Bird flu still a threat 10 years after leap to humans

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Bird flu still a threat 10 years after leap to humans

By Anita Manning, USA TODAY

In Hong Kong, when a mysterious avian flu virus jumped from poultry to

people for the first time, killing six of the 18 people infected,

world health experts sounded the alarm. They warned that the stage was

set for a global flu pandemic.

That was 10 years ago, and the virus, known as H5N1, has not yet

changed in a way that would allow it to spread easily from person to

person. But health experts say the danger has not diminished.

" It is still a threat as long as we have transmission in poultry, "

says flu expert Arnold Monto of the University of Michigan. " We have

absolutely no precedent of having had this transmit in the bird

population in so many different places, and having, almost every week,

reports of another human case. "

Among the most recent infections in people reported by the World

Health Organization was the death of a man in Indonesia Dec. 13 and

the first case in Burma, also known as Myanmar, in a child who was

hospitalized in November and has recovered. The first confirmed case

in Pakistan involved the death of a 25-year-old man Nov. 28 whose

brother, a veterinarian, became sick after culling infected poultry.

The vet, whose infection with H5N1 is suspected but not confirmed,

recovered.

In 1997, officials in Hong Kong, hoping to stamp out the virus,

ordered all chickens in the territory, more than 1 million, to be

slaughtered. That action, led by the city's health director, Margaret

Chan, who is now director-general of WHO, appeared to work, and the

virus receded. But it re-emerged in China in 2003 and began to spread.

Since 2003, WHO has confirmed 346 infections in 14 countries, and 213

deaths.

The virus has traveled far: It has turned up in countries in Asia,

Africa, Europe and the Middle East, says Tim Uyeki, a medical

epidemiologist with the Centers for Disease Control and Prevention.

" Just in 2007, we've seen the first reports of human cases in Laos,

Nigeria and Burma, " he says. Cases tend to coincide with poultry

outbreaks and spike in winter, he says, " so it would not be surprising

to see cases increasing. "

Uyeki says the highly pathogenic form of H5N1 has never turned up in

North America in wild birds, poultry or people. And because of

heightened awareness of the pandemic threat, governments around the

world have started to prepare.

" There has been a lot of progress in this area, but more needs to be

done, " Uyeki says. " We need much better collaboration, communication

and sustained funding for strengthening of both animal health

surveillance and public health surveillance. "

Scientists are monitoring strains of the ever-evolving virus so if it

does become easily contagious, pandemic preparations can move into

high gear.

Indonesia has the most cases: 116 people infected, of whom 94 have

died. But health officials there have balked at sharing virus samples,

believing they could be used to create a vaccine the country might not

be able to afford. " WHO, in recognition of this problem, is trying to

address this issue, " Monto says, " but there has not been a

satisfactory conclusion. "

Meanwhile, Uyeki says, preparedness for a flu pandemic should not stop.

" The risk continues, people continue to be infected, we've had new

countries affected and the mortality rate is higher than 60%, " he

says. Though human infection with H5N1 is rare, especially compared

with seasonal flu that causes 36,000 deaths each year in the USA, he

says, " the pandemic threat is ongoing. "

http://www.usatoday.com/news/health/2007-12-30-bird-flu-threat_N.htm