Chinese Man Survives H5N1 After 20 Days Of Treatment

A 52 year old Jiangsu man, Lu, lost his son to the bird flu virus in early November. Lu developed a fever shortly after his son died, and it was confirmed he too had become infected with H5N1.

But after 20 days of treatment, Lu recovered and was discharged from a hospital into the care of his family :

Lu's son died on Nov. 2, a couple of days after being diagnosed with "lower left lobe pneumonia" in Nanjing, the capital of Jiangsu. He was the 17th Chinese to die of avian flu since 2003.

He was said to have had no contact with dead poultry and the Jiangsu Animal Husbandry and Veterinary Bureau said no bird flu epidemic had been discovered in the province.

China's health authorities previously said that no human-to-human transmission had been confirmed in the two human cases of bird flu and the means of transmission in these cases, involving the two family members in the Nanjing area, remained unknown.

As with all human bird flu cases in China, details are thin.

Ten Years Later, Scientists Still Baffled By Bird Flu

Despite a decade of testing and research, the H5N1 virus remains, mostly, a complete mystery to scientists, even as it becomes part of daily life for hundreds of millions of people around the world :

Baffled scientists first watched a mysterious virus called H5N1 jump from birds to humans a decade ago in Hong Kong, killing six people and forcing the territory to slaughter its entire poultry population. It quieted for a while, but resurfaced in 2003 with even more questions.

Bird flu has since spread to more than 60 countries in Asia, Africa, Europe and the Middle East, killing at least 211 people along with hundreds of millions of birds. Pakistan and Myanmar reported their first human infections earlier this month. Indonesia, the world's hardest-hit country, reported its 94th death Wednesday while Vietnam and Egypt also logged a death each the same day.

In stricken places like Vietnam, people have learned to live with the disease. Children are taught about bird flu in elementary school, and the nation's poultry is vaccinated twice a year.

But much about the H5N1 virus remains unknown. Experts are still puzzled by its ability to spread and kill. They also do not understand why it infects only a few people, and fear it could morph into a new form that spreads easily among humans, potentially sparking a pandemic that kills millions and cripples national economies.

"It doesn't cease to amaze me that every week or every day we learn something new about this virus," said Juan Lubroth, an animal health expert at the U.N. Food and Agriculture Organization in Rome. "From the very beginning we've been saying that no poultry producing country is safe from this disease."

The World Health Organization is currently working to determine whether limited human-to-human transmission could have occurred in Pakistan where up to nine suspect cases were detected, including several relatives. The last infection was reported Dec. 6, and experts say there appears to be no threat of further spread.

A number of other countries have recently detected poultry outbreaks during the winter months when the virus typically flares. The reason why remains unclear, though some experts suspect a pattern that may be similar to seasonal human influenza, which surfaces every year as temperatures drop.

Another mystery is how the virus spreads internationally. How much of a role do migrating wild birds play in transmitting it compared to the trade and movement of poultry, which often crosses borders illegally?

"There are so many questions that are unanswered, and so many things have to come together to cause a pandemic, that nobody can predict it," said Dr. David Heymann, the WHO's top flu official in Geneva. "We don't know all the risk factors."

Most human cases have been linked to contact with infected birds. Scientists believe human-to-human transmission has occurred a few times, but only among relatives in close contact.

WHO is watching other strains of bird flu, including H7 and H9, that are circulating among poultry and have also infected humans.

Still, H5N1 continues to be the virus experts worry most about, because it has spread so far, so fast. More than 60 percent of people infected by it have died.

"We just don't understand it, and what you don't understand is what's dangerous," Heymann said. "So, you have to be dramatic and take the most severe precautions."

Bird Flu Linked To Human Deaths In Indonesia, Egypt, Vietnam

Christmas Day saw the deaths of two young women believed to have been infected with the H5N1 virus :

In Egypt, a 25-year-old woman died Christmas day after being hospitalized on Dec. 21. The woman, from Bany Suwef Governorate, was the first case in Egypt since July, WHO officials said. The source of her exposure was being investigated.

Egypt has 39 confirmed cases of bird flu, with 16 of them fatal, since 2006.

In Indonesia, a 24-year-old woman from West Jakarta, also died Dec. 25 from bird flu. The woman developed symptoms on Dec. 14 and was hospitalized five days later. It was not immediately known how she contracted the virus.

Xinhau is reporting the death of a four year old child in the Son La province of Vietnam. The child was suffering high fever and pneumonia, two symptoms of bird flu infection :

The child ate a dead chicken before developing bird flu symptoms. Specimens from the child are being tested for bird flu virus strain H5N1, the representative told a meeting of the country's Anti-Bird Flu Steering Committee on Tuesday.

Vietnam has detected seven bird flu patients from the five northern provinces of Vinh Phuc, Thai Nguyen, Thanh Hoa, Ha Nam and Ha Tay since May 10, of whom four died, according to the ministry's Preventive Medicine Department.

Confirmed : Human To Human Bird Flu Spread In Pakistan

The World Health Organisation has now officially confirmed that the H5N1 virus was passed from one person to another in Pakistan. However, they are calling this human transmission of one of the world's most deadliest viruses "limited" :

World Health Organization, WHO, officials say there has been limited human transmission of bird flu in Pakistan - with no new cases reported recently.

WHO's top bird flu official David Heymann Friday, said there appears to be no threat of the further spread of the H5N1 virus, with the last human case reported December 6.

At least eight people were infected in Pakistan's northwest in recent weeks - in the country's first human cases of bird flu.

One man who worked on poultry farm in North West Frontier Province has died. His brother also died recently, but was not tested for the virus.

Heymann says the cases appear to be part of a small chain of human-to-human transmission.

A WHO team is investigating the outbreak and results from initial laboratory tests are expected in the next few days.

Indonesia : At Least Four Recent Human Bird Flu Victims Had No Contact With Infected Poultry



Depending on which media, or government reports you believe, there has been at least 20 human bird flu infections in recent months, in Pakistan, China and Indonesia, where the victim had no known contact with infected poultry, which has been the most common way humans become infected with H5N1.

Indonesia 'bird flu officials' are now investigating at least four cases of human infection, where the most likely source of infection is human transmission. The same AFP story reveals that 20 percent of human bird flu infections in 2006 were not linked to infected poultry. But in 2007, that figure has risen to 3o percent. The good news for Indonesia is that human deaths from H5N1 have dropped in 2007 :

"In the last three to four months, we have had four cases where the poultry in the victim's neighbourhoods (tested) negative for the virus," said Bayu Krisnamurthi, head of Indonesia's National Avian Influenza Committee.

"The number is significant enough for us to intensify our investigations so that we could have a more accurate explanation," he told a press briefing giving an overview of what has happened in Indonesia this year with bird flu.

Krisnamurthi nevertheless insisted that Indonesia had made progress in tackling bird flu, with the number of reported cases decreasing this year.

In 2007, 40 cases were confirmed with 35 fatalities, compared to figures of 55 and 45, respectively, in 2006.

But he also conceded that Indonesia needed more effective measures, particularly to combat bird flu in poultry.

According to Krisnamurthi, even though the agriculture ministry vaccinated 70 percent of the country's farmed poultry in 2007, "the quality of the vaccine must be improved," he said.

Fallout : Christmas Turkeys In UK Cost $200!

For the Brits, an organic turkey for Christmas dinner has become the luxury food of the season. The price of Christmas birds in the UK have soared by more than 38% in a matter of weeks, following bird flu outbreaks and mass cullings on organic poultry farms.

Some 200,000 poultry birds were culled in the UK after the recent outbreak, and added costs of raising poultry have come from the huge rise in the costs of feed, after wheat prices reached record highs.

Although paying more than £100 ($205) for a single turkey may seem outrageous, organic turkey suppliers have sold out, and are still fielding calls for more orders.

And turkey prices may climb even higher, according to Poultry World.

Sales of organic turkeys will jump 46%, the British Retail Consortium predicts. That compares with a 7% increase the industry group forecasts for total turkey sales.

As the bird flu virus continues to spread, and with tens of millions of poultry birds every few months to stop outbreaks from spreading, higher organic poultry rices are expected to become the norm for near future.

Bird Flu Spreading Rapidly As Winter Arrives In The Northern Hemisphere

A quick round-up of recent bird flu outbreaks :

Germany : EU Rolls Out Bird Flu Containment Measures After New Outbreak, Culling Begins

West Africa : Benin Confirms Outbreaks On Two Poultry Farms

Myanmar : First Human Case Confirmed, Victim Recovering

Saudi Arabia : New Outbreak Leads To Cull Of 13,000 Ostriches

Poland : Fresh Outbreak On Poultry Farm Reported

China : Human Infections Contained Claims Health Ministry

Pakistan : WHO Sends In Team To Investigate Human Transmission Claims

Pakistan : H5N1 Virus Spreads Through Family

Pakistan Officials Waited 13 Days After Bird Flu Positive Test Results To Alert World Health Organisation
The Pakistan human transmissions reports grows only more confused and contradictory, but this story appears to lay out a few firm facts :

Authorities in Pakistan announced the country's first reported human cases of H5N1 avian flu Saturday in a cluster of family members which may have involved person-to-person transmission.

There was some confusion Saturday about how many people had tested positive for the virus, with Pakistan announcing six cases but the World Health Organization saying eight suspected cases had been identified.

The WHO said confirmatory testing must still be done. And a spokesperson for the agency said investigations are underway to try to determine how the various people became infected, but noted some human-to-human spread may have occurred.

"We can't rule it out," Gregory Hartl said from Geneva.

"There are other plausible explanations.... We don't know enough at this point. And in some of these cases, one never will know enough."

The cluster of cases involved four brothers and two cousins living in the country's North-West Frontier Province. Two of the brothers died, one without having been tested.

While the brothers who died are believed to have had at least some exposure to infected poultry, they were also known to have nursed the first case in the family, a brother who worked as a livestock official.

A doctor who treated members of the family also has tested positive for H5N1, but with a non-standard diagnostic test, Hartl said. He cautioned that further testing is needed to determine if she is indeed a case, noting she hadn't shown signs of infection.

Three people who are unrelated to the family but who were involved in culling H5N1-infected poultry in the same area have also tested positive; all are still alive. At least one of the cullers worked on the same farm as the livestock official.

The initial infection in this family dates back to late October, when the livestock official became sick. It appears that it was only after two of the man's brothers fell ill and died that testing was done looking for H5N1 infection. It is believed the first positive test was received in late November.

The WHO was officially alerted Dec. 12, Hartl said.

"We feel that the Pakistanis have done everything right in terms of their response," he said, noting the country has done a "huge" amount of work to strengthen infection control and increase surveillance.

"(But) yes, they could have alerted us earlier."

There was also a mild scare in the United States relating to the Pakistan outbreak. It's remarkable to see how fast the CDC can move when it needs to :

Meanwhile, U.S. public health authorities have confirmed they conducted H5N1 testing on a man who had recently visited Pakistan and was complaining of mild respiratory symptoms. The man, who officials will only identify as having a link to the cluster, is said to have been concerned he might have been infected.

"The individual went to his private physician after returning from Pakistan, and discussed this with his physician," said Claire Pospisil, a spokesperson for the New York State department of health.

Pospisil said the doctor contacted the local health department in Nassau County, where the man lives, and they collected samples for testing. The tests came back negative.

David Daigle, a spokesperson for the U.S. Centers for Disease Control, said the CDC sent its plane to Albany on Dec. 8 to collect specimens for confirmatory testing. Within hours a CDC lab verified the state lab's findings.

"He was negative. There was no doubt about it," Daigle said from Atlanta on Saturday.

And more on other recent human infections :

On Friday, the WHO announced that Myanmar had reported its first human case in a seven-year-old girl who fell ill in late November. She has since recovered.

Earlier this month, China reported infections in a son and father from Jiangsu province; the son died. And in recent weeks Indonesia, the country hardest hit by H5N1, has reported several human cases.

China and Indonesia are warning there may be more human infections in the weeks ahead.

Pakistan : Two Brothers Attending H5N1 Infected Veterinarian In Hospital Caught Virus and Died

Amongst the conflicting reports coming out of Pakistan, comes this extraordinary story, which
claims that a veterinarian who fell ill with H5N1 then infected his two brothers with the virus, while in hospital, and both brothers died. The veterinarian, however, recovered.

There are many details in this story that are not reaching the wire reports from Reuters and Associated Press, including the claim that this is the first case of human transmission of the virus in Pakistan :

The deaths of two brothers of a veterinarian, who acquired the deadly H5N1 Avian Influenza virus after coming into contact with infected poultry at a farm in Abbottabad late-October, and the recent hospitalisation of a Mansehra-based poultry handler who has also tested positive for the disease, provide sufficient evidence for the government to institute concrete measures for interruption of human transmission of the disease from birds to poultry handlers and their close contacts.

Of the 40 suspected human samples collected from Peshawar and Abbottabad in the wake of the first-ever confirmed human transmission of H5N1 in Pakistan, 36 have tested negative, while four are positive, investigations conducted by ‘The News’ have revealed.

This is the first time that human cases have been reported in Pakistan, placing an onerous responsibility on the government and its partners to eradicate some of the dangerous trends in the poultry industry that could spell disaster for the country.

It is learnt that both the veterinarian, Dr. Ishtiaq Durrani, who is working as livestock production officer at the Department of Livestock and Dairy Development, NWFP, as well as the poultry handler from Mansehra, did not follow the recommended protective measures while handling infected birds. They may either have come into contact with the saliva, nasal excretions and faeces of the infected birds, or the feed and water that are given to them.

Dr. Ishtiaq was involved in culling of 3,000 birds following the October 21 outbreak of bird flu at a poultry farm in Abbottabad. The other victim from Mansehra happens to be a daily wage labourer who was commissioned for culling without being advised on how he should protect himself. The labourer’s daughter, along with another male, is also under observation at a hospital in Abbottabad.

While Dr. Ishtiaq himself is on the path to recovery, his brothers Mohammad Ilyas Durrani and Mohammad Owais Durrani — both of who were attending him at the Khyber Teaching Hospital during his illness — died on November 19 and November 29, respectively.

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother’s blood sample could not be collected, health experts talking to ‘The News’ said clinical evidence suggests that he too succumbed to the deadly virus. The blood samples of two of the three brothers were received by the National Institute of Health on October 28.

This Bloomberg wire report is vastly different to the above story, claiming that no samples were collected from the two dead brothers and that the most recent outbreak of H5N1 occurred in late November, instead of October.

Pakistan : H5N1 Kills One, Six Infected

Reuters is now reporting that there is only one person dead from the H5N1 virus in Islamabad, and not the two brothers as previously reported. The two brothers don't even get a mention in this report :

Pakistan has recorded its first human death from bird flu and six other people have been infected with the deadly H5N1 virus over the last two months, a senior Health Ministry official said on Saturday.

"Seven in total. One died and six other people were infected with the H5N1 virus," Federal Health Secretary Khushnood Akhtar Lashari told Reuters. "It was confirmed by blood tests."

The cases were reported in the North West Frontier Province, Lashari said.

Two people have recovered and four are in quarantine.

While Pakistan has registered cases of bird flu in poultry this is the first time it has been reported in humans, Lashari said. The first poultry case appeared in early 2006.

There is a number of confusing, conflicting reports coming out of Pakistan about how many have died, how long ago the first human death actually occurred, and how many are now in quarantine.

Bird Flu Returns To Asia, Deaths In Three Countries

This report in the Jakarta Post supplies a fairly comprehensive round-up of recent events, and makes for a concerning 'big picture' view of the H5N1 spread :

Bird flu has resurfaced in parts of Asia, with human deaths reported in Indonesia and China and fresh poultry outbreaks plaguing other countries during the winter months when the virus typically flares.

Indonesia, the nation hardest hit by the H5N1 virus, announced its 93rd death on Friday after a 47-year-old man died a day earlier in a Jakarta hospital, said Health Ministry spokesman Joko Suyono. He fell ill on Dec. 2 and was admitted with flu-like symptoms, becoming Indonesia's 115th person infected with the disease.

In China, the military in eastern Nanjing banned the sale of poultry this week after a father and son were sickened by the disease earlier this month. Health officials confirmed the 24-year-old man died from the virus a day before his father, 52, became sick. It was the country's 17th bird flu death.The two were believed to have eaten a traditional dish known as "beggar's chicken," in which the bird is wrapped in lotus leaves and baked. However, the cause of infection remained unclear. The father is recovering after taking the antiviral Tamiflu, said Hans Troedsson, World Health Organization representative in China. More than 80 people who had contact with the family were being monitored for symptoms.

Local animal health officials said last week no H5N1 outbreaks had been detected among the province's poultry, but Troedsson said sick birds typically are not reported prior to human deaths in China...

That's startling news. Mass deaths of poultry birds aren't officially logged unless their human deaths?

Officials in Pakistan were investigating the country's first suspected bird flu cases Friday after two poultry farm workers died this week after being hospitalized with flu-like symptoms in Peshawar, said Khushdil Khan, medical superintendent of the Khyber Teaching Hospital.

Meanwhile, the disease has resurfaced in several provinces across Vietnam in recent months, killing or forcing the slaughter of thousands of birds. So far, 46 people have died from the virus nationwide.

Hong Kong closed its famed Mai Po bird sanctuary to the public for three weeks starting Friday after a wild gray heron discovered nearby tested positive for the virus.

Russia and Poland also have experienced recent outbreaks among poultry, but neither have detected human cases.

Indonesia : Two Bird Flu Deaths In Four Days

The confirmed human death toll from H5N1 in Indonesia now stands at 93. The unofficial figure, meaning deaths that were not logged by medical authorities, are believed to be much higher.

From Reuters :

A Indonesian man from an area west of the capital Jakarta died from bird flu on Thursday, an official said...

Runizar Roesin, head of the bird flu centre in Jakarta, told Reuters the 47-year-old man from Tangerang died on Thursday evening.

The man, who had kept ducks at his home, had tested positive for bird flu and was being treated at a hospital in Jakarta, a Health Ministry official said on Wednesday.

Earlier this week, a 28-year-old woman, also from Tangerang, died of bird flu after being treated at the same hospital.

Two deaths at the same Indonesian hospital in less than one week, with both patients being treated with anti-virals after the onset of the virus.

Pakistan : Claim That Two Brothers Died From Bird Flu

I'm treating this report with a bit of skepticism because I haven't found it reported elsewhere, as yet.

If it's indeed true, then these are the first two human deaths related to bird flu reported in Pakistan. The story claims the two brothers were working on a farm where bird flu has been detected :

For the first time in the history of Pakistan, Bird Flu influenza has been confirmed among human beings after two brothers died at a local hospital in Peshawar.

According to spokesman of Health Ministry, two brothers Muhammad Ilyas and Tariq working in a poultry farm in Mansera suffered flu, few days back that later turned to be critical in the form of Bird Flu influenza (H5N1).

They were admitted to a local hospital in Peshawar where on Monday they died.

After the blood samples of both the brothers were sent for formal testing in Laboratory, it was found that both brothers died due to Bird Flu virus (H5N1).

...spokesman of Health Ministry confirmed the death due to Bird Flu adding both the brothers were working in a Poultry farm in Mansera and had direct link with the chickens that resulted in the transformation of the virus (H5N1).

A report here, from November, claims Pakistan has had 76 outbreaks of the bird flu virus amongst poultry and birds in 2007.

Deadly Human To Human Bird Flu Spread In China?

Man Dies Of H5N1, Father Now Infected, No Contact With Poultry Suspected

Why does this Reuters story make no mention at all of recent news that human to human transmission of the bird flu virus is now regarded as a fact by experts?

The father of a Chinese man who died from the H5N1 strain of bird flu last week has also been diagnosed with the disease, authorities said on Friday.

The National Disease Authority has confirmed that a 52-year-old man surnamed Lu from the Nanjing, capital of the eastern province Jiangsu, was feverish with the H5N1 strain on Thursday, the Ministry of Health reported on its Web site (www.moh.gov.cn).

This latest case raises troublesome questions about how the man was infected.

Humans can contract H5N1 from close contact with infected birds, but scientists fear the disease could mutate into a version that spreads from person-to-person, risking wider outbreaks or even a global pandemic.

Lu's son died on Sunday from the same disease, making the question of how these two infections occurred especially important.

The Xinhua news agency had earlier reported that the son had had no contact with dead poultry and there had been no reported poultry outbreak in the province.

China has had 27 confirmed human deaths linked to the bird flu virus.


More from the BBC :

A statement on the Chinese ministry's website said a 52-year-old man in eastern Jiangsu province identified only by his surname, Lu, has been confirmed with the virus, just days after his 24-year-old son succumbed to it on 2 December.

WHO spokesman John Rainford said: "We are concerned. The fact that we have two cases here without necessarily a clear source of animal infection and within the same family means we need to make sure we do a thorough investigation."

The father began presenting symptoms on Monday and was confirmed as having the virus on Wednesday. He is being monitored in hospital.

Human To Human Bird Flu Transmission Is A Fact

World Health Organisation Confirms Humans Can Pass H5N1 To Each Other

Human To Human Bird Flu Transmission Is A Reality

Professor Paul Reynolds has told an international medical conference that "potentially lethal bird flu is being passed from person to person."

The story below was up on the Australian ABC News site on December 4, but has since been pulled. This link takes you to a Google cache version of the story :

A total of 1,600 doctors and scientists from 42 countries have attended a lung disease conference on Queensland's Gold Coast. The conference convenor, Professor Paul Reynolds, says human victims of avian flu in the past have contracted the disease from direct contact with sick birds, but that is changing.

"It's usually very close household contacts at this stage," he said. "Sometimes it's a little bit difficult to tease out if people are living together in a village whether the transmission has truly been person-to-person or the fact that the people involved have happened to come into contact with the same infected birds, but there are certainly some case reports emerging that are highly suggestive that direct person-to-person transfer is occurring."

Then there is this interesting story from 2004 where World Health Organisation officials flatly ruled out the possibility of human to human transmission, without further mutations. As we've reported here recently, those mutations have now occurred :

The World Health Organisation (WHO) has confirmed that new tests show there is no evidence that the deadly bird flu has passed from person-to-person.

It says DNA tests on a 23-year-old Vietnamese woman who died of the virus showed no evidence she caught it from her sister, who also died.

The WHO originally reported the results last week but then recalled them, saying they had in fact tested a different woman.

Health experts say the bird flu virus must mutate before it can pass from person-to-person, although people can clearly catch it from birds.

Meanwhile, the father of a six-year-old boy who was the first in Thailand to die of bird flu, is to sue the government, for covering up the presence of the disease.

Chamnan Bounmanut says he would not have lost his son if the government had told the public the truth about the epidemic.

The government has denied any cover-up, saying provincial authorities "screwed up" in not recognising the disease.

The government says it acted swiftly last month once it realised bird flu had arrived in Thailand.

The $2 Trillion Pandemic

Human Death Toll For 2007 Down On 2006 Figures

The Acting Vice President of the World Bank has warned that a global bird flu pandemic could lead to more than 35% of the workforce being absent and cost some the global economy some $2 trillion.

From AFP :

The risk of a pandemic was still as great as it was two years ago despite improvements in the capacity of many countries to respond to the infection, a joint report by the United Nations and World Bank said last week.

"The global economic costs could be between 1.5 to two trillion dollars," Peter Harrold, acting Vice President of the World Bank, told an international conference on avian flu in New Delhi that wraps up Thursday.

More than 600 delegates from 105 countries are in New Delhi to discuss preparedness and challenges in fighting avian flu.

"About 20 percent of the global population will be affected during the next pandemic," Margaret Chan, director general of the World Health Organisation, told the gathering.

Chan said 28 million people may need medical care over a relatively short period and worker absenteeism could reach 35 percent of the work force.

Forty-eight people died of the infection in 2007, down from 71 in 2006, according to the WHO, and experts said outbreaks were also being detected more rapidly and responses have become more effective.

Twenty-six countries reported flu outbreaks in birds in 2007, of which four -- Bangladesh, Ghana, Saudi Arabia and Togo -- experienced them for the first time.

Poor Nations Ask "Why Should Be Share H5N1 Samples, When Rich Nations Won't?"

Forget The People, Says US, Patents Must Be Protected

In a perfect world, world pharmaceutical giants would put aside the profit sheet in the face of a coming pandemic we've been repeatedly told could wipe out as many as a few hundred million people and work together, with the poorer nations, to create the kinds of vaccines that may help to halt the spread of a highly pathogenic H5N1 virus.

After all, who wants to loose that many potential future customers for larger profits in the interrum?

But instead we have an absurd situation where countries like Indonesia are now forced to virtually hold their H5N1 samples hostage to ensure that whatever vaccines result from such samples will be made available to its people, in the event of a pandemic, for reasonable prices.

From Xinhua :

Richer nations and drugmakers refused to share their bird flu virus samples which upset developing countries that wanted to develop cheap vaccines by the virus samples, media reported Monday.

Developing states like Indonesia -- which with 91 of the 206 human bird flu deaths since 2003 is the hardest hit country -- want guarantees from richer nations and drugmakers that they will have access to cheap vaccines if they share samples.

"We must have equitable sharing of benefits arising from the use of viruses through a fair, transparent and equitable mechanism. It is the moral thing to do," said Siti Fadillah Supari, Health Minister of Indonesia.

The WHO agreed last May to revamp its 50-year-old system for sharing flu virus samples with researchers and drug firms. It had wanted its 191 member states to adopt an agreement by May but divisions remain.

John Lange, U.S. special representative for avian and pandemic influenza, ruled out any automatic reward for sharing.

Research and development of vaccines was "very risky, time-consuming and extremely expensive" and it was critical to protect patents to ensure their continued development, he said.

You would think there would be nothing more expensive in the history of mankind than a bird flu pandemic that kills more people than the 1918 'Spanish Flu' wipeout.

Indonesia is also well aware that if they hand over H5N1 samples, and a vaccine is patented from such samples, they may find they are not allowed to develop their own vaccines from the same, now patented, viral strains.

You can understand Indonesia's reluctance.

What is more important to protect? People, or patents?

England : Poultry Farm H5N1 Outbreaks Now Contained

Just another bizarre bird flu virus outbreak, with no apparent source for the initial infections :

An investigation by Defra into the latest outbreaks of the highly-pathogenic strain of bird flu on the Norfolk and Suffolk border have shown that the virus has been contained, an official report has concluded today.

Defra's initial epidemiology report into the H5N1 avian influenza outbreak at Park Farm, Redgrave, concludes that the outbreak has has been contained on the first farm.

It notes that the most likely explanation for the secondary case at Hill Meadow Farm, Knettishall, was a result of transmission by vehicles, people or other things between the sites.

Defra's investigation has been unable, at this stage, to identify categorically the source of the outbreak. “No evidence has so far been found to indicate introduction via infected poultry or poultry products or vehicles/people transporting them, from countries which have undisclosed infection in their domestic turkey, geese and duck population.”

While wild birds cannot be ruled out as a source of infection, no evidence of H5N1 infection has been found in the local wild bird population.

Vaccines, Anti-Virals Will Not Stop A Pandemic's Spread

Face Masks, Handwashing First Better Than Drugs Later

New research shows that it is far better to stop H5N1 getting into your body in the first place, instead of relying on pharmaceuticals to treat it once you're infected. Obviously.

But the simple, and very effective, benefits from regular, thorough handwashing would still appear to be part of the information gap in preventing the spread of bird flu amongst humans.

From the Melbourne Age :

Face masks and regular hand-washing are more likely to halt the spread of a deadly flu than all the antiviral drugs stockpiled worldwide, Australian experts say.

A global review has concluded that simple physical barriers will be more effective than drugs to prevent a pandemic of bird flu or another virulent bug.

The researchers from Australia, Italy, the US and the UK warn that combining measures like hand-washing and rigorous use of masks, gloves and gowns could be the best, and indeed only, line of treatment.

The findings, published in the British Medical Journal, are at odds with most government pandemic plans, which rely heavily on large stockpiles of antiviral drugs like Tamiflu in an outbreak.

How much did governments of the world spend stocking warehouses full of Tamiflu? Was it $10 billion? Or $15 billion? The stockpiling is still going on :

The UK government this week announced it was doubling its stockpile of antiviral medicines in preparation for any future flu pandemic.

Co-investigator Professor Chris Del Mar, from Bond University on the Gold Coast, said cheaper, simple physical measures should be given higher priority in national pandemic preparation.

"The world is increasingly concerned about global pandemic viral infections such as avian influenza and SARS," Prof Del Mar and his colleagues wrote.

"Mounting evidence suggests that the use of vaccines and antiviral drugs will be insufficient to interrupt the spread of influenza ... but there have been no comprehensive reviews of this evidence."

The team reviewed 51 published studies on the effect of simple physical means of preventing animal-to-human or human-to-human transmission of respiratory infections.

They compared interventions like isolation, quarantine, barriers, personal protection and hygiene with doing nothing. They excluded vaccines and antiviral drugs.

They found that handwashing and wearing masks, gloves and gowns were effective individually in preventing the spread of respiratory viruses, and were even more effective when combined.

"In fact, combining these measures may be more effective than prescribing antiviral drugs in the event of a pandemic," they wrote.

The team called for further large trials to evaluate the best combination of interventions.

A Canadian expert writing in the same journal, Professor Martin Dawes, said governments worldwide should have commissioned such a study many years ago, given the potentially catastrophic effects of a pandemic.

Such a study had never been commissioned before?

It should have been, but anti-viral marketeers were winning the propaganda war back then. Let's hope the shift to actual physical prevention begins before the pandemic does.