H5N1: The *Oncoming* Pandemic Jaggernaut

[The Flying Dutchman]

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<i>I am reposting this article to this thread - as I have found several simular articles; and they all are coming from the public newspaper medias. This likely will the the last time I link anything on H5N1....

The virus is becoming main-stream news; and too difficult for one person to cover (sigh-I was on the puter 14 hours yesterday, and still didn't recover all the news on H5N1 that was/is out there.)

Besides there are several members who are covering this Pandemic potential (I have seen their sigs on other news sites; and posting some of the same news I have found. I just hope that they'll post it to TB2000 as well (there are people here who want and need to know about this on-coming Jaggernaut.....

Shakey</i>


<B><font size=+1 color=blue><center>Countries face quarantine in bid to beat killer disease</font>

MARGARET NEIGHBOUR
Thursday, 26th May 2005

TRAVEL and trade restrictions could be placed on countries if there is a serious outbreak of deadly diseases such as bird flu and SARS under new rules agreed by the World Health Organisation yesterday. </B></center>
The regulations, adopted by the WHO's 192 member states after two years of negotiations, oblige countries to tighten up disease detection and lay down guidelines for international measures.

In future, the United Nations agency must be informed quickly of any outbreak of four diseases - bird flu, Severe Acute Respiratory Syndrome (SARS), smallpox and polio.

The news came as China became the latest country to be caught up in the bird flu scare. It rushed millions of doses of vaccine to a western province near Tibet after migrating geese were found to have died from the virus.

The 178 bar-headed geese found in a nature reserve in Qinghai province were the first cases of bird flu that China has reported since last July. Health experts worry that the birds, which cross the country on routes that stretch from Siberia to New Zealand, could spread the virus to China's vast population of domesticated ducks and geese.

Humans in close contact with infected birds have died from the condition and scientists say it is only a matter of time before bird flu mutates to became a disease passed between humans.

The Chinese government closed all the country's nature reserves to the public and ordered ducks, geese and other poultry in Qinghai to be vaccinated against bird flu. Officials said three million doses of vaccine had been sent to the province.

Farms near bird migration routes elsewhere were also ordered to vaccinate poultry against the disease.

The Beijing government said the virus in Qinghai had not spread to humans or other poultry. However, the death toll in the latest Asian bird flu outbreak rose to 54 yesterday, when another fatality was reported in Vietnam.

China was the source of the 2003 SARS outbreak which spread to 30 countries and killed 800 people, and it has been accused of being slow to inform the WHO and neighbouring countries of what was at the time a new disease.

Under the new rules agreed yesterday, any "potential international public health concern", including outbreaks from unknown causes or sources, and potentially deadly sicknesses such as cholera and yellow fever, must be reported when they are sufficiently serious.

Dr Lee Jong-wook, the WHO's director-general, said: "This is a major step forward for international health. These new regulations recognise that diseases do not respect national boundaries. They are urgently needed to help limit the threats to public health."

The regulations greatly extend the scope of the previous guidelines, drawn up in 1969, which required countries to report only three diseases - cholera, plague and yellow fever - to the UN agency, but demanded little else.

In any disagreement between the WHO and a member state on the seriousness of an outbreak, the rules allow the head of the UN body to summon a committee of experts to make recommendations on tackling the health threat. Such recommendations could range from continued vigilance to the requesting of proof of vaccination and to travel bans for people or goods.

Member states now have two years to make the regulations part of their own national law.
http://news.scotsman.com/topics.cfm?tid=161&id=565702005

 

[The Flying Dutchman]

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<B><font size=+1 color=red><i><center>World unprepared for flu capable of killing 10 million </font>
May 26, 2005
World unprepared for flu capable of killing 10 million
By Mark Henderson, Science Correspondent</B></center>
THE world is unprepared for an influenza pandemic that would infect well over a billion people and trigger global economic disaster, leading scientists say today.
International leaders are ignoring indications that the virulent H5N1 strain of avian flu presents a severe threat, and have failed to introduce the cross-border measures essential if a worldwide outbreak is to be contained.

Such a pandemic could affect 20 per cent of the world’s population, putting 30 million in hospital and killing a quarter of them, according to even optimistic predictions. It would also lead to the collapse of international trade and cause economic and social chaos even in rich countries that can protect their populations with drugs and vaccines.

In expert commentaries published today in Nature, some of the world’s foremost authorities on flu argue that only a meticulously planned global response stands a chance of averting a catastrophe.

They call for a permanent international taskforce to prepare for a pandemic, in place of country-by-country arrangements. Urgent action is needed to develop ways of designing and manufacturing vaccines against the virus — a process that now takes six months — and to agree international guidelines for eliminating reservoirs of potentially dangerous strains in poultry and wildlife.

The calls come amid growing concern that the H5N1 virus circulating in Asia has the potential to start a human pandemic. It has infected at least 97 people in Thailand, Vietnam and Cambodia, of whom 53 have died. Most of those cases were contracted from birds, but there are emerging indications of occasional transmission between people — the key step to a pandemic. Last week, the World Health Organisation said it was concerned about possible human-to-human infection in north Vietnam, though this has not been confirmed.

Even if H5N1 does not start a pandemic, another is certain to strike: they generally happen at intervals of about 30 to 40 years, and the last took place in 1968, killing a million people. The worst on record was the Spanish flu of 1918-19, which may have caused 50 million deaths.

Michael Osterholm, of the University of Minnesota, said “bold leadership” and meaningful financial investment in vaccine research is required from the G8 industrialised countries, which are not taking the issue sufficiently seriously.

“When the G8 leaders next meet, in Scotland in July, avian flu will be on the agenda, but major commitments are unlikely,” Dr Osterholm said. “These nations urgently need to recognise the economic and security and health threat that the next flu pandemic poses, and invest accordingly. The arrival of pandemic flu will trigger a reaction that will change the world overnight.

“We must demand nothing less than an international effort. If industrial countries continue to develop vaccines for just themselves, they, and everyone else, will remain vulnerable to a global disaster. Even if nations vaccinate their entire populations, they cannot remain isolated from a pandemic shock.”

Albert Osterhaus, ofthe Erasmus Medical Centre, Rotterdam, wants a task force of experts in human and animal medicine, virology, epidemiology, pathology, ecology and agriculture. Teams would be sent to investigate outbreaks, to assess pandemic potential and institute containment measures. Such a taskforce would cost $1.5 million (£820,000) a year.

This compares with agricultural losses of up to $880 million for H5N1 outbreaks in Thailand and Vietnam.
<A href="http://www.timesonline.co.uk/article/0,,3-1628083,00.html">(LINK to the Times)</A>

 

[The Flying Dutchman]

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<B><center>Bird flu virus 'close to pandemic'
<font size=+1 color=purple>Expert warns estimate of 7.5m global deaths is optimistic</font>
Thursday May 26, 2005
The Guardian
A leading scientist warned yesterday that the avian flu virus is on the point of mutating into a pandemic disease and says that current estimates that such a pandemic could cause 7.5m deaths may understate the threat. </B></center>
His warnings come as experts writing in today's edition of Nature voice concerns about the world's inability to manufacture sufficient vaccines for a pandemic and warn of the impact that the virus - H5N1 - could have on the global economy.

In an accompanying editorial Nature argues that so far such warnings have "fallen on deaf ears". It backs a call by Prof Osterhaus and his colleagues at the Erasmus Medical Centre, in Rotterdam - one of the world's leading virus research labs - for a global taskforce to strengthen agencies on the ground.

There have been 90 human infections in south-east Asia , from which 54 people have died. But while culling and the vaccination of poultry appears to have slowed outbreaks in Thailand and other parts of south-east Asia, this year Vietnam has seen a worrying number of human infections in the same family groups. According to Prof Osterhaus such clustering could mean the virus is becoming more efficient at infecting humans - a precondition for a pandemic.

Another concern are reports which emerged from China last weekend that H5N1 was responsible for the deaths of 178 migratory geese at a wildfowl reserve in the western province of Qinghai earlier this month. Prof Osterhaus says the geese's deaths could be another indication that the virus is mutating and becoming more virulent. The problem is that countries such as China and Vietnam are not providing animal and human health officials with enough data, leaving scientists in the dark.

According to the WHO, within a few months of the pandemic 30 million people would need to be hospitalised, and a quarter could be expected to die. In his Nature commentary, Prof Osterhaus describes current estimates that a pandemic could infect 20% of the world's population and cause 7.5m deaths as "among the more optimistic predictions of how the next pandemic might unfold".

Such pandemic viruses emerge every 30 years or so. The most virulent was the 1918 Spanish flu pandemic, which is believed to have claimed 40 million lives worldwide. By contrast the 1957 Asian flu pandemic and 1968 Hong Kong flu claimed less than one million lives each. Prof Osterhaus wants the WHO, the UN Food and Agricultural Organisation and the World Organisation for Animal Health to set up global teams of vets, medics, virologists and agriculturalists to respond rapidly to outbreaks.

His comments are backed by the other experts in Nature, who also criticise the WHO and international efforts to develop vaccines against H5N1 and other strains of avian influenza.

According to Michael Osterholm of the University of Minnesota, antiquated vaccine manufacturing systems mean that countries like the US are unable to protect their populations against annual flu strains, let alone pandemic ones.
<A href="http://www.guardian.co.uk/international/story/0,3604,1492320,00.html">(LINK)</A>

 

[The Flying Dutchman]

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<B><center>Flying Dutchman mans the species barrier
<font size=+0 color=red>A dynamic professor dubbed the virus hunter believes that bird flu is the greatest threat to mankind. He tells Mark Honigsbaum how the world should fight back </font>
Thursday May 26, 2005
The Guardian
To reach Albert Osterhaus's office on the 17th floor of the Erasmus Medical Centre in Rotterdam you negotiate several biohazard laboratories, two corridors lined with deep freezes and a pair of old-fashioned egg incubators. Finally, you reach a room decorated with posters of seals and cats, and are ushered into the professor's presence by one of three secretaries he employs to manage his increasingly hectic schedule.</B></center>
Like the viruses he chases for a living, Osterhaus is continually on the move, and the demands on his time are constantly multiplying. Three weeks ago he was in China and Vietnam to meet officials from the World Health Organisation. The week before that, it was India. This week, he is back in his office to check on the progress of research projects - and to make time to talk to the Guardian.

A veterinarian turned virologist, Osterhaus is an authority on several viruses that have crossed the species barrier. In 1998, he showed that the canine distemper virus was responsible for the mass deaths of Siberian seals in Lake Baikal. The following year, he identified influenza B - a strain of flu that normally infects only humans - in seals off the coast of the Netherlands. Then, in April 2003, at the height of the panic over Sars (severe acquired respiratory syndrome) in Hong Kong, he showed that the disease was caused by a coronavirus that normally resides in civet cats and other carnivorous animals (Osterhaus beat rival labs in the US and Germany to the proof by fast-tracking approvals to conduct live virus trials).

<b>But the virus which increasingly occupies his time these days, and the one that he believes poses the greatest threat to mankind, is the avian influenza virus, H5N1.</b>

On his trip to Vietnam, <b>the World Health Organisation presented data about how cases of H5N1 were multiplying in members of the same family group, a process known as clustering. This could indicate that the virus, which has prompted mass culling of poultry throughout south-east Asia, is becoming infectious among people.</b>

The following week, <b>Nature reported that the UN Food and Agricultural Organisation (FAO) was struggling to get serum samples from people and poultry infected with the latest strains of the virus forwarded to its labs for analysis. Then, no sooner had he returned to Rotterdam last weekend, the Chinese reported that 178 wild geese had been found dead at a research centre in a western province, Qinghai - also victims of H5N1.</b>

"It's another worrying finding," he says. "Normally, these viruses don't kill wild birds. They only heat up when they pass from wild birds to poultry. It could be that we haven't looked at the mortality in wild birds closely enough. Or it could be a spill back from domestic poultry."

The more pressing concern, however, is the threat H5N1 poses to people. Since the start of the current outbreak in south-east Asia in 2003, there have been more than 90 human infections and 54 deaths.<b> If H5N1 were to become a super-spreader like Sars, then infections could leap round the world in a matter of days, triggering a global pandemic.</b>

Indeed, such is the concern among Osterhaus and his colleagues at Holland's National Influenza Centre t<b>hat he is now calling for the WHO and FAO to join forces with the World Organisation for Animal Health (OIE) and establish a global task force to combat the virus.</b>

In a leading commentary for today's edition of Nature, Osterhaus argues that while Vietnam, Hong Kong and other south-east Asian states have taken steps to cull infected poultry and contain human outbreaks, the responses at a national level have been patchy and ad hoc. <b>In particular, the failure to forward serum samples to WHO reporting labs quickly enough means that the true incidence of infections may be underestimated.</b>

One of the task force's roles, argues Osterhaus, would be to ensure that farm workers with the greatest exposure to the virus are properly monitored and that adequate virological and clinical data are collected, including detailed post mortem reports. Animal health experts recruited by the task force should also survey poultry and other domestic birds for all sub-types of the virus. Osterhaus would also like to see better monitoring of wild bird populations, the natural reservoir of influenza A viruses.

"We need much more data on influenza in wild birds because that's where it comes from," he says. "But at the same time we also need better data on outbreaks in poultry and better reporting from labs so that we can get the sequences out and know if and in what direction the virus is mutating. And we need these data sets to be linked, from humans to birds, so that we can build up a repository of information. At the moment all we have is a series of snapshots."

Osterhaus argues that <b>nothing can stop a global influenza pandemic.</b> On average, pandemics occur every 30 years and are as inevitable as the tides. However, just as the United Nations is now establishing listening posts to provide an early warning of another tsunami, so the global flu task force could provide an equivalent early warning system.

According to Osterhaus, the task force would come under the umbrella of the WHO's flu pandemic preparedness plan and include virologists, epidemiologists and other specialists from the fields of animal and human health, as well as ecologists, agriculturists and experts in translating science into policy.

The result, write Osterhaus and his colleagues in Nature, is that when people begin to fall ill, "outbreak management teams can be formed and targeted at a specific outbreak".

To do nothing is not an option.<b> The mortality rate from H5N1 is already high, but as the virus mutates, it could become more pathogenic. Some experts estimate conservatively that within a few months, close to 30 million people would be hospitalised and a quarter would die.</b>

"Although these estimates are speculative, <b>they are among the more optimistic predictions of how the next flu pandemic might unfold," </b>warns Osterhaus in Nature.

In five accompanying commentaries, other experts, including Antony S Fauci of the US National Institute of Health, and Dr Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota, also argue that time is running out and that if more money is not poured into vaccine research, the world could be heading not just for a pandemic, but economic disaster too.

This is not the first time experts have issued such dire warnings. In 1957 and again in 1967, avian influenzas crossed the species barrier, triggering the Asian and Hong Kong flu pandemics. But though those pandemics, caused by H1 and H2 strains of the virus, claimed about 1 million lives worldwide, their impact was not nearly as great as the 1918 Spanish influenza, a pandemic which may have killed as many as 50 million people. And while Sars triggered scares in 2003, there were only 1,000 deaths - a mortality rate of just 10%.

What makes Osterhaus think H5N1 is different?

Osterhaus pauses, surveying the pictures of seals and cats pinned to his walls - a secretary placed them there as a reminder of Osterhaus's previous life as a vet.<b> "We know the virus kills different mammalian species, not just humans but cats and tigers, and we know that the virus spreads easily in other animals and is highly pathogenic if they are infected in the right way,"</b> he says.

"We also know that the virus has a high fatality rate. For some reason, it is not transmitting efficiently from human to human at present. However, if that were to happen, either through mutation or reassortment, it would be a big worry."

Osterhaus's is a powerful voice. "He's very dynamic. He's always on the move. We call him the flying Dutchman," says John Oxford, professor of virology at Queen Mary Medical School in London. "As a trained vet he can deal with the interface between animal and human viruses. He's got experience on both sides of the fence, which is a tremendous advantage in this field. He's really a superstar."

In Holland, Osterhaus is known as the virus hunter because of his instinct for smelling out new viruses. After qualifying as a vet, he obtained a PhD in virology from Utrech University in 1978. He then joined the Netherlands' National Institute of Public Health and Environment where in between producing vaccines, he began studying animal viruses. Besides seals, Osterhaus has found new viruses in dolphins, African wild dogs, lions, finches and cats. Then, in 2001, he isolated the human metapneumovirus. The cause of respiratory disease in young children and people with compromised immune systems, hMPV is actually an old virus; Osterhaus has found antibodies for it in serum samples from patients from the 1950s, but until 2001 no one had realised people were infected with it.

Osterhaus's discoveries enabled him to assemble his own team at Erasmus in association with the hospital's virology department, funding his research through a combination of grants, commercial trials and patent agreements with biotech companies. The result was that when in 2003 the WHO approached Osterhaus to work on Sars, he was in the perfect position.

The problem was that many of the serum samples from patients in Hong Kong contained both hMPV and the coronavirus. The only way to prove which was the primary cause of disease was to conduct live tests for each virus separately in animals. Side-stepping the hospital's animal ethics panel, Osterhaus appealed directly to a senior civil servant in the Dutch ministry of health and got clearance to experiment on macaque monkeys. His resulting proof that the cause was the coronavirus enabled the WHO to contain the outbreak faster.

Osterhaus's unconventional methods drew criticism from animal welfare activists and led to a reprimand from the Dutch parliament. But he insists that he did the right thing, and points out that the Netherlands has since amended its laws governing animal experiments. Osterhaus was subsequently knighted.

The irony is that when Klaus Stohr, the head of the WHO's influenza programme, first approached his lab to conduct the trials, Osterhaus nearly turned him down. In the winter of 2003, Dutch poultry farms were infected with a deadly plague. The virus responsible, H7N7, had already led to the death of a 57-year-old veterinarian and Osterhaus's team were seeing cases of conjunctivitis in farm workers and chicken cullers, a sure sign that they were also infected with the virus. With Holland in the grip of a winter flu epidemic, caused by the most common human strain of the virus, H3, Osterhaus feared that there was a risk of double infections.

Normally, avian influenza strains infect only bird populations or are not highly pathogenic in people and other animals. But virologists believe that pigs and sometimes people can be infected with avian and human influenza strains at the same time, providing a "mixing bowl", which allows the viruses to swap genes. Such a reassortment may have been behind the virulence of the 1918 flu, and is the reason why Osterhaus and other virologists fear that it could happen again.

Until 1997, virologists did not think avian strains could infect people directly. But when a doctor in Hong Kong sent Osterhaus serum from a three-year-old boy who had died of a mysterious respiratory disease there, to his surprise, he found H5N1. It was another first for his lab. He immediately alerted the WHO, and the Hong Kong authorities implemented a cull, killing 1.2m of the territory's chickens.

What worries Osterhaus is that while in 1997, only six of the 18 people hospitalised in Hong Kong with H5N1 died - a mortality rate of 33% - since then, the mortality rate has doubled, suggesting that the latest strain is more virulent. Then there are the reports of clustering, which suggest that it may also be becoming more infectious. However, Osterhaus points out that the cases may simply reflect the fact that family members are being directly exposed to the same infected poultry.

"The fact that we are seeing more clusters of human infections points in the direction of human transmission, but this should not be exaggerated. I think the bigger danger is that we will get a reassortment," says Osterhaus.

It could happen with H5N1, but it could also occur with another avian strain that scientists have yet to identify. Earlier this year, for instance, Osterhaus's colleagues discovered a new subtype of hemagglutinin - the protein spike which protrudes from the surface of the virus and enables it to invade animal cells - in black-headed gulls from Sweden. The discovery brings the number of hemagglutinin subtypes to 16. But had Erasmus not had an arrangement with ornithologists in Sweden to forward faecal samples from wild birds regularly, it would never have made the discovery.

A task force need not be that expensive. Osterhaus estimates the cost at less than $1.5m a year - a snip set against the $120m losses incurred by Vietnam and Thailand since the current H5N1 outbreak devastated their poultry industries.

The problem is that the WHO, FAO and the World Organisation for Animal Health are already huge bureaucracies, and politicians may well decide that they already have sufficient resources to respond to the threat

That, argues Osterhaus, would be a mistake. He points out that after the 9/11 attacks, the US poured billions into combating the threat of bio-terrorism.

"That's fine, but we should not forget that the main bio-terrorist is nature herself," he says. "Flu is knocking on the door. It is only a matter of time."
<A href="http://www.guardian.co.uk/life/feature/story/0,13026,1491811,00.html">(LINK)</A>

 

[The Flying Dutchman]

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<B><center>USAToday
<font size=+1 color=red>Flu pandemic warnings escalate</font>
5/25/2005
Growing concern over a persistent epidemic of bird flu across Asia is leading to urgent calls from international scientists to prepare for a global flu pandemic that could strike, by some estimates, 20% of the world's population.</B></center>
In a collection of articles published today in the journal Nature, scientists sketch out a scenario in which a strain of bird flu, which usually would not be dangerous to people, adapts to become highly contagious and deadly to humans. The scientists warn that not enough antiviral medicines are stockpiled and that there are no human vaccines yet. There also are no plans in most countries to cope with the health and economic disaster the scientists say would result.

Also today, in Washington, D.C., the Health Subcommittee of the U.S. House Energy and Commerce Committee will hear testimony from leaders of industry and federal health agencies on steps being taken to prepare for a pandemic.

In Nature, Albert Osterhaus and colleagues at Erasmus Medical Center in Rotterdam, the Netherlands, cite a World Health Organization estimate suggesting that within months of the start of a pandemic, nearly 30 million people would be hospitalized and as many as 7.5 million would die. They call on WHO to assemble a task force made up of experts in such fields as human and animal health, agriculture and ecology.

The World Health Assembly, WHO's governing body, ended a 10-day meeting in Geneva on Wednesday calling on member states to develop pandemic plans and urging WHO director-general Lee Jong-wook to "seek a solution to the current global shortage of influenza vaccines," a statement said.

Bird flu, which has killed millions of birds and has been found in 10 countries, most recently in wild geese in China, has killed 53 people. It "has the potential to trigger the next pandemic, which, judging from history, is well overdue," writes Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in Nature.

Clinical trials of vaccines have begun. But without more factories and new technologies to make it possible to produce millions of doses quickly, Fauci writes, "we may experience again the devastation of past pandemics," such as those in 1918, 1957 and 1968.

Though some countries, such as the USA, have begun planning, "preparation worldwide is insufficient," Osterhaus said in a telephone interview. "Vaccines are not available, and stockpiles of antivirals are insufficient at the moment."

There is still uncertainty about when a pandemic might emerge, says Michael Osterholm of the University of Minnesota's Center for Infectious Disease Research and Policy. But "the accumulation of evidence is very disturbing." In his Nature article, Osterholm calls WHO's pandemic plan "non-specific" and says it "falls far short of what is needed" for local or long-term planning.

Development of a vaccine should be a top priority, he says, along with availability of antivirals and protective masks.

The danger goes beyond public health, he warns.

"Even if a country had access to a protective pandemic vaccine ... its economy is going to crash," he says. International trade will halt as countries close their borders. "We will see major shortages in products that mean life and death," such as food and drugs, he says, and when the pandemic is over, the question will be how to get the world's economy going again.

"How do you prime a pump when you have no electricity?" he asks. "Nobody has ever seen the global economy go down."
<A href="http://www.usatoday.com/news/health/2005-05-25-bird-flu_x.htm"(USAToday News LINK></A>

 

[The Flying Dutchman]

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<B><font size=+1 color=purple><center>Bird flu: 20% of globe may be hit</font>
Thursday, 26th May 2005
A FIFTH of the world's population could be struck down with a new influenza pandemic, triggering global economic meltdown and a complete freeze on international travel, experts have warned. </B></center>
Scientists say world leaders should start planning now for an outbreak that could lead to several million deaths, widespread panic and the collapse of international trade.

Only a global response, rather than countries focusing wholly on their own protection, would stand any chance of averting the catastrophe, it is claimed.

Fears of a pandemic have arisen after outbreaks of the H5N1 bird-flu strain in south-east Asia, which has caused a total of more than 50 confirmed human deaths. The fatality rate of humans infected by the virus is as high as 60 per cent.

At present, there is no evidence that the strain can be transmitted from one person to another, but it may only be a matter of time before the virus mutates into a form that can easily pass between people. Should that happen, it would spread rapidly around the world, with devastating consequences.

Scientists writing in the journal Nature said the world today was far more vulnerable to the effects of a pandemic than it was in 1918, when a deadly strain of influenza killed between 20 million and 40 million people.

An optimistic estimate suggests that the next flu pandemic could cause 20 per cent of the world's population to become ill. Within a few months, almost 30 million people would need to be hospitalised, and a quarter of them would die.

But the effects on today's highly interconnected world economy would be just as serious, it is claimed.

Professor Michael Osterholm, of the Centre for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis, said: "The arrival of pandemic flu will trigger a reaction that will change the world overnight.

"There will be an immediate response from leaders to stop the virus entering their countries by greatly reducing and even ending foreign travel and trade - as was seen in parts of Asia in response to the severe acute respiratory syndrome [SARS] epidemic.

"These efforts are doomed to fail given the infectiousness of the virus and the volume of illegal crossings that occur at most borders. Global, national and regional economies will come to an abrupt halt."

International co-operation was vital to minimise the impact of a pandemic, Prof Osterholm said. In particular, a global effort was needed to develop a new type of vaccine that could be manufactured quickly and that targeted multiple strains. But he added: "Unfortunately, most industrial countries are looking at the vaccine issue through myopic lenses."

He warned that time was running out to prepare for the next flu pandemic and said there was a "critical need" for medical and non-medical planning, involving both the public and private sectors, at a level beyond anything considered so far.

Meanwhile, four Dutch experts, led by Dr Albert Osterhaus, from the Erasmus Medical Centre in Rotterdam, made an urgent call for a global taskforce to control a future pandemic.

It would consist of leading specialists in the fields of human and animal medicine, virology, epidemiology, pathology, ecology and agriculture. It would also include experts in translating science into policy. Management teams would be available to target specific flu outbreaks occurring anywhere in the world.

"Given the large geographical area in which the H5N1 virus has become endemic, and the greater potential for rapid virus spread, an efficient, effective, outbreak management team strategy, with centralised guidance, is urgently needed," the Dutch team said. Early detection and a rapid response to bird flu at a global level would greatly reduce the cost of dealing with a full-blown outbreak, they added.

Hugh Pennington, the internationally renowned emeritus professor of bacteriology at Aberdeen University, said: "If the mutation takes place or some kind of gene exchange happens to allow it to spread from person to person, then we get into the severity that this article [in Nature] discusses.

"Against this virus, we don't have any immunity, and it is the fact that it is brand new to our immune systems that gets people worried.

"How serious it is will depend on the kind of virus that develops, but we have no way of knowing, so it is really quite difficult to make any definitive predictions or put any odds on it happening at all. They are right to be concerned, and to call for well-formulated contingency plans, but it is very much something that we will have to wait and see about."
<A href="http://thescotsman.scotsman.com/index.cfm?id=573902005">"The Scotsman" News paper</A>

 

[The Flying Dutchman]

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<B><font size=+1 color=green><center>Final Phase 6 Bird Flu Pandemic in Qinghai China?</font>

<A href="http://www.recombinomics.com/News/05260504/H5N1_Qinghai_Phase_6.html">Recombinomics Commentary</A>
May 26, 2005

>> Officials have closed all China's nature reserves, including Bird Island, a tourist attraction on Lake Qinghai. They will attempt to vaccinate all three million farmyard poultry in Qinghai province within two days.</B></center>
One specialist said: "People do not need to panic and should be confident that the new cases will be brought under control as effective measures have been taken." <<

Reports coming out of Qinghai suggest H5N1 infections in humans and birds are out of control, with birds distributing H5N1 to the north and west, while people are being cremated and told to keep quiet.

Reports from Chinese language papers detail over 200 suspected infections in over two dozen locations in Qinghai Province. In the most affected 18 regions, there are 121 deaths, generating a case fatality rate above 60%.

Even if only a small fraction of the deaths are H5N1 linked, the cases would move the bird flu pandemic stage from 5 to the final stage 6, representing sustained human-to-human transmission of H5N1.

The high case fatality rate suggests the H5N1 in Qinghai has achieved efficient human transmission while retaining a high case fatality rate. If confirmed, these data would have major pandemic preparedness implications. These cases began almost a month ago and are now spreading via people who have previously entered the high risk area.

The official media comments coming out of China appear to be carefully worded, describing "new cases" being brought under control, inability to "see" human cases, or lack of "pneumonia" cases.

Several reports from Qinghai have cited limitations on discussing or reporting details. All nature reserves in China have been closed.

Clearly independent diagnosis of the cases described (including names) in media reports coming out of Qinghai are immediately required.

Phone calls and repetition of official denials are unacceptable.

 

[noelle4]

Shakey,

Thank you so much for keeping us informed! I appreciate all your time (14 hours!) and effort researching this information for us. You’re so thoughtful and kind.

Since I am also monitoring the Bird Flu (Avian Influenza H5N1), may I share this research/news short-cut with you? It will save you hours of research----

To bring up ALL the up-to-the-minute world news in three seconds, go to Google’s NEWS section,

http://news.google.com/news?hl=en&ned=us&q=Bird+Flu&btnG=Search+News

key-in “Bird Flu” or “Avian Influenza H5N1” (or any topic) and you will receive hundreds of articles (newspaper and magazine). Then, click on “reload” on your computer screen to up-date the information. I bookmark the page and then click “reload” when I visit the site.

I hope this saves you some time in your future research. Please know your 14 hours of research were appreciated—the articles are outstanding and unfortunately, very frightening. Thank you, again.

Noelle

 

[Christian for Israel]

gee, if they quarantine mexico, does that mean we'll ACTUALLY have to lock down the border?

 

[summerthyme]

CfO- right! THINK ABOUT THAT for a minute.... quarantines are the ONLY real weapon we'll have to prevent this from hitting every corner of the globe, including every state in the US. And we have a culture of people who believe that laws don't apply to them at all, as long as those laws *are preventing them from doing what they want*. Like crossing the border. Or leaving home to buy cigs, or beer.

I know of southern California residents who think nothing of smuggling poultry over from Mexico for their own flocks, or pets, or whatever. If this has truly jumped the species barrier and become a "super flu" (as is becoming more and more probable) nothing on earth is going to prevent it from being a global diaster. The Black Horseman has been released, mayhap?

The last epidemic was WAY back in 1918. People didn't go from TOWN TO TOWN without forethought and planning. Forget globe trotting in a matter of hours. I believe that IF this hits, the current estimates of morbidity are WAY understated because of this modern propensity for instant gratification and global trade and travel.

Got preps?

Summerthyme

 

[The Flying Dutchman]

-


<center>

<B>*BUMP*

some one give me a nail and
cyber hammer. I'll "sticky" this
ole boy to the top</center>

 

[susan48]

Bless you Mr. Shakey................you've done a wonderful job keeping us informed. Don't forget to sleep!

Susan

 

[Christian for Israel]

The last epidemic was WAY back in 1918. People didn't go from TOWN TO TOWN without forethought and planning. Forget globe trotting in a matter of hours. I believe that IF this hits, the current estimates of morbidity are WAY understated because of this modern propensity for instant gratification and global trade and travel.

Got preps?

Summerthyme

i 100% agree with ya sis. when the people are told they CAN'T leave their homes to run to the store, first they won't believe it really applies to them and go anyway, then when they realize it DOES apply to them, they'll likely riot!

and the end result will be this thing spreading to far more people than the 'experts' believe (or are willing to admit). one of the bad aspects of creating a self serving society is no one is willing to change their ways to protect others (and of course, it 'can't happen to me' ).

 

[tsk]

Christian for Israel: i 100% agree with ya sis. when the people are told they CAN'T leave their homes to run to the store, first they won't believe it really applies to them and go anyway, then when they realize it DOES apply to them, they'll likely riot!

The USA is ready for this, silly! (sarcasm intended!)

http://www.timebomb2000.com/vb/showthread.php?t=152422
US conducts joint urban war game
WASHINGTON, May 25 (Xinhuanet) -- The US Marine Corps and the US Joint Forces Command are hosting the "Joint Urban Warrior," a seminar style war game, this week to prepare the military for future urban operations, the US military said Wednesday. ...




tsk, tsk...

 

[Hansa44]

Maybe I'm just sounding pessimistic here, but on a planet of 5 billion or more, 10 million deaths due to a pandemic does not seem like anywhere near what the original predictions were.

 

[Heliobas Disciple]

bumping back to the front page.

HD

 

[gdpetti]

It's not the number that counts....it's the fear put into the marketplace that will crash the party....as this party has been built on smoke and mirrors....and anything that dispurses some of the smoke, allows too much to be seen.

The only fear allowed into this game is that of our own choicing...any outside generator would be most unwelcome....think panic....not controlled fear, but biologically driven panic.
That's the possibility, and it seems its probability is rising.

 

[whitebird]

Shakey and all those interested.

Further news.....I thought you might be interested in the following from The Daily Telegraph in Sydney Australia today. I'll have to type it because there wont be a direct link, but the paper has a website and it's www.dailytelegraph.com.au

To quote....."armed and ready for flu".......If you can't find any syringes or surgical masks at your local chemist, it's probably because the Government has them all.

The Federal Government is stockpiling 50 million syringes and 40 million surgical masks in case a flu pandemic strikes Australia.

If it does, Australia will meet the challenge with one of the world's largest stockpiles of anti-viral drugs, syringes, surgical masks and extra ventilators.

"Last year's Budget provided $114 million to stockpile drugs and because of this we now have one of the world's largest stockpiles," Health Minister Tony Abbott told Parliament.

Getting closer so needs more bumps?
Best to all - Whitebird

 

[Christian for Israel]

thank you whitebird. i'm not sure whether to be glad or not that people here don't seem that concerned...

 

[Deena in GA]

Very interesting, whitebird! I'm glad to see that your country is taking this seriously and making preparations. More individuals and countries need to be doing the same.

 

[y2kmisfit]

Maybe I'm just sounding pessimistic here, but on a planet of 5 billion or more, 10 million deaths due to a pandemic does not seem like anywhere near what the original predictions were.

That's exactly the problem. It's really not that the predictions have lessened, it still varies wildly by who is stating it.
It seems many want to alert, but not scare, so they come out with minimal projections and even say "up to" as if it's worse case.
They will never get people to act (prepare) if they don't scare. I'm not saying make up numbers that can't happen, but please don't exclude "Possible" real "worse cases".

The estimates of the 1918 fatalities range widely. 20-100 million, with 40-50 million quoted the most that I've seen. That was with the world population 1/3 what it is now. A similar pandemic would killed 150 million (or more).

The Avian (H5N1) is just as good a candidate for a repeat of 1918 as any flu seen for many a decade, probably better.

It's a real disservice to humanity to not be honest with what it truely "could" be like.

 

[y2kmisfit]

Here is a more realistic read, IMHO

http://content.nejm.org/cgi/content...164741600_10325&FIRSTINDEX=0&journalcode=nejm

Preparing for the Next Pandemic

Michael T. Osterholm, Ph.D., M.P.H.

Annual influenza epidemics are like Minnesota winters — all are challenges, but some are worse than others. No matter how well we prepare, some blizzards take quite a toll. Each year, despite our efforts to increase the rates of influenza vaccination in our most vulnerable populations, unpredictable factors largely determine the burden of influenza disease and related deaths. During a typical year in the United States, 30,000 to 50,000 persons die as a result of influenzavirus infection, and the global death toll is about 20 to 30 times as high as the toll in this country. We usually accept this outcome as part of the cycle of life. Only when a vaccine shortage occurs or young children die suddenly does the public demand that someone step forward to change the course of the epidemic. Unfortunately, the fragile and limited production capacity of our 1950s egg-based technology for producing influenza vaccine and the lack of a national commitment to universal annual influenza vaccination mean that influenza epidemics will continue to present a substantial public health challenge for the foreseeable future.

An influenza pandemic has always been a great global infectious-disease threat. There have been 10 pandemics of influenza A in the past 300 years. A recent analysis showed that the pandemic of 1918 and 1919 killed 50 million to 100 million people,1 and although its severity is often considered anomalous, the pandemic of 1830 through 1832 was similarly severe — it simply occurred when the world's population was smaller. Today, with a world population of 6.5 billion — more than three times that in 1918 — even a relatively "mild" pandemic could kill many millions of people.

Influenza experts recognize the inevitability of another pandemic. When will it begin? Will it be caused by H5N1, the avian influenzavirus strain currently circulating in Asia? Will its effect rival that of 1918 or be more muted, as was the case in the pandemics of 1957 and 1968? Nobody knows.

So how can we prepare? One key step is to rapidly ramp up research related to the production of an effective vaccine, as the Department of Health and Human Services is doing. In addition to clinical research on the immunogenicity of influenza vaccines, urgent needs include basic research on the ecology and biology of influenzaviruses, studies of the epidemiologic role of various animal and bird species, and work on early interventions and risk assessment.2 Equally urgent is the development of cell-culture technology for production of vaccine that can replace our egg-based manufacturing process. Today, making the 300 million doses of influenza vaccine needed annually worldwide requires more than 350 million chicken eggs and six or more months; a cell-culture approach may produce much higher antigen yields and be faster. After such a process was developed, we would also need assured industrial capacity to produce sufficient vaccine for the world's population during the earliest days of an emerging pandemic.

Beyond research and development, we need a public health approach that includes far more than drafting of general plans, as several countries and states have done. We need a detailed operational blueprint of the best way to get through 12 to 24 months of a pandemic.

What if the next pandemic were to start tonight? If it were determined that several cities in Vietnam had major outbreaks of H5N1 infection associated with high mortality, there would be a scramble to stop the virus from entering other countries by greatly reducing or even prohibiting foreign travel and trade. The global economy would come to a halt, and since we could not expect appropriate vaccines to be available for many months and we have very limited stockpiles of antiviral drugs, we would be facing a 1918-like scenario.

Production of a vaccine would take a minimum of six months after isolation of the circulating strain, and given the capacity of all the current international vaccine manufacturers, supplies during those next six months would be limited to fewer than a billion monovalent doses. Since two doses may be required for protection, we could vaccinate fewer than 500 million people — approximately 14 percent of the world's population. And owing to our global "just-in-time delivery" economy, we would have no surge capacity for health care, food supplies, and many other products and services. For example, in the United States today, we have only 105,000 mechanical ventilators, 75,000 to 80,000 of which are in use at any given time for everyday medical care; during a garden-variety influenza season, more than 100,000 are required. In a pandemic, most patients with influenza who needed ventilation would not have access to it.

We have no detailed plans for staffing the temporary hospitals that would have to be set up in high-school gymnasiums and community centers — and that might need to remain in operation for one or two years. Health care workers would become ill and die at rates similar to, or even higher than, those in the general public. Judging by our experience with the severe acute respiratory syndrome (SARS), some health care workers would not show up for duty. How would communities train and use volunteers? If the pandemic wave were spreading slowly enough, could immune survivors of an early wave, particularly health care workers, become the primary response corps?

Health care delivery systems and managed-care organizations have done little planning for such a scenario. Who, for instance, would receive the extremely limited antiviral agents that will be available? We need to develop a national, and even an international, consensus on the priorities for the use of antiviral drugs well before the pandemic begins. In addition, we have no way of urgently increasing production of critical items such as antiviral drugs, masks for respiratory protection, or antibiotics for the treatment of secondary bacterial infections. Even under today's relatively stable operating conditions, eight different antiinfective agents are in short supply because of manufacturing problems. Nor do we have detailed plans for handling the massive number of dead bodies that would soon exceed our ability to cope with them.

What if an H5N1 influenza pandemic began not now but a year from now? We would still need to plan with fervor for local nonmedical as well as medical preparedness. Planning for a pandemic must be on the agenda of every public health agency, school board, manufacturing plant, investment firm, mortuary, state legislature, and food distributor. Health professionals must become much more proficient in "risk communication," so that they can effectively provide the facts — and acknowledge the unknowns — to a frightened population.3

With another year of lead time, vaccine might have a more central role in our response. Although the manufacturing capacity would still be limited, strategies such as developing antigen-sparing formulations — that is, intradermal formulations that take advantage of copious numbers of dendritic cells for antigen processing or formulations including adjuvants to boost the immune response — might extend the vaccine supply. Urgent planning efforts are required to ensure that we have the syringes and other essential equipment, as well as the workforce, for effective delivery. Finally, a detailed plan for vaccine allocation will be needed — before the crisis, not during it.

What if the pandemic were 10 years away and we embarked today on a worldwide influenza Manhattan Project aimed at producing and delivering a pandemic vaccine for everyone in the world soon after the onset of sustained human-to-human transmission? In this scenario, we just might make a real difference.

The current system of producing and distributing influenza vaccine is broken, both technically and financially. The belief that we can greatly advance manufacturing technology and expand capacity in the normal course of increasing our annual vaccination coverage is flawed. At our current pace, it will take generations for meaningful advances to be made. Our goal should be to develop a new cell-culture–based vaccine that includes antigens that are present in all subtypes of influenzavirus, that do not change from year to year, and that can be made available to the entire world population. We need an international approach to public funding that will pay for the excess production capacity required during a pandemic.

Today, public health experts and infectious-disease scientists do not know whether H5N1 avian influenzavirus threatens an imminent pandemic. Most indications, however, suggest that it is just a matter of time: witness the increasing number of H5N1 infections in humans and animals, the documentation of additional small clusters of cases suggestive of near misses with respect to sustained human-to-human transmission, the ongoing genetic changes in the H5N1 Z genotype that have increased its pathogenicity, and the existence in Asia of a genetic-reassortment laboratory — the mix of an unprecedented number of people, pigs, and poultry.

It is sobering to realize that in 1968, when the most recent influenza pandemic occurred, the virus emerged in a China that had a human population of 790 million, a pig population of 5.2 million, and a poultry population of 12.3 million; today, these populations number 1.3 billion, 508 million, and 13 billion, respectively. Similar changes have occurred in the human and animal populations of other Asian countries, creating an incredible mixing vessel for viruses. Given this reality, as well as the exponential growth in foreign travel during the past 50 years, we must accept that a pandemic is coming — although whether it will be caused by H5N1 or by another novel strain remains to be seen.

Should H5N1 become the next pandemic strain, the resultant morbidity and mortality could rival those of 1918, when more than half the deaths occurred among largely healthy people between 18 and 40 years of age and were caused by a virus-induced cytokine storm (see diagram) that led to the acute respiratory distress syndrome (ARDS).4 The ARDS-related morbidity and mortality in the pandemic of 1918 was on a different scale from those of 1957 and 1968 — a fact that highlights the importance of the virulence of the virus subtype or genotype. Clinical, epidemiologic, and laboratory evidence suggests that a pandemic caused by the current H5N1 strain would be more likely to mimic the 1918 pandemic than those that occurred more recently.5 If we translate the rate of death associated with the 1918 influenzavirus to that in the current population, there could be 1.7 million deaths in the United States and 180 million to 360 million deaths globally. We have an extremely limited armamentarium with which to handle millions of cases of ARDS — one not much different from that available to the front-line medical corps in 1918.

Proposed Mechanism of the Cytokine Storm Evoked by Influenzavirus.
The key element in generating the storm is an uncontrolled exuberant immune response to the virus, in which there is an outpouring of proinflammatory cytokines and chemoattractants. An animated version of this figure is available at www.nejm.org.

Is there anything we can do to avoid this course? The answer is a qualified yes that depends on how everyone, from world leaders to local elected officials, decides to respond. We need bold and timely leadership at the highest levels of the governments in the developed world; these governments must recognize the economic, security, and health threats posed by the next influenza pandemic and invest accordingly. The resources needed must be considered in the light of the eventual costs of failing to invest in such an effort. The loss of human life even in a mild pandemic will be devastating, and the cost of a world economy in shambles for several years can only be imagined.

 

[tsk]

Deena in GA : Very interesting, whitebird! I'm glad to see that your country is taking this seriously and making preparations. More individuals and countries need to be doing the same.

Hey,
I'm tellin' ya the USA is prepared!
...'specially in Washington:
http://abcnews.go.com/US/wireStory?id=514058

Coroner Wants to Shrink-Wrap Bodies in the Case of a Natural Disaster or Terrorist Attack
The Associated Press

OLYMPIA, Wash. Feb 18, 2005 — In the case of a natural disaster or terrorist attack, some emergency officials in Western Washington plan to be prepared with a large, shrink wrap machine. ...The shrink-wrapped bodies could be moved with forklifts, and the extra plastic covering would seal in biohazards such as anthrax in the case of bioterrorism.
...

What?, were you expecting stockpiles of Tamiflu or something?

tsk, tsk...

 

[darkdakota]

Hey,
I'm tellin' ya the USA is prepared!
...'specially in Washington:
http://abcnews.go.com/US/wireStory?id=514058

Coroner Wants to Shrink-Wrap Bodies in the Case of a Natural Disaster or Terrorist Attack
The Associated Press

OLYMPIA, Wash. Feb 18, 2005 — In the case of a natural disaster or terrorist attack, some emergency officials in Western Washington plan to be prepared with a large, shrink wrap machine. ...The shrink-wrapped bodies could be moved with forklifts, and the extra plastic covering would seal in biohazards such as anthrax in the case of bioterrorism.
...

What?, were you expecting stockpiles of Tamiflu or something?

tsk, tsk...

This reminds me of a coupke of years back when Uncle Sam asked everone to buy duct tape and visqueen. My brother is a contractor and was standing in line at Home Depot with his clueless helper watching all the sheep buy the recommended supplies. His worker asked why and my brother replies loudly: "so after the terrorist's hit us with smallpox they can wrap your body as they put it out at the curb" or something close to that. He said heads flipped around and his worker was still clueless.

Dark

 

[whitebird]

Tsk.....Tamiflu! - that's the name we have been trying to think of all day. I believe that you swallow it and it has quite a long shelf life? Is that correct - anyone? Thanks in advance

Whitebird.

 

[The Flying Dutchman]

<B>Tamiflu!</B>

Unfortunately I have ran into several articles stating that Tamiflu will not do any good against H5N1......

 

[pkchicken]

I spoke to the infection control nurse today at our local hospital about bird flu. She said it wasn't on our list of things to be concerned about.

Prepared? nope.

pk

 

[gisgaia]

Red Alert scenario?

A big thanks & hug to Shakey for his hard work gathering all these articles.

Anybody thought about how lots of the products being restocked in some big chain stores tonight are right now being taken out of boxes that were loaded in China & shipped from ports in that country just a few weeks ago? Also thinking that some things like stuffed toys, pillows, feather boas, decorative items, etc could contain feathers or ??? from affected areas?

Here is a Bird Flu thread from about 8 weeks ago - has 2 posts (4-3 and 4-6) concerning insider "rumors":

April 2, 2005: "WTF?!? - Bush Authorizes Use of Quarantine Powers in Cases of Bird Flu"
http://www.timebomb2000.com/vb/showthread.php?t=152300&page=2&pp=40

Also thanks to y2kmisfit for providing that very important article from the New England Journal of Medicine.

PREPARING FOR THE NEXT PANDEMIC
Volume 352:1839-1842 - May 5, 2005 - Number 18
Preparing for the Next Pandemic - by Michael T. Osterholm, Ph.D., M.P.H.

Note the estimate of deaths in that article - quote snip:

"If we translate the rate of death associated with the 1918 influenzavirus to that in the current population, there could be 1.7 million deaths in the United States and 180 million to 360 million deaths globally."

I may be mistaken but it seems there were articles 3-4 (or?) years ago by this Michael Osteholm & that he was considered a top BCW expert. I think he was also in interviews about Bioterrorism preps & Homeland Security issues (etc) on various news programs like CNN, etc.

My hunch is that something much, much bigger is playing out behind the scenes and this is happening as a part of warfare. That there are secret wars taking place between the world's power factions & that warfare is now breaking forth on to the global stage where the masses will be profoundly impacted. Well, actually I think it's even more than that .. that we are going into the final phases of the "shift" / a new time cycle (or whatever label fits) as has been prophecied but don't wanna drift the thread so will leave it as that...

Prayers for all creation and may the force be with us all!

PS: Also to read is this thread of 3 pages started by Canada Sue on 5-25-05 when first reports surfaced per ProMed list about rumors of human Bird Flu cases & deaths in China:

5-25-05: BRKG - H5N1 human deaths in China - this may be it folks - By Canada Sue
http://www.timebomb2000.com/vb/showthread.php?t=152300&page=1&pp=40

 

[susan48]

My hunch is that something much, much bigger is playing out behind the scenes and this is happening as a part of warfare. That there are secret wars taking place between the world's power factions & that warfare is now breaking forth on to the global stage where the masses will be profoundly impacted.



gisgaia, I have been troubled about this issue as I've followed the various threads. I pray that this is not what is happening, but I confess, I have entertained the thought!

Susan

 

[The Flying Dutchman]

-


<B><center>"The main bioterrorist is nature herself"
<font size=+1 color=purple>A Dutch expert on viruses warns that bird flu is a huge threat to humankind and urges scientists to cooperate in tracking it.</font>
May 26, 2005 | To reach Albert Osterhaus's office on the 17th floor of the Erasmus Medical Center in Rotterdam, the Netherlands, you negotiate several biohazard laboratories, two corridors lined with deep freezers and a pair of old-fashioned egg incubators.</B></center>
Finally, you reach a room decorated with posters of seals and cats, and are ushered into the professor's presence by one of three secretaries he employs to manage his increasingly hectic schedule. Like the viruses he chases for a living, Osterhaus is continually on the move, and the demands on his time are constantly multiplying. Three weeks ago he was in China and Vietnam to meet officials from the World Health Organization. The week before that, it was India. This week, he is back in his office to check on the progress of research projects -- and to make time to talk to the Guardian.

A veterinarian turned virologist, Osterhaus is an authority on several viruses that have crossed the species barrier. In 1998, he showed that the canine distemper virus was responsible for the mass deaths of Siberian seals in Lake Baikal. The following year, he identified influenza B -- a strain of flu that normally infects only humans -- in seals off the coast of the Netherlands. Then, in April 2003, at the height of the panic over SARS (severe acquired respiratory syndrome) in Hong Kong, he showed that the disease was caused by a coronavirus that normally resides in civet cats and other carnivorous animals. (Osterhaus beat rival labs in the United States and Germany to the proof by fast-tracking approvals to conduct live virus trials.)

But the virus that increasingly occupies his time these days, and the one that he believes poses the greatest threat to mankind, is the avian influenza virus, H5N1.

On his trip to Vietnam, the World Health Organization presented data about how cases of H5N1 were multiplying in members of the same family group, a process known as clustering. This could indicate that the virus, which has prompted mass culling of poultry throughout Southeast Asia, is becoming infectious among people.

The following week, Nature reported that the U.N. Food and Agricultural Organization was struggling to get serum samples from people and poultry infected with the latest strains of the virus forwarded to its labs for analysis. Then, as soon as he returned to Rotterdam last weekend, the Chinese reported that 178 wild geese had been found dead at a research center in a western province, Qinghai -- also victims of H5N1.

"It's another worrying finding," he says. "Normally, these viruses don't kill wild birds. They only heat up when they pass from wild birds to poultry. It could be that we haven't looked at the mortality in wild birds closely enough. Or it could be a spill-back from domestic poultry."

The more pressing concern, however, is the threat H5N1 poses to people. Since the start of the current outbreak in Southeast Asia in 2003, there have been more than 90 human infections and 54 deaths. If H5N1 were to become a super-spreader like SARS, then infections could leap around the world in a matter of days, triggering a global pandemic.

Indeed, such is the concern among Osterhaus and his colleagues at Holland's National Influenza Center that he is now calling for the WHO and FAO to join forces with the World Organization for Animal Health and establish a global task force to combat the virus.

In the leading commentary in Thursday's edition of Nature, Osterhaus argues that while Vietnam, Hong Kong and other Southeast Asian states have taken steps to cull infected poultry and contain human outbreaks, the responses at a national level have been patchy and ad hoc. In particular, the failure to forward serum samples to WHO reporting labs quickly enough means that the true incidence of infections may be underestimated.

One of the task force's roles, says Osterhaus, would be to ensure that farmworkers with the greatest exposure to the virus are properly monitored and that adequate virological and clinical data are collected, including detailed postmortem reports. Animal health experts recruited by the task force should also survey poultry and other domestic birds for all subtypes of the virus. Osterhaus would also like to see better monitoring of wild bird populations, the natural reservoir of influenza A viruses.

"We need much more data on influenza in wild birds because that's where it comes from," he says. "But at the same time we also need better data on outbreaks in poultry and better reporting from labs so that we can get the sequences out and know if and in what direction the virus is mutating. And we need these data sets to be linked, from humans to birds, so that we can build up a repository of information. At the moment all we have is a series of snapshots."

Osterhaus argues that nothing can stop a global influenza pandemic. On average, pandemics occur every 30 years and are as inevitable as the tides. However, just as the United Nations is now establishing listening posts to provide an early warning of another tsunami, so the global flu task force could provide an equivalent early warning system.

According to Osterhaus, the task force would come under the umbrella of the WHO's flu pandemic preparedness plan and include virologists, epidemiologists and other specialists from the fields of animal and human health, as well as ecologists, agriculturists and experts in translating science into policy.

The result, write Osterhaus and his colleagues in Nature, is that when people begin to fall ill, "outbreak management teams can be formed and targeted at a specific outbreak."

To do nothing is not an option. The mortality rate from H5N1 is already high, but as the virus mutates, it could become more pathogenic. Some experts estimate conservatively that within a few months, close to 30 million people could be hospitalized and a quarter would die. "Although these estimates are speculative, they are among the more optimistic predictions of how the next flu pandemic might unfold," warns Osterhaus in Nature.

In five accompanying commentaries, other experts, including Antony Fauci of the National Institutes of Health and Michael Osterholm of the Center for Infectious Disease Research and Policy at the University of Minnesota, also argue that time is running out and that if more money is not poured into vaccine research, the world could be heading not just for a pandemic but for economic disaster too.


This is not the first time experts have issued such dire warnings. In 1957 and again in 1967, avian influenzas crossed the species barrier, triggering the Asian and Hong Kong flu pandemics. But though those pandemics, caused by H1 and H2 strains of the virus, claimed about 1 million lives worldwide, their impact was not nearly as great as the 1918 Spanish influenza, a pandemic that may have killed as many as 50 million people. And while SARS triggered scares in 2003, there were only 1,000 deaths -- a mortality rate of just 10 percent.

What makes Osterhaus think H5N1 is different? Osterhaus pauses, surveying the pictures of seals and cats pinned to his walls -- a secretary placed them there as a reminder of Osterhaus's previous life as a vet. "We know the virus kills different mammalian species, not just humans but cats and tigers, and we know that the virus spreads easily in other animals and is highly pathogenic if they are infected in the right way," he says.

"We also know that the virus has a high fatality rate. For some reason, it is not transmitting efficiently from human to human at present. However, if that were to happen, either through mutation or reassortment, it would be a big worry."

Osterhaus' is a powerful voice. "He's very dynamic. He's always on the move. We call him the 'Flying Dutchman,'" says John Oxford, professor of virology at Queen Mary Medical School in London. "As a trained vet he can deal with the interface between animal and human viruses. He's got experience on both sides of the fence, which is a tremendous advantage in this field. He's really a superstar."

In Holland, Osterhaus is known as the virus hunter because of his instinct for smelling out new viruses. After qualifying as a vet, he obtained a Ph.D, in virology from Utrech University in 1978. He then joined the Netherlands' National Institute of Public Health and Environment, where in between producing vaccines he began studying animal viruses. Besides seals, Osterhaus has found new viruses in dolphins, African wild dogs, lions, finches and cats. Then, in 2001, he isolated the human metapneumovirus. The cause of respiratory disease in young children and people with compromised immune systems, hMPV is actually an old virus; Osterhaus has found antibodies for it in serum samples from patients from the 1950s, but until 2001 no one had realized people were infected with it.

Osterhaus' discoveries enabled him to assemble his own team at Erasmus in association with the hospital's virology department, funding his research through a combination of grants, commercial trials and patent agreements with biotech companies. The result was that when in 2003 the WHO approached Osterhaus to work on SARS, he was in the perfect position.

The problem was that many of the serum samples from patients in Hong Kong contained both hMPV and the coronavirus. The only way to prove which was the primary cause of disease was to conduct live tests for each virus separately in animals. Sidestepping the hospital's animal ethics panel, Osterhaus appealed directly to a senior civil servant in the Dutch Ministry of Health and got clearance to experiment on macaque monkeys. His resulting proof that the cause was the coronavirus enabled the WHO to contain the outbreak faster.

Osterhaus' unconventional methods drew criticism from animal welfare activists and led to a reprimand from the Dutch Parliament. But he insists that he did the right thing, and points out that the Netherlands has since amended its laws governing animal experiments. Osterhaus was subsequently knighted.

The irony is that when Klaus Stohr, the head of the WHO's influenza program, first approached his lab to conduct the trials, Osterhaus nearly turned him down. In the winter of 2003, Dutch poultry farms were infected with a deadly plague. The virus responsible, H7N7, had already led to the death of a 57-year-old veterinarian, and Osterhaus' team was seeing cases of conjunctivitis in farmworkers and chicken cullers, a sure sign that they were also infected with the virus. With Holland in the grip of a winter flu epidemic, caused by the most common human strain of the virus, H3, Osterhaus feared that there was a risk of double infections.

Normally, avian influenza strains infect only bird populations or are not highly pathogenic in people and other animals. But virologists believe that pigs and sometimes people can be infected with avian and human influenza strains at the same time, providing a "mixing bowl" that allows the viruses to swap genes. Such a reassortment may have been behind the virulence of the 1918 flu, and is the reason why Osterhaus and other virologists fear that it could happen again.

Until 1997, virologists did not think avian strains could infect people directly. But when a doctor in Hong Kong sent Osterhaus serum from a 3-year-old boy who had died of a mysterious respiratory disease there, to his surprise, he found H5N1. It was another first for his lab. He immediately alerted the WHO, and the Hong Kong authorities implemented a cull, killing 1.2 million of the territory's chickens.

What worries Osterhaus is that while in 1997, only six of the 18 people hospitalized in Hong Kong with H5N1 died -- a mortality rate of 33 percent -- since then, the mortality rate has doubled, suggesting that the latest strain is more virulent. Then there are the reports of clustering, which suggest that it may also be becoming more infectious. However, Osterhaus points out that the cases may simply reflect the fact that family members are being directly exposed to the same infected poultry.

"The fact that we are seeing more clusters of human infections points in the direction of human transmission, but this should not be exaggerated. I think the bigger danger is that we will get a reassortment," says Osterhaus.

It could happen with H5N1, but it could also occur with another avian strain that scientists have yet to identify. Earlier this year, for instance, Osterhaus' colleagues discovered a new subtype of hemagglutinin -- the protein spike that protrudes from the surface of the virus and enables it to invade animal cells -- in black-headed gulls from Sweden. The discovery brings the number of hemagglutinin subtypes to 16. But had Erasmus not had an arrangement with ornithologists in Sweden to forward fecal samples from wild birds regularly, it would never have made the discovery.

A task force need not be that expensive. Osterhaus estimates the cost at less than $1.5 million a year -- a snip set against the $120 million in losses incurred by Vietnam and Thailand since the current H5N1 outbreak devastated their poultry industries. The problem is that the WHO, the FAO and the World Organization for Animal Health are already huge bureaucracies, and politicians may well decide that they already have sufficient resources to respond to the threat. That, argues Osterhaus, would be a mistake. He points out that after the 9/11 attacks, the United States poured billions into combating the threat of bioterrorism.

"That's fine, but we should not forget that the main bioterrorist is nature herself," he says. "Flu is knocking on the door. It is only a matter of time."
<A href="http://www.salon.com/news/feature/2005/05/26/avian_flu/index_np.html">(LINK)</A>

 

[pkchicken]

it goes on.....