Monday, October 30, 2006

Government In Talks With Glaxo Over Bird Flu Vaccine

(Oct 30, 2006) LONDON - GlaxoSmithKline is in talks with the government about a nation-wide bird flu vaccination after signing a similar deal with Singapore, it was reported on Monday.

Chief Executive J. P. Garnier met Prime Minister Tony Blair and Chancellor Gordon Brown this month to discuss the possibility of stockpiling tens of millions of doses of the firm's H5N1 vaccine, the Times said, without citing sources.

Glaxo had already reached a deal with Singapore, the newspaper said without revealing any details.

The firm was also close to singing a contract with France and had spoken to the U.S. government about the possibility of a mass vaccination programme although no imminent decision was on the cards, the newspaper added.

A spokesman for Glaxo was not immediately available for comment.

Last week, Europe's biggest drugmaker said it expected to sign more contracts to supply governments with its experimental vaccine for humans following a deal with Switzerland.

The Swiss Federal Office of Public Health has ordered 8 million doses of the vaccine to protect its entire population in the event of an influenza pandemic, which many experts fear may be triggered by bird flu.

The vaccine has not yet won regulatory approval but Glaxo plans to file it with the European Medicines Agency by the end of 2006.

Britain's population is about 60 million while Singapore has a population of 4.4 million. (from Reuters)

Thursday, October 26, 2006

Glaxo says more govts plan to buy bird flu vaccine

LONDON, Oct 26 (Reuters) - GlaxoSmithKline Plc expects to sign more contracts to supply governments with its experimental bird flu vaccine for humans, following purchases by Switzerland and an unidentified Asian country.

"Between now and Christmas, I expect we will sign a few more in Europe and elsewhere," Chief Executive Jean-Pierre Garnier told analysts in a post-results conference call.

Europe's biggest drugmaker announced earlier this month that the Swiss Federal Office of Public Health had ordered 8 million doses of its H5N1 vaccine to protect its entire population in the event of an influenza pandemic, which many experts fear may be triggered by bird flu.

The vaccine has not yet won regulatory approval but Glaxo plans to file it with the European Medicines Agency by the end of 2006.

Glaxo's vaccine uses only a very low dose of active ingredient, which should help to stretch scarce supplies.

A key challenge in the race to produce a vaccine for millions of people around the world -- which governments are keen to stockpile -- is how to make the maximum number of shots from the minimum amount of antigen, or active ingredient.

While Glaxo's vaccine offers protection against the deadly H5N1 avian flu virus now circulating, its impact on any mutated strain of virus is not certain.

However, experts say it could "prime" an individual's immune system so they will get stronger effects from a later, better-matched vaccine.

The H5N1 strain of avian influenza has spread rapidly out of Asia and has killed more than 150 people who have come into close contact with infected birds.

Experts fear it could trigger a pandemic, a global epidemic of flu that could kill millions, if it acquires the ability to pass easily from human to human.

Rival companies including Sanofi-Aventis , Novartis AG and Baxter International Inc. are also racing to develop pandemic H5N1 vaccines.

Sparrows in China carry bird flu virus

(Oct 26) Chinese scientists recently reported that they found H5N1 bird flu virus in sparrows two years ago, the first time the virus has been detected in the common, non-migratory bird on the Chinese mainland.

Wuhan Institute of Virology in central China's Hubei Province tested excrement samples from 38 sparrows after an outbreak of bird flu in a county in Henan Province in 2004. Some of samples tested positive of H5N1 virus, said Li Tianxian, a researcher with the institute.

"There's no need for the public to panic. The findings are two years old and there is no indication that sparrows pose a risk," said Li, adding that scientists found the bird flu virus in sparrows in the region of Hong Kong in 2002 and also in Turkey and South Africa.

Working with the Beijing Institute of Zoology, both under the Chinese Academy of Sciences, the scientists isolated four H5N1 strains among the 25 positive excrement samples.

Li said tests on the four strains have shown they are a new genotype of H5N1, adding that researchers did not find dead sparrows.

It was thought that bird flu was mainly transmitted by migratory water fowl, but this finding proves that non-migratory birds are also a potential channel for bird flu transmission, Li told the Chutian Metropolitan News published in Hubei Province.

The finding was published in December of last year in the U.S-based Journal of Virology, according to the newspaper. (China daily)

Tuesday, October 24, 2006

Bird flu take an increasing toll but the world escaped an immediate influenza pandemic, U.N. bird flu chief says

More than 30 countries reported outbreaks of bird flu this year and the number of people dying every month is increasing, but the world escaped an immediate influenza pandemic possibly because of the energetic global response to warnings a year ago, the U.N. bird flu chief said Monday.

Dr. David Nabarro said his warning last year that a mutation of the virulent H5N1 virus which has ravaged poultry stocks since late 2003 could appear anytime and cause an influenza pandemic in humans that kills millions of people was not "overblown."

"There will be an influenza pandemic one day. I don't know — you don't know — when it will be. When it does come along, it will have really major economic and social consequences," he said.

"The one absolutely requirement for this is that we have to get prepared."
The H5N1 virus has affected poultry all over the world except the Western hemisphere and has killed tens of millions of chickens, ducks, geese and other birds, Nabarro told a news conference.

"In 2006, we did see more than 30 countries reporting outbreaks," he said. "Unfortunately, the virus continues to affect humans — with 256 people known to be affected and 151 dying" since 2003.

"The trendline is that the number of deaths per month seems to be increasing at the momnt globally ... and that is primarily because of quite a lot of human death in Indonesia," he said.

Nabarro estimated that the H5N1 avian influenza virus will remain a major animal health issue for most of the world for at least five years, and perhaps 10 years, because it is very virulent but at the same time can survive in certain communities of birds without symptons for long periods.

In addition, he said, bird flu seems to be spread by a combination of wild birds that migrate and trade in infected birds.

One key to tackling bird flu is to change the way people and countries raise chickens and ducks and experts believe it will take five to 10 years to change poultry rearing practices, especially in countries where poultry is plentiful and birds are kept in the backyard, Nabarro said.

While the Western hemisphere has escaped bird flu so far, Nabarro urged countries in the Americas to be be very vigilant in the coming winter months when birds start migrating south from Alaska, through the Mississippi River area and then south. He said countries on another migratory route south from Siberia to the Ukraine, the Black Sea and the Middle East must also be on alert for infected birds.

Nabarro said that in his entire career he had never seen a greater concerted global effort to tackle an issue than he had this year in fighting bird flu and preparing for an influenza pandemic.

"Government ministers are all aware it is their responsibility to prepare for the possibilty of a pandemic and get on top of the avian influenza ... and they're doing it really very energetically," he said.

There have been "huge efforts" by governments in many countries to stop trade in birds which might be infected by H5N1, to restrict movements, to keep different groups of birds apart, and to cull birds when outbreaks occur, he said.

That means many governments now know how to deal with outbreaks, Nabarro said, "and that's a really excellent thing and may well have reduced the probability of pandemic happening immediately, and may well have reduced the probability of H5N1 causing the pandemic."

"But we are never going to drop our vigilance within the U.N. on this issue," he said.
Nabarro said he looked at the present time "as a wonderful breathing space in which we can get prepared so that when the pandemic comes we can deal with it."

He called for stepped up assistance, especially for Indonesia and Africa.
Indonesia accounts for about a third of the human deaths and remains a country of great concern with bird flu in 30 of 33 provinces, Nabarro said.

He praised the government's commitment but said a lot remains to be done and the country needs money to change the way poultry is raised, improve veterinary services and compensate farmers whose birds are culled.

There are also serious concerns about the ability of some African countries to deal adequately with bird flu because of understaffed animal health services and low budgets, Nabarro said, noting a recent outbreak in Juba in southern Sudan.

He praised the successful efforts to combat bird flu in Vietnam and Thailand, the "good and rapid response" to outbreaks in Niger, Cameroon and Burkina Faso, and Myanmar's rapid response to very intense outbreaks earlier this year.

"Myanmar authorities seem to have had better cooperation with the outside world on this issue than they've had on any other issue," Nabarro said. "At the moment, it seems the government is poised so that if there are further outbreaks, the government can deal with them quite quickly." (AP)

Russia tests bird flu vaccine

(Oct 24, 2006) MOSCOW - Clinical tests of a bird flu vaccine, developed by the Russian Health Ministry's state-owned Science and Production Association Mikrogen in conjunction with the Academy of Medical Sciences, have been conducted in the last three months.

The tests involved 240 healthy volunteers, separated into two groups numbering 120 men and women each. All of them received insurance policies and benefits in line with international standards.

Mikrogen general director Dr. Anton Katlinsky said the tests had produced encouraging results. "We used the World Health Organization's recommendations in our work, as well as our own unique methods and patented technologies," Professor Katlinsky said.

Dr. Vitaly Zverev, director of the Mechnikov Vaccine and Serum Research Institute, said a study of post-vaccination side effects showed the preparation was well tolerated, safe, and did not produce any serious negative effects.

Vaccine developers now have to conduct augmented tests and to officially register the new medication.

Several hundred million rubles have already been spent on this high-priority medical project. This is seen as the only course of action since a possible bird flu pandemic is likely to kill an estimated one-third of the world's population.

Due to efforts by the WHO and numerous national medical and sanitary services, including Russian agencies, no new bird flu outbreaks have been registered to date. But this does not mean that the disease has been eradicated.

Russian authorities have not yet registered any bird flu cases, but this ominous virus killed six people in Baku, the capital of Azerbaijan, this April.

Wavering global interest in bird flu is directly linked with the manifestations of this disease. A series of bird flu outbreaks, which began in 1997 and lasted until 2006, convinced everyone that the virus was a threat to humans and could cause serious complications and even death.

A major outbreak terrified mankind in December 2003 and fanned rumors of a possible epidemic and even a global pandemic. Many countries, including Russia, rushed to develop prototype bird flu preparations capable of dealing with this new menace.

Of the 15 known bird flu virus strains, H5N1 is the most active and dangerous one. The World Health Organization is worried that there may not be sufficient quantities of the vaccine for everyone if a pandemic breaks out.

At present 360 million flu vaccines are produced annually. What makes the situation grave is that the whole of mankind, or over six billion people, would have to be vaccinated under the worst scenario.

Marie-Paule Kieny, director of the WHO Initiative for Vaccine Research, told journalists she was satisfied with the completion of initial clinical vaccine tests in Russia, a well-known and generally recognized producer of such preparations. She stressed the latest Russian achievements were encouraging, and the WHO will look forward to augmented clinical tests and final results.

Many scientists believe that the H5N1 virus cannot cause a major epidemic in the near future. "I see no reason to agree with assertions that bird flu will wipe out mankind," said Vladimir Ivanitsky, PhD, a lecturer at Moscow State University. He said the bird flu virus had been known for a long time, birds had always contracted this disease, which sometimes affected humans. "Nothing has changed in the nature of the virus and birds," he said.

Globalization and enhanced medical control make it possible to more effectively diagnose and treat various diseases than before. Mankind is now better prepared to deal with a possible bird flu epidemic.

Vitaly Zverev said migrating birds would once again spread the active H5N1 virus all over the world the following spring.

Scientists believe the extremely mutagenous bird flu virus is bound to change within the next few years, and new viruses are a major threat.

The new Mikrogen vaccine is vital because its initial strain can be modified and used against a new strain, say, of the H7N2 virus.

Experts said it would take Russia seven to eight weeks to obtain the first several million vaccines after singling out the initial strain. In short, this country will receive enough anti-flu vaccines in 45 to 60 days.

Sunday, October 22, 2006

INTERVIEW-OIE chief urges world bird flu compensation fund

PARIS, Oct 19 (Reuters) - The head of the World Animal Health body OIE said on Thursday an international fund to compensate farmers in poor countries for bird flu culls was urgently needed to ensure reporting of the deadly virus.

Officials from the OIE, World Bank, European Commission and the U.N. Food and Agriculture Organisation (FAO) met in Paris this week with the aim of setting up a fund by early next year.

"We'd like to convince the international financial institutions to have a world fund reserved for animal health emergencies," OIE Director General Bernard Vallat said.

"Once a crisis erupts in a developing country, it's very rare there are funds available for compensation, which costs a lot of money," he told Reuters.

Experts believe there has been significant under-reporting of the H5N1 bird flu virus in poultry in parts of Asia and Africa, largely because farmers fear heavy losses if they notify the authorities and are then forced into widespread culling.

"If there is not an absolute guarantee that the farmer will be reimbursed in a fair, equitable and rapid way, there is a tendency towards very dangerous behaviour," Vallat said, adding this could mean selling birds on at local open-air markets.

"This could be a powerful vector in circulating the virus."

H5N1 still mainly affects birds, but has killed more than 150 people in nine countries. It re-surfaced in Asia in 2003 and has since spread to Europe and Africa.

The World Health Organisaenv tion believes H5N1 could be the most likely cause of the next flu pandemic if it mutates into a form that could be easily passed among humans.

The World Bank has estimated that a severe flu pandemic could cost the global economy up to $2 trillion.

The OIE says the best way to prevent such a pandemic is by tackling the virus at source by stamping out the disease as quickly as possible in the bird population.

It also says this saves money.

"It's essential that declarations are made rapidly because the hours count in these situations. Without early detection and a rapid response, the spread becomes exponential, and the costs become extremely heavy," Vallat said.

While outbreaks of the virus in Europe have proved relatively short-lived due to tight veterinary controls, H5N1 has become endemic in parts of Asia and Africa, where government budgets in dealing with such crises are severely limited.

Vallat said it took around 18 months for the international community to react properly to the emergence of H5N1 in Asia.

"And that's why the disease spread to Europe and Africa. We need a world fund that can act immediately," he said.

Vallat said it was too early say how much money would be needed. He said officials were now working on more detailed economic assessment of needs and this would be discussed at a major bird flu conference in Mali in early December.

Swiss place first order for Glaxo bird flu vaccine

(Oct 18. 2006) LONDON (Reuters) - Switzerland on Wednesday became the first country to order a stockpile of GlaxoSmithKline Plc's experimental bird flu vaccine for humans.

Europe's biggest drugmaker said the Swiss Federal Office of Public Health had ordered 8 million doses of its H5N1 vaccine to protect its entire population in the event of a influenza pandemic, which many experts fear may be triggered by bird flu.

Supply and stockpiling of the pre-pandemic vaccine is expected in early 2007 once the Swiss regulatory agency, Swissmedic, has reviewed and approved the regulatory file for the product.

Glaxo said it was also working with other governments across Europe on pandemic preparation plans and remained on track to file its vaccine for approval with the European Medicines Agency by the end of 2006.

Glaxo's vaccine uses only a very low dose of active ingredient, which should help stretch scarce supplies.

A key challenge in the race to produce a vaccine for millions of people around the world -- which governments are keen to stockpile -- is how to make the maximum number of shots from the minimum amount of antigen, or active ingredient.

While Glaxo's vaccine offers protection against the deadly H5N1 avian flu virus now circulating, its impact on any mutated strain of virus is not certain.

However, experts say it could "prime" a person's immune system so they will get stronger effects from a later, better-matched vaccine.

The H5N1 strain of avian influenza has spread rapidly out of Asia and has killed more than 150 people who have come into close contact with infected birds.

Experts fear it could trigger a pandemic, a global epidemic of flu that could kill millions, if it acquires the ability to pass easily from human to human.

Rival companies including Sanofi-Aventis, Novartis AG and Baxter International Inc are also racing to develop pandemic H5N1 vaccines.

Wednesday, October 18, 2006

Indonesia defends efforts in fighting bird flu outbreaks

Indonesia defended its efforts to fight bird flu yesterday as the number of people killed by the virus continued to climb. The death of a 27-year-old woman, the third in as many days, brought the country's toll to 55.

The government, which has been accused of doing too little to fight the disease since it first appeared in poultry stocks three years ago, said it has worked hard in recent weeks to raise public awareness about the dangers posed by sick chickens.

"We are doing the best we can," Nyoman Kandun, a senior health ministry official said as the WHO announced that a woman from Central Java Province died of the disease on Friday.

The woman identified as Mistiyem, was hospitalised on Oct. 12 and died a day later. Positive results from two Indonesian laboratories mean that the WHO includes the case in its records.

"Both tests showed her to be positively infected with the bird flu virus, making her the 55th fatal casualty" in Indonesia, said Tontro, an official at the ministry's national bird flu information center.

Her death, one day after she was hospitalized, was followed by that of an 11-year-old boy in the capital Jakarta on Saturday and a 67-year-old woman in West Java's town of Bandung on Sunday, health officials announced earlier this week.

The government has been criticized for failing to aggressively deal with the virus in poultry stocks, either by mass slaughters or vaccination. It says it does not have the funds to compensate farmers for birds culled in affected areas.

Kandun said Indonesian officials launched an all-out media campaign last month promoting simple but effective steps people can take to reduce the risks of contracting the H5N1 virus. (from Taipei times)

Bird flu vaccine may hit many strains

LONDON - Human trials indicate an H5N1 bird flu vaccine developed using a virus isolated in Vietnam can neutralize antibodies from H5N1 viruses found in other countries, the vaccine's manufacturer said Wednesday.

The preliminary trial results raised hopes that vaccines based on older H5N1 bird flu strains might prove effective against future variants of the virus in the event of a pandemic.

In Sanofi Pasteur's trial, 300 volunteers were vaccinated with a strain of the virus isolated in Vietnam in 2004. Antibodies were then examined from their blood, and tests were done using H5N1 viruses from Turkey and Indonesia. The results indicated that the volunteers' antibodies were able to neutralize the other H5N1 viruses, proving that some measure of cross-protection is possible.
"This is a milestone for vaccine development," said Dr. Klaus Stohr, the World Health Organization's top official on pandemic influenza vaccines.

Stohr said that while tests in mice and ferrets had suggested that cross-protection might be possible, this is the first evidence available from human trials.

The H5N1 strain of bird flu has been circulating since late 2003 in Asia. Last year, it spread to parts of Europe and Africa. Flu experts believe it is the leading candidate to ignite the next flu pandemic. To date, WHO has recorded 151 deaths worldwide from H5N1.

More than a dozen companies are working on possible pandemic vaccines, based on the Vietnamese 2004 H5N1 strain.

However, tests need to be conducted on these candidate vaccines to determine if they would also protect against newer versions of the virus.

"We don't know enough right now to make any blanket statements about cross protection," said Dr. John Treanor, a flu vaccine expert at the University of Rochester. Sanofi Pasteur's initial results, however, could be reassuring for governments investing in vaccine stockpiles, Treanor said.

"This tells us that stockpiling does make sense," Stohr said. "It gives us another avenue of pandemic preparedness," Stohr said, suggesting that people could be inoculated with a pre-pandemic vaccine, before being given a booster shot once the pandemic strain emerges.

Still, an effective H5N1 vaccine that protects against other H5N1 strains does not guarantee protection against a pandemic. Such a vaccine could offer no protection against other subtypes of influenza.

"We don't know if the next pandemic will be started by H5," said Dr. Angus Nicoll, director of influenza coordination at the European Centre for Disease Prevention and Control.

"It's still a very difficult risk judgment," says Nicoll. "While it's good to have a vaccine that offers cross-protection, it is not the ultimate answer." (from AP)

Swiss announce stockpile of bird flu vaccine

(Oct 18, 06) Switzerland has ordered enough bird flu vaccine to protect its entire population in the event of a pandemic, it was announced on Wednesday.

The government said this amounted to eight million doses of a new pre-pandemic vaccine made by Anglo-American firm GlaxoSmithKline. The cost is expected to be SFr180 million ($142 million).

Supply and stockpiling of the medication is expected to take place from January 2007, said a statement. The cost of the delivery will also have to be approved by parliament.

"If needed, it will therefore be possible to offer a first immunisation to the whole of the [7.4 million] population," said the government.

"This vaccination will be voluntary and will only be administered once its effect against a pandemic virus has been proven."

Advanced development efforts to create an effective H5N1 influenza vaccine are currently based on an H5N1 virus isolated from a Vietnamese patient infected by a chicken in 2004.

Since there is no pandemic among humans, this vaccine is referred to as a pre-pandemic H5N1 vaccine. The pre-pandemic vaccine helps prepare the human immune system against the threat of a human pandemic.

Should a pandemic virus emerge that can be easily transmitted among humans, a vaccine based on that specific strain will have to be developed.

The government has therefore concluded a further agreement with Glaxo for 7.5 million doses of a pandemic vaccine should the need arise.

The immunisation programme, part of the government's national bird flu plan, will be carried out by the authorities concerned and the cantons.

Action plan

The government's bird flu action plan, finalised in August, proposes detailed guidelines, plans and responses in the event of an outbreak of the virus in the country.

Experts say that although cross-infection of the virus to humans is rare, there have been almost 150 deaths from the illness in humans, mainly in Asia.

Switzerland has already built up a stock of the anti-viral drug Tamiflu to treat more than two million people and protect health workers.

The country has also continued to protect its borders from a possible outbreak of the virus. The latest measures include locking up poultry kept within one kilometre of major Swiss lakes and rivers.

The restrictions are designed to prevent domestic flocks from coming into contact with migratory birds infected with the H5N1 virus and will remain in place until April 30 next year.

Thirty-two dead wild birds were found with the H5N1 virus in Switzerland in February and March, mainly around lakes. But no new cases have been detected in Switzerland since April. (from

Monday, October 16, 2006

Bird flu's spread around the globe

(Oct 16, 06) Bird flu has spread rapidly since late 2003 from Asia to Europe, the Middle East and Africa.

Following are some facts about the H5N1 avian flu virus and its spread around the globe.

* Since the virus re-emerged in Asia in 2003, outbreaks have been confirmed around 50 countries and territories, according to data from the World Organisation for Animal Health (OIE).

* Since the beginning of January 2006, more than 30 countries have reported outbreaks, in most cases involving wild birds such as swans.

* The virus has killed 151 people since 2003, according to the WHO. Countries with confirmed human deaths are: Azerbaijan, Cambodia, China, Egypt, Indonesia, Iraq, Thailand, Turkey and Vietnam.

* In total, the virus is known to have infected 256 people since 2003, according to the WHO. Many of those who have died are children and young adults.

* Vietnam and Indonesia have the highest number of cases, accounting for 97 of the total deaths.

* The H5N1 virus is not new to science and was responsible for an outbreak of highly pathogenic avian influenza in Scotland in 1959. Britain confirmed a new case in Scotland on April 6.

* H5N1 is not the only bird flu virus. There are numerous strains. For example, an outbreak in 2003 of the H7N7 bird flu virus in the Netherlands led to the destruction of more than 30 million birds, around a third of the country's poultry stock. About 2.7 million were destroyed in Belgium, and around 400,000 in Germany. In the Netherlands, 89 people were infected with the H7N7 virus, of whom one (a veterinarian) died.

* The H5N1 virus made the first known jump into humans in Hong Kong in 1997, infecting 18 people and killing six of them. The government ordered the immediate culling of the territory's entire poultry flock, ending the outbreak.

* Symptoms of bird flu in humans have ranged from typical influenza-like symptoms, such as fever, cough, sore throat and muscle aches, to eye inflammations (conjunctivitis), pneumonia, acute respiratory distress, viral pneumonia, and other severe and life-threatening complications. (Sources: OIE, WHO, Centers for Disease Control and Prevention)

Indonesian woman dies of H5N1 strain of bird flu, lifting death toll to 54

JAKARTA, Indonesia (AP) - A 67-year-old woman died overnight of bird flu, the second death in as many days, taking Indonesia's human toll from the disease to 54, Health Ministry and hospital officials said Monday.

The woman, who was also diagnosed with encephalitis, or inflammation of the brain, was hospitalized with bird flu symptoms on Oct. 10 after coming into contact with fowl in West Java province, said Runizar Roesin of the National Bird Flu Information Center.

She died late Sunday, he said, a day after an 11-year-old boy succumbed to the disease in a Jakarta hospital.

Health officials were trying determine whether there was any link between bird flu and the woman's brain inflammation, said Hadi Yusuf, her chief doctor at the Hasan Sadikin hospital in Bandung town.

The H5N1 virus has killed at least 148 people worldwide - more than a third of them in Indonesia - since it began ravaging Asian poultry stocks in late 2003, according to the World Health Organization.

Most of those killed have been infected by domestic fowl, but WHO fears the virus could mutate into a form that easily spreads among humans, sparking a pandemic with the potential to kill millions.

Indonesia, the world's fourth most populous country and home to millions of backyard chickens, is considered a hot spot for that to happen.

The government has been criticized for failing to aggressively deal with the virus in poultry stocks, either by mass slaughters or vaccination.

It says it lacks the resources to compensate farmers for slaughtered birds and earlier complained that while it needed US$250 million a year to fight bird flu it had received only US$100 million from its own coffers and the international community.

Friday, October 13, 2006

New study tackles bird flu protection

(Oct. 13) Washington- A unique study suggests a possible way to kick-start people's protection against bird flu just in case the virus triggers a worldwide outbreak years from now.

If a flu pandemic should begin, it would take several months to tailor a vaccine to the precise strain causing illness and then to make enough vaccine. Worse, people almost certainly would require two doses to protect against a flu strain their bodies had never encountered.

Scientists have long wondered if giving shots in advance might help, a vaccine that would not fully protect but would introduce people's immune systems to a new type of flu. Then, once a pandemic had begun, they would need one booster shot of vaccine tailored to the exact strain, which would cut significantly the time it would take to protect a population.

On Friday, University of Rochester scientists are reporting the first evidence that this so-called "prime-and-boost" method could work.

If the findings hold up, they raise the possibility of giving "priming" shots to doctors, nurses and other first-responders who would be on the front lines of a flu pandemic long before much vaccine was ready. A decision also might be made even to offer such shots to whoever wanted them.

"You'd have people who were prepared as much as possible in advance," said Dr. John Treanor, a Rochester vaccine specialist who led the research. "It is something a lot of people are very, very interested in. It does have some major implications for policy."

The researchers tracked down 37 people who had tested an experimental bird flu vaccine in 1998. At the end of 2005, each got a single booster shot designed to fight a different strain of the H5N1 virus.

H5N1 is thought to have made its first jump from poultry into people in Hong Kong in 1997. The Rochester volunteers got their first inoculations with vaccine made from that Hong Kong strain.

The deadly Asian bird flu has continued evolving as it hop-scotched across the globe, and the booster doses were made from a very different strain that emerged in Vietnam in 2004. The booster recipients were compared with people vaccinated for the first time against the Vietnam strain.

The booster method worked better, Treanor and colleague Dr. Nega Ali Goji will report on Friday at a meeting of the Infectious Diseases Society of America.

More than twice as many of the booster recipients had a protective immune response compared with people given their first-ever doses of H5N1 vaccine. They even seemed a little more protected than those who got the optimal two doses.

The findings are intriguing, said Dr. Anthony Fauci, infectious disease chief at the National Institutes of Health, which paid for the work.

"It really does add some degree of scientific credibility to the issue of priming," Fauci said.

But, he cautioned, much more research is needed before the government would even consider recommending advanced shots for bird flu: "Policy decisions would require considerably more information than we have."

The work reflects what happens every winter with seasonal flu. When small children are first vaccinated against regular flu, they need two doses. After that, one shot a year is enough. Even though the strain that circulates each winter is slightly different, the shot awakens the immune system's memory of influenza just enough.

"Your flu vaccine experience is a constant series of booster doses," Treanor explained.
(from AP)

WHO Western Pacific chief vows to make bird flu priority if elected director-general

(Oct. 12) HANOI, Vietnam
He has battled SARS and bird flu in Asia and says the world would be in experienced hands during a flu pandemic if he became head of the World Health Organization.

Shigeru Omi of Japan, currently WHO's Western Pacific regional director, is among 13 candidates nominated by their countries to fill the top job after Director-General Lee Jong-wook died unexpectedly in May two years before his term was up.

A short list will be voted on next month in Geneva by the organization's executive board, and a final candidate will then be proposed to the World Health Assembly on Nov. 9.

The change comes at a time when the U.N. health agency is under increasing pressure to respond to global health threats and prepare the world for a possible pandemic that experts fear could spread rapidly around the world, killing millions and crippling economies.

"Pandemic preparedness is my first commitment," Omi told The Associated Press by phone from Sri Lanka, where he was campaigning this week. "The virus may change all of a sudden so that a human pandemic may happen. That's why we have to prepare ourselves for the worst-case scenario."

He said leaders and donors must not become fatigued with the message he's been preaching since the H5N1 bird flu virus began decimating poultry stocks across Asia in late 2003. Initially, many countries paid little attention to the threat, but after bird flu jumped from Asia to Europe and Africa, it became a top health priority.

The virus, which has killed at least 148 people globally, remains hard for people to catch but scientists fear it will mutate into a form that spreads easily among humans. So far, most cases have been linked to contact with infected birds.

Omi said he would push donors to fulfill pledges totaling US$1.9 billion (€1.5 billion) made in January to tackle bird flu and prepare for a possible pandemic. Last month, acting WHO chief Anders Nordstrom said the organization is still lacking about half the funds it needs to help countries in that fight.

Omi, 57, of Japan, who has worked at WHO for 16 years, says his experience in building consensus among countries and pushing WHO to work more closely with other key agencies, such as the U.N. Food and Agriculture Organization, makes him the best choice for the job. He has served as regional director since 1999 and was challenged in 2003 when SARS emerged in Asia and spread rapidly across the world, killing nearly 800 people and infecting more than 8,000 before it was stopped.

"The director-general of the World Health Organization, at this point, should go to somebody whose leadership has been tested and proven and whose track record speaks for itself," he said. Member states "feel very comfortable and they think that I can help this international community to go through a very, very difficult period."

Working to increase AIDS prevention and treatment and eradicating polio also are among Omi's top goals. He said using celebrities to increase public awareness and build momentum for fighting disease in poverty-stricken countries would be part of his strategy.

Omi also wants countries to set up national plans to fight chronic killers such as diabetes and heart disease, and to help slim down nations facing obesity epidemics.

The other candidates are Margaret Chan, Hong Kong's former health director and a WHO point person on bird flu; Ecuador's outgoing president, Alfredo Palacio Gonzalez; French politician Bernard Kouchner; Kazem Behbehani, a senior WHO official from Kuwait; Julio Frenk, Mexico's health minister; David A. Gunnarsson, Iceland's health minister; Nay Htun, a former high-ranking U.N. development and environment official from Myanmar; Karam Karam, former Lebanese health minister; Elena Salgado Mendez, Spain's health minister; Manuel Mocumbi, former prime minister of Mozambique; Pekka Puska, head of Finland's national health institute; and Tomris Turmen, a Turkish woman who heads WHO's family health division. (from AP)

Thursday, October 12, 2006

China to start 2nd trial for bird flu vaccine soon

(Oct. 12) A Chinese company that is developing a H5N1 bird flu vaccine for humans plans to kick off a second clinical trial before the end of the year and will have its production capacity expanded ten-fold by mid-2007.

"The second clinical trial should be over by July or August next year, just before the flu season begins," Yin Weidong, managing director of state-backed Beijing Sinovac Biotech Co., told Reuters in an interview on Thursday.

He tried to ease concerns over using a strain of the virus found in Vietnam in the vaccine, saying it would offer some protection against other H5N1 strains.

The company needs to obtain the approval of the State Food and Drug Administration (SFDA) for the second trial and will file its application with the agency within the next two weeks.

"The government values this project very highly and it will get going faster," Yin said. He added that the World Health Organisation had provided advice in the first clinical trial and would probably do so again in the second trial.

Sinovac ran its first clinical trial involving 120 volunteers in Beijing this year.

It published its findings in The Lancet medical journal in September, saying the experimental vaccine was effective and well tolerated at low doses.

It used whole-virus vaccine in 1.25, 2.5, 5 and 10 microgram amounts, but the 10 microgram dose was found to be most effective in producing an immune response.

The volunteers, aged between 18 and 60, did not suffer serious side effects, but some experienced pain, swelling and fever.

The second trial will have a wider age limit, taking in people below 18 and over 60, but Yin said the drug administration would make the final decision.

Apart from Beijing, Sinovac will look for volunteers in two other cities, most likely in southern China. There will be two dosages: 5 and 10 micrograms.

By mid-2007, Sinovac will have expanded its production capacity to 20 million doses from a current 2 million, but when the vaccine goes into production will hinge on how soon it secures orders.

Sinovac and several companies around the world are in a race to develop a vaccine to combat what experts fear would be a flu pandemic triggered by the H5N1 bird flu virus, which has killed 148 people since late 2003.

Although it remains a disease among birds, scientists say it could wreak havoc and kill millions if it mutates and learns to transmit efficiently among humans.

Some experts, however, question the rationale behind designing these "pre-pandemic vaccines" based on a H5N1 strain found in Vietnam in recent years, saying they might not protect against other H5N1 strains and the eventual pandemic strain.

At least two other H5N1 strains have become geographically more widespread; with one spreading across not only Asia, but parts of Europe, Africa and the Middle East.

But Yin said there should be some amount of cross protection.

"Even though the virus is changing, it is still H5N1. We are facing one enemy," he said. (from Reuters)

Another human case of bird flu in Egypt

CAIRO, 12 October (IRIN) - Egyptian health officials on Thursday blamed the most recent case of human bird-flu infection in Egypt on poor observance of government regulations aimed at stamping out the virus, after it was confirmed on Wednesday that a 39-year old woman in the Nile Delta province of Gharbiya had contracted avian influenza.

Ministry of Health spokesperson Sayyid Abbasi said that "people are sticking to their habits, and they are forgetting our message."Earlier this year, the Egyptian government and international agencies embarked on a nation-wide campaign to persuade the population not to keep poultry inside their homes.

The latest victim to be infected with the H5N1 virus , Hanan Aboul Magd, was admitted to hospital on 4 October. She reportedly contracted the virus after buying and slaughtering infected ducks at her home. She is the 15th human case of bird-flu in Egypt since the first signs of the outbreak were seen in the country in February. Six of those patients have since died.Hanan is reported to be in a stable condition, and her family are being tested for the virus.

Egypt's densely populated Nile Valley saw the worst concentration of bird-flu infection this year outside Asia. The Valley lies on major routes for migratory birds, and has a large rural population that has traditionally reared poultry for food and income.

The government has overseen the culling of some 30 million birds since then, and has put into place tough restrictions on poultry keeping. So-called 'backyard birds', which are chickens or ducks kept in small numbers in low-income homes for extra food or cash, have been outlawed.

Dr John Jabbour, of the Communicable Diseases Surveillance Department at the World Health Organization's regional office in Cairo, said that "it is a matter of changing behaviour. People are sometimes not honest [about keeping birds]. They know they are in danger but for other reasons they still have them."Jabbour also added that the government has succeeded in removing poultry from the homes of people in Cairo, "but in more rural areas people are not accepting that they have to get rid of backyard birds."

Minister for Health and Population Hatem el-Gabali said on Tuesday that hospitals across Egypt had been put on a high state of alert. The Ministry's spokesperson Abbassi also added "we are working to 'recharge' the media message, through all the available channels."An incidence of the virus amongst poultry was also recorded last month in the Upper Egypt town of Edfu, although no human infection was reported. (from Reuters)

An Indonesian woman has bird flu

JAKARTA, Oct 11 (Reuters) - An Indonesian woman being treated in hospital has tested positive for bird flu, a health official said on Wednesday.

Indonesia has become one of the frontlines in the battle against the disease. So far, 52 people have died of bird flu, the highest of any country, with the majority of deaths occurring since the beginning of this year.

"A 67-year-old woman living in the Cisarua area of Bandung had contact with fowl," the official from the bird flu information centre said by telephone. The woman was admitted to the hospital on Oct. 7 and was still alive, the official added.

The woman tested positive to the H5N1 virus after a test at a health ministry laboratory and one conducted by NAMRU, the U.S. Naval Medical Research Unit based in Jakarta, the official added.

Hadi Yusuf, the director of the Hasan Sadikin hospital in Bandung, southeast of the capital Jakarta, said the woman was being treated with the anti-viral drug Tamiflu and antibiotics.

"Her condition is bad. For a second day, she has been on a respirator and her blood pressure is high."

Yusuf said the woman had come down with a fever two weeks after being in the vicinity of dead chickens.

Despite the rise in the human death toll, the Indonesian government has resisted mass culling of birds, citing the expense and impracticality in a huge, populous country where keeping a few chickens or ducks in backyards is common.

Worldwide, 148 people have died of bird flu since 2003.

Monday, October 09, 2006

Bird flu found in pigs in Indonesia's Bali

JAKARTA, Oct 9 (Reuters) - The H5N1 bird flu virus has infected pigs on the Indonesian resort island of Bali, a senior agriculture ministry official said on Monday.

"There were two pigs that were infected by bird flu in Bali. These were old cases that happened last July," Musni Suatmodjo, agriculture ministry director of animal health, told Reuters.

Koran Tempo newspaper had reported on the weekend that a team from the veterinary faculty at Udayana University had discovered avian influenza infected two pigs in the regencies of Gianyar and Tabanan in Bali.

It was not clear if the pigs died. Pigs are a concern because they are susceptible to many of the viruses that infect humans. Swines can act as mixing vessels in which genetic material from avian flu viruses can mix with human influenza viruses, potentially producing new and deadly strains for which humans have no immunity.

I Gusti Putu Suwandi, head of the Tabanan agriculture office, said there have not been new cases of avian influenza in the area since July. "As for the pigs' cases, we haven't received a formal report of the finding from the university," Suwandi told Reuters by telephone.

The agriculture ministry's Suatmodjo said bird flu had been detected in 30 out of 33 provinces in the country, with the latest cases in North Sulawesi province.

He said that although that was an increase from 29 provinces last year, the percentage of deaths in poultry was lower thanks to better vaccination and other control measures.

"The number of death cases in poultry due to bird flu were relatively small as commercial farms have done proper vaccination and biosecurity, but the main problems remain on the backyard farms," Suatmodjo said, referring to the many Indonesians who keep a handful of chickens at their homes.

Indonesia has become one of the frontlines in the battle against the disease. So far, 52 people have died of bird flu, the highest of any country, with the majority of deaths occurring since the beginning of this year.

Worldwide, 148 people have died of bird flu since 2003. Although the human death toll has climbed, the Indonesian government has resisted mass culling of birds, citing the expense and impracticality in a huge, populous country where keeping a few chickens or ducks in backyards is common.

Culling at selective farms and their immediate surroundings has been the preferred method. Millions of chickens and other fowl in Indonesia have died from the disease or been killed to prevent its spread since it first surfaced in the archipelago in late 2003.

Saturday, October 07, 2006

Don't sleep with your chickens

WASHINGTON, Oct 5 - U.S. preparations against a possible outbreak of the deadly form of the H5N1 avian flu virus are solid, but other countries may not be as ready, a U.S. health safety official warned on Thursday.

"We're ... close to the state-of-the-art in the United States with preparations and strong biosecurity measures," said Ambassador John Lange, the State Department's special representative on avian and pandemic influenza.

But abroad, "it's a mixed bag," Lange said during a meeting of poultry industry leaders in Washington.

The United States is spending $392 million over two years, Lange said, to help other countries prepare for a possible human outbreak of the disease, known as bird flu.

U.S. support has included sending experts and laboratory equipment to other nations, he said.

The H5N1 avian flu virus has killed at least 148 people since 2003, mostly in Indonesia, Thailand, Vietnam and China. Currently, the disease almost exclusively affects birds although health officials fear that it could mutate and be passed easily between humans.

Lange said it was especially challenging for poor countries to gird for an outbreak because they don't have resources for sufficient surveillance, culling, and vaccinations.

Sherrill Davison, director of an avian medicine and pathology laboratory at the University of Pennsylvania, detailed to industry officials ongoing testing of U.S. bird flocks and other surveillance and safety procedures.

"Over the years our diagnostics have become quicker ... we know that they work," she said.

She said poultry companies and agriculture officials were now working with law enforcement and emergency coordinators to plan a response to a possible outbreak.

In any suspicious case, Davison said, bird flocks would be quarantined and could be killed and buried on-site.

Michael Doyle, director of the University of Georgia's Center for Food Safety, said consumers' fears about getting bird flu from eating eggs and chicken need to be allayed.

Because the virus is normally transmitted by contact with live animals, not by handling or cooking poultry, he pointed to a Nigerian proverb as the best advice: "Don't sleep with your chickens."

Thailand launches anti-bird flu campaign in schools

BANGKOK (AFP) - Thailand is launching a campaign across its 40,000 schools to teach children how to avoid bird flu, the government said.

Posters and pamphlets will promote frequent hand washing, early reporting of sick or dead birds, and safe poultry-cooking practices, organizers said Friday.

"The majority of those affected by bird flu are children under the age of 18 who contract it from playing with chickens," said Mark Thomas, a spokesman for
UNICEF, which organized the campaign with the education ministry.

As part of the campaign, teachers will be given a new curriculum to educate children about bird flu, and 300,000 bars of soap will be sent to elementary schools.

The organizers hope the lessons the children learn will spread to the families and communities they live in.

Thailand is among the countries hardest hit by the deadly H5N1 strain of the bird flu virus, recording 25 human cases, 17 of them fatal, since the outbreak began here in 2004. 11 of the deaths have been children under the age of 18.

Almost all cases of the deadly H5N1 infection in humans have been linked to close contact with sick or dead birds, according to UNICEF.

The most recent fatality announced in Thailand was a 59-year-old farmer who died in August after touching dead chickens with his bare hands.

Thursday, October 05, 2006

Indonesia to help develop rapid bird flu test

JAKARTA, Oct 5 (Reuters) - The Indonesian government has teamed up with a Singaporean firm to develop an early diagnostic bird flu test kit for humans, the health minister said on Thursday.

A rapid test for bird flu infections in humans is key for existing treatments to be more effective, potentially saving lives.

Tamiflu, a drug made by Swiss giant Roche AG which has been used successfully to treat some patients, rapidly loses its effectiveness if not used in early stages of the disease.

"With this, case finding will be much faster, so treatment can be done as soon as possible," Siti Fadillah Supari told reporters after a signing ceremony between the health ministry and Temasek Life Sciences Laboratory.

"Temasek already has the concept of the development but they need the virus strains, something which we have, to produce the rapid test kit," she added.

The laboratory is part of Singapore's state financial arm Temasek Holdings.

Tan Kok Keng, chief operating officer of Temasek Life Sciences Laboratory, said he hoped the diagnostic kit would be produced within a year.

"We have the technology, so we are here to evaluate further for detection of the H5N1 virus. First we have to develop it for animals and farms, subsequently and obviously it will be extended for humans," Keng said.

"We are concerned with the various strains of the virus. We want to make sure the diagnostic kit will have a good coverage of deeper strains of H5N1, whether for Indonesia, Vietnam or elsewhere in the world."

Indonesia has become one of the frontlines in the battle against the disease. So far, 52 people have died of bird flu, the highest of any country, with the majority of deaths since the beginning of this year.

Worldwide, 148 people have died of bird flu since 2003.

The H5N1 virus mainly affects birds but experts fear it could mutate into a strain capable of killing millions of people in a global pandemic.

More deaths are feared in Indonesia because the virus is endemic in poultry across much of the huge archipelago of 17,000 islands.

Bird flu vaccine shows good results in early trial

CHICAGO, Oct 4 (Reuters) - Preliminary results from an early clinical trial of a vaccine for pandemic bird flu suggest the vaccine is safe and well tolerated and may prove effective against divergent strains of the disease, Baxter International Inc. said on Wednesday .

"This is the first clinical demonstration that a candidate H5N1 (bird flu virus) vaccine can induce antibodies that neutralize widely divergent strains of H5N1," said Noel Barrett, vice president of Global research and development for Baxter's vaccines business.

"These preliminary data, which must be confirmed in a larger study, suggest that the vaccine may provide wider protection for a larger number of people before and during a pandemic," he said.

H5N1 mainly affects birds, but experts fear it could mutate into a strain easily transmitted from person to person, capable of killing millions of people in a global pandemic.

An H5N1 virus has killed at least 148 people since 2003, mostly in Indonesia, Vietnam, Thailand and China, according to the World Health Organization.

Baxter said the clinical trial of the experimental H5N1 pandemic vaccine in 270 healthy adults in Austria and Singapore suggested the vaccine had similar side effects to those reported for seasonal flu vaccines.

The preliminary results suggest the vaccine is highly capable of producing an immune response and can create antibodies to H5N1 even at the lowest dose level, it said.

A preliminary analysis of serum samples obtained from study subjects showed the vaccine was able to neutralize the pandemic virus contained in the vaccine as well as other diverse strains of the H5N1 virus.

Baxter plans to begin a late-stage clinical trial of the vaccine early next year and said it will present final results by the end of 2007.

Deerfield, Illinois-based Baxter has said its cell-based vaccine production system is more rapid than traditional methods using chicken eggs.

Baxter's H5N1 pandemic vaccine candidate was produced using four different antigen concentrations. Two of the concentrations were with and without adjuvant, a substance added to vaccines to improve immune response.

Baxter and a number of other companies are working to develop a vaccine to protect against a potential bird flu pandemic. GlaxoSmithKline Plc in July said its vaccine could be mass produced in 2007.

There is currently no vaccine against the virus, which is now treated with Tamiflu, also known as oseltamivir, an antiviral drug made by Roche and Gilead Sciences Inc..

Glaxo also makes the inhaled drug Relenza under license from Australia's Biota , which also appears to treat both types of flu.

Monday, October 02, 2006

New bird flu outbreak reported in Inner Mongolia

An outbreak of bird flu has been identified in North China's Inner Mongolia Autonomous Region, according to the Ministry of Agriculture (MOA).

The national avian influenza laboratory confirmed that the H5N1 virus was found in samples of the dead poultry in Xincheng village, Baotou City.

The H5N1 strain of bird flu had killed 985 chickens. Another 8,990 chickens had been culled to control the outbreak.

The local agricultural department had quarantined the infected area. and the outbreak was under control, the ministry said.

The last outbreak of bird flu in poultry was in Changsha, capital of Central China's Hunan Province, in August.

The MOA said 1,805 ducks were killed by the disease and another 217,000 were culled.

The quarantine of the region was lifted on September 6, after no new cases were reported for 21 consecutive days.

China has reported nine outbreaks of bird flu in poultry this year, in northwestern Xinjiang Uygur Autonomous Region, North China's Shanxi Province and Inner Mongolia, East China's Anhui Province, southwestern Guizhou and Sichuan provinces and the central province of Hunan.

The previous eight outbreaks have been controlled and restrictions lifted. (

Docs fear world not ready for bird flu pandemic

The specter of a bird flu pandemic haunts epidemiologists who said US and world preparedness falls short, should the H5N1 virus become transmissible between humans.

"I hope H5N1 won't be able to acquire transmissibility because this is an extraordinary quagmire," Robert Webster, a world-class expert on the virus, said at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy meeting this week in San Francisco.

"Don't become complacent. We need to put into place every possible way" to stop this virus from transmitting from human to human, he said.

"If it does happen, we have to be prepared for a pandemic.

"It would be a pandemic flu, it's an absolute certainty," said the epidemiologist from St Jude Children's Research Hospital in Memphis, Tennessee.

He said that the extremely pathogenic H5N1 virus causes symptoms in humans similar to those of the H1N1 pandemic of 1918, including diarrhea, which is not a good sign.

"In 1918 at least a half million American died. With the current population structure in the US and nothing else different, two million would die," said Arnold Monto, epidemiologist of the University of Michigan.

"We have learned a lot from seasonal influenza which is applicable to pandemic influenza. The basic thing that will happen is that we have to look very quickly once the pandemic has started to find out what the characteristics are like -- like in 1918 where young adults were dying or if it's like 1957 (and) 1968, which had more the characteristics of a very severe seasonal influenza."

In 1918, the H1N1 or "Spanish" flu killed 20 million to 50 million persons worldwide, because it had mutated into a form that could be transmitted from one human to another.

"Like the Spanish flu, if (the bird flu is) going to acquire transmissibility, it has been estimated it will take something like 10 critical mutations," Webster said.

"So with its huge distribution in the world," Webster said, the virus could become transmissible "anytime."

Worse yet, Webster said, "We know surprisingly little of what constitutes the ability of the virus to transmit" human to human.

That said, "It makes sense to stockpile vaccines even though it doesn't prevent infection, there is a lot of difference between infection and death," he said.

"There is an urgent need to increase the influenza vaccine manufacturing capacities in the world because the capacities are too low."

David Bell of the US Centers for Disease Control and Prevention did not look to stopping the epidemic completely.

"The goal of these measures isn't to stop a pandemic but rather to mitigate its impact on the community, to flatten the epidemic, to take the pressure out of the health care system by reducing the number of people getting sick," he said. (


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