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Bird flu strategy prepared

Health experts are meeting Monday to develop a global plan for dealing with bird flu.

BY PJ HELLER | GENEVA, Switzerland | November 7, 2005

"This virus is very treacherous."

—Dr. Margaret Chan

Health experts are meeting Monday to develop a global plan for dealing with bird flu and the threat of a human pandemic which could kill millions.

The three-day meeting in Geneva, hosted by the World Health Organization (WHO), is the culmination of a series of international meetings held over the last ten weeks. The goal of the meeting is to develop a worldwide agreement for dealing with the disease caused by the H5N1 influenza virus. Since 2003, the virus has killed more than 60 people and infected at least 123 throughout Asia. It has also led to the culling of more than 150 million birds worldwide and has spread in birds from Southeast Asia to Russia, Turkey, Romania, Kazakhstan and Croatia.

"It's impossible to exaggerate how important pandemic preparedness is, and how dire the consequences would be for the entire world if some of the worst-case scenarios for a human influenza pandemic were to unfold," said James Adams, the head of the World Bank's avian flu task force.

"This virus is very treacherous," added Dr. Margaret Chan, an official with the WHO responsible for monitoring bird flu. "While we cannot predict when or if the H5N1 virus might spark a pandemic, we cannot ignore the warning signs."

Officials are concerned that migrating birds could carry the H5N1 strain to Europe, Africa and the Middle East.

Most recently, Indonesia reported the death of a 19-year-old woman from bird flu and said her 8-year-old nephew was infected. A nurse who cared for the woman may also have been infected.

Meanwhile, China reported its fourth bird flu outbreak in poultry in three weeks. It also asked the WHO to help determine if the death of a 12-year-old with flu symptoms was due to bird flu. The girl lived near the site of a bird flu outbreak. Her 9-year-old brother and a 36-year-old teacher were also infected.

If confirmed, it would be China's first human case of bird flu.

Health officials have yet to confirm any cases where the disease has been passed from human to human, although possible cases have been reported in Hong Kong, Thailand and Vietnam. Rather, it appears that humans catch the disease through close contact with infected birds. The first cases seen in humans were in 1997 in Hong Kong.

Officials fear that the H5N1 strain could mutate and combine with human flu viruses, which would allow it to spread easily and rapidly. That could trigger a human pandemic in which millions of people could die. Death toll projections have ranged from more than 7.4 million people to as many as 150 million.

The Geneva gathering includes human and animal health experts, senior policy makers, economists and industry representatives. Topics to be discussed at the conference include how to contain the H5N1 disease in birds, ways to strengthen disease surveillance systems, and pandemic preparedness issues such as scientific cooperation on vaccine development and establishing regional stockpiles of anti-viral drugs and vaccines.

The World Bank, one of the co-organizers of the event, is scheduled to lead a session Wednesday on how to help countries and agencies fund those program. A spokesman said "initial" donations of between $300 million and $500 million would be required. The total cost could be enormous.

Japan was considering giving $2.6 million to the WHO to help combat bird flu, the newspaper Yomiuri Shimbun reported Sunday. The U.S. has offered $251 million to fight bird flu in Asia, part of an overall $7.1 billion package proposed by the government. China has said it would donate $248 million.

Countries worldwide have been developing plans on how to deal with an outbreak of bird flu and the possibility of it spreading between humans. WHO has urged countries to stockpile enough anti-viral drugs to handle a pandemic; Tamiflu is widely mentioned as the drug of choice although supply has not been able to keep up with demand and it was not specifically designed for bird flu.

Although Tamiflu manufacturer Roche said it could take two to three years for others to develop the expertise to manufacture its drug, two Asian groups have announced they have produced generic versions of the drug.

Some countries are researching other anti-viral drugs and one news report said China had developed a vaccine to prevent bird flu in humans. According to the WHO, "at least 10 vaccine developers in as many countries are carrying out demonstration projects to develop and evaluate vaccines primarily against the H5N1 subtype."

In the U.S., President George W. Bush has proposed a $7.1 billion plan to cope with a possible flu pandemic. The plan includes spending $1.2 billion to purchase enough vaccine to protect 20 million Americans from bird flu and $2.8 billion to speed the development of new vaccines. On a local level, Hawaii became the first state in the nation to begin airport monitoring to detect signs of bird flu or other viruses.

In the United Kingdom, officials plan to stockpile 14.6 million doses of anti-viral drugs. They also plan to develop enough vaccine - 120 million doses - to cover the entire population if a human pandemic occurs.

At a Canadian conference on bird flu, a proposal was made to transfer manufacturing vaccines and anti-viral drugs to other countries to increase manufacturing.

Several countries, including a group of 28 in Europe, have announced plans to stage mock drills to test their ability to deal with a human flu pandemic. Other drills are planned for Hong Kong and the Asia-Pacific region.

Among other steps being taken, the European Union has banned the import of captive live birds. In Italy, there is compulsory labelling of Italian poultry including where the chicken was raised and date and place of slaughter; imported poultry must be labelled with country of origin and date of entry. Indonesia is offering urgent and free hospital treatment for people who test positive for bird flu. In New Zealand, options being considered if a human flu pandemic occurs include prohibiting public or private gatherings, closing schools and universities, restricting internal travel and closing borders.

Chan of the World Health Organization stressed the importance of the Geneva conference.

"For the first time in human history, we have a chance to prepare ourselves for a pandemic before it arrives," she said. "It is incumbent upon the global community to act now."

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