria Cheng, a spokeswoman for the W.H.O. in Geneva.

Residents of urban districts of the capital said almost nobody here keeps birds, instead buying poultry at the supermarket. But poultry is found all around Turkey, even here.

Ibrahim Ercan, a shopkeeper, said he keeps seven chickens in the backyard of his small store, "mostly as pets, to create a farm-like atmosphere." He is supposed to call the authorities to have them culled, though he has not yet done so.

The huge number of animal outbreaks across the country is also perplexing, scientists said. One theory is that migrating birds seeded the disease in various areas in late December. But that is contradicted by the fact that no outbreaks have been reported in adjacent countries where the birds would also have passed.

Another possibility is that poultry-selling practices in Turkey contributed to the spread. In Dogubayazit City, home to 4 of Turkey's 15 human A(H5N1) cases, people said the big chicken farms often send huge trucks of old birds to the town, selling them at low cost to poor farmers. The last truck arrived two or three weeks ago, they said.

If even one bird on such a truck had bird flu, experts said, it could have quickly infected the others on board, disseminating A(H5N1) to many villages. "We are very keen to support the Turkish authorities in exploring the details of the movements of poultry," Mr. Sumption said.

* Copyright 2006The New York Times Company

February 1st, 2006, 06:50 PM
New Bird Flu Vaccine Nears Human Tests

DNA-Based Vaccine Could Be Ready Fast if Flu Pandemic Hits
By Daniel DeNoon

WebMD Medical News
Reviewed By Louise Chang, MD
on Monday, January 30, 2006

Jan. 30, 2006 -- A new bird flu vaccine promises broad protection against bird flu -- even if the virus mutates.

In animal tests, the genetically engineered vaccine protects chickens and mice against the deadly H5N1 bird flu virus, the strain that has killed people in Asia and Europe.

Human safety tests are poised to start in just a few months, says University of Pittsburgh researcher Andrea Gambotto, MD.

"We are ready to go," Gambotto tells WebMD. "We are ready to start production of vaccine for human trials. In a couple of days, we expect to hear from the federal government about funding for clinical production. Four to six months after that, we can begin human trials."

Vaccines and Virus Mutations

It's not your dad's flu vaccine. Normal flu vaccines -- including the bird flu vaccine now in limited production -- are made from inactivated flu virus grown in hens' eggs. It's a tried-and-true technology that's been around for decades.

But inactivated flu vaccines work only against the exact virus strain they are made from. If a flu virus mutates even slightly -- what experts call genetic "drift" -- the vaccine won't work. That's why the seasonal flu vaccine has to be changed every year or so.

Also, it takes longer to grow vaccine viruses in eggs than it does to grow them with more modern cell-culture techniques. And in the case of bird flu, to which humans have no pre-existing immunity, vaccine protection may take at least two shots given weeks apart.

How the New Approach Works

Gambotto's team uses a different approach. Instead of making a vaccine from pieces of killed virus, the researchers use a common cold virus -- adenovirus -- genetically engineered to carry bird flu DNA. When given by nose spray or injection, these vaccine viruses infect human cells. They go through a single round of replication, during which they "express" pieces of bird flu virus.

These pieces of bird flu virus do two things. One is to stimulate production of antiflu antibodies. These antibodies quickly form a first line of defense against flu infection and disease.

The second thing they do -- something the current inactivated vaccine does not do -- is stimulate antiflu T-cell immunity. This long-lasting form of immunity offers a second line of defense. And it may offer protection against drift variants of the virus used in the vaccine.

"In humans, the H5N1 bird flu takes about two weeks to kill, so there is time for T cells to come out and give protection," Gambotto says.

Will It Work?

Adenoviruses induce very powerful immune responses, says flu expert John Treanor, MD, director of the vaccine and treatment evaluation unit at the University of Rochester in New York.

"Applying this to an H5 bird flu vaccine makes a lot of sense," Treanor tells WebMD. "Gambotto's team shows it can be quite protective in the mouse model. … That is interesting because this could be a pathway toward a more broad-based vaccine that could protect against all viruses in the H5 subtype."

But Treanor warns that lots of vaccine approaches that look promising in mice never turn out to work in men and women. And he notes that experimental adenovirus vaccines have yet to live up to their potential.

"While adenoviruses have been evaluated as potential vaccine vectors for many years, there is no human vaccine that uses adenovirus for a vector," Treanor says. "There is no evidence that an adenoviral vaccine can protect humans against any disease except adenovirus."

Gambotto says this situation soon may change.

"I think this adenovirus technology is like the electric car," Gambotto says. "We all know that sooner or later we will drive an electric car. The technology just isn't quite there yet. But soon we will all be driving one."

Bird Flu Vaccines -- What's Next?

Gambotto says if the adenovirus vaccine works, it could be geared up to full production very soon after a flu pandemic breaks out.

Treanor warns, however, that the time savings offered by new technologies won't resolve all the problems with making a pandemic flu vaccine.

"This is not going to have as big an effect on the time to make a vaccine as you might think," he says. "It is generating the [ingredients needed to produce vaccine], it is the processing time, it is the putting-things-in-vials time, and all the other steps involved in making a vaccine," he says. "Growing a virus is one thing, but not the only thing. A process like this where you clone the gene into something would be faster. You shave time off the growth of the product, but there are other components that would still pose a time barrier."

Treanor hopes that the Gambotto team succeeds. If they don't, it's not the only chance for improved bird flu vaccines.

The next big breakthrough, Treanor predicts, will be finding a way to stretch out vaccine supplies by making small doses more effective. This can be done by giving the vaccine along with a substance called an adjuvant. Treanor says a new adjuvant, called MF59, looks very promising.

And Treanor notes that researchers at the National Institutes of Health are exploring a live-virus bird flu vaccine.

There's already a live-virus vaccine for seasonal flu -- FluMist.

"A development program at NIH is trying to make an H5 version of FluMist," Treanor says. "When we see how effective that is, that could be a big thing."

SOURCES: Gao, W. Journal of Virology, Feb. 15, 2006; vol 80, online edition. News release, University of Pittsburgh Medical Center. Andrea Gambotto, MD, assistant professor of surgery and molecular genetics & biochemistry, University of Pittsburgh School of Medicine. John Treanor, MD, professor of medicine and director, vaccine and treatment evaluation unit, University of Rochester, N.Y.

© 2006 WebMD Inc. All rights reserved.

February 12th, 2006, 12:28 AM
February 12, 2006

Bird Flu Detected in Greece, Italy and Bulgaria


The lethal A(H5N1) bird flu virus has been detected in wild birds in Italy and Greece, European officials announced yesterday, the first time its presence has been detected in the European Union. It was also detected in Bulgaria.

"The bird flu virus has arrived in Italy," said Francesco Storace, the Italian health minister, at a news conference, announcing that 17 swans had been found dead in three southern regions, Calabria, Sicily, and Puglia.

Testing at the National Avian Influenza Lab in Padua determined the cause to be the A(H5N1) virus, he said, although it was not clear if all 17 swans had been tested.

The arrival of bird flu in Western Europe had been predicted for some months, since the virus has marched steadily from China, to Russia, to the Balkans and, in the last week, to West Africa. It is being carried by migrating birds, so all countries on their flight paths are vulnerable.

"In some ways we would have expected it earlier in Italy," said Dr. Juan Lubroth, a senior veterinarian at the United Nations Food and Agriculture Organization in Rome.

The Italian outbreak seems to have been a model of early detection, underlining how bird flu can be controlled in countries that have the money and the scientific resources to do it.

Recent outbreaks in poor countries like Nigeria, Turkey and Iraq have percolated for months before they were discovered, allowing the virus to spread widely to commercial chicken flocks and even to humans.

While the A(H5N1) virus currently does not readily spread from human to human, scientists worry that it will mutate into a form that can, setting off a devastating worldwide human pandemic.

Only about 160 people have become infected with the disease, mostly through close contact with sick birds, and about half of them have died. In Italy, police officers near Messina, in Sicily, found two dead swans on Thursday and performed rapid screening tests on them in the wild, which suggested that the swans had a flu virus, according to ANSA, the official Italian news agency. Such simple tests are not specific enough to indicate a particular virus or strain, like A(H5N1).

The carcasses were immediately sent to a veterinary institute in Palermo, the Sicilian capital, which sent samples to the lab in Padua, where the positive test results were returned yesterday.

In the wake of the tests, Mr. Storace prohibited all movement of live animals in the affected regions. There are no signs of infection in commercial poultry yet, he said.

"There is no immediate danger for our country because our system of surveillance is efficient and has not contaminated bird farms," Mauro Delogu, an Italian virologist at the University of Bolgona, told ANSA.

In Greece, health officials announced that three swans in the northern part of the country tested positive for the virus, and hours later, European Union officials said some swans in Bulgaria, near the Danube Delta, did as well.

Dead swans have become an important flu sentinel because they are very susceptible to the virus and are so large that people notice when they die, Mr. Lubroth said.

Swans in southern Italy do not normally migrate, he said, but their wetlands are along many bird migration routes.

Last autumn, several European nations, including Switzerland, Austria and the Netherlands, mandated that all commercial poultry be kept indoors, to prevent any contact with migrating birds. Greece now requires that poultry be kept indoors and bans the sale of live birds at street markets.

Trying to calm public fears, the European Union's health commissioner, Markos Kyprianou, said: "We should not be unduly surprised or alarmed if such cases are found in the European Union. What is important is that we have the framework in place to take the appropriate measures as soon as possible to contain it and prevent its spread to poultry, and that is what we are doing."

Dr. Julie L. Gerberding, director of the federal Centers for Disease Control and Prevention, said she was not surprised that infected birds had been found in southern Europe.

"I view that as an expression of how birds fly," she said. "It's just like West Nile marching across the U.S. — you follow the flight patterns."

The variant strain of the A(H5N1) flu found in Turkey and confirmed in Africa last week is identical to one found last year in dead migratory birds in a nature reserve in northern China, and later in Siberia. It is different from strains circulating among poultry in Southeast Asia and Indonesia.

Two species of ducks, the northern pintail and the garganey, migrate in a southwesterly direction each fall from Siberia to Turkey and the Black Sea coast, and in some cases to central Africa, according to a recent article in New Scientist. Other species that share the same African wetlands migrate north in the spring, which raises the threat that the disease will be spread more widely around Western Europe later this year.

But movements are unpredictable. Dr. William B. Karesh, director of the field veterinary program for the Wildlife Conservation Society, which runs New York City's zoos, noted that northern pintails from Siberia were also found from East Africa to Britain, which suggests that some picked it up from domestic flocks during the fall migration.

"The simple presence of the same species of wild birds in two geographic areas does not indicate a transmission route," he said.

Donald G. McNeil Jr. and Lawrence K. Altman contributed reporting for this article.

* Copyright 2006The New York Times Company

March 13th, 2006, 11:58 PM
Rumsfeld makes bird flu killing


By Geaffrey Lean and Jonathan Owen
The Independent
March 12, 2006

Donald Rumsfeld has made a killing out of bird flu. The US defence secretary has made more than $5-million (about R31-million) in capital gains from selling shares in the biotechnology firm that discovered and developed Tamiflu, the drug being bought in massive amounts by governments to treat a possible human pandemic of the disease.

More than 60 countries have so far ordered large stocks of the antiviral medication - the only oral medicine believed to be effective against the deadly H5N1 strain of the disease - to try to protect their people. The United Nations estimates that a pandemic could kill 150 million people worldwide.

Britain is about halfway through receiving an order of 14,6 million courses of the drug, which its government hopes will avert some of the 700 000 deaths that might be expected. Tamiflu does not cure the disease, but if taken soon after symptoms appear it can reduce its severity.

</SPAN>The drug was developed by a Californian biotech company, Gilead Sciences. It is now made and sold by the giant chemical company Roche, which pays it a royalty on every tablet sold, currently about a fifth of its price.

Rumsfeld was on the board of Gilead from 1988 to 2001, and was its chairman from 1997. He then left to join the Bush government, but retained a huge shareholding .

The firm made a loss in 2003, the year before concern about bird flu started. Then revenues from Tamiflu almost quadrupled, to $44,6-million, helping put the company well into the black. Sales almost quadrupled again, to $161,6-million last year. During this time the share price trebled.

Rumsfeld sold some of his Gilead shares in 2004 reaping - according to the financial disclosure report he is required to make each year - capital gains of more than $5-million.

The report showed that he still had up to $25-million-worth of shares at the end of 2004, and at least one analyst believes his stake has grown well beyond that figure, as the share price has soared.

Further details are not likely to become known, however, until Rumsfeld makes his next disclosure in May.

The 2005 report showed that, in all, he owned shares worth up to $95.9-million, from which he got an income of up to $13-million, owned land worth up to $17-million, and made $1-million from renting it out.

Late last week no one at Gilead Sciences was available to comment on Rumsfeld's sale of its stock.

In a statement to The Independent on Sunday the Pentagon said: "Secretary Rumsfeld has no relationship with Gilead Sciences, Inc beyond his investments in the company.

"When he became secretary of defence in January 2001, divestiture of his investment in Gilead was not required by the Senate Armed Services Committee, the Office of Government Ethics or the Department of Defence Standards of Conduct Office.

"Upon taking office, he recused himself from participating in any particular matter when the matter would directly and predictably affect his financial interest in Gilead Sciences."

<LI class=articletext>This article was originally published on page 2 of Cape Argus (http://www.capeargus.co.za/) on March 12, 2006
© 2006 Independent Online.

January 16th, 2007, 12:56 AM
Bird flu spreading again in Asia

4 deaths reported in Indonesia; virus active in Vietnam and Thailand

Officials and residents cull poultry in a residential area
in Jakarta on January 15. A recent spurt of infections
of the H5N1 virus has alarmed officials.

Updated: 12:43 p.m. PT Jan 15, 2007 (http://www.msnbc.msn.com/id/16635479/)

JAKARTA - An Indonesian hospital was on Monday overwhelmed with patients suffering bird flu symptoms as the disease spread further in Vietnam and Thailand reported its first case in poultry in six months.

But farm ministry officials in Japan said there was no evidence of the disease spreading there following confirmation at the weekend of a bird flu outbreak at a poultry farm in the southwest in which 3,800 chickens died.

A recent spurt of infections of the H5N1 bird flu virus, which re-emerged in Asia in late 2003, has alarmed health officials.

Four Indonesians have already died this year after a six-week lull in cases, taking the number of human deaths from bird flu in the country to 61, the highest in the world.

At Jakarta’s Persahabatan hospital, where doctors were treating 9 people with bird flu symptoms, including a 5-year-old girl in intensive care, its isolation wards were overwhelmed.

“If we get more patients, we will send them to Sulianti Saroso,” Muchtar Ichsan, the head of the bird flu ward, told Reuters, referring the country’s main bird flu treatment center in North Jakarta.

The patients included the son and husband of a woman who died of bird flu last week. The 18-year-old son has been confirmed to have the disease, signaling a cluster case, although tests so far on the husband show he does not have the virus.

U.S. threat

An infectious disease expert at John Hopkins University said a bird flu pandemic remains a threat that the U.S. health care system must take seriously despite less frequent media coverage and the absence so far of human cases in the United States.

John Bartlett of John Hopkins University said the decentralized U.S. health system will make it more difficult to get ready for a possible human pandemic of H5N1 avian virus — or anything else.

He denied the threat from bird flu has been overstated by the media.

“The number of cases in 2006 was more than it was in 2005, which is more than it was in 2004 ... so it continues to go up in people,” he said in an interview.

The H5N1 virus is steadily changing and could at any time acquire the changes it needs to be easily transmitted from human to human. It would then spark a pandemic that could kill millions within months.

Bird flu as an issue in the United States suffered from ”press fatigue” in the absence of new things to say about the health threat, he said.

Adding to regional worries in Asia, a senior Thai agriculture official said on Monday that 1,900 ducks had been culled in the northern province of Phitsanulok after some of the birds had tested positive for H5N1.

The case is Thailand’s first in birds since last July. The last human death — the country’s 17th — occurred in August.

Experts fear the H5N1 virus could mutate into a form that could spread easily between people, but there has been no evidence of human-to-human transmission of the virus so far in the latest cases.

Emergency levels

The World Health Organization (WHO) says the spike in cases in the northern hemisphere winter follows a similar pattern to that seen over the past three years and was to be expected.

But it was encouraging that outbreaks were being quickly reported and dealt with, a senior WHO official said.

“It is not surprising that we are seeing an increase (in cases) ... but we are seeing much more effective responses than we were a few years ago,” Keiji Fukuda, WHO’s coordinator for the global influenza program, told journalists.

In Vietnam, where bird flu has killed 42 of the 93 people infected since 2003, the virus appeared to be spreading fast among fowl in the country’s southern Mekong Delta, threatening to engulf the major rice-growing region.

The Animal Health Department said in a report seen on Monday that tests showed H5N1 had killed ducks in the province of Soc Trang, just a day after bird flu was found in the neighboring province of Tra Vinh.

The Agriculture Ministry has ordered an additional poultry vaccination campaign in the Mekong Delta area and requested reinforcement of animal health teams to contain the spread.

Agriculture officials have warned the country’s 84 million people that the virus could spread to all 64 cities and provinces nationwide via migrating birds.

Indonesia planned to prohibit people from keeping backyard fowl in three high-risk provinces.

“We are taking the step because the current condition has reached emergency health levels,” Aburizal Bakrie, coordinating minister for welfare, told a news conference.

Millions of chickens live in close proximity to humans in Indonesia and bans on backyard fowl could be difficult to enforce. Health education campaigns are patchy and power has been increasingly devolved to the provinces.

Past campaigns to cull poultry have met with stiff resistance because little or no compensation has been paid.

WHO says H5N1 has infected 265 people and killed 159 of them in 10 countries since 2003 and has urged vigilance as the disease continues to circulate among birds.

China and Egypt have reported new human cases in recent weeks and Nigeria last week culled around 20,000 chickens in the latest outbreak among poultry.

Copyright 2007 Reuters Limited.

March 1st, 2007, 03:48 AM
Dead Aristocrat May Hold Key to Bird Flu

Associated Press Writer
February 28, 2007

LONDON -- Scientists want to exhume the body of a British diplomat who died of Spanish flu during the 1919 pandemic in hopes of discovering clues to fight a possible future global outbreak sparked by the deadly H5N1 bird flu virus.

Sir Mark Sykes, best known for his work dismantling the Ottoman Empire, was buried in a lead-lined coffin, which may have preserved enough human tissue to yield useful information on how he died and the nature of the avian flu that killed him.

"We're after an intact body," said John Oxford, a professor of virology at Queen Mary's College. "Sometimes people who have been buried in lead are very well preserved. If we obtain (the body), then we can ask a lot of important questions about the way that Sir Mark died."

Understanding more about the Spanish flu might help scientists design better treatments for H5N1. Victims of Spanish flu frequently experienced an overly aggressive immune response, which began to attack their own bodies. The same phenomenon has been seen in human H5N1 cases.

"The first thing we'll be looking at is the pathology of the lung -- whether he was overwhelmed by his own immune response," Oxford said.

Spanish flu victims have been studied before -- including Inuit bodies recovered from the Arctic permafrost and corpses of World War I soldiers. Experts estimate the Spanish flu killed more than 40 million people worldwide.

Oxford said it was extremely difficult to locate flu victims who were buried in lead-lined coffins, in part because few records were kept about coffins. In addition, it can be difficult to find the descendants of victims.

However, Sykes was a famous victim because of his diplomatic status, and his coffin was photographed before he was interred.

Although permission has been obtained from Sykes' family, Oxford said he still needs permission from Britain's health and safety body. He said it would not be known how well Sykes' body was preserved until his coffin was opened.

"These are all expectations and hopes that can be easily dashed," he said.

An aristocratic, well-traveled and talented linguist, Sykes was chosen to draw up the British half of a secret agreement to divide the Arab provinces of the Ottoman Empire into French and British spheres of influence, drawing lines which would eventually coalesce into the borders of Iraq, Syria and Israel.

Sykes later returned to the Middle East to try to secure an understanding among French, British and Arab officials there, a marathon effort which taxed his endurance, Sykes' biographer Roger Adelson said.

"He'd spent weeks burning the midnight oil trying to get these factions to agree, but he didn't succeed," Adelson said, adding that Sykes had lost weight, "so he was very vulnerable."

Sykes traveled to Paris in early 1919, and he died soon afterward.

Although he was a Roman Catholic, Sykes was buried in a Church of England graveyard at St. Mary Sledmere church, near his ancestral home about 200 miles north of London.

The Church of England has granted permission to unearth the corpse, ruling that the possible benefit -- and the family's approval -- outweighed the church's strong preference for leaving human remains undisturbed.


January 22nd, 2008, 12:43 AM
January 22, 2008

A Pandemic That Wasn’t but Might Be

Parth Sanyal/Reuters
PRECAUTIONS Flocks are being culled in India amid
an outbreak of avian flu.



Last year, for the first time since avian flu emerged as a global threat, the number of human cases was down from the year before. As the illness receded, the scary headlines — with their warnings of a pandemic that could kill 150 million people — all but vanished.

But avian flu has not gone away. Nor has it become less lethal or less widespread in birds. Experts argue that preparations against it have to continue, even if the virus’s failure to mutate into a pandemic strain has given the world more breathing room.

There were 86 confirmed human cases last year compared with 115 in 2006, according to the World Health Organization, and 59 deaths compared with 79. Experts assume that the real numbers are several times larger, because many cases are missed, but that is still a far cry from a pandemic.

Dr. David Nabarro, the senior United Nations coordinator for human and avian flu, recently conceded that he worried somewhat less than he did three years ago. “Not because I think the threat has changed,” he quickly added, but because the response to it has gotten so much better.”

The world is clearly more prepared. Vaccines have been developed. Stockpiles of Tamiflu and masks have grown. Many countries, cities, companies and schools have written pandemic plans. The European Center for Disease Prevention and Control, created in Stockholm in 2005, just estimated that the European Union needed “another two to three years of hard work and investment” to be ready for a pandemic, but that is improving because previous estimates were for five years.

In the worst-hit countries — all poor — laboratories have become faster at flu tests. Government veterinarians now move more quickly to cull chickens. Hospitals have wards for suspect patients, and epidemiologists trace contacts and treat all with Tamiflu — a tactic meant to encircle and snuff outbreaks before the virus can adapt itself to humans.

Bernard Vallat, director general of the World Organization for Animal Health, recently called the virus “extremely stable” and, thus, less likely to mutate into a pandemic form. Many prominent virologists would vehemently disagree. But others who argued three years ago that H5N1 would not “go pandemic” are feeling a bit smug.

Dr. Paul A. Offit, a vaccine specialist at Children’s Hospital in Philadelphia, was one of those who, he jokes, “dared to be stupid” by bucking the alarmist trend in 2005.

“H5 viruses have been around for 100 years and never caused a pandemic and probably never will,” he said.

But Dr. Offit said he backed all preparedness efforts because he expected another pandemic from an H1, H2 or H3, the subtypes responsible for six previous epidemics, including the catastrophic one in 1918.

“What I worry is that this has been a ‘boy who cried wolf’ phenomenon,” he said. “When the next pandemic comes, people will say, ‘Yeah, yeah, we heard that last time.’ ”

Some who were Cassandras in 2005 still are.

The fact that human cases fell slightly last year is “pretty much meaningless,” argued Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. The virus is still circulating and has evolved 10 clades and hundreds of variants.

World preparations thus far are “incremental,” he said, “like sending 10 troops to a war when you need 10,000.”

He noted that the H3N8 flu found in horses in the 1960s took 40 years to adapt to dogs, but that since 2004 it has spread to kennels all over the country.

The most worrisome aspect of H5N1, virtually all scientists agree, is that it persists in birds without becoming less lethal to them.

“This is the most serious bird flu virus that has ever been known,” Dr. Nabarro said. “By 2007, it was in 60 countries. It must be dealt with.”

Despite the culling of hundreds of millions of birds and the injection of billions of doses of poultry vaccine, the virus is out of control in some of the most populous countries — though exactly which ones are in dispute, because some are touchy about conceding that they cannot rid their flocks of it.

Dr. Vallat has named three countries where it is now endemic in local birds: Egypt, Indonesia and Nigeria.

Dr. Nabarro added Bangladesh, Vietnam and parts of China. Reports of recurrent outbreaks also persist in parts of India, Myanmar and Pakistan. Last week, villagers in India were reported to be killing and eating their flocks before government cullers, who paid less than a third of market value, could seize them.

Dr. Henry L. Niman, a biochemist in Pittsburgh whose Web site tracks mutations, argues that there is a separate reservoir in wild birds that extends across Eurasia. Late each fall, fresh outbreaks appear across Europe and down into the Middle East as geese and swans migrate from Asia toward Africa.

In December, dying birds were found in Poland and Russia, in Saudi Arabia and even in a kindergarten petting zoo in Israel.

On Jan. 8, it reached one of England’s most famous swan-breeding grounds, the Abbotsbury Swannery, which has been around since the 11th century.

The Western Hemisphere is in less danger, according to a study published in the journal PloS Pathogens, which analyzed viruses found in migratory birds sampled from 2001 to 2006 in Alberta and along the Jersey Shore. It found that none carried whole viruses from Eurasian bird pathways.

Therefore, the authors argued, it is more likely that any importation of the virus would be in “birds moved legally or illegally by humans.”

It may be even more likely that a human will be the first carrier. There was a close call in early December, when six members of one family in northern Pakistan fell ill, probably infected by a brother who had culled sick poultry.

Another brother, who lived on Long Island, went to Pakistan for the funeral and felt sick when he returned home. He turned out not to have H5N1, but it showed how easily the virus could have reached the Western Hemisphere.

Pakistan had its first human cases last year, as did Laos, Myanmar and Nigeria.

Many small mutations have been recorded that seem to make the virus more adaptable to humans and more resistant to known drugs, but no combination of those producing a superstrain has yet emerged.

Ninety percent of cluster cases have been among blood relatives, and Dr. Arnold S. Monto, an avian flu expert at the University of Michigan School of Public Health, said that suggested a genetic susceptibility that has not yet been defined.

It has long been known that the virus has difficulty attaching to receptors in human noses. A team at M.I.T. has refined that, showing that those receptors come in two shapes, cones and umbrellas, and that avian viruses attach more easily to the cones.

Rapid progress has been made in vaccines. The newest, Dr. Monto said, need just small amounts of antigen — 4 micrograms an injection instead of 90 micrograms — making them much more practical to produce.

Some scientists argue for vaccinating millions of people as a precaution. One dose, even if it is based on a three-year-old strain, might protect against death, if not infection. A second, fully protective dose could be made up from whatever strain has gone pandemic.

Right now, said Dr. Klaus Stöhr, who was chief of flu vaccines for the W.H.O. and now does the same for Novartis, it would take manufacturers about one year to produce a billion doses of any vaccine based on a new pandemic strain. But the pandemic would have circled the globe within three months.

“The peak would be over, and, principally, you’d be vaccinating survivors,” Dr. Stöhr said. Switzerland, he added, has a vaccine stockpile and plans to test it on soldiers, police officers and health care workers before deciding whether to offer it to all Swiss.

Because of the American swine flu debacle of 1976, in which a vaccine made against a pandemic that never emerged harmed more people than the flu did, experts say they think it is unlikely that many Americans would be willing to take such precautions.

Copyright 2008 The New York Times Company

May 29th, 2009, 07:44 PM
Scientists develop new basis
for H5N1 vaccine: WHO

By Laura MacInnis Laura Macinnis Thu May 28, 10:04 am ET

GENEVA (Reuters) – Scientists have used bird flu virus samples from Egypt to develop a new basis for a vaccine against the toxic H5N1 strain that continues to circulate, the World Health Organization said on Thursday.

Avian influenza kills about half the people it infects, but unlike the quickly circulating H1N1 flu virus has not been shown to pass easily between humans to date.

The WHO said the candidate virus was developed at the U.S. Centers for Disease Control and Prevention in Atlanta "thanks to the ministry of health and population of Egypt, for providing virus specimens,"

"This recombinant vaccine virus is available for distribution," it said in a statement on its website.

"Institutions, companies and others interested in pandemic vaccine development who wish to receive these candidate vaccine viruses should contact either the WHO Global Influenza Program ... or the Centers for Disease Control and Prevention."

Pharmaceutical companies including Novartis are already working on vaccines against H5N1 bird flu, which has killed or forced the culling of more than 300 million birds since 2003 as it spread to 61 countries in Asia, the Middle East and Africa.

While eclipsed on the headlines by the highly contagious H1N1 strain, which proved deadly in its North American epicenter but has caused mild symptoms as it spread, the WHO stressed it was important to remember the risks posed by avian influenza.

The U.N.'s Food and Agriculture Organization reported 250 outbreaks of H5N1 in birds in February alone -- in Bangladesh, China, Egypt, India, Indonesia, Laos, Nepal and Vietnam.

Avian influenza has killed 261 people out of 424 infected since 2003. By contrast, the H1N1 strain, commonly known as swine flu and which has put the world on pandemic alert, has infected more than 13,000 people but killed just 95, according to WHO figures.

Its statement on Thursday said flu experts were continuing to monitor the evolution of avian influenza and other flu viruses and stressed the need for countries to keep providing samples of identified strains.

"Countries are encouraged to share with WHO their specimens and/or isolates, both from humans and animals, for their inclusion in the WHO H5N1 vaccine virus development and selection process, in addition to other activities of public health significance," it said.

Virus sharing is a sensitive topic for developing countries such as Indonesia, who have bristled at the idea of companies using their biological material to manufacture and patent vaccines that are then sold at unaffordable prices.

WHO Director-General Margaret Chan, who raised the United Nations agency's pandemic alert to 5 out of 6 in response to the fast spread of swine flu, is trying to broker an international agreement on the sharing of virus samples by January 2010.

She has called on countries to do all they can to ensure fresh samples of both H5N1 and the new H1N1 strains reach the pharmaceutical community so that their vaccines can offer immunity against the latest forms of the viruses.

The WHO's statement did not include new guidance on the H1N1 virus or vaccines to fight it. WHO officials have said they would offer recommendations "during the summer" about how many pandemic vaccines focused on that strain may needed, depending on whether it continues to cause mild effects as its spreads.

British scientists have produced a strain of H1N1 flu virus which could be used for large-scale production of a vaccine, should it go ahead.

That strain is being made available to the pharmaceutical industry and other flu laboratories, Britain's Health Protection Agency said on Thursday, describing it as "a crucial step toward large scale production of a vaccine against swine flu."

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May 29th, 2009, 10:40 PM
I think the main thing we should be made aware of with this is not the potency of any individual virus, but the ease of transmission of any virus that becomes transmissible through airborne modes.

We had very little to fear from H1N1 other than its ease of infecting 13,000 people, even after everyone was aware of it. I just keep being reminded of 13 days.......

Bruce and Brad man! Terry is absolutely psychotic!