Dear readers,

The blog is temporarily suspended because of the ongoing emergency medical relief operation of Médecins du Monde - France in Yogyakarta after the 27th of May earthquake. Basically, we don't have time to search for information regarding the bird flu in Indonesia and South East Asia...
We apologyzed for the inconvenience and will try to come back asap.

No bird flu virus mutation seen in Indonesia

By Diyan Jari

JAKARTA, May 24 (Reuters) - Limited human-to-human transmission of bird flu might have occurred in an Indonesian family and health experts are tracing anyone who might have had contact with them, the World Health Organisation said.

But a senior WHO official said in Jakarta this was not the first time the world was seeing a family cluster and said that fresh scientific evidence has shown the virus in Indonesia has not mutated to one that can spread easily among people.

WHO said on Wednesday it had no immediate plans to call a meeting of experts to discuss raising its global bird flu alert.

"Right now it does not look like the task force will need to meet immediately, but this is subject to change depending on what comes out of Indonesia," WHO spokeswoman Maria Cheng said, when asked to comment on press reports of an imminent meeting.

Financial markets, however, were spooked on fears the Indonesia cluster could be the start of a pandemic. Currencies in Asia, where most bird flu cases have occurred, fell. U.S. commodity prices came under pressure while European markets slipped as investors turned jittery.

Concern has been growing about the case in north Sumatra in which seven family members from Kubu Sembilang village died this month. The case is the largest family cluster known to date.

WHO and Indonesian health officials are baffled over the source of the infection but genetic sequencing has shown the H5N1 bird flu virus has not mutated, the U.N. agency said on its Web site (http://www.who.int) on Tuesday.

Nor was there sign of the virus spread among villagers.

"To date, the investigation has found no evidence of spread within the general community and no evidence that efficient human-to-human transmission has occurred," the WHO said.

Sick poultry have been the source of bird flu infection for most human cases worldwide. Pigs are susceptible to the virus.

Clusters are looked on with far more suspicion than isolated infections because they raise the possibility the virus might have mutated to transmit efficiently among humans.

That could spark a pandemic, killing millions of people.

The WHO statement came after one of the family members, a 32-year-old father, died on Monday after caring for his ailing son, who had died earlier. The agency said such close contact was considered a possible source of infection.

CLOSING IN

But Firdosi Mehta, acting representative of the WHO in Indonesia, urged against any over-reaction, saying this was not the first cluster that the world has known.

Limited transmissions between people are caused by close and prolonged contact when the sick person is coughing and probably infectious. Experts in Kubu Sembilang were acting to contain any further spread.

"We are going wide, contacting the various contacts, putting on (anti-viral) Tamiflu whoever has had close contact, basically putting family members who have not been affected on Tamiflu as a precaution," Mehta told Reuters in an interview in Jakarta.

"There is active surveillance in the village, fever surveillance to look for any more cases that are occurring outside this immediate family cluster," he said.

But another WHO spokesman said the agency was worried.

"This is the most significant development so far in terms of public health," Peter Cordingley, spokesman for the West Pacific region of the WHO, said in the Philippine capital on Wednesday.

"We have never had a cluster as large as this. We have not had in the past what we have here, which is no explanation as to how these people became infected."

"We can't find sick animals in this community and that worries us," he added.

Bird flu has killed 124 people in 10 nations since it re-emerged in Asia in 2003. It is essentially a disease in birds and has spread to dozens of countries in wild birds and poultry.

In China, where the virus has been entrenched for the last 10 years, fresh trouble may be brewing as authorities confirmed an outbreak of the H5N1 among wild birds in its remote far-western Qinghai province and Tibet.

About 400 wild birds had been found dead "recently", its state Xinhua news agency said, quoting the Agriculture Ministry.

An outbreak of the H5N1 killed thousands of birds in Qinghai Lake this time last year and this strain of the virus has since turned up in parts of Europe, Africa and the Middle East.

Markets are also nervous about a suspected cluster in Iran.

An Iranian medical official told Reuters on Monday that a 41-year-old man and his 26-year-old sister from the northwestern city of Kermanshah had tested positive for bird flu.

But Health Minister Kamran Lankarani denied this although international health officials are still investigating.

The two siblings were among five members of a family who became sick and the other three remain in hospital.

WHO says no plans to raise bird flu alert level

Wed 24 May 2006

GENEVA, May 24 (Reuters) - The World Health Organisation (WHO) said on Wednesday it had no immediate plans to call a meeting of experts to discuss raising its global bird flu alert.

A WHO spokeswoman was asked to comment on press reports that the U.N. agency could convene a meeting of experts within the next few days because of concern about Indonesia where seven members of a family died this month.

"Right now it does not look like the task force will need to meet immediately, but this is subject to change depending on what comes out of Indonesia," WHO spokeswoman Maria Cheng told Reuters.

Under WHO's action plan for dealing with bird flu, the panel will be consulted before any change is made to the level of alert, which currently stands at three on a six-point scale.

There needs to have been increased human-to-human transmission, along with signs that the deadly virus is becoming more easily transmissible for a change in readiness to be made.

"Today we have no indication that the virus is more efficient," said Cheng.

In the Indonesian case -- which set international alarm bells ringing because it is the biggest cluster of human infections yet -- there was no indication that the virus had spread beyond the family members, she said.

"This is the biggest cluster we have seen, there may have been human-to-human transmission, and all this is something that needs to be responded to as quickly as possible," Cheng said.

Indonesia struggles to track H5N1 source, 2 more die

22 May 2006 11:37:23 GMT
By Fitri Wulandari and Tan Ee Lyn

JAKARTA, May 22 (Reuters) - Health officials in Indonesia are still struggling to track down the source of a worrying family cluster of H5N1 bird flu infections as tests showed that two more people have died of the same disease.

One of the latest victims belonged to a Sumatran family, which lost several members earlier this month to bird flu, sparking fears of human-to-human transmission.

While H5N1 is still regarded as a bird disease, experts have warned for more than a year that it might mutate and pass efficiently between humans and cause a global pandemic.

"One man from the same Sumatra cluster died this morning. He is the father of the child who died on May 13. He ran away after he received Tamiflu," said I Nyoman Kandun, director-general of communicable disease control at the health ministry.

"He was found in the village later but refused treatment," Kandun told reporters at a news conference.

Five of his relatives have been confirmed as bird flu deaths by the World Health Organisation (WHO) which also says another family member has survived being infected with H5N1.

Another death could not be confirmed because no samples were obtained but she is considered the initial case of the cluster in Kubu Simbelang village in north Sumatra.

The woman died on May 4 but, nearly three weeks on, Indonesian experts have come no closer to finding the source of the virus.

Blood samples taken from chickens, ducks and pigs in the neighbouring district of Kabanjahe -- where there was an outbreak of H5N1 in chickens in January -- have tested positive for antibodies for the H5 component for the virus.

But local scientists have yet to test the samples specifically for N1 antibodies.

Nasal swab samples of the animals tested negative for H5N1, meaning they were no longer infected.

Abdul Adjid of Indonesia's Veterinary Research Institute, which is handling the animal samples, said his laboratory would try to test the samples for N1 antibodies.

"We are trying to do the N1 tests. Maybe we will ask the WHO or the FAO (Food and Agriculture Organisation) to provide (assistance) so that we can improve our ability to do that," Adjid told Reuters.

If these samples come back positive for N1 antibodies, it could mean that the animals, which are healthy and free of the disease now, were infected with H5N1 some time in the past.

It takes between one and two weeks to test definitively for H5N1 antibodies in more sophisticated laboratories.

DISEASED POULTRY THE LINK?

Adjid suggested that the movement of diseased poultry might have played a role in the Sumatran family's tragedy. Kabanjahe is about eight kilometres (five miles) from Kubu Simbelang.

"There was an H5N1 outbreak in chickens in Kabanjahe in January, so maybe that's why the pigs, ducks and chickens are positive for H5," he said.

"People buy chickens and pigs from Kabanjahe ... the family bought chickens and pigs from Kabanjahe," he said.

The cluster has alarmed the medical community, which has called repeatedly for stronger measures to stem the disease in poultry.

"The fact that so many people are infected means that a lot of its poultry is infected ... if a place is infected, it usually starts with the chickens first, then pigs, then man," said Lo Wing-lok, a Hong Kong based infectious disease expert.

"There is no evidence yet of human-to-human transmission, but the problem is in poultry and mutation can happen in chickens."

Kandun, however, said there was no evidence the H5N1 virus had mutated or reassorted in the family members.

Based on previous genetic sequencing, the H5N1 virus in Indonesia is believed to have originated from Yunnan province in southern China. The first H5N1 poultry outbreak in Indonesia was identified in late 2003.

Kandun said a 38-year-old man from Jakarta who died last week had also been declared positive for bird flu by local tests.

The WHO has confirmed 32 fatalities from avian influenza in the world's fourth most populous nation, the second highest number of human deaths after Vietnam.

Commenting on the family cluster, Kandun said: "We cannot conclusively confirm nor rule out human-to-human transmission ... maybe they have genetics susceptibility, exposed to a common source ... a lot of things we don't know."

Bird flu deaths in Medan raise fresh fears

New Straits Times/Annie Freeda Cruez/23 May 2006

KUALA LUMPUR: Six avian flu deaths in Medan, a mere 157km across the Straits of Malacca, are sending chills up the spine of veterinary and health officials here.

Following a request by the Veterinary Services Department, the Customs and Immigration departments are looking out for the possibility of birds being smuggled to Malacca on barter and passenger boats.

Checks have been stepped up in Malacca and Port Klang.

Veterinary Services Department acting director-general Datuk Dr Mustapa Abdul Jalil said the department had been informed by its counterparts in Indonesia that the situation in Medan was serious.

"We have also been told that the source of the deaths were chickens," he told the New Straits Times.

Dr Mustapa urged Malaysians and Indonesians to abide by directives on the import and export of birds and their products from all avian flu-affected countries.

Under the Customs Act 1967, smugglers can be fined 10 times the amount of the seizure or jailed three years for the first offence. Subsequent offences carry a penalty of 20 times the amount or five years’ jail.

Dr Mustapa also urged farmers to be alert and to report unusual bird deaths to the nearest Veterinary Services Department.

An AFP report yesterday quoted Nyoman Kandun, director of the Indonesian health ministry communicable disease control centre, as saying that an epidemiological investigation had been launched into the deaths.

Five died some weeks ago with the sixth death, that of the father of one of the other victims, occurring yesterday.

He said experts feared this might be Indonesia’s first few cases of human-to-human transmission of the virus.

"We cannot confirm that (human-to-human transmission) has occurred but we cannot rule it out," said Kandun.

He said Indonesian officials were being assisted by the World Health Organisation, and the Centre for Disease Control and Prevention in Atlanta. Indonesia’s bird flu toll now stands at 32.

It has witnessed more bird flu deaths than any other country this year with the world’s second highest number of fatalities since 2003.

Meanwhile, Health Ministry Disease Control Division acting director Dr Zainal Ariffin Omar said his staff were working closely with the Veterinary Services Department on the matter.

"All doctors have also been directed to alert the ministry if they come across patients, especially foreigners and Malaysians who arrived from avian flu-affected countries, seeking treatment for bird flu symptoms."

He said clinical and ground surveillance had started, aside from checks on human traffic between the two nations and other avian flu-affected countries.

Coordination 'too poor' to contain bird flu virus

Tb. Arie Rukmantara, The Jakarta Post, Jakarta 22/05/06

Although the recent discovery of the country's largest bird flu cluster in North Sumatra has made Indonesians anxious about a possible human pandemic, a senior official says government agencies have just started to come up to speed on something they should have accomplished a long time ago: coordination.

A senior official at the National Commission on Bird Flu, Emil Agustiono, said the lack of coordination among government agencies, and between them and such international partners as the World Health Organization (WHO) and Food Agricultural Organization, partly contributed to the rapid spread of the H5N1 strain of virus across the 27 of the country's 33 provinces.

"There was a tendency to work individually, but now we're starting to step up our internal communication," he told The Jakarta Post over the weekend.

Lack of communication between the agencies has been a chronic problem. People have observed that the Health Ministry and the Agriculture Ministry always announce the results of their investigations separately, he said.

He cited the case of Medan, where the WHO confirmed a cluster of seven people in Karo regency were infected by the deadly flu. Leter, teams from the Health Ministry and Agriculture Ministry came and announced their findings separately, causing local residents to react with everything from panic to apathy.

"In the next several days, I will coordinate a visit to the Karo regency. This time we'll have a strong team, consisting of representatives of all the agencies, to find out the source of the virus and how it spread," he said, adding that he suspected organic fertilizers would likely turn out to be the source.

On Friday, a test from the Agriculture Ministry's laboratory in Bogor contradicted Agriculture Minister Anton Apriyantono's statement that pigs in the Karo regency tested positive.

"Based on this second test, our conclusion is that pigs there are free from the H5N1 virus," said the ministry's director for animal health, Samsul Bahri.

He said the earlier test indicated that the pigs had once been exposed to the virus but were not infected with it.

Samsul said he believed that the Medan case would be a good chance for both ministries to join forces in halting the spread of the disease.

"It should be a good start at working together for us, which we may have failed to do before," he said.

At least 32 of the 41 confirmed patients in Indonesia have died since the first human case was found in 2004.

WHO has confirmed the deaths of two more victims, one of whom was a 10-year-old boy from the Karo Regency cluster. The second was a 12-year-old boy from Bekasi, West Java.

WHO - Avian influenza – situation in Indonesia – update 13

19 May 2006

The Ministry of Health in Indonesia has confirmed an additional case of human infection with the H5N1 avian influenza virus. The case occurred in a 12-year-old boy from Bekasi in East Jakarta. He was hospitalized on 7 May and died on 13 May.

An investigation is under way to determine the source of his infection.

The newly confirmed case brings the total in Indonesia to 41. Of these cases, 32 have been fatal.

WHO - Avian influenza – situation in Indonesia – update 12

18 May 2006

The Ministry of Health in Indonesia has confirmed an additional seven cases of human infection with the H5N1 avian influenza virus. Six of the cases were fatal.

One fatal case, in a 38-year-old woman, occurred in the city of Surabaya, in East Java. She developed symptoms on 2 May, was hospitalized on 7 May, and died on 12 May. The case is the first reported from this area.

The remaining six cases are from the village of Kubu Sembelang in the Karo district of North Sumatra. All six are members of an extended family, and all but one lived in neighbouring houses.

Associated with the Kubu Sembelang outbreak is a seventh family member, a 37-year-old woman. She developed symptoms on 27 April and died of respiratory disease on 4 May. No specimens were obtained before her burial, and the cause of her death cannot be confirmed. She is, however, considered the initial case in this family cluster.

The six confirmed cases in Sumatra include the woman’s two sons, aged 15 and 17 years, who died respectively on 9 May and 12 May. The 28-year-old sister of the initial case died on 10 May. This sister had an 18-month-old girl, who died on 14 May. The fifth confirmed case, who is still alive, is the 25-year-old brother of the initial case. The sixth confirmed case is the 10-year-old nephew of the initial case. He died on 13 May.

One additional family member, who had been hospitalized, has subsequently been ruled out based on both negative laboratory results and the absence of clinical symptoms compatible with H5N1 infection.

This is the largest cluster of cases, closely related in time and place, reported to date in any country and is being carefully investigated by Indonesia’s ministries of health and agriculture and by WHO epidemiologists. The source of exposure for the initial case is still under investigation, with exposure to infected poultry or an environment contaminated by their faeces considered the most plausible source.

The likely source of infection for the additional cases has not yet been determined. Multiple hypotheses are being investigated. Apart from living in close proximity to each other, the cases in this cluster are known to have participated in a family gathering around 29 April. The cases may have acquired their infection from a shared environmental exposure yet to be identified. The possibility of limited human-to-human transmission cannot be ruled out at present.

Investigators at the outbreak site have found no evidence that infection has spread beyond members of this single extended family. No influenza-like illness has been identified in health care workers or other persons in close contact with the patients. If human-to-human transmission has occurred, it has not been either efficient or sustained.

The newly confirmed cases bring the total in Indonesia to 40. Of these cases, 31 have been fatal.

Indonesia says no bird flu cover-up, Egyptian dies

18 May 2006 15:17:18 GMT
By Achmad Sukarsono

JAKARTA, May 18 (Reuters) - Indonesia pledged on Thursday there would be no cover-up if human-to-human transmission of bird flu does occur, after five members of a family were confirmed to have died from the H5N1 avian flu virus.
The case has baffled experts because the source of the virus has not been confirmed and human-to-human transmission cannot be ruled out.
But, offering a possible answer, Indonesia's agriculture minister said pigs had tested positive for bird flu in the same village in North Sumatra.
The family slaughtered animals for a barbecue feast in late April before the outbreak in Kubu Simbelang village where pigs and chickens live near homes and cats and dogs roam freely.
Six of the family have died and one has survived. The sixth family member was buried before tests could be carried out.
"This is the largest cluster of cases, closely related in time and place, reported to date in any country ...," the World Health Organisation said in a statement.
The U.N. agency said exposure to infected poultry or an environment contaminated by their faeces was the most plausible source.
"The possibility of limited human-to-human transmission cannot be ruled out at present," the WHO said, but added: "If human-to-human transmission has occurred, it has not been either efficient or sustained."
I Nyoman Kandun, the Indonesian health ministry's director-general of communicable disease control, said there was no proof of H5N1 virus transmission between people in Indonesia.
"I guarantee Indonesia is not covering up. A cover-up has more harm than benefits. By opening up, we are actually welcoming contribution from everywhere."
He also called on leaders at all levels in the country to step up efforts to raise awareness among the public.
TIME BOMB
"There are so many people who do not know what has happened. Even the educated do not know the situation is like a time bomb," Kandun said.
Thirty-one people have died of bird flu in Indonesia, the second-highest toll of any country. More than half that number have died this year.
Egypt confirmed a sixth death on Thursday, a 75-year-old woman from Minya in the south.
H5N1 has killed 122 people worldwide since re-appearing in 2003. Virtually all the victims caught the disease from poultry.
Denmark on Thursday halted exports of poultry from Funen after birds on a farm on the island tested positive for the H5 strain of avian flu. The outbreak may force Denmark to halt all poultry exports.
In Russia, the H5N1 bird flu virus was found in six dead chickens in Siberia, where more than 80 dead birds have been found since the end of April, a regional health official said.
Indonesian Agriculture Minister Anton Apriyantono said a number of pigs from the village 50 km (30 miles) south of Medan city, had tested positive.
"After we brought them to Bogor, the serology test found positive results. From 11 pig samples, 10 are positive. Reconfirmation testings are still underway," he said, but did not refer specifically to the H5N1 virus.
The minister's comments are likely to concern health officials. Pigs can act as mixing vessels in which human and bird flu viruses can swap genes, leading to a strain that can easily infect people and pass from person to person.
Clusters of human infections are worrying because they indicate that the virus might be mutating into a form that is easily transmissible among humans. That could spark a pandemic in which millions might die.
For the moment, the virus is mainly a disease in birds and is hard for humans to catch.
The WHO and the U.N.'s Food and Agriculture Organisation say better surveillance is crucial for rapid detection of outbreaks in birds and family clusters like the Sumatra case.
"If we do not hear about it for a couple of weeks and there are already a hundred or so cases, then it may be too late," WHO spokeswoman Maria Cheng said in Geneva.
"We heard about it relatively quickly (Sumatra). Indonesia has much higher awareness than other countries because they have been dealing with human cases for almost year now," she said. (Additional reporting by Yoga Rusmana in Jakarta, Tan Ee Lyn in Hong Kong and Richard Waddington and Stephanie Nebehay in Geneva)

Bird flu case not human-to-human spread - Indonesia

JAKARTA, May 17 (Reuters) - An outbreak of H5N1 bird flu involving up to eight members of a family in Indonesia's North Sumatra province is not a case of human-to-human transmission, a Health Ministry official said on Wednesday.

Concern has been growing about the case in which six of the eight have already died. Local tests showed five members of the cluster were positive for the bird flu virus and tests were being carried out on the remaining three.

"The spread was through risk factors from poultry or other animals. There is no proof of human to human," Nyoman Kandun, director-general of disease control, told Reuters.

"The world is watching us. We are not being hasty," he added.

He said authorities were still trying to identify the source of the virus in the cluster case in Kubu Simbelang village in Karo regency, about 50 km (30 miles) south of the North Sumatran city of Medan.

Some reports have suggested chicken manure used as fertiliser might be the link, but there has been no confirmation of this. Infected birds can excrete large amounts of the H5N1 virus and this can be one way it can spread to birds, and people.

The World Health Organisation has sent a team to the area. The agency said it is on alert for signs that the virus is mutating into one that can be easily transmitted between people, a development that could signal the start of a pandemic in which millions could die.

Such a mutation could occur anywhere there is bird flu, the WHO says.

Experts have said in the past that possible bird flu cluster cases among family members do not mean the virus is necessarily mutating. It could be caused by the close contact normal in families.

There have been a number of such examples in Vietnam and Thailand, a WHO spokeswoman said in Geneva earlier this week.

The Indonesian Health Ministry has said blood samples of the five family members who had tested positive locally had been sent to a WHO-affiliated laboratory in Hong Kong for confirmation. Local tests are not considered definitive.

Bird flu has killed 115 people worldwide, the majority in east Asia, since reappearing in 2003. Virtually all the victims caught the disease from poultry.

The WHO has confirmed 25 deaths in Indonesia from the H5N1 virus, the second highest number after Vietnam, which has confirmed 42 deaths.

The virus is endemic in much of Indonesia, and on Tuesday a senior Agriculture Ministry official said H5N1 had been detected for the first time in poultry in remote eastern Papua province.

Bird flu found in fowl in Indonesia's Papua-official

JAKARTA, May 16 (Reuters) - Indonesia has found the avian flu virus in chickens in Papua province, the first bird flu case in the archipelago's easternmost province, a senior government official said on Tuesday.

A number of fighting cocks in Manokwari regency of western Papua tested positive for the H5N1 virus in late April, prompting authorities to cull about 200 chickens, Syamsul Bahri, animal health director at the agriculture ministry, told Reuters.

"The fighting cocks might have been brought to Papua from neighbouring Sulawesi island," Bahri said. "It was the first case we had in Papua."

"We culled around 200 chickens, mostly from backyard farms around the neighbourhood where the virus was found to prevent it from spreading," he said.

Bird flu has been found in poultry in about two-thirds of the country's 33 provinces.

The latest case in poultry in Papua highlights international concern over Indonesia's ability to contain the spread of the virus, which has killed 25 people in the country and at least 115 worldwide since 2003.

Although the human death toll has climbed, the government has resisted mass culling of birds, citing the expense and impracticality in a country where keeping a few chickens or ducks in backyards is common.

Culling at selective farms and their immediate surroundings has been the preferred method.

Millions of chickens and other fowl have died from the disease in Indonesia or been killed to prevent its spread since it first surfaced in the sprawling archipelago in late 2003.

Bahri said the government was considering intensifying culling, but faced opposition from the public over compensation.

"The government can only offer 10,000 rupiah ($1.07) for each fowl culled. But people want higher compensation," he said.

Shigeru Omi, the World Health Organisation's director for the Western Pacific, told Reuters earlier in Jakarta that Indonesia -- the nation with the most human deaths from bird flu this year -- had the will to combat the disease but far-flung provinces had fallen short at putting plans into action.

In the latest case, Indonesia is investigating an outbreak of bird flu in up to eight members of a North Sumatran family, of whom six have died.

WHO confirms avian flu case cluster in Indonesia

May 17, 2006 (CIDRAP News) – World Health Organization officials have confirmed five cases of H5N1 avian influenza in an Indonesian family in North Sumatra, plus a fatal case in a woman from East Java, news services reported today.

Additionally, Indonesia's health ministry said local tests revealed the H5N1 strain in a 12-year-old Jakarta boy who died 4 days ago, according to a Reuters report. This case, however, has yet to be confirmed by the WHO.

The North Sumatra case cluster was first reported by Indonesian officials several days ago, sparking concern about the possibility of person-to-person transmission. In today's reports, officials said the situation was still unclear and investigation was continuing. The WHO had not yet published an online update on the situation at this writing.

WHO officials said four of the five infected family members in North Sumatra have died, according to reports. An Agence France-Presse (AFP) story described them as two males, aged 19 and 17, a 29-year-old woman, and an 18-month-old baby. The fifth person, a 25-year-old man, was recovering, according to AFP.

The case in East Java was in a 38-year-old woman who worked as a caterer in Surabaya before her death last week, according to Reuters. She dealt with live pigs and handled pork in her work, the story said.

The five cases in North Sumatra were confirmed by a WHO-accredited laboratory in Hong Kong, Reuters reported. Tests on a sixth family member, a 10-year-old boy who died, are pending, according to AFP. A 37-year-old woman was the first person in the group to fall ill, but she died without any samples being taken.

WHO spokeswoman Maria Cheng in Geneva said it was "too early to draw any conclusions" about whether the virus has acquired the ability to spread among humans, according to Reuters. "I have not heard any suggestion that the virus is any different," she said.

Another WHO spokeswoman, Sari Setiogi, said the agency was carefully investigating the cases, according to AFP. "The current investigation that we have has no evidence of further spread beyond the cluster, so that's quite good news for us because it tells that the virus is not spreading further," she said.

However, Hong Kong virologist Guan Yi told Reuters that the lag reported between symptom onset in the first victim and in the second wave of victims in the extended family was unusual.

"If they were all infected by the same source," Guan said, "their onset time [of illness] would have been closer. . . . They may have infected one another . . . but we have no evidence."

Unofficially, the six new cases—the North Sumatra family and the caterer in East Java—bring Indonesia's case total to 39 and death toll to 30. The WHO had not yet updated its online case count at this writing.

In Laos, H5N1 was found in a duck on a backyard farm, but it appears to be an isolated case, the UN Food and Agriculture Organization reported in a Reuters news story today.

The duck, found 12 miles south of Vientiane in February by researchers, represents the first case in Laos since an outbreak in poultry in early 2004. There have been no human cases in the country, according to WHO data.

Test confirms 25th bird flu death in Indonesia

08 May 2006

JAKARTA, May 8 (Reuters) - International tests have confirmed a 30-year-old Indonesian man who died last month had bird flu, a Health Ministry official said on Monday, taking the country's death toll from the virus to 25.

"A 30-year-old male from West of Jakarta who died on April 26 ... has been confirmed positive of bird flu by a Hong Kong laboratory," said Joko Suyono of the ministry's bird flu information centre.

Vietnam calls for more international aid for anti-bird flu

People's Daily Online 28/04/06

Vietnam needs some 400 million U.S. dollars for its fights against bird flu, 50 percent of which is expected to come from international donors, a local official said Friday.

Vietnam has done its utmost in preventing bird flu, and hoped that the international community would grant it stronger assistance, Minister of Agriculture and Rural Department Cao Duc Phat said at a press briefing after the wrap-up meeting of the joint assessment mission for the finalization of "Vietnam Integrated Operational Work Program for Avian and Human Influenza Control."

International donors have pledged to support the country 46 million U.S. dollars to combat the disease, he said, noting that the Vietnamese government has also poured large amount of money into the fight.

The government has recently decided to invest more than 1,000 billion Vietnamese dong (VND) (nearly 62.9 million dollars) in its healthcare system, and over 100 billion VND (nearly 6.3 million dollars) in its veterinary one, he said, adding that each locality in the country, on average, also spent one million dollars preventing bird flu early this year.

Talking about the Asia-Pacific Economic Cooperation (APEC) Meeting on Avian Influenza slated for early next month in the country, he said the meeting will discuss such issues as socioeconomic effects of the disease, regional and international cooperation on bird flu prevention, and APEC's specific plans on the matter.

Responding to the appeal of Vietnam, Laurent Msellati, Rural Sector Coordinator, Rural Development and Natural Resources Management of the Word Bank, said"we are still working on cost" to meet Vietnam's demand of 400 million dollars for the fight, under a medium-term plan for the 2006-2010 period. "The bank will help the country access sources of support as well as bank loans," he added

No new human cases of bird flu infection have been spotted in the country in the last six months, according to the joint assessment mission. Bird flu has hit 93 local people, causing 42 deaths, in 32 cities and provinces since December 2003.

The country has also detected no bird flu outbreaks among fowls for over four months, it said.

Source: Xinhua

Bird-flu hit Myanmar to end ban on fowl movement

27 Apr 2006 06:18:53 GMT
Source: Reuters
By Aung Hla Tun

YANGON, April 27 (Reuters) - Bird flu in central Myanmar is under control and a ban on the sale and movement of poultry will be lifted within days, the Livestock Department said on Thursday.

The restrictions were imposed after the country's first outbreak of the H5N1 virus was detected in March and spread to 13 townships in central Myanmar.

Officials now say the disease is under control after thousands of birds and eggs were destroyed on hundreds of farms in Sagaing and Mandalay Divisions.

"The committees will lift the ban before the end of April and are making arrangements for the regular flow of commodities," the Livestock Breeding and Veterinary Dept (LBVD) said in a statement carried in state media on Thursday.

Restrictions in Yangon, where no outbreaks are known to have occurred, were lifted this week.

Livestock officials defended the decision to lift the bans, saying it would not hurt surveillance efforts against the disease now endemic in many parts of Asia.

"Lifting the ban does not mean stopping measures to prevent this disease. We'll continue monitoring and surveillance in cooperation with experts from FAO and others," Dr. Myat Kyaw, a senior LBVD official, told Reuters.

Despite the military government's promise to stay vigilant, the decision is likely to unsettle neighbouring Thailand, where bird flu has not re-emerged for months.

Thailand is tightening surveillance along its porous border with Myanmar, fearing the disease could come across in smuggled poultry despite a ban on imports.

A senior official at the U.N. Food and Agriculture Organization (FAO) said two weeks ago Myanmar was battling more than 100 outbreaks of bird flu in poultry and the situation appeared to be "more serious than what we imagined".

He Changchui, the FAO's Asia-Pacific representative, said public awareness of bird flu in a nation ruled by military diktat for the past 44 years was a concern.

He also worried about getting accurate data from one of the most reclusive regimes in the world.

Thailand, Japan and U.N. agencies have sent experts, laboratory equipment, protective gear and vaccines to Myanmar since the first outbreak was announced on March 13.

There have been no reported human cases of H5N1 in Myanmar but it has killed 14 people in Thailand.

Scientists fear the virus, which has killed 113 people worldwide since 2003, could mutate into a form that jumps easily between people and start a global flu pandemic.

Vietnam - Smuggled poultry blamed for spreading bird flu

2006/4/27
LANG SON, Vietnam (AP)

Hired runners strap bamboo cages loaded with 20 live chickens onto their backs in China. Under cover of darkness, they navigate well-worn footpaths across a mountain into Vietnam, where bicycles wait to haul the clucking contraband away.

The smugglers easily evade patrols along the rugged 1,350-kilometer (840-mile) border by using two-way radios and a network of illegal crossings that have become gateways for a new threat _ bird flu.

Vietnam estimates about 4,500 chickens are trafficked into the country this way every day from China in a trade that is nearly impossible to police because of scarce resources.

The H5N1 bird flu virus has recently shown up in samples taken from confiscated birds, raising the stakes in Vietnam's battle to shift from the hardest-hit country to one that has successfully contained the virus.

"I think there is a very large undercover, underground trade that is going on," said Dr. Jeff Gilbert, an animal health expert at the U.N. Food and Agriculture Organization in Vietnam. "I think the biggest risk of re-infection (in Vietnam) is infection from China."

Many scientists believe much of the worldwide spread of H5N1 is linked to the migration of wild birds, but the Paris-based World Organization for Animal Health says it is investigating the possible role smuggling has played in some countries.

Last year, Taiwan confirmed its first case of bird flu, which was found in birds smuggled from China. A Nigerian official also has blamed illegal poultry imports for introducing the virus there earlier this year, though agency spokeswoman Maria Zampaglione said that has not been confirmed.

She said the organization is recommending that governments worldwide pay more attention to the illegal trade of poultry, but said China is not specifically being looked at as a source. Chinese officials have not responded to queries about whether smuggling has occurred.

The virus has killed at least 113 people since it began ravaging Asian poultry stocks in late 2003. Experts fear it could mutate and become highly contagious among people, potentially sparking a pandemic. So far, most human cases have been traced to contact with infected birds.

Most countries have strict quarantine laws to protect against importing infected animals and meat products. Bans have also been quickly slapped on countries where bird flu and other diseases like mad cow have appeared.

But a global smuggling network that has long existed hasn't been shut down by new bird flu precautions.

"There's lots of illicit movements of livestock products around the world," said Dr. Peter Roeder, an animal health expert at the FAO's base in Rome. "The meat comes in packed in vegetable containers and with other goods and the customs authorities just find it extremely difficult to be on top and inspecting everything."

In the past, infected beef and pork smuggled into Europe from Asia were blamed for outbreaks of foot-and-mouth disease and classical swine fever, Roeder said.

Roeder said he wouldn't be surprised if frozen poultry meat from Asia is entering Europe illegally.

He said another worry is the trade of manure-based fertilizers and animal feed, which often contains ground up poultry parts, from infected countries. FAO is examining what role they could play in the spread of H5N1.

Vietnam, where most human infections and deaths have occurred, launched a nationwide poultry vaccination campaign last year and has intensified surveillance and public awareness. It has not detected any outbreaks in poultry for four months and no human cases have been reported since November.

Its success has boosted demand for poultry as more Vietnamese shed their fears of eating infected meat. That, in turn, has fueled the smuggling.

Smuggled birds typically come from large Chinese farms where high volume and low feed prices keep overall costs low. The poultry can be resold in Vietnam for up to five times more, depending on the market.

For instance, older chickens that no longer lay eggs can be bought by smugglers for about 14,000 dong (88 cents) per kilogram, and can end up in markets in Hanoi and other cities.

In the Vietnamese border town of Lang Son, such birds fetch 37,000 dong (US$2.34) a kilogram _ still 10,000 dong (63 cents) cheaper per kilogram than Vietnamese-farmed chicken, said Do Van Duoc, director of the Lang Son Department of Animal Health.

In Vietnam, no outbreaks have been directly linked to smuggled poultry from China. But it's market inspector Lanh Van Nghe's biggest fear.

He leads an eight-man team responsible for stopping all Chinese poultry and eggs from entering Vietnam along a 100-kilometer (62-mile) stretch of border near the town of Dong Dang _ too few to be really effective, he says.

Dirt paths, some as wide as roads, have been worn into the landscape by traffickers toting in everything from bootlegged DVDs to shoes and electronics.

"Sometimes we lay our ambush until two or three in the morning," Nghe said. "Nearly a month ago, the smugglers built a cart, so they could use the railway here to transport up to eight cages of chickens. They moved the smuggled chickens for two kilometers to evade a checkpoint."

Current WHO phase of pandemic alert (just a reminder ;-)

November 2005

Current phase of alert in the WHO global influenza preparedness plan





Experts at WHO and elsewhere believe that the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century's three pandemics occurred. WHO uses a series of six phases of pandemic alert as a system for informing the world of the seriousness of the threat and of the need to launch progressively more intense preparedness activities.

The designation of phases, including decisions on when to move from one phase to another, is made by the Director-General of WHO.

Each phase of alert coincides with a series of recommended activities to be undertaken by WHO, the international community, governments, and industry. Changes from one phase to another are triggered by several factors, which include the epidemiological behaviour of the disease and the characteristics of circulating viruses.

The world is presently in phase 3: a new influenza virus subtype is causing disease in humans, but is not yet spreading efficiently and sustainably among humans.

Ducks on Bali culled for bird flu

The Sydney Morning Herald/April 25, 2006

Authorities on Indonesia's resort island of Bali have slaughtered and burned hundreds of ducks after tests showed some had the bird flu virus, officials said.

The birds had been smuggled to Bali from neighbouring Java island, said Bali's senior government veterinarian, Anak Agung Gde Putra.

Bali has banned live poultry imports to try to stop the spread of the virus, which so far has killed at least 24 people in Indonesia, the world's fourth most populous nation.

Initial tests showed that 16 of almost 400 ducks seized at a house on Bali had the bird flu virus, Putra said.

The owner said they had been shipped in from Java, Indonesia's main island, he said.

Officials in protective suits culled the birds and burned them in a yard behind the house, which was then sprayed with disinfectant, Putra said.

"We don't want to take any risks because ducks infected with bird flu would spread the disease to other birds," he said.

Tuesday's tests used South Korean-made rapid testing kits, said another government veterinarian, Ketut Suarda.

He said that blood taken from the birds would be studied at a laboratory to confirm the results.

The bird flu virus is widespread in poultry on Bali, as in most Indonesian provinces, but is not known to have infected humans on the island.

The government is vaccinating birds and carrying out limited culls in areas where humans have died. It says it lacks the money for mass bird slaughtering in infected areas, the tactic recommended by the United Nations as the best way to stop the virus.

Health experts fear the bird flu virus will mutate into a form easily spread among people, potentially sparking a pandemic. So far, most human cases have been linked to contact with infected birds.

Thailand in the Dark about Burma’s Bird Flu

The Irrawaddy News
By Sai Silp
April 24, 2006

Thai public health authorities and medical NGOs are getting ready for a bird flu outbreak on the Thai-Burma border area of Tak province.

An official from the Tak Provincial Public Health Office told The Irrawaddy today that they have already supplied flu vaccines to all medical staff working in refugee camps and with Burmese migrants in Tak province. A limited number of Tamilflu tablets have also been distributed to refugee camps and the Mae Tao Clinic in Mae Sot.

Representatives from NGOs were given the vaccine today and Tamilflu will be issued on April 26, the official said.

“Medical staff [working with migrants] is the first group to receive this vaccine because of their work with high risk groups and they can identify the disease. The vaccine for refugees is not available yet because of a budget problem.”

A local staff member for the International Organization for Migration based in Mae Sot said that the control of a possible bird flu outbreak in the refugee camps would be easier to manage than one among the transient migrant groups living along the border.

Thai public health authorities are concerned about a lack of information about the bird flu situation in Burma. The IOM staff member said they had decided having a protection plan was the safest way to proceed.

“We’ve heard about outbreaks in poultry and human cases inside Burma, but the news is not confirmed. We have to be careful because we cannot control wild bird migration, and movement of people on the borderline is unpredictable.”

Thai health authorities say there is a need to raise awareness and concern among aid agencies working with Burmese migrants. An official said a lack of reliable health data from Burma meant they could not predict the actual situation inside.

The IOM official said they were working closely with Thai authorities.

“They gave us five doses of Tamilflu for each camp, and five for Mae Tao Clinic. Tamilflu is most effective if used within 48 hours of the flu symptoms starting. If we need more, we can ask the Thai authorities to supply it,” the official added.

The IOM official said bird flu management in Thailand is successful, but for refugees and migrants the policy is still not clear and local organizations are trying to set up a testing system and an immediate treatment response plan to prevent the spread of the disease.

The provincial health authority has already provided medical equipment, such as disease rapid testing kits, for use along the border area by specially trained staff.

Thai health officials say that in the event of a suspected case of H5N1 bird flu virus occurring in the refugee camps, a lock down would be enforced to stop people and poultry moving in and out of the camp. Following recent bird flu outbreaks, authorities have already stopped the flow of poultry in and out of the camps.

Tak public health officials have been meeting to formulate plans for possible outbreaks on the border since January 2006.

Thailand On Vigil For Bird Flu Outbreak

April 25, 2006 10:40 AM

BANGKOK, April 25 (Bernama) -- Caretaker Public Health Minister Pinij Jarusombat warned that Thailand, despite its success in containing bird flu outbreaks, must continue to be vigilant, TNA reported Tuesday.

Anticipating possible human flu and avian flu pandemic around the globe, he called on related government agencies to prepare their contingency plans.

The minister, who chaired a meeting to follow up progress in containing bird flu virus and the authorities' readiness to deal with future outbreaks, was quoted by the news agency as saying that international health experts had warned of possible pandemic and the probability of bird flu virus being transmitted from human to human.

Since last year's outbreaks, he said, bird flu viruses have been found in many different strains and spread in 17 countries in Asia, Europe and Africa.

The deadly H5N1 strain has so far killed 101 people.

The caretaker public health minister said Thailand had prepared two levels of contingency plans -- one for domestic outbreak of the flu and the other to provide assistance to other countries in the region.

He said Thailand had reserved 1.5 million capsules of anti-viral drug Oseltamivir and 300,000 doses of human flu vaccine.

Oseltamivir is a generic version of the drug Tamiflu which Thailand began manufacturing this year.

"The ministry has ordered health officials nationwide to be on alert and organise drills from time to time in dealing with possible bird flu outbreaks particularly in areas already infected by the flu," he said.

-- BERNAMA

Indonesian Ag Min: Govt Winning War Against H5N1

By Phelim Kyne

JAKARTA, Apr 18, 2006 (Dow Jones) -- Indonesia's government is confident that it can purge the country of H5N1 avian influenza by 2008, Minister of Agriculture Anton Apriyantono said Tuesday.

"We are on a declining curve (of H5N1 infections in poultry), Apriyantono told reporters.

"I am still optimistic that Indonesia, as we have expected, will be bird flu-free by 2008."

Indonesia's human and poultry H5N1 infections increased during the country's October-to-April rainy season, but the prevalence of the virus was on a "declining trend," he said, without elaborating.

But Apriyantono's optimism appears at odds with the reality of Indonesia's ongoing bird flu outbreak.

A growing number of avian flu cases in Indonesia, both in birds and humans, suggests there is a breakdown in the country's efforts to combat the disease, an expert at the World Organization for Animal Health said Friday.

Avian influenza has caused 23 human fatalities out of a total of 31 cases in Indonesia since July, the world's highest H5N1 human mortality tally after Vietnam.

Human and animal health experts say the virus is endemic in Indonesia's poultry stocks and that the widespread existence of essentially rural agricultural traditions within city limits heightens the potential for animal-to-human H5N1 virus transmission.

Epidemiologists warn that Indonesia's resource-starved public health sector makes the country a potential weak link in global efforts to prevent the emergence of a mutant H5N1 viral strain that could kill millions worldwide.

The Indonesian government in December unveiled its 2006-2008 National Avian Influenza Strategic Management Plan, a two-plank strategy that includes the control of avian influenza outbreaks in humans and animals and preparation for the possible emergence of a human pandemic bird flu strain.

WHO Says Ag Ministry Efforts Essential To Fight H5N1

The Ministry of Agriculture's efforts to contain H5N1 are "critical"
to reducing human infections of the illness, Jakarta-based World Health Organization press officer Sari P. Setiogi told Dow Jones Newswires.

"As long as (H5N1) remains circulating in poultry, it still poses a threat to human health," Setiogi said.

Successful containment of avian influenza requires Indonesia to implement "painstaking" bio-security measures for the country's millions of backyard farmers, David Nabarro, the United Nation's Senior System Coordinator for Avian and Human Influenza, told Dow Jones Newswires in an interview last week.

But Indonesia's cash-strapped government lacks the resources to effectively tackle its bird flu outbreak and prevent future human infections, analysts say.

"(Indonesia's) 2006 budget allocates just $14 million to combat the disease, although the government's own estimate is that at least 30 times that amount would be prudent," said the Asian Development Bank's latest Development Outlook released earlier this month.

Indonesia's animal health experts have gained valuable experience battling H5N1 since July and will implement a combination of "cleanup efforts and vaccination drives" to fight the spread of the virus, Apriyantono said, without elaborating.

But adequate resources to do that may be in short supply.

Indonesia's Ministry of Agriculture lacks the funds to purchase 480 million out of a total of 600 million H5N1 poultry vaccine doses needed for vaccination campaigns planned for May and June, the English-language Jakarta Post reported earlier this month.

Family 'infected' with bird flu

The Jakarta Post
April 19, 2006

BANDARLAMPUNG, Lampung: A family of five was admitted to Abdul Moeloek hospital in Bandurlampung on Sunday, all suffering from suspected bird flu.

The family -- Abidi, the husband and his wife Sarmawati, both 52, and three of their six children, Septi, 12, Fitri, 8 and Putra, 5 -- are now being treated in an isolation room. The five have all demonstrated a high fever and a cough, symptoms of the deadly bird flu.

Sarmawati has been treated at the hospital since last Thursday. Her other three children had been diagnosed with bird flu earlier. Mohtar Rozi, 15, died March 31, and Betharia, 19, died April 4, while Bakhrudin, 26, is still being treated at the hospital.

Both Mohtar and Betharia died at home before they could be sent to the hospital. Their parents had limited funds and knew little about the virus.

Laboratory tests on drug samples taken from the patients confirmed Bakhrudin, Septi, Fitri and Putra were infected with the bird flu virus, while Abidi and Sarmawati were negative, according to data from the Lampung health office.

In 2004 at least 1.83 million hens in nine regencies throughout Lampung province died, possibly from bird flu, and last year the virus killed another 4,305 hens in the province.

Seven other suspected bird flu patients had been admitted to Abdul Moeloek hospital before the family. After appropriate medical treatment, all recovered.

WHO - Avian influenza – situation in Indonesia – update 10

19 April 2006

The Ministry of Health in Indonesia has confirmed the country’s 32nd case of human infection with the H5N1 avian influenza virus. The case occurred in a 24-year-old man from Tangerang, near Greater Jakarta. He developed symptoms on 29 March, was hospitalized on 5 April, and died on 8 April.

His source of exposure is presently under investigation.

Of the 32 laboratory-confirmed cases in Indonesia, 24 have been fatal.

Sorry... I have been unable to "feed" the blog for a while...
Am back on it !

Vaccine shortage hampers government's bird flu fight

Tb. Arie Rukmantara, The Jakarta Post, Jakarta 11/04/06

A shortage of vaccines has hampered the government's plan to carry out a nationwide poultry vaccination drive against bird flu next month, a senior government official said Monday.

"We planned to hold two rounds of a massive vaccination campaign in May and June, but because we are short of vaccines, we have to reconsider the plan," Agriculture Ministry head of bird flu emergency response Delima Hasri Azahari told The Jakarta Post.

The vaccination effort would target mostly backyard and small-farm poultry, she said.

She explained that to carry out the drive, the government needed about 600 million doses of the vaccine for some 300 million birds across the country. Each would receive two shots.

"However, the 2006 state budget could only afford enough money to purchase 120 million dosses. So we are facing a gap of 480 million doses," Delima said. She could not specify how much money was needed to cover the shortage.

Delima said she believed if the shortage was not addressed immediately, the vaccination drive would not be effective.

"We could still carry out the vaccination drive according to schedule, but we could only focus on high-priority regions where bird flu is pandemic. Such measures wouldn't be effective, however, because to contain the spread of the virus we should vaccinate all poultry at the same time," she said.

High numbers of bird flu fatalities among humans and poultry have been recorded in nine provinces across Indonesia -- Jambi, Lampung, Jakarta, Banten, Central Java, West Java, East Java, Yogyakarta and South Sulawesi.

The H5N1 virus has killed 24 of 32 confirmed human bird flu patients. It has also killed millions of birds.

Health experts fear the virus could mutate into a form that can spread from human to human, potentially causing a global pandemic that could kill millions of people.

Delima said she and other senior government officials, led by Coordinating Minister for the People's Welfare Aburizal Bakrie, would discuss the disease Tuesday with World Bank chief Paul Wolfowitz in Tangerang, West Java.

"Recently, a team of World Bank experts did a preliminary assessment of bird flu in the country. So we expect they will understand our needs," she said.

"However, we also encourage the private sector to support the campaign," Delima said.

An advisor to Aburizal on bird flu issues, Emil Agustiono, told the Post recently that the private sector should do more to help the government battle bird flu.

He said that to date, of the Rp 9 trillion needed to fight bird flu from 2006 to 2008, the private sector had donated only Rp 200 million.

Secretary-General of the Indonesian Employers Association Djimanto said businesses were actually eager to help fight bird flu, since a pandemic could cost companies billions of rupiah in losses.

"Unfortunately, we are currently facing endless problems with this high-cost economy. We can barely afford to cover maintenance for our machinery. How do you expect us to set aside funds for bird flu?" he said.

Indonesia's Bird Flu Cases Indicate Virus Control Isn't Working

April 12 (Bloomberg) -- Human bird flu cases in Indonesia, averaging one a week since September, indicate measures to control the virus haven't stopped it spreading among poultry, a United Nations envoy said.

``I remain very concerned about the continued reports of human cases and fatalities because this means that bird flu in rural and urban areas is very pronounced,'' David Nabarro, the UN's senior coordinator for bird flu and pandemic influenza, said yesterday in an interview in Indonesia's capital, Jakarta.

Indonesia, the world's fourth-most-populous nation, has had outbreaks of the H5N1 avian flu strain in 26 of its 33 provinces, and so far 32 people have become sick and 24 of them have died. Diseased fowl increase the risk for humans and create opportunities for the virus to mutate into a form that may kill millions of people.

The disease is known to have infected at least 193 people in Asia, the Middle East and Africa since 2003, killing 109. The H5N1 strain has all prerequisites to spawn a pandemic except the ability to spread easily from person-to-person, the World Health Organization said last week. The last flu pandemic, in 1968, killed 1 million people worldwide, according to the Geneva-based agency.

The WHO yesterday confirmed Indonesia's 32nd avian flu case after a man in Padang city on Sumatra island tested positive for the H5N1 virus. The health agency also said confirmatory tests on samples taken from an 8-year-old who died in July 2005 showed she had the virus in the same month the country's first fatality was reported.

Jakarta

About half the Indonesians infected with the H5N1 virus have come from Jakarta and surrounding areas. Thirty million households in Indonesian villages keep more than 200 million chickens in backyards, according to the UN's Food and Agriculture Organization.

Nabarro said Indonesia needs to ``build up the animal health services from the bottom up'' and maintain disease surveillance.

``The government is very focused on the issue and the government is giving higher priority in improving animal health,'' he said. ``You have to maintain this effort for many years to come, particularly in improving bio-security in small- scale and backyard sectors.''

Bird flu controls in Indonesia, which successfully eradicated foot-and-mouth disease in cattle in the 1970s, have suffered because the government doesn't have enough people to monitor the spread of the disease in poultry. A law that came into effect in 2001 gave power to provinces and regencies with little supervision from the national government in Jakarta.

`Very Slow'

A ``very slow'' surveillance and monitoring system and communication problems between central and provincial governments are hampering efforts to contain the virus, Azmi Mat Akhir, an official with the Association of Southeast Asian Nations, said last month.

Indonesia, with a population of 220 million people, may spend about 3 trillion rupiah ($334 million) this year to implement control measures, including culling and vaccinating poultry, Finance Minister Sri Mulyani Indrawati said in February. The government on Feb. 24 started checking homes in Jakarta for diseased fowl in an effort to stem the spread of the virus.

Burma battles 100-plus bird flu outbreaks

www.bangkokpost.com 11/04/2006

The bird flu situation in Burma is more serious than expected, and the UN Food and Agriculture Organisation alone is tracking more than 100 separate outbreaks of H5N1 flu in areas near Mandalay and Sagaing, officials said in Bangkok on Monday.

He Changchui, FAO representative for Asia-Pacific, said the information in Burma is not comprehensive, and Burma is not ready to fight avian flu in terms of equipment, diagnosis and awareness. He said the FAO is trying to help get funds to send necessary medicine, equipment and compensation.

“The situation there was more serious than we imagined," he told a news conference in Bangkok, Thailand. "Up to now, there are over 100 outbreaks."

He said, "The issue there is that awareness is rather poor. The information is not that comprehensive."

World Health Organisation representative Somchai Peerapakorn said Burma's ruling generals have requested help from the WHO, which will send a team to the country at the end of this month.

UN Coordinator for Avian and Human Influenza David Narbarro said he was satisfied with the improving situation in several countries, especially Thailand and Vietnam, but he is still concerned about Burma and Cambodia.

Burma reported its first case of bird flu on March 13 and said thousands of birds were culled to prevent the spread of the often dangerous H5N1 virus.

In Rangoon, the weekly Burma Times reported Monday that the outbreak of the H5N1 type bird flu in central Burma is ongoing, and claimed the authorities have contained it from spreading.

Burma has culled more than 470,000 birds and destroyed more than 400 farms in Mandalay and Sagaing, according to Burma's Livestock Breeding and Veterinary Department.

But the department is still receiving reports of chicken deaths, with the latest reports coming in from five poultry farms in different townships in Mandalay early this month, the paper said.

Dr Nabarro said that nations should be prepared to pledge hundreds of millions more dollars to combat bird flu as the H5N1 virus affects more developing nations.

Western and Asian donors had pledged $1.9 billion in January during a conference in Beijing to combat bird flu and improve containment and prevention methods in 12 countries, mostly in Asia.

But with the virus steadily spreading across the world through migratory birds, including infections in at least five African nations, health officials must reassess how much funding they will need to help developing nations that lack proper resources to detect, prevent and contain outbreaks, Dr Nabarro said.

"The amount of H5N1 in birds is considerably more than it was a year ago," he said.

The virus has killed at least 109 people who have come into contact with sick birds. But international health officials fear H5N1, the strain of the virus that has been deadly in humans, will mutate into a form that can be transmitted from human to human and spark a global pandemic that could kill tens of millions.

Nabarro, who is on a five-nation trip through Asia to assess bird-flu preparedness, warned in Bangkok against prolonged debates on whether more money should be pledged so soon after the Beijing conference.

"The potential cost of a global influenza pandemic is massively greater than might be the amount required to meet an international threat," he said.

Health officials fear Asia might be "ground zero" for a human pandemic, and Nabarro outlined a "mixed report" on how well affected countries were coping.

He applauded Thailand and Vietnam, which has the most reported human deaths from bird flu, as making tremendous progress while China, Indonesia and especially Myanmar (Burma) were lagging behind.

"The general impression I have is avian influenza remains a major challenge here," Nabarro said, but added that there had been "enormous progress" across the region in the past six months.

Myanmar has reported outbreaks in two administrative regions, which health officials fear could mushroom because public awareness there remains poor.

In Indonesia, the government is playing catch-up after an initial slow start in detecting and isolating the virus in its poultry population, where it is now endemic. To make matters worse, the Jakarta government recently postponed the signing of a multimillion-dollar agreement with Australia to combat bird flu because of a separate diplomatic row over refugees from the Indonesian province of Papua.

Nabarro said he hoped "political circumstances" would not prevent countries that need resources to fight bird flu from receiving them.

WHO confirms new bird flu case in Indonesia

JAKARTA (AFX)04.11.2006 - The World Health Organization has confirmed Indonesia's 33rd case of bird flu in a 23-year-old poultry worker, the health ministry said.

The patient is being treated at the M Djamil hospital in Padang, West Sumatra province, said Hariyadi Wibisono, director general of animal borne disease control.

Results arrived this morning from the WHO-affiliated Centers for Disease Control and Prevention in the United States which confirmed earlier local tests, Wibisono told Agence France-Presse.

'He had been in contact with sick chickens at his work place in the Bekasi suburb,' he said.

Local tests for the virus, which are usually accurate, are routinely sent to WHO-affiliated laboratories in Hong Kong or the US for confirmation.

Vietnam to cull smuggled poultry to prevent bird flu

People's Daily Online/UPDATED: 15:05, April 04, 2006

Vietnam will try to destroy all smuggled fowls and related products without compensation for their owners or transporters to prevent the outbreak of bird flu, local newspaper Pioneer reported Tuesday.

Under a recent instruction of Deputy Prime Minister Pham Gia Khiem, the People's Committees of 14 northern and southern cities and provinces will cooperate with relevant agencies to cull the smuggling of poultry and related products from bird flu-hit neighboring countries.

Earlier, the government ordered localities and ministries to step up monitoring bird flu, disinfecting farms, and accelerating the vaccination. Seeing no bird flu outbreaks over the past three months, some Vietnamese provinces have dropped their vigilance against the disease.

Last year, bird flu hit 44 cities and provinces of Vietnam, leading to the forced culling of nearly 4.8 million poultry. The total direct loss caused by the disease was estimated at more than 100 billion Vietnamese dong (6.3 million U.S. dollars).

Now, the country has a total fowl population of 220 million.

Source: Xinhua

Singapore Plans July Drill to Test Bird-Flu Readiness (Update2)

April 5 (Bloomberg) -- Singapore plans to hold a two-day drill in July, simulating an outbreak of avian influenza, to test the readiness of its public hospitals, clinics and nursing homes.

The government is also distributing an information handbook to 1.1 million households and may close schools and impose other measures. The country has stockpiled Roche Holding AG's Tamiflu, an antiviral drug, which will be enough for 680,000 doses, the government said and added it will have 1.05 million by the end of the year.

``The government is making every effort to ensure that Singapore can cope with a flu pandemic,'' Lee Boon Yang, Singapore's information minister, said at a briefing today, adding that the drill ``will involve the participation of the public and patients to test the work procedures and processes that have been worked out for crisis situations.''

Singapore, which hasn't yet had a bird-flu case, is girding for a widespread outbreak of avian influenza amid cases in Vietnam, Indonesia, Thailand, China, Turkey, Azerbaijan, Iraq and Cambodia. The World Health Organization confirmed four cases of bird flu in Egypt over the past month, including two fatalities, the first time the agency found human infections in Africa.

SARS Experience

Singapore's preparation follows the Severe Acute Respiratory Syndrome or SARS outbreak in the city-state three years ago, which killed about 33 in the country, one of the five most affected areas worldwide. At the height of the outbreak, tourist-arrivals plunged to a two-decade low, forcing the government to shut schools and isolate more than 4,000 people.

With avian influenza, the disease in birds creates more opportunity for human infection and increases the risk of the virus changing into a pandemic form. So far, there isn't any evidence that H5N1 is evolving to become more easily transmissible to humans as the disease spreads across Europe, Africa and Asia. The most recent flu pandemic in 1968 killed 1 million people worldwide.

Singapore has also stockpiled 50,000 doses of GlaxoSmithKline Plc's Relenza to combat the disease, as well as masks, gowns and antibiotics, the government said. It also almost tripled the number of rooms in public hospitals to isolate patients with infectious diseases to 320 since the SARS outbreak, said Balaji Sadasivan, senior minister of state for health and information.

``Since the time of SARS our physical infrastructure has been improved,'' Balaji said at the briefing, adding that ``all our hospitals are equipped with a surveillance system'' to detect patients suspected of bird flu.

The government has also taken measures to ``bird-proof'' local poultry farms to prevent chickens from coming into contact with wild birds. It will also vaccinate birds at public parks such as the zoos, swans in the botanic garden and peacocks on the southern tourist island of Sentosa.

AIDS, TB, Malaria, Bird Flu Go Unchecked in Burma

The John Hopkins Univ. Gazette, April 3, 2006

Public health experts say diseases pose threat to regional and global health

By Tim Parsons
School of Public Health

Government policies in Burma that restrict public health and humanitarian aid have created an environment where AIDS, drug-resistant tuberculosis, malaria and bird flu (H5N1) are spreading unchecked, according to a report by researchers at the Johns Hopkins Bloomberg School of Public Health.

In that report authors Chris Beyrer, director of the Bloomberg School's Center for Public Health and Human Rights; Luke Mullany, Voravit Suwanvanichkij and Nicole Franck document the spread of these infectious diseases, which if left unchecked could pose a serious health threat to other Southeast Asia nations and the world.

They believe international cooperation and policies are needed to restore humanitarian assistance to the Burmese people but caution that new restrictions imposed by the military junta are making such efforts more difficult. The full report was presented at a briefing for State Department officials on March 24 and is available from the Johns Hopkins Center for Public Health and Human Rights at www .jhsph.edu/burma. The report is also under review for publication with the journal Public Library of Science Medicine.

The report states that Burma reported its first cases of bird flu among poultry to the World Health Organization on March 8. However, the ruling junta censored reports of the outbreak to its own public until March 17, by which time the outbreak had killed 10,000 more birds, and 41,000 needed to be culled to stem further spreading.

The report documents a long-standing and severe underfunding of health and education programs in Burma. Health expenditures in Burma are among the lowest globally, including an annual budget of less than $22,000 for the prevention and treatment of HIV among a total population of 43 million people. Much of the country lacks basic laboratory facilities to carry out a CD4 blood test, the minimum standard for clinical monitoring of AIDS care. In 2005, 34 percent of tuberculosis cases in Burma were resistant to any one of the four standard first-line drug treatments, which is double the rate of drug-resistant cases in neighboring countries. Nearly half of all deaths from malaria in Asia occur in Burma. The report also reveals that 70 percent of anti-malarial pills sold in Burma contain substandard amounts of active ingredients, which increases the risk of drug resistance.

"There is a growing humanitarian crisis in Burma. In our report, we document how the ruling government's policies have restricted nearly all aid and allowed serious infectious diseases to spread unchecked," said Beyrer, who is also an associate professor in the Department of Epidemiology at the Bloomberg School. "With the global spread of bird flu, there is a fear that if a human form of H5N1 were to take hold in Burma, it could potentially spread unchecked for weeks or months before anyone knew about it. Uncontrolled spread of any disease, especially an emerging disease like H5N1, poses a serious health threat to Burma's populous neighbors, like China and India, as well as the rest of the world."

The report also documents threats and restrictions to foreign relief workers and relief groups, including the Red Cross. Because of the deteriorating situation, the United Nations Global Fund for AIDS, Tuberculosis and Malaria was forced to withdraw its five-year $96 million grant agreement with Burma. Backpack Health Worker Team, an aid group that provides primary health care services in rural areas of Eastern Burma and Thailand, is also raising concerns about its ability to monitor and contain outbreaks of bird flu and other diseases.

"The Burmese junta is increasing restrictions on humanitarian assistance and public health while the health of Burmese people deteriorates, posing a widening threat to Burma and her neighbors," Beyrer said.

The report was funded by the Center for Public Health and Human Rights and the Bill and Melinda Gates Population and Family Health Institute.

Indonesia confirms 24th flu death

Indonesian health officials say an eight-year-old girl who died last July had the deadly H5N1 strain of bird flu.

A spokesman for the Indonesian health ministry, Runizar Ruesin, said the virus was confirmed in tests by the World Health Organization (WHO).

The result brings to 24 the number of deaths from bird flu in Indonesia.

The girl's father and sister were confirmed last year to have died from the H5N1 strain of the virus, but further tests had been delayed.

The government had problems getting adequate specimens of the girl's blood, which delayed shipment to a WHO-affiliated laboratory in Hong Kong, Mr Ruesin told Reuters news agency.

The H5N1 strain of the bird flu virus has been found in birds in 26 of Indonesia's 33 provinces. Almost all the deaths have been linked to contact with infected poultry.

On Friday, the WHO confirmed that a one-year-old girl died from bird flu after coming into contact with dead poultry.

More than 100 people around the world have died from the disease since 2003.

The vast majority of the deaths have been in Asia, but cases in people and birds have also been recorded in Europe and Africa.

Experts fear the virus could combine or mutate into a form that passes easily between humans, possibly sparking a pandemic, but there is no evidence that this has happened yet.
Story from BBC NEWS Published: 2006/04/04 09:05:48 GMT

WHO - Avian influenza – situation in Indonesia - update 8

4 April 2006

The Ministry of Health in Indonesia has confirmed an additional case of human infection with the H5N1 avian influenza virus. The case, which was fatal, occurred in a 20-month-old girl who resided in Kapuk, West Jakarta. She developed symptoms of fever and cough on 17 March, was hospitalized on 22 March, and died on 23 March.

Field investigation found a history of deaths in a chicken flock near her home about one week prior to symptom onset. Chicken deaths in the neighbourhood have continued, but the cause has not yet been identified. Family members and neighbours have been placed under observation and samples from these people have been taken for testing. Preliminary results are negative, but follow-up investigation is continuing.

The newly confirmed case brings the total in Indonesia to 30. Of these cases, 23 were fatal.

Bird flu killed Indonesian baby girl

Reuters - Jakarta, Saturday, April 01, 2006

A one-year-old baby girl, who died this month, has been confirmed as Indonesia's latest bird flu victim, the Health Ministry said on Friday, citing results from a World Health Organisation-affiliated laboratory.

The girl, from west Jakarta, is the country's 23rd victim of bird flu, senior ministry official I. Nyoman Kandun told Reuters after receiving results from the laboratory in Hong Kong.

He said it was unclear if the baby had had any contact with sick birds, the usual mode of transmission of the virus to people, but added there was a lot of fowl in her neighbourhood.

Indonesia first announced the death last Saturday, but had been awaiting confirmation of the cause. The H5N1 avian influenza virus has spread in birds at an alarming rate in recent months, sweeping through parts of Europe, down into Africa and flaring anew in Asia.

It is difficult for humans to catch but has killed 105 people, according to the most recent WHO figures.

Experts fear the virus could evolve into a form passed easily from human to human, causing a pandemic that could kill millions.

In Indonesia, the highly pathogenic strain of bird flu has affected birds in about two-thirds of the country's provinces.

Indonesia had the most bird flu deaths of any country so far this year.

Stamping out the virus is a huge, if not impossible, task in Indonesia, a sprawling archipelago of about 17,000 islands and 220 million people.

The government has resisted the mass culling of fowl seen in some other nations, citing the expense and the impracticality in a country where the keeping of a few chickens or ducks in backyards of homes is common in cities and on farms.

Agencies have concentrated instead on selective culling, and on public education and hygiene measures aimed at prevention.

A sweeping door-to-door campaign to try to control the disease in the capital Jakarta, the country's biggest city which along with its suburbs has about 12 million people, only got underway at the end of February.

Agriculture officials estimate that Jakarta alone has some 500,000 fowl.

Indonesia forms national bird flu control committee

Jakarta, Tuesday, March 28, 2006

Indonesia has established a national committee for bird flu pandemic preparedness (KFBPI) in a bid to enhance control over bird flu outbreaks.

The KFBPI is tasked with outlining national strategies and policies, directing the country's fight against bird flu, and making preparations for a possible bird flu pandemic. The 20-member committee is chaired by the Indonesian Minister of Coordination and People's Welfare, with its vice chairmen being the Ministers of Economic Coordination, Agriculture and Public Health.

In the next three months, the committee plans to speed up implementation of strategies and programmes on bird flu control currently overseen by the Ministry of Public Health and the Ministry of Agriculture.

(Vietnam News Agency Via Thomson Dialog NewsEdge)Jakarta, March 27 (VNA)

Indonesia aims to cut tuberculosis deaths

The Associated Press
Wednesday, March 22nd, 2006

JAKARTA, Indonesia (AP) - Indonesia aims to cut in half the number of deaths from tuberculosis by 2015, reducing the threat from the disease that is one of the nation's leading killers, officials said Wednesday.

Health Minister Siti Fadilah Supari, speaking to reporters ahead of world Tuberculosis Day on March 24, said Indonesia ranks third after India and China in the number of cases for the respiratory disease, which kills 140,000 people each year in the nation of 220 million.

"We expect to meet the Millennium Development Goals target to halve tuberculosis deaths from the current 300 deaths daily to around 200 in 2010 to eventually 150 in 2015," she said.

Indonesia joined this year's global effort with China, India and the Philippines to step up the fight against tuberculosis. According to the World Health Organization, the disease kills 1.7 million people worldwide each year.

Indonesia has improved its case detection rate - the number of cases reported as a percentage of total estimated cases - from 20 percent in the years before 2001 to 67 percent last year, said Dr. Firdosi Mehta, WHO Indonesia Medical Officer for Tuberculosis, who was present at the health minister's announcement.

Jan Voskens, a senior consultant for the Hague-based tuberculosis foundation KNCV, who was also at the news conference, expressed concern that international concern of a possible bird flu pandemic could draw funding away from the programs to combat tuberculosis.

He said the aid arm of the U.S. government, USAID, now "has more concern for bird flu" than tuberculosis.

Mehta said among the challenges ahead, health providers need to focus on handling tuberculosis infections in HIV/AIDS patients and maintain an international standard in handling tuberculosis cases.

The WHO says tuberculosis is the top killer of HIV/AIDS patients, whose compromised immune systems are more vulnerable to the disease.

Papua New Guinea - Migratory birds, ducks pose bird flu threat

Migratory birds, ducks pose bird flu threat

The National, PNG, By BONNEY BONSELLA 03/23/06

THE National Agriculture Quarantine and Inspection Authority said yesterday migratory water birds and nomadic ducks pose the biggest threat to the entry of bird flu into PNG.
NAQIA managing director Andrew Yamanea said the migratory birds could spread the disease across the PNG/Indonesian borders, especially along the Tonda wetlands of Morehead district of the Western province.
Mr Yamanea said the area was a well known stopover between the months of August and October for migratory and nomadic ducks from Russia, China and even Indonesia.
Wetland areas in Manus and Sepik were also considered high risk surveillance areas.
Mr Yamanea revealed this while clarifying media reports about the outbreak of the bird flu in Timika across the border in the West Papua province.
“NAQIA wishes to officially inform the public that there is no such outbreak or confirmation of it and West Papua province remains free of bird flu,” said Mr Yamanea.
He said the closest affected place is South Sulawesi, which is quite far from Papua New Guinea.
He said NAQIA was only aware of Classical swine fever (hog cholera) cases in Timika which could have been mistaken for bird flu.
It is a predominantly pig disease that spreads rapidly in pig population and pose no harm to humans which NAQIA has already issued alert notices to officers on the ground.
Mr Yamanea said NAQIA had taken preventive measures against the bird flu and other plants and animal diseases across the border and has instructed communities and public servants to immediately report any suspected cases of plants or animals dying, including poultry and water birds to the nearest NAQIA or other authorities for further investigations.
Mr Yamanea said NAQIA would be conducting a joint public awareness with the Health Department and the Ok Tedi Mining Ltd and the communities in the Fly River next week.
Similar campaigns have been done in West Sepik province while other high risk areas will be targeted when funding is available.
Minister responsible for Disaster and Emergency Services and Inter-Government Relations Minister Sir Peter Barter is taking no chances, and has directed his office and the director-general of National Disaster Centre to liaise with NAQIA and Health Department to seek donor assistance to ensure stock of anti-viral for bird flu is available to treat any detection.

Vietnam clamps down on Chinese poultry smuggling

23 Mar 2006
Reuters

HANOI, March 23 (Reuters) - Vietnam, where bird flu has been contained for nearly three months, has ordered a new crackdown on poultry smuggling from neighbouring China to keep out healthy looking birds which may carry the H5N1 virus.

Agriculture Minister Cao Duc Phat, in an urgent message seen on Thursday, ordered authorities in all Vietnam's 64 cities to act against smuggling.

The National Anti-Bird Flu Committee also ordered health, agriculture, finance, trade and police officials to join forces to stop smuggling of poultry from China through the northern border.

Vietnam banned the import of poultry and poultry products from all neighbouring countries last year, including China, to fight the spread of bird flu.

The new crackdown on smuggling, Animal Health Department officials told Reuters, came after reports of asymptomatic cases of the H5N1 virus in Chinese poultry.

But they said random tests samples from 20,000 chickens around Vietnam had not turned up any such cases, in which birds show no symptoms of the disease despite carrying the virus, which they can pass on to other fowl.

Smuggling of poultry from the northern neighbour has been on the rise as Chinese chicken can cost as little as 5,000 dong ($0.31) per kg and sell for as much as 60,000 dong per kg in Vietnam.

The H5N1 virus has killed 42 people in Vietnam, the highest number of fatalities in any of the nations where bird flu has infected people.

Bird flu has spread rapidly from Asia to Europe, the Middle East and Africa with 30 countries having reported outbreaks this year.

Indonesia bird flu campaign exposes loopholes

22 Mar 2006
By Tomi Soetjipto

PURWAKARTA, Indonesia, March 22 (Reuters) - Armed with vaccines and green rubber boots, veterinarian Sri Wuryasturati is ready to hit the road for Indonesia's anti-bird flu campaign.

Except she doesn't have the most essential item to get going: a motorcycle.

Dressed in a crisp brown civil servant's uniform and scarf, the 42-year-old eventually takes off hours later to join hundreds of veterinarians at the forefront of efforts to contain bird flu in Indonesia, which has the world's second highest number of human deaths from the disease.

"We have got the vaccines ready," she said, pointing to a refrigerator full of vaccines for poultry. "But sometimes some of us can't go out because there are no vehicles."

Without motorcycles, it is impossible for vaccinators to reach villages in the morning before locals release their backyard chickens into the fields.

And there are lots of villages in Indonesia, a country of 220 million people spread across thousands of islands.

Although Indonesia has launched high-profile, door-to-door checks of poultry and birds in some provinces, the country remains vulnerable because of poor planning and surveillance.

Jakarta has set up a national team to combat bird flu, but its members and volunteers only reach areas in the capital while those in provinces rely on their own networks of vaccinators.

WEAKNESS

Yoke Sudarbo, a programme manager at Partnership, a U.N.-sponsored non-governmental organisation, said lack of coordination mirrored the state of bureaucracy in Indonesia.

"The weakness in handling bird flu is an example of inadequate public services in Indonesia and it highlights the country's poor infrastructure," said Sudarbo.

Government officials in Jakarta said they were in control.

"Support systems such as two-wheeled and four-wheeled vehicles will be provided, we are working on that," said Mathur Riyadi, head of the Agriculture Ministry's poultry department.

He added the government had distributed leaflets to government offices, outlining basic health and hygiene procedures and safe ways to cook chicken.

Indonesia has had 22 confirmed deaths from the H5N1 strain of the avian flu virus since 2003 and half of those deaths have occurred this year.

The rising toll is worrying U.N. health officials who fear the more the virus spreads in birds, the more human cases there will be and the greater the risk H5N1 might mutate into a form that could pass from person to person.

If such a mutation occurs, it could spark a pandemic in which millions could die.

Globally, the virus has killed at least 103 people since 2003, the majority in Asia where many people live side-by-side poultry. For the moment, it remains hard to catch from birds.

In Indonesia, most bird flu cases in humans have been in or around Jakarta. But the virus has been detected among poultry in about two-thirds of the country's 33 provinces.

HOSTILITY

A big stumbling block is opposition to the control campaign from villagers.

"People get hostile sometimes. Some even hide their chickens, which is silly because we can still hear the noise," said Sri the veterinarian.

Despite a 30 billion rupiah ($3.3 million) scheme to cull fowl within a kilometre radius from the point where the virus is found, some workers are afraid to kill the birds as there is no legal apparatus to act freely.

Moreover, there is no monitoring system as in Thailand to alert authorities in case of a suspected outbreak.

In Thailand, the government has tagged its bird flu monitoring efforts onto a nationwide network of 800,000 health volunteers, set up decades ago as a first line of defence against ailments such as diarrhoea, tuberculosis and chickenpox.

With each volunteer assigned to monitor between 10 and 20 households in Thailand, as well as educate them about the risks and symptoms of bird flu, officials are confident any outbreak in either poultry or humans will not go unnoticed for long.

"If a chicken dies unusually, we will know about it within the day," said 58-year-old Manop Sungyont, who has been a health volunteer for 29 years in Suphan Buri province, 100 km (60 miles) northwest of Bangkok.

In the event of a possible outbreak, the likes of Manop pass the information up a command chain to either animal or human health officials, triggering the swift arrival of expert teams to collect samples, treat victims or start culling. (Additional reporting by Ed Cropley in Bangkok and Diyan Jarri in Jakarta)

OIE says some China bird flu vaccines ineffective

21 Mar 2006

PARIS, March 21 (Reuters) - China may be using some substandard poultry vaccines to fight bird flu that could allow birds to keep spreading the virus despite not showing symptoms, a top animal health expert said on Tuesday.

Christianne Bruschke, a member of the bird flu task force at the Paris-based World Animal Health Organisation (OIE), said the vaccines made in China at the Harbin Veterinary Institute conformed to international standards and were fully effective.

"But there are local companies in China that produce vaccines and it's possible these don't have the efficacy of those made at Harbin," she told Reuters.

Chinese officials have said their vaccines are effective and that no healthy-looking bird has yet been found carrying H5N1.

But there have been outbreaks in areas where poultry were supposedly already vaccinated and this has raised the possibility that birds are continuing to spread the virus.

"There are two possibilities," Bruschke said. "Either the vaccine is not strong enough, or that it is a good vaccine but not administered properly. Vaccines have to be given twice to be fully effective, maybe that is not happening.

"When a vaccine is not effective enough, it could prevent clinical signs from showing but the bird could still spread the virus. That's certainly a possibility," she said.

And she said poultry that had not been properly vaccinated may also pose a health risk to humans although it was difficult to quantify the danger.

Research in Europe, which did not import vaccines from China, showed drugs stopped the spread of the virus, she said.

"The vaccines are, when administered properly according to manufacturers' instructions, effective in preventing the spread in chickens and ducks," she said, adding that more research was needed on other bird species.

The Netherlands, France and Russia have announced plans to vaccinate some of their poultry against bird flu. But Dutch farmers have mostly chosen to wait before vaccinating their birds because they fear a negative impact on exports.

David King, the British government's chief scientific adviser, said the often close contact between humans and chickens in China meant that vaccines were particularly necessary there.

"The Chinese are using a number of different vaccines and one of the vaccines it is claimed has a high efficacy," he said.

"But we couldn't possibly use a vaccine that hadn't been fully through the European procedures of testing," he added.

It would be interesting to know if these suspicious vaccines have been exported from China and where...

Corporate bird flu worry highest in Asia - survey

21 Mar 2006

NEW YORK, March 21 (Reuters) - About one in five multinational companies is not at all concerned about avian flu, and among those that are, few have plans in place to deal with a deadly global outbreak of the disease, according to a survey by Watson Wyatt Worldwide.

Not surprisingly, the survey of 90 multinational companies conducted within the last 60 days found the greatest level of concern from those operating in the Asia-Pacific region, where the vast majority of bird flu deaths among humans has occurred.

Some 74 percent of companies surveyed expressed great or moderate concern for operations in the Asia-Pacific region, with 52 percent saying they are considering putting programs in place to deal with a human outbreak in the region. Some 32 percent said they already have a plan in place for Asia.

Despite warnings from world health officials that a global bird flu pandemic among humans was highly likely, the level of concern remains far lower for other regions, as was the percentage of companies with avian flu outbreak plans in place, the survey found.

"While focusing on Asia is a logical response to news of flu cases there, employers need to make sure they are considering the possible impact the avian flu could have on all regions," said Robert Wesselkamper, director of international consulting at Watson Wyatt.

"A good first step for companies is to note what worked and what didn't in their planned responses to past threats such as SARS," Wesselkamper said

PLANNED RESPONSE

Forty-eight percent of companies operating in the United States said they are considering such plans, although only 15 percent said they have plans in place. Thirty-four percent of responders with U.S. operations said they were greatly or moderately concerned about avian flu.

Among those with European operations, 45 percent expressed a high level of concern for the region with only 11 percent saying they have plans set to deal with a European outbreak. Some 47 percent said they were considering such programs.

Just 9 percent of responding companies said they have plans in place to deal with an outbreak in Latin America, where 36 percent of companies expressed great or moderate concern.

Wesselkamper declined to identify any of the 20 percent of companies that expressed no concern, for fear of upsetting their employees.

The vast majority of the companies surveyed were headquartered in the United States, with several based in Asia or Europe, Wesselkamper said.

Responding companies on average had more than 15,000 employees worldwide, with nearly half having operations in at least five regions.

The World Health Organization has confirmed 103 human deaths from the H5N1 strain of avian influenza. The disease has not mutated into a form that can easily be transmitted from human to human, but health officials have said they believe it is more a matter of when rather than if that will happen, and that such a development could kill millions.