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                                                   World Health Organization Still Assessing Bird Flu Threat

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World Health Organization Still Assessing Bird Flu Threat

Eric Schmiedl

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Bird or Avian Influenza has killed more than 68 people in several Asian countries, according to the World Health Organization (WHO) and news reports. Although health officials say panic isnt warranted at this point, the evidence is ample to create serious concerns.

Whether the potentially-lethal H5N1 strain of the disease has made the leap from bird-to-human to human-to-human transmission has yet to be determined, said Daniel Epstein, information officer with the WHOs Washington, D.C.-based regional office. WHO is the United Nations specialized agency for health and among the foremost organizations dealing with the infectious illness.

I think were at the stage of still assessing the threat, Epstein said. On the WHOs scale, the Avian Flu situation ranks at a No. 3, with the least problematic threats coming in at No. 1 and the most serious at No. 6.

That No. 3 rating is based on no or limited human-to-human transmission of the disease, Epstein said, adding health officials worldwide are studying whether human-to-human transmission is occurring. People living on the same farms in some areas of the world have come down with the disease, but its uncertain whether they picked up the illness from each other or from fowl on those same farms, Epstein explained.

If evidence surfaces that the unpredictable Avian Flu virus has started moving through human-to-human transmission, the seriousness of the situation will rise to a No. 4 ranking, he said. There are other, conflicting reports as to whether human-to-human transmission has occurred. Even so, those reports point to limited transmission only.

Generally, the disease attacks birds or, less commonly, pigs, However, it continuously mutates and is spread through bird migration, ultimately attacking humans, making it more of a potential threat outside Asia.For example, the disease was recently reported as appearing in the Arab world for the first time.

In addition, a subtype of H5N1 has turned up in North America, at a west-coast Canadian poultry farm. Even though the virus found in a commercial duck there was deemed to be a low pathogenic North American strain, according to the Canadian Press, that find prompted the slaughter of 60,000 birds as a precaution against the diseases spread. The U.S. has also taken trade action against the Canadian province of British Columbia as a result, although far bigger and costly bird culls have gone ahead in other jurisdictions to prevent the spread of the virus in the past.

This confirmation means were looking at a virus capable of causing only a mild disease (in birds), if any at all, Cornelius Kiley, a veterinarian and Canadian Food Inspection Agency worker, said of the British Columbia situation. The expanding geography associated with H5N1 is one of the reasons many are concerned a pandemic a worldwide spread of the disease is possible.

But the lack of available information on bird migration pathways and the influenzas that hit avian populations is, among other things, making it tough for public health experts to battle the disease. We would be so far ahead of the game right now if we knew more about the actual natural history and what the wild-type viruses actually do in these waterfowl populations or bird populations in general,'' David Stallknecht, a Bird Flu specialist at the University of Georgia's college of veterinary medicine in Athens, told the Canadian Press. The lack of funding and the lack of appreciation for knowing what these wild-type viruses do, I think has put us behind, he said. The maintenance of general good health through nutrition, vitamins and exercise to ward off the Avian Flu has been recommended by health officials. Even getting a regular flu shot available for free from some public health groups in North America has been suggested as a way to help ward off the flu.

For people who eat chicken or other fowl, cooking it at a minimum of 70 C or 158 F will kill any virus it contains, health officials on both sides of the Canadian-American border have said. In addition, laboratory studies suggest that prescription medicines including Oseltamivir (commercial name: Tamiflu) and Relenza, which were licensed in the United States and Europe in 1999, could ward off the disease. Even so, the Atlanta-based Centers for Disease Control and Prevention (CDCP) warns that flu viruses might become resistant to these drugs. More studies are needed to prove the medicines effectiveness, according to the organizations Web site.

As for the WHO, it isnt pushing either medication to combat the Bird Flu, Epstein said. (The drugs) will ease (Avian Flu) symptoms, he said, but theyre not a cure for the disease. However, other WHO officials have recommended that some countries stockpile Tamiflu in particular, as it prevents viruses from spreading from one infected group to another. (Tamiflu) is a broad spectrum drug, Dr. Frederick Hayden, a clinical virologist at the University of Virginia, said in the Canadian edition of Readers Digest magazine. Flus can have nine different NA proteins and Tamiflu has been shown to be effective against all of them. It reduces the duration of illness and the risk of complications and hospitalization, Hayden said.

The drawbacks to Tamiflu are its relative high cost and short supply, Dr. Bruce Gellin, director of the U.S. National Vaccine Program Office, said in the magazine. But since 2003, Roche a Swiss firm and the worlds only manufacturer of the drug has stepped up Tamiflu production, boosting its output of the medication eightfold in the past two years. In addition, U.S.-based manufacturing facilities to produce the drug are in the works, according to the magazine.

The WHO is not recommending the use of virus-fighting face masks, which cover the nose and mouth, at this time to prevent the spread of the illness, Epstein said. Such masks were used in Toronto, Canada in 2003 to combat the spread of the Severe Acute Respiratory Syndrome (SARS) virus in that city. SARS also emerged in several other cities throughout the world. The WHO is working with public health agencies globally regarding the Bird Flu, Epstein said, to help ensure such things as communications plans to keep the public informed in the event of a major outbreak are in place.

Eric Schmiedl is a freelance journalist and a contributor to

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