See related info, links below. KwC

Signs point to global flu outbreak, WHO says
Recent events stir growing concerns among health officials tracking virus

Reuters, Updated: 12:17 p.m. ET July 22, 2005

GENEVA - Indonesia’s first human bird flu case, coupled with more birds dying elsewhere including Russia, are signs a long-dreaded global influenza pandemic may be approaching, the World Health Organization said on Friday.  Health officials fear the virus will mutate and mix with human influenza, creating a deadly pandemic strain that becomes easily transmissible and could kill millions of people.  Margaret Chan, WHO’s new director for pandemic influenza preparedness, said there had been no known sustained human to human transmission of the deadly virus, but called for stepping up disease surveillance among poultry and humans worldwide.

Indonesia this week confirmed its first death from the virus, which has so far killed more than 50 people since late 2003 in Vietnam, Thailand and Cambodia, roughly half of the known cases.  An Indonesian government official was confirmed as having died of the H5N1 bird flu virus, but results of laboratory tests on his two young daughters who also died are still awaited.

'More and more birds are dying'  “This is more evidence for us to be concerned about developments in the region,” Chan told a news briefing.  “This is perhaps the only time since 1968, which was the last pandemic, that we are getting signs, symptoms and warnings from nature ... More and more birds are dying in different parts of the world — this is the kind of signals, and early warnings that we are referring to.”

Russia this week said it had discovered a disease in poultry in a remote village in Siberia, its first suspected case of bird flu. Around 300 birds died and specimens are being analyzed.

Chan, a former health director of Hong Kong who helped contain its bird flu and SARS outbreaks of 1997, said the WHO’s risk assessment of a global pandemic still stood at three on a scale of six.  “We need to be very vigilant and look for early signals or signs of sustained human to human transmission,” she said. “We need to advise people from farm to table on what actions they can take or can advise communities to take to reduce that risk.”

Preventative measures: Mixed poultry trading — where ducks, geese, chickens and sometimes pigeons are sold side-by-side at market — can be an "enabling environment for the virus to mutate," Chan said. Recommended measures include separating poultry, vaccination of poultry, and other biosecurity measures on farms, she said.  “Our experience is that if you are prepared for a pandemic you get less impact in terms of mortality and morbidity and social and economic disruption,” she said.

Chan also said that the WHO, a United Nations agency, was still pressing China to allow international laboratories to examine specimens from birds in Qinghai, where the H5N1 virus has killed more than 5,000 birds from five species.

The WHO is urging China to test the other 184 species in the area, fearing birds which appear healthy could also spread the disease. This would help understand the evolution of the virus and inform public health decisions, according to Chan.

Copyright 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters.

 

http://www.msnbc.msn.com/id/8667835/

 

Bird Flu News http://www.sars.com.sg/birdflu/bfnews.php

Bird Flu confirmed at farm in Japan http://www.washingtonpost.com/wp-dyn/content/article/2005/06/26/AR2005062601053.html

Center for Disease Control (CDC) Pandemic Influenza Response and Preparedness Plan http://www.cdc.gov/flu/avian/gen-info/pandemics.htm

US criticized for Bird Flu plans http://my.webmd.com/content/Article/106/108247.htm

 

This is what I found on US emergency plans for an expected flu pandemic: most of this information is from 2004.

  • Pres Bush signed an order allowing quarantine of anyone flying into the country suspected of being a carrier.
  • US may close schools, restrict travel, restrict public events, ration medications in an outbreak, depending on where and how bad it is.  http://www.msnbc.msn.com/id/5820548/
  • Health experts say when the pandemic comes, it won't happen overnight. "We believe there will be different phases," Stohr says. "It will not start immediately with a full-blown, fully transmissible pandemic virus."  Response plans are designed to ratchet up as the pandemic develops, moving from steps that might include school closings or travel restrictions to increased vaccine production and antiviral distribution. "We don't expect it this year," Fauci says. "It's extremely unlikely."  http://www.azcentral.com/health/news/articles/1223pandemic-ON.html

 

From Nursing Spectrum:  Epidemiologists are now watching for a mutation of the virus allowing person-to-person transmission. The most likely scenario, health officials say, is someone infected with a human flu virus also becoming infected with bird flu. The viruses could merge, unleashing a deadly illness as contagious as common flu upon a population with no ready antibodies. Scientists now believe some forms of human-bird viral combination were responsible for flu pandemics in the previous century.

…Government health officials are preparing for clinical trials of an H5N1 vaccine this month. But any vaccine specific to a virus responsible for a pandemic would probably not be ready for at least six months after the first infections — and when it was ready, there would not be enough to vaccinate everyone, says Shelly McKeirnan, RN, MPH, epidemic response coordinator for the communicable disease, epidemiology and immunization section of the public health department for Seattle and surrounding King County, Wash.

Some countries are stockpiling the antiviral drug oseltamivir, or Tamiflu, which has been shown to be effective against H5N1 in laboratory tests. But the drug is expensive, and other tests have shown the virus can mutate to make the drug less effective, according to press reports.

Nurses need to have increased awareness of what is happening with avian influenza, says Linda Chiarello, RN, MS, an infection control consultant with the CDC who is helping the organization develop a pandemic plan for health care facilities. They should be reading avian flu reports on the CDC and WHO websites.

Health care facilities should be able to monitor the diagnoses and hospital admissions of patients who have regular influenza and be ready to detect any new strain, she says. They should look for suspicious cases, such as a patient with flu symptoms who comes to the hospital after the normal flu season is over.  McKeirnan recommends that nurses get involved in creating or familiarizing themselves with their facilities’ emergency preparedness plans. She also recommends that they read the Department of Health and Human Service’s Pandemic Influenza Preparedness and Response Plan.”  http://community.nursingspectrum.com/MagazineArticles/article.cfm?AID=13780

 

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