March 21, 2006
Tuesday

WASHINGTON - Springtime is here and, with it, fevered chirping about bird flu.

Health and Human Services Secretary Michael Leavitt, Agriculture Secretary Mike Johanns and outgoing Interior Secretary Gale Norton began the week by presenting a joint update on national preparedness, covering bird testing, poultry industry protections, anti-smuggling measures, vaccine development and the status of state and local emergency planning.

Bird flu Q&A McClatchy Newspapers WASHINGTON -- Q & A on avian flu Q: Do I have to worry about catching bird flu, or is the threat of a pandemic overblown? A: If you live in the United States, there has yet to be a reported case of birds, animals or humans with the H5N1 virus. What has scientists concerned is that the disease has been moving west, from Asia into Europe and Africa, touching at least 43 countries and killing millions of birds since 2003. It appears to be spreading via wild birds as well as poultry. Between this spring and autumn, migratory birds could bring the virus to the United States through any of four major routes; many scientists are focused on the one through Alaska and Western states. In other countries, avian flu has killed some people and pets, but it has yet to manifest itself as highly transmissible from person to person. Q: If it hits the United States, how quickly will avian flu spread? A: That depends on how the virus mutates between now and then. It also depends on the controls in place in the poultry industry, the public health infrastructure, and airlines and other transit systems; how quickly and effectively vaccines and treatments could be produced and distributed; and whether uninfected people could sequester themselves from contagious people soon enough, if necessary. So far, the disease mostly has been contagious from bird to bird. Millions of birds have died. Fewer than 200 cases in people have been confirmed and all in Asia, but the fatality rate in humans is more than 50 percent. If the virus mutates in a way that makes it more likely to spread from person to person, without losing strength, scientists say it could become a pandemic and kill millions of people worldwide. But it may remain predominantly a problem for birds. Q: Can I get bird flu from eating chicken? A: Not if it's properly cooked, officials say. That means heating bird meat all the way through to at least 158 degrees Fahrenheit - no pink meat - according to the World Health Organization, and cooking eggs until the yolks set. The danger, scientists say, is in making contact with live or uncooked poultry that has the disease, or with infected poultry feces or juices, directly or via contaminated surfaces. In any case, at this point, officials say no U.S. poultry has the virus. Q: Isn't there a bird flu vaccine? A: Not really. Vaccines are produced each year for the seasonal flu, and some antiviral prescription drugs can reduce seasonal flu symptoms. These might provide some relief but are not considered sufficient. Vaccine for the H5N1 virus is under development but is not commercially available. If the avian flu became a human flu pandemic, new vaccine likely would need to be tailored to the mutated virus - and that could take months after an outbreak. Q: How do I stay informed about avian flu, and what should I do to prepare? A: Visit the U.S. government's Web site, http://www.pandemicflu.gov, or call 800-232-4636; World Health Organization's site is http://www.who.int/en/ World Organization for Animal Health's site is http://www.oie.int Distributed by Scripps Howard News Service.

Leavitt also is in the midst of a multi-city tour, answering questions about the virus' spread globally and telling Americans how to respond should it reach U.S. shores. He is asking people not to panic - even if it should reach birds here, that doesn't mean people are at risk - but to start stockpiling enough non-perishable food, water, flashlights, batteries and medicine to last a couple of weeks, just in case. In a report issued last week, Leavitt said: "It is only a matter of time before we discover H5N1 birds in America."

A confluence of science and politics are at work:

- The change of seasons each year, from winter to spring, sends wild birds from Asia and the continental United States north to Alaska, where they commingle while they nest and molt.

While U.S. birds, including ducks, geese and swans, follow four major migratory patterns, it is the Pacific Flyway, the route through Alaska and down through the Western states, to Mexico, that scientists predict as the most likely conduit of avian flu should it spread here through wild birds. By summer, scientists could know how great that risk appears.

- The H5N1 avian flu virus has remained resilient as it makes its way around the globe, from Asia into Europe and Africa. It has touched at least 43 countries, scientists say, overwhelmingly affecting birds but also being transmitted across species.

This month brought reports of the deaths of three women in Azerbaijan, of a dog there, and of a cat in Germany, from bird flu. The virus has been mutating. Scientists have identified at least half a dozen sub-lineages of the H5N1 strain, at least two of which can be fatal to people, prompting a call for new vaccine development.

Since 2003, the World Health Organization has confirmed 177 human cases overseas, half of which were fatal.

- The annual appropriations process on Capitol Hill is gearing up. Each spring, federal officials and lobbyists representing various industries begin making their cases to have their priority programs funded by taxpayer dollars. Late last year, President Bush last year sought $7.1 billion for avian flu preparations. Congress at the time gave him about half, or $3.8 billion.

Scientists say April through September of this year may be a crucial time frame in terms of knowing whether the disease will spread to the United States via migratory birds.

If it does, that doesn't necessarily mean humans, the poultry industry, pets, airline travel or the economy overall will be afflicted.

Globally, the disease has not been spread directly from wild birds to humans but from people handling diseased live or uncooked poultry. And disease specialists are hoping bio-security measures insulate poultry farms and processing plants from outside infection - a question being tested in Western Europe, where the virus already has spread.

Still, with the high fatality rate in those unusual cases of human transmission, and with past experience of flu pandemics - the one in 1918 killed at least 40 million people, according to world health statistics - U.S. officials are on guard for any incursion of bird flu into the country.

That has led to a major ramping up in the testing of thousands of live birds and hunted birds this year.

The emphasis now is in Alaska. Each day, biologists are trapping birds and probing them with nylon-tipped swabs for samples of their feces and cells from their digestive tracts before tagging them and setting them free.

FedEx trucks deliver these samples to the Diagnostic Virology Laboratory at the U.S. Geological Survey's National Wildlife Health Center in Madison, Wis. There, scientists test the samples for viral influenza, preserve them and inject them into chicken eggs to be replicated for research. No worrisome cases have been identified.

By late summer, that lab alone expects to be processing up to 1,500 samples a day. The Agriculture Department is testing thousands of samples as well.

During the autumn, as birds head south again and hunters take to the woods, much of the focus will shift to the states of Washington, Oregon and California, because of their location in the migration route. Other spots throughout the country also are being monitored.

"We haven't bet the farm on just Alaska," said Hon Ip, director of the virology lab in Wisconsin and one of the nation's leading bird flu experts. "We have people all over the place. We are training wildlife biologists, rangers and, in some places, the public health officers as to what to look for."

Whether the Bush's administration's preparations for a pandemic that may never come amount to prudent planning - or an overcompensation for the lack of readiness with Hurricane Katrina - has been a subject of debate among government spending experts.

But in the scientific community, there is ample concern.

In most of the outbreaks in Southeast Asia in the past couple of years, Ip said, the movement of the virus was associated with the legal and illegal spread of poultry products. But with the recent spread of H5N1 in Europe, the flu tracked with the movement of wild birds, and absent the movement of questionable poultry.

"That highlights the need for a surveillance program such as we're starting in North America," Ip said.

As it now exists, he said, H5N1 has been fairly ineffective as a virus in attacking humans. "The situation in Southeast Asia has been brewing nine years now and a lot of people live in close proximity to a lot of birds. Even with that level of contact, less than 100 people have died."

The concern, he said, is that the virus could mutate and catch everyone off guard.

"People need to stay educated," he said. "What used to be OK a couple months ago may not be anymore, if it comes."

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