States plans for avian flu pandemic

If an avian flu pandemic strikes, states will need to cope not just with severe strain on their hospitals but also with a serious impact on stores, schools, power plants and office cubicles, according to a report released Tuesday (July 18).

Governors would have a tough time just keeping basic services going. As many as 40 percent of workers might stay home for a period of up to 14 months, and outside help from the federal government or other states would be severely limited, the National Governors Association warned in the report.

“The difference between a pandemic and (Hurricane) Katrina is, as huge as Katrina was, it was a localized event to a particular geographic region of the country. Therefore, resources – first responders, National Guard, public safety – could be deployed from all states over the country to the Gulf area, and they were,” Arizona Gov. Janet Napolitano (D), the NGA’s vice-chairwoman, said in a telephone news conference.

“In a pandemic situation, you’re not going to have that kind of resource base, because every state is going to have to be focused on the citizenry within its own borders. That’s why the planning for the pandemic is different than the planning for a natural catastrophe,” she added.

A key consideration for policy-makers will be the depleted workforce that a pandemic would likely cause. Even people who aren’t infected might stay home, fearing they would contract the disease from others in public. That means policing streets, fixing power lines, cleaning wastewater, delivering food and keeping government agencies running could become difficult, the report noted.

The 32-page document released by the NGA’s Center for Best Practices is meant to help governors and their staffs prepare for the unique problems posed by pandemics.

The report centers on the possibility that a strain of the deadly avian flu that already has jumped from birds to humans will mutate, so that it can be passed more easily from one human to another. Birds have spread the virus into Europe, Asia and Africa. As of March 1, the virus had infected 174 people and killed 94 worldwide, according to the World Health Organization.

States will play a crucial role in responding to a pandemic, because they have the tools and the authority to respond to local conditions quickly, said John Thomasian, director of the Center.

Governors and their agencies can shut schools, close highways, deploy National Guard troops, coordinate medical personnel, stockpile and distribute equipment, communicate with the federal government and work with local business leaders.

In fact, with the help of the federal government, states already have conducted drills to practice for outbreaks, so most governors already are up to speed on the challenges, Thomasian said.

But the NGA’s primer can educate new governors – there will be at least nine freshmen governors after November’s elections – and help the executives inform other officials, he explained.

One of the key lessons the NGA’s report stresses is that governors will have to make decisions quickly under changing circumstances. The exact scenarios they’ll have to deal with likely won’t come up in drills, but the test runs are important because they develop relationships before disaster strikes, Thomasian said.

“You can only go so far in a book. Ultimately you’ve got to know the person to call on the other end of the line,” he said.

He said the coordination would be similar to the run-up to Y2K, when government agencies worked with private industry to prevent computer failures caused by the switch to the year 2000.

But in a pandemic, the scope of the problem wouldn’t be known until the disease attacks. The 1918 influenza pandemic killed as many as 50 million people worldwide in less than a year. But the 2003 epidemics of severe acute respiratory syndrome (SARS) were more limited, killing 800 people in Asia and Canada.

Minnesota Gov. Tim Pawlenty (R), who leads the NGA’s pandemic flu task force with Napolitano, said past lessons still play a crucial role in designing pandemic responses.

“We know some things. We’re not just guessing. We know a virus exists. We know it has mutated from bird-to-bird to bird-to-human. We know it has the potential to go to human-to-human. We know if that happens, that there’s a likelihood of pandemic. We know if there’s a pandemic, there’s certain things we need to do to minimize and contain it,” Pawlenty said.

Past pandemics have lasted as long as a year, coming in two- or three-month waves. The report cautions that governments must be ready for new waves of infections even while they’re recovering from the initial shock

So state officials can use the time between waves to recover, but they’ll also be dealing with a public distressed because of lost family and friends, fatigue and financial hardships, the report noted.

Pawlenty said it’s important to be forthright with the public when talking about the problems a pandemic poses.

“I think part of the challenge here is making sure people are aware and informed and prepared but not unduly alarmed. I think we have to be candid,” he said.

The Minnesota governor, for example, said he appreciated the up-front assessment of the U.S. Department of Health and Human Services, which has told states they can’t rely heavily on the federal government for relief during a pandemic.

The NGA’s Thomasian agreed. “It’s not that the federal government is abandoning states. It’s simply that (responding to) the pandemic flu requires a lot of human assets, and the federal government does not stockpile doctors or nurses or truck drivers or utility workers, so it really does it come down to the state level,” he said.

Thomasian said some federal agencies are helping states prepare better than others are. He said HHS has gone out of its way to plan for an outbreak. Just last week, the agency awarded states $225 million to prepare for avian flu (a state-by-state breakdown is here.)

But he said the U.S. Department of Homeland Security has lagged behind.

Send your comments on this story to letters@stateline.org. Selected reader feedback will be posted in the Letters to the editor section.

Thailand's got new cases of bird flu

Two more suspected bird flu cases in Phichit

PHICHIT, July 19 (TNA) - Health authorities in the lower northern province of Phichit hospitalised two young sisters earlier this week after they developed bird flu-like symptoms, provincial officials said Wednesday.

The two suspected cases are sisters aged three and four years old, according to doctors who sent the children's blood samples to a laboratory for testing. Test results were to be known on Thursday.

The two sisters were sent to the Phichit Provincial Hospital from the Ta Pan Hin District Hospital after they developed bird flu-like symptoms including a high fever and cough.

Many poultry in their home village sickened and died of unknown causes before the girls themselves became sick.

Medical doctors at the Phichit Provincial Hospital sent the sisters' blood samples to the provincial Medical Sciences Centre for testing and the results are expected to be known on Thursday.

The two girls are now quarantined and their symptoms are being monitored.

Meanwhile, in order to stop the possible spread of bird flu from the diseased birds, provincial livestock officials buried about one hundred domestic chickens which died of unknown causes and disinfectant

was sprayed around the burial sites. (TNA)-E003

Last Update : 2006-07-19 / 16:40:42 (GMT+7:00)

WHO has troubles with Indonesia bird flu (H2H2H?)

Long, long article with, I believe a bias, but interesting and worth reading. I took the entire article and accompanying pictures from a website called CrimeLibrary.com. Could make one want to prep for bird flu.

Deception Dominates World Health Organization's Bird Flu Releases

By Marilyn Bardsley

July 16, 2006

Culture of Deception

If ever there was a need for clear and accurate information about the spreading and rapidly mutating avian influenza, it is now as the threat of a pandemic looms increasingly large. At a time when governments and individuals around the world are making preparations to battle a potentially life-altering disaster, there is no need for a group of bureaucratic elites to decide what information people are capable of handling.

The U.N.'s World Health Organization (WHO) has published its guidelines for the communicating of information about disease outbreaks, but these guidelines have not prevented a deliberate culture of deception from dominating the statements WHO makes to the press.

It has been suggested that WHO does not want people to panic, hence they are not candid when significant events in the evolution of a pandemic are unfolding. What is wrong with this rationale?

WHO seal

On a scale of death, destruction and disaster, Hurricane Katrina would be a minor event compared to an H5N1 influenza pandemic. Would anyone suggest today that state and local governments on the Gulf Coast should have played down the potential for destruction before Katrina hit? So that people wouldn't panic? Then why deceive the world about a pandemic that would kill tens of millions? Why not be truthful so that people and governments have the maximum time available to prepare?

Human-to-Human (H2H) comes out of the closet

WHO cannot guarantee that H5N1 will turn into a pandemic strain and, if it does, when it will happen, any more than people on the Gulf Coast knew for certain where Katrina would hit and what strength it would pack when it did hit. But those uncertainties didn't stop officials and forecasters from warning the region days in advance and cable news broadcasters from almost non-stop coverage as Katrina moved closer. The rationale was that everyone should be as prepared as possible as soon as the danger was recognized.

A pandemic can emerge as quickly as a hurricane and engulf the entire world in a few weeks on the wings — not of migratory birds — of big metal "birds" with airline logos on their sides. One big difference is that one can evacuate from the path of a hurricane, but the pandemic will be global.

Chicken

Now that most people, at least in western countries, know that the deadly H5N1 strain of avian flu is the most likely candidate for the next pandemic, many are watching the news for any sign that a major evolutionary change in the virus has occurred. The change that people have been trained to look for by countless media reports is that the virus has adapted to humans and can be easily transmitted from person to person like the annual flu.

Earlier this year, WHO did not admit to any human-to-human transmission, despite a number of very suspicious family clusters in Asia, Turkey, Iraq and Azerbaijan. In every single case, WHO used some excuse or another to hide these human-to-human transmissions from the media and the public.

Maria Cheng

That is, until Indonesia made it impossible to hide — and still the WHO did its very best to deceive the media and the public. It was only on May 30 that Maria Cheng, WHO spokeswoman, finally admitted that there were "probably about half a dozen" cases of human-to-human transmission. These cases went back years and WHO knew then that they were human-to-human cases, but refused then to admit it.

And Dr. Angus Nicoll, chief of flu activities at the European Center for Disease Prevention and Control, acknowledged that "we are probably underestimating the extent of person-to-person transmission."

Indonesia, the Time Bomb

In mid-April 2006, Bernard Vallat, head of the Paris-based World Organization for Animal Health (OIE) told reporters: "Indonesia is a time-bomb for the region." Vallat was referring to Indonesia having Asia's highest number of unchecked infection sites, which he correlated to the number of bird flu cases in birds and humans. Ever mindful of its tourist revenue, the Indonesian agriculture minister rebutted Vallat's comment by announcing that Indonesia was winning its fight against bird flu and expects to be free of the killer virus by 2008.

Bernard Vallat

This Indonesian official's comment was greeted with scorn, but then reports of new cases went comparatively quiet at the end of April and into the first week in May. But the events that put Indonesia squarely into the international spotlight for two months had begun in late April and had gone virtually unnoticed even by the Indonesia media until May 9 when the local media announced that in the Karo area of North Sumatra a man had been hospitalized with suspected bird flu. The Indonesian press also took notice that his mother had died a few days earlier and that others in the family were sick.

Family cluster is near Medan, Indonesia

Indonesia and other countries had experienced a number of family clusters, which raised the specter of human-to-human transmission, but WHO maintained that in these clusters family members were all infected from exposure the same flu-infected birds, usually in the preparation or eating of them. It was difficult to prove otherwise because WHO withheld critical information about onset dates. Significant gaps between onset dates can account for transmission from one person to another.

But this time it was different: facts emerged that made it impossible for WHO to sweep things under the rug, although they did try.

WHO Saves the World: the Containment Plan

WHO kept talking about a barbeque that occurred on April 29 where all the family members ate chicken and pork, implying that they all ate the same infected meat, but then it became known that the first person to die was already sick on April 27, meaning that she had probably become infected from an unknown source some 2-5 days earlier.

Village in Indonesia

As her condition worsened, many of her relatives came into close contact with her either to nurse or comfort her. Several spent the night in her small room sitting in close proximity while she coughed violently. When she died May 4, her relatives had already been infected and started dying five days later: one on May 9, one on May 10, two on May 12 and one on May 13^th. From the onset dates it was likely that she had infected her family members, one of whom was still alive in the hospital.

By that time WHO's laboratory in Hong Kong was confirming that it was an H5N1 infection and WHO was bringing in its team and Tamiflu just like it had done in several countries a few months before. By WHO's calculations they had a maximum 3-week window to contain, or at least slow a pandemic strain after it emerged. They were late in the process since they only had one man on the ground 19 days after the first victim had become sick. The larger team of three didn't assemble in Indonesia until May 18.

Tamiflu capsules

But, late or not, the WHO team would go into the village, treat everyone with Tamiflu, test the chickens and kill them if they were infected. Everything would be okay.

But it was a long way from okay.

"Evil Spirits"

The WHO team got a nasty shock in mid-May when they tried to work their usual magic on the villagers in North Sumatra. This small village was a Christian community in the midst of a dominantly-Muslim country, but it had maintained some of the types of beliefs found in other rural communities around the world.

Testing birds in Indonesia (AP)

The villagers understood perfectly the tragedy that had befallen their neighbors: "it had been caused by evil spirits." The family had been cursed. No one would go anywhere near their three modest homes. The remaining family members had fled the village to get away from the "evil spirits" and the suspicions of their neighbors.

Declan Butler, reporter for the highly respected Nature publication, summarizes the various reports coming from Indonesian media:

"...villagers concerned that their animals would be killed became hostile to outsiders, resulting in international experts and local teams being subsequently barred from the village for a whole five days. Victims refused to take Tamiflu, fled the government hospital, while families refused protective gear when caring for their sick...the list of unanticipated confusion goes on."

The villagers did not permit the WHO team to go in and test their animals so the source of the infection of the first victim will never be known. It could have been poultry, pigs, cats or any other H5N1-susceptible animal.

As if to underscore the magnitude of the Indonesia problem, a group of protesters beheaded a chicken and drank its blood to show authorities that poultry was not the source of the problem. Later, 100 poultry dealers tore apart live chickens and ate them.

None of the villagers' behavior is necessarily WHO's fault, but it shows that the WHO containment plan won't work in much of the Third World, which represents the areas most likely to produce a pandemic strain.

On that same day, Gina Samaan, a field epidemiologist for the World Health Organization in Kubu Sembilang investigating the recent cluster told reporters that the "avian flu deaths confirmed this week on Sumatra were probably not a result of human-to-human infection and did not suggest that the virus had mutated into a more deadly form." Unfortunately, she was wrong.

Buying chickens in Jakarta (AP)

The Double Skip

Then on May 22 came the news that another cluster family member, Dowes Ginting, the father of 10-year-old Rafael who died of H5N1 on May 13, died right after they had brought him to the hospital. Dowes started coughing a couple of days after his son's death. He had close contact with his son, caring for him as he was dying.

Dowes was deeply depressed by his son's death, refused treatment for the deadly flu and escaped from the hospital, traveling through at least four villages before he found someone to take care of him. He sought out a local healer — referred to in the press as a "witch doctor " — and hid out in one of the local villages until he was near death, when his wife took him to the hospital.

This event created some very serious credibility problems for WHO. The infection onset dates strongly suggested that son Rafael had been infected by his aunt, the first victim in the family, and that Dowes was infected by his son. Not only did this cluster point to human-to-human transmission, it pointed to human-to-human-to-human transmission. Even worse, you have a man infected with a potential pandemic strain of the virus running around exposing any number of people. So much for the containment plan.

Did the WHO team know about Dowes? If they did know about it, why did they suppress that information and what is one to make of WHO field epidemiologist Gina Samaan's statement?

Damage Control

Something very frightening had happened in that North Sumatran village which was clearly different from other outbreaks. Not only was the variation of the virus a threat, the dangerous, but understandable, behavior of the terrified villagers compounded the threat. For the first time a huge global audience saw how a pandemic could emerge.

Instead of admitting the obvious, WHO went into damage control mode and issued this statement on May 23, the day after Dowes Ginting died:

"All confirmed cases in the cluster can be directly linked to close and prolonged exposure to a patient during a phase of severe illness. Although human-to-human transmission cannot be ruled out, the search for a possible alternative source of exposure is continuing."

Johannes Ginting, the only survivor of the cluster family

The exposure of the family members, at least from what was described in the Indonesian press, was probably not much different than one would get sitting next to a person for a couple of hours on an airplane or children playing in school. The first victim's family members sat in a room with her for several hours, which is similar to exposure that exists in homes, schools and businesses everywhere.

"....Priority is now being given to the search for additional cases of influenza-like illness in other family members, close contacts, and the general community. 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."

From now on there is no talk of "no confirmed cases of human-to-human transmission" in what WHO tells the media. Now the wording has changed ever so slightly to "no evidence that efficient human-to-human transmission has occurred." Good thing that there wasn't because that is a pandemic, but WHO never explained that to reporters.

"Full genetic sequencing of two viruses isolated from cases in this cluster has been completed by WHO H5 reference laboratories in Hong Kong and the USA. Sequencing of all eight gene segments found no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations. The viruses showed no mutations associated with resistance to the neuraminidase inhibitors, including oseltamivir (Tamiflu).

"The human viruses from this cluster are genetically similar to viruses isolated from poultry in North Sumatra during a previous outbreak."

The world was left to puzzle out how something so dangerous could occur within the context of this statement. "No significant mutations?" Obviously something significant occurred in this variation of the virus. While the most of the media latched onto this phrase and trumpeted it in the headlines, others wondered if WHO's experts understood enough about the virus to even know what mutations were significant.

More Spin

On May 24 a very nervous global audience, astonished that the Indonesians had let the infected Dowes Ginting leave the hospital, was soothed by WHO spokesman Dick Thompson: "There are 33 people identified as close contacts," he told reporters. "We've asked them to observe home quarantine. That's something they are willing to do to protect themselves and their families." The number quickly rose to 54 people as WHO realized how many people Dowes had exposed in his escape from the hospital in Medan and there was absolutely no assurance that they had identified them all.

Dick Thompson

At the same time, Maria Cheng, another WHO spokesperson, told the New York Times the villagers were quarantined. She did not mention that the quarantine was voluntary, not enforced, and villagers went about their business as usual. Furthermore she neglected to mention that many refused to have their blood tested and refused the anti-viral Tamiflu. Not exactly an ideal quarantine — not even close to ideal. Upon questioning, she admitted that the villagers "had not been as cooperative as we'd like." Quite an understatement, given the facts.

In the next few days WHO continued to downplay the events in Indonesia, telling the press "that even if human-to-human transmission did occur, it was in a very limited way and the infection has not spread beyond the family cluster. In addition, scientific evidence has shown the virus has not mutated into one that can be easily passed among people."

That statement may have been true, but WHO would have had no way of knowing it when they announced it. They had no effective means of identifying everyone that had been exposed and no effective way of monitoring those that they knew had been exposed.

Keeping WHO honest

At least one expert wasn't impressed by WHO's attempts to play down the significance of the Indonesian cluster. Dr. Henry L. Niman, founder of Pittsburgh-based recombinomix, Inc., has been promoting a theory of viral evolution called recombination, which he calls "elegant evolution." Recombination, as Niman explains it, permits researchers to predict the genetic components of a pandemic influenza virus because changes in the viruses are predictable and permit vaccines to be prepared in advance.

His daily commentary on his web site and his explanations of virus behavior on discussion forums like Flutrackers have made him a popular figure among the growing number of people who closely watch the forward march of the deadly H5N1 virus. Several of his predictions have been unnervingly accurate. Niman also brings into high relief inaccuracies and spin in the WHO press releases.

Dr. Henry L. Niman

For example, WHO's desire to pretend, while it could, that human-to-human transmission did not occur in various cluster cases around the world, led various WHO spokespeople to claim during last winter's large Turkish cluster that the H5N1 incubation period was as long as 17 days. Niman punctured the credibility of this statement by referring his audience to a New England Journal of Medicine article indicating that most H5N1 infections had an incubation period of 2-5 days.

Niman always reminds his audience that the H5N1 virus doesn't read WHO press releases.

As long as WHO could keep a lid on the virus genetic information, Niman's theories on a particular cluster could not be proven. Imagine WHO's surprise when Niman was the first to expose WHO's deceptions about the virus mutations in the large Indonesian cluster that had not yet been made public.

Withholding The Evidence

WHO has been able to get away with many of its deceptions regarding the genetic mutations in the H5N1 virus because of its increasingly controversial practice of not making the genetic information public so that the world's scientific community can study it. Hopefully, this practice is coming to an end — one way or another.

Some interesting things happened when various influenza experts met in Jakarta June 21-23. The presentations and the information about the mutations in the large Indonesian cluster discussed in this closed session were leaked. Niman received the genetic sequences from that cluster and divulged what he learned to his entire audience.

It was no surprise to Niman that the mutations were much more extensive than WHO let on to the public. Apparently, the statement that WHO released was accurate, but the wording was very carefully parsed and much information had been left out.

Subsequently, Nature published a revealing article on the full mutations in the Indonesian cluster where human-to-human transmission took place at least twice. Declan Butler commented on it in his blog:

"WHO said on 23 May that there was 'no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations.'

"The data obtained by Nature suggests that although the WHO statement was not incorrect, plenty more could have been said. Viruses from five of the cases had between one and four mutations each compared with the sequence shared by most of the strains. In the case of the father [Dowes Ginting] who is thought to have caught the virus from his son — a second-generation spread — there were twenty-one mutations across seven of the eight flu genes."

WHO has to abide by the constraints put on them by member states, who own the genetic information gathered within their countries. Countries may not permit the sharing of the influenza genetic data because they want to have an advantage in developing a vaccine faster if a pandemic strain emerges in their country — a vaccine which would find a ready market in the rest of the world. Some media reports have suggested that Indonesia is willing to share its information, but WHO has not yet formally requested it.

1918 influenza pandemic

In a world where it is increasingly difficult to get a large number of countries to agree on anything and where the levels of ignorance and poverty encourage a perfect breeding ground for the development of a pandemic strain of influenza, it is unreasonable to expect that WHO can always contain the outbreaks in time and that they can persuade corrupt and negligent governments to act responsibly.

What we can and should expect from WHO is the truth — as soon as they know it — not spin or information management that insults human intelligence. If the United Nations' World Health Organization cannot be trusted in the prelude to a pandemic, what good do they serve?

Count in Indonesia rises CIDRAP reports

Indonesia reports 54th avian flu case

Jul 17, 2006 (CIDRAP News) – Indonesian health officials are reporting that a 44-year-old man who died last week tested positive for the H5N1 avian influenza virus, according to news services.

If the man's lab results are confirmed by a World Health Organization (WHO) accredited laboratory in Hong Kong, he will be Indonesia’s 42nd avian flu fatality and 54th confirmed case. Also, Indonesia will be tied with Vietnam for the highest avian flu death toll.

The man, who lived in East Jakarta, died Jul 12 after being hospitalized for 2 days with high fever, coughing, and breathing difficulties, Indonesian health official I Nyoman Kandun told The Jakarta Post. Kandun said the man had a history of contact with chickens, and the article said he was a fried-chicken vendor.

With the latest death, the case-fatality rate for avian flu in Indonesia is 78%, whereas Vietnam, with 93 cases and 42 deaths, has a fatality rate of 45%. According to the WHO tally, the overall case-fatality rate is 57% (230 cases, 132 deaths).

Kandun said Indonesia expects more human H5N1 cases because the disease continues to circulate throughout the country, with a presence in 27 of 32 provinces. He added that culling millions of chickens throughout the country would be too costly and urged Indonesians to take basic safety measures such as washing their hands after handling sick birds.

Vietnam seems to have stemmed avian flu outbreaks. The country has not reported a human fatality this year, whereas Indonesia has had several cases each month.

According to the Post report, the Indonesian government needs $980 million to finance its avian influenza programs from 2006 to 2008. The funds would go toward activities such as compensating farmers for culled chickens, purchasing vaccines, and planning for a pandemic.

A senior WHO official in Indonesia, Steven Bjorge, told the Post that worldwide concern about the avian flu situation in Indonesia is continuing and said he hoped that health and agriculture ministries would work more closely to fight the disease. He suggested that that comparisons between Indonesia and Vietnam can be misleading, because Indonesia is much larger than Vietnam. (Indonesia has the world's fourth largest population and the 16th largest area, whereas Vietnam ranks 12th and 65th in those measures.)

In other developments, yesterday at the Group of Eight summit meeting in St Petersburg, Russia, world leaders issued a joint statement supporting a Russian proposal to build "the WHO Collaborating Centre on Influenza for Eurasia and Central Asia," provided the center meets WHO and other international standards. Leaders also vowed to follow through on the commitments they made last January at the Beijing International Pledging Conference on Avian and Pandemic Influenza.

Meanwhile, Channel NewsAsia reported that Singapore will stage a large-scale test of its pandemic response plan on Jul 21 and 22. The test, called Exercise Sparrowhawk II, will involve 1,000 personnel from key government agencies and 19 locations, including transportation terminals, hospitals, clinics, and schools.

The report said masks will be given to visitors at hospitals, and the health ministry will ask the public to wear masks if they experience flu-like symptoms. Rapid-response teams are slated to institute infection control measures and manage initial cases at healthcare facilities. Hundreds of volunteers will play the role of patients, and police will practice for crowd-control situations, such as when people descend on clinics to purchase antiviral medications.

See also:

WHO's avian flu case count

G8 summit statement on global fight against infectious diseases
http://www.en.g8russia.ru/docs/10.html

Virginia testing for avian flu

Virginia will test birds for avian flu

Waterfowl, shorebirds focus of effort that starts next month

BY A.J. HOSTETLER TIMES-DISPATCH STAFF WRITER

Jul 17, 2006

Next month, wildlife officials will start searching for avian influenza among the millions of waterfowl and shorebirds that flock each fall to Virginia's coast, waterways and marshes,making them easier to catch. At least four other species will be tested as they arrive later from their summer breeding grounds up north.

In all, state and federal officials plan to sample some 800 waterfowl and about 800 shorebirds, mostly around the Eastern Shore, the Chesapeake Bay and rivers in eastern Virginia.

The samples will join a federal database that by the end of the year will number roughly 100,000, gathered by universities, private organizations, and state and federal agencies, including the departments of Interior and Agriculture.

"The resident mute swans are a good one to look at because they are highly susceptible," said ornithologist Dan Cristol of the College of William and Mary. "If one turns up positive, we will know that a migratory species brought it in and transferred it to a resident."

Virginia and other states are implementing wildlife-surveillance plans for avian influenza in addition to their public health preparations for any pandemic human flu.

The commonwealth's wide diversity of wetlands makes it a great autumnal getaway for birds heading south. That is one of the reasons Virginia is considered a primary sampling state, according to Bob Ellis, assistant director of the wildlife division for the Virginia Department of Game and Inland Fisheries. Ellis led development of Virginia's plan, which will extend through the fall.

The state's surveillance program was developed in accordance with a federal strategy as well as a plan expected to gain approval this week at a meeting of the Atlantic Flyway Council, which includes state and wildlife representatives from Maine to Florida. Ellis, who chairs the National Flyway Council, also represents Virginia on the Atlantic Flyway.

"This is almost the cart before the horse, but we can't wait too long for the [Atlantic] Flyway plan," Ellis said.

Since 2003, the H5N1 virus has killed more than 100 people and millions of birds worldwide, sparking fears that the virus could mutate into a pandemic influenza.

Dozens of species of wild birds as well as domestic poultry have been hit by bird flu. So far, officials know of no U.S. bird infected by the H5N1 virus, nor has anyone in the country been sickened by it.

Federal officials this summer are monitoring Alaska and the Pacific Northwest as the likeliest region for the virus' entry from Asia into the United States. In Alaska alone, the U.S. Geological Survey has 50 camps to take samples from 27 species of shorebirds and waterfowl, said Paul Slota, who oversees laboratory testing of the samples at the National Wildlife Center.

But the virus could also come via the Atlantic Flyway, which stretches from Greenland to Canada and south through Virginia to Florida and Puerto Rico. American birds summering in Greenland mix with those migrating from Africa and Europe, where avian flu already exists.

The first infected birds could show up along the East Coast as soon as late August or September, experts say.

By then, game and wildlife officials will have fanned out along eastern Virginia's waterways. In some cases they will be capturing live waterfowl but more often seeking out birds harvested by hunters along the Chesapeake Bay and inland waterways.

About a dozen officials will participate, and additionally game officials will work with the U.S. Department of Agriculture on a separate sampling program of live shorebirds.

Partly because of manpower issues, Ellis said, the Virginia waterfowl plan relies heavily on hunters to provide birds for sampling.

Swabs taken from the waterfowl birds' windpipes and rectums will be tested by the state Agriculture Department's lab in Harrisonburg. The USDA will reimburse the game agency $100 per bird for the sampling process, Ellis said. USDA spokeswoman Gail Kiern of the National Wildlife Research Center said the state lab will be reimbursed at least $11,200 for its work.

Any results that indicate an avian-flu strain of the H5 or the milder H7 type will be considered a preliminary positive result of avian flu. The H7 strain has cost Virginia's poultry farmers millions of dollars in recent outbreaks.

The game department will then notify the governor, state and federal health and wildlife officials and the public of any preliminary positive results. The suspected sample will be sent to the USDA's National Veterinary Services Laboratory in Ames, Iowa, for further testing, which can take several days.

Most plans for states in the Atlantic Flyway will resemble Virginia's. Where they differ will generally be in the specific avian species, the sample number and location, chosen to cast the best dragnet for avian flu, said Paul Peditto, director of Maryland's Wildlife and Heritage Service.

The plan for Maryland, which began testing similar species around the bay this month, is similar to Virginia's, Peditto said.

However, it relies more on live-bird capture because to avoid duplicating Virginia's efforts, Maryland is looking at other waterfowl, such as canvasback ducks that descend on the Chesapeake Bay, Ellis noted.

Cristol said that while he thinks migrating songbirds such as the blackpoll warbler or the gray-cheeked thrush also pose a risk in Virginia, "you can't test everything and waterfowl are the most likely carriers as far as we know."

"The $6 million question is, 'is 800 birds enough?'" he said. "Literally millions of birds move through [Virginia] in a season."

Federal officials estimate that they have a 95 percent chance of finding H5N1 even if it is present in as little as 1.5 percent of the sample bird population.

Wildlife veterinarian Jonathan Sleeman of Virginia's game agency said the target goal of 200 birds per species was developed using mathematical modeling based on the accuracy and sensitivity of the H5N1 test, random sampling and the increased prevalence of the disease and birds during fall migration.

Contact staff writer A.J. Hostetler at ahostetler@timesdispatch.com

The reason Thailand is keeping mum about H5N1??

Thai chicken exports set to rise as bird flu fears ease

Monday • July 17, 2006

Thailand has said its chicken exports were expected to rise by almost 30 percent this year as concerns ease among key export markets over the deadly bird flu virus in the kingdom.

The agriculture ministry said exports of cooked chicken were targeted at 350,000 tonnes this year, a jump from 276,000 tonnes shipped in 2005, due mainly to increased orders from Japan and the European Union.

Thailand has already shipped 140,000 tonnes of chicken abroad during January to June. Japan and the EU are the two biggest buyers of Thai chicken.

"Together with rising consumption in Japan and the EU, consumers there are more confident in the quality of chicken exported from Thailand," Yukol Limlamthong, director of the livestock development department, told AFP.

"While maintaining its ban on raw chicken exports from Thailand until December 2007, the EU has ordered 10 percent more cooked chicken from us this year compared to 2005," he said.

Raw poultry products from Thailand, one of the world's biggest chicken exporters, have been banned internationally since the first cases of the deadly H5N1 virus were detected here in January 2004.

Cooked chicken does not carry the virus and is not affected by the bans.

Thailand has suffered 22 cases of bird flu in humans, including 14 fatalities, most recently in December.

Ministry officials have tried to reassure Thailand's trading partners of the quality of Thai chicken.

"Almost all the bird flu cases were detected in chicken raised in backyards, not in the commercial sector where sanitation standards are quite high," said Pornchai Chamanpood, director of the National Institute of Animal Health.

"Even in areas where the flu was widespread, we didn't find any contamination in chicken factories there."

Thailand announced early this month it hopes to be completely free of the deadly bird flu virus in three years, after eight months so far without the outbreak. — AFP

From Russian News Agency Avian Flu News

Bird flu pandemic could claim $800bln in first year alone - WHO

18:16 | 17/ 07/ 2006

STRELNA (near St. Petersburg), July 17 (RIA Novosti) - A bird flu pandemic could inflict hundreds of billions of dollars in economic losses within a year, an assistant director-general of the World Health Organization said Monday.

Margaret Chan said the virus was mutating to spread to humans and could cause global economic losses of $800 billion in the first year of the pandemic alone, according to data of the World Bank.

Chan said governments throughout the world must be persuaded to focus on bird flu and a human-to-human form because people have no immunity to the illness.

She added no country would be able to avoid a pandemic, but said most countries had already drafted special plans to fight avian influenza.

Since late 2003, about 200 people have died in the world from the H5N1 strain of the disease.

Alberta avian flu testing

Avian Flu: Alberta Officials Begin Monitoring Birds for Virus - 07/17/2006

The Canadian province of Alberta, as part of a national survey, is monitoring wild waterfowl and shorebirds for possible avian influenza virus.

Alberta's surveillance program will focus on wild waterfowl and shorebirds found dead during migration from July to October. According to the government of Alberta, these birds may have used Arctic breeding grounds and may have come into contact with birds that migrated from Asia, where the dangerous Eurasian H5:N1 strain of virus has spread from domestic poultry.

The Alberta monitoring program will not include wild birds in urban or residential areas.

Alberta Sustainable Resource Development staff members will look for and collect dead waterfowl and shorebirds during the course of their work. Other government departments and cooperating agencies will be involved.

The provincial government is encouraging its residents to submit or report any waterfowl and shorebirds that they find dead in the province. These include ducks, geese, swans, plovers, sandpipers and phalaropes.

As swans seem particularly vulnerable to the H5:N1 virus, people in remote areas of northern and central Alberta where swans nest are urged to report or collect any swans found dead.

Dead waterfowl or shorebirds should be submitted fresh or should be frozen if they cannot be delivered to a Fish and Wildlife office within 24 hours, the Alberta government says. Rotten or dried-out carcasses cannot be tested for avian influenza, according to the government.

The Alberta government recommends the following basic precautions when handling dead wildlife:

• Wear disposable gloves.
• Place a plastic bag over your hand, or use a stick to move the bird into a box, container or double plastic bags to avoid contact with it.
• Wash your hands and disinfect surfaces that come into contact with the dead birds.
• Any unusual wildlife mortality should be reported to a Fish and Wildlife office.

The Alberta government has created a Web page with information on avian influenza in wild birds.

- Josh Cable

Thailand may be keeping bird flu secrets

Bird flu has returned, suspects senator

By Phoojadkarn Daily

17 July 2006 02:11

Outgoing Ubon Ratchathani senator Nirand Pitakwatchara said at the weekend that he believes bird flu has resurfaced in Thailand, but that state authorities have concealed the matter for political reasons. Nirand, a former chairman of the senate committee on social development and human security, said it was most likely that the Agriculture Ministry, under Khunying Sudarat Keyuraphan, who was responsible for dealing with avian flu when she was Public Health Minister, has teamed up with the Public Health Ministry to cover up the reappearance of the disease to protect the Thai Rak Thai government. “If bird flu has really come back, it means that all the government’s measures to prevent the disease have failed miserably,” said Nirand. “It seems to me that the government’s previous actions were only meant to build up its image and gain political popularity,” he added. The senator’s comments coincided with the disclosure by a livestock official who told a Phoojadkarn Daily reporter that bird flu has returned in Phichit and Phitsanulok provinces, killing poultry there in recent months. Livestock officials have been told to keep their mouths shut as the news may affect the government’s stability and lead to a worsening of political and economic conditions, said the source, who asked not to be named.

Indonesia's dubious distinction

Date: Sun 16 Jul 2006


Indonesia: Suspected (42nd) Death from H5N1 Avian Influenza
-----------------------------------------------
A 44-year-old Indonesian who died 4 days ago has tested positive for bird
flu, a senior Health Ministry official said on Sunday [16 Jul 2006], citing
a local test. If the diagnosis is confirmed by a laboratory sanctioned by
the World Health Organization (WHO), the East Jakarta man would be the 42nd
bird flu death in Indonesia, a sprawling archipelago where the virus has
killed millions of fowl and caused more human deaths this year [2006] than
in any other country. Confirmation would take Indonesia level with Viet Nam
as the country recording the most human fatalities from the H5N1 strain of
the avian flu virus. Viet Nam's 42nd death occurred in 2005. "Like so many
other bird flu cases, the man had contact with a dead chicken in his
neighborhood. He died on 12 Jul 2006, and we are now waiting for the
confirmation," I Nyoman Kandun, director general of communicable disease
control at the Health Ministry, told Reuters.

According to the WHO, the H5N1 strain has killed 132 people across the
globe since 2003. The global health arm has so far confirmed 41 deaths in
Indonesia, where the virus is endemic in poultry in nearly all of the
country's 33 provinces. Earlier this month [July 2006], a senior government
official said Indonesia's poultry death rate from bird flu was worsening,
possibly due to poor vaccination coverage. In 2005, [poultry] deaths for
the year as a whole were 1.2 million.

Indonesia has been criticized for doing too little to stamp out the H5N1
virus, which remains essentially an animal disease but which experts fear
could spark a pandemic if it mutates into a form easily transmissible
between humans. The government has so far shied away from mass poultry
culling, citing lack of funds and the impracticality of the move in a
country with millions of backyard fowl. Vaccination is the preferred method
to prevent the spread of bird flu among poultry.

Indonesia drew international attention in May 2006 when the virus killed 7
members of a single family in North Sumatra. Experts said there could have
been limited human-to-human transmission in the cluster case. On Thu [13
Jul 2006], the leading science journal Nature reported that multiple
mutations had been found in the H5N1 virus that killed the Sumatra family,
although scientists are unsure of their significance [see: Avian influenza,
human (95): China, Indonesia 20060713.1934].

[Byline: Achmad Sukarsono]

--

G8 talks about bird flu

	G8 backs Russia's proposal on center to control bird flu
	15:26 | 16/ 07/ 2006

ST. PETERSBURG, July 16 (RIA Novosti) - Leaders of the Group of Eight leading industrialized nations gave their support to Russia's initiative to build within its territory a World Health Organization center for the fight against bird flu in Eurasia and Central Asia in a joint statement Sunday.

"We welcome the Russian proposal to establish the WHO Collaborating Centre on Influenza for Eurasia and Central Asia, subject to meeting all applicable WHO and other international standards, to enhance international capacity to counter the spread of the viruses in the region," the document on the fight against infectious diseases adopted at the G8 summit in St. Petersburg says.

In the statement, the leaders pledge "to help the global community prepare for a possible human influenza pandemic, including timely implementation of the commitments made at the January 2006 Beijing International Pledging Conference on Avian and Pandemic Influenza."