London, UK - 19 January 2006, 13:50 GMT - Kofi Annan: World not prepared to combat bird flu; Response: Dr Pete Moore; 14 Avian flu cases confirmed in Turkey; Response: Dr Ian Perry; ATCA: Turkey Avian flu proliferation much worse...

Dear ATCA Colleagues

UN Secretary General Kofi Annan has warned of the possibility of human-to-human transmission of the Avian Influenza virus, also known as bird flu, unless the international community pulls together in a massive effort to combat the virus.

"There's no time to waste. Let's ensure we're ready. We are not yet there," said Annan in a video address to the International Donors Conference on Avian Influenza in Beijing, China. "To be truly prepared, we will need to mount a massive effort - from upgrading veterinary systems and launching vaccination drives, to encouraging change in the ways people coexist with animals." Annan called for sharing information, biological material, and scientific expertise, providing essential medicines to those in need, and galvanizing international efforts "with a minimum of red tape and quibbling." Pledging the UN's full support for this effort, he said, "I have asked all parts of the United Nations system to have contingency plans in place, so that we can sustain vital support, if and when a human pandemic does erupt. I encourage all governments to do the same," he added. "There is no time to waste."

The conference was jointly arranged by the Chinese government and the World Bank to garner over one billion dollars in terms of financial support. "Our effort requires resources. The amount asked for is small compared to the costs," said Annan. Chinese Premier Wen Jiabao also urged the developed nations and international donor agencies to come forwards and lend support.

In response to the appeal, many Western countries have pledged their support to fend off the pandemic. The assurance of 1.9 billion dollars from donor countries has already exceeded what was aimed for in the conference. The United States has pledged USD 334 million in the form of funding and technical assistance. The European Union has promised USD 250 million.

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 10 January 2006 19:21
To: ATCA Members
Subject: Response: Dr Pete Moore; 14 Avian flu cases confirmed in Turkey; Response: Dr Ian Perry; ATCA: Turkey Avian flu proliferation much worse than first understood; WHO: Avian Influenza spreads to EU border

Dear ATCA Colleagues

We are grateful to Dr Pete Moore for his submission in regard to Avian flu.

Dr Pete Moore has authored 12 books over the last decade that reflect on the way that science and technology has had an impact on humanity. These include 'Killer Germs - rogue diseases of the 21st century' a book that is about to reappear in a new edition with additional chapters on Avian flu and hospital acquired infection. Dr Moore has worked as a rapporteur at vate meetings in the House of Lords, and at St George's House, Windsor Castle. He is a visiting lecturer in ethics at Trinity College Bristol, and a Course Tutor on the Science Communication MSc course at the University of the West of England, Bristol. He is the immediate past Chairman of the Medical Journalists' Association. He is a member of the National Health Service (NHS) Health Technology Assessment Programme's Diagnosis and Imaging Panel. He writes:

Dear DK

A few thoughts on Avian Flu:

One of the intriguing things about viral infections is that we have so few ways of combating them. In the majority of cases the treatment is to support the patient while the body's immune system attacks the virus. This can include giving antibiotics to ward off any opportunistic infection by bacteria. The main approach is prevention with vaccination campaigns that work by priming the immune system so that its ability to fight specific viruses is enhanced.

Part of the problem is that pharmaceutical treatments for disease tend to work by killing the infective agent. For example antibiotics work because scientist have discovered and developed chemicals that kill bacteria but do no affect animal or plant cells. This approach works well with diseases caused by parasites, bacteria or fungi, but is more difficult with viruses because viruses are not alive in the first place. They are simply packages containing a small number of genes that on their own are virtually inert. They can only replicate when they invade a living cell. At that point they hijack the living machinery inside the cell, and use it to generate thousands of new copies of themselves. Any approach aimed at 'killing' them would have to kill the cells that the virus is invading, and that would do more harm than good.

The approaches that are beginning to come onto the market work by blocking the virus' ability to invade or exit cells, and therefore blocking its ability to replicate. Tamiflu has made headlines and allows viruses to enter a cell and replicate, but the drug then coats the viral particles so they can't escape. This means that the infecting dose of viruses will cause a small amount of damage, but the viruses are prevented from triggering a cascade of replication that results in major disease. Worryingly, though, there are already signs that the virus is learning to evade Tamiflu. Two children died in Vietnam from the H5N1 version of flu that had mutated sufficiently to make Tamiflu next to useless.

The flu virus is remarkable in that it only contains 8 genes, and its ability to infect people is largely regulated by the two genes that build the spikes in the viral coat - one the Hemagglutinin protein (H), the other the Neuraminidase protein (N). There are many different versions of these two proteins - and scientists have numbered basic sub-types - hence H5 and N1 of the current version of bird flu that is so troubling. The first time your immune system sees a particular set of spikes it takes time to react - and in that time the virus may replicate so much that it causes severe disease or even death. If you survive the first assault, then your immune system will be alerted to that variant should it arrive at some point in the future, and should remove the virus before it causes harm.

The problem with flu is that the genes for these surface mutate, so new versions frequently appear. Each time there is a new version there is a chance of an epidemic. If the mutation makes a significantly new protein, then the epidemic can be severe. A example of this is a mutation that enables a virus to jump from infecting one species (ie birds) to another (ie humans). This is what seems to have happened in 1918 when the virus probably went from wild ducks to pigs and then to humans - that virus was H1N1. Many millions died - too many for accurate numbers.

The other problem with flu viruses are that they don't stop mutating when they have swapped species. At the moment we have a version of the virus that can move from birds to humans, but it seems ill-equipped to jump from human to human. We can potentially stamp it out if we kill enough birds, but if it gains the ability to jump from human to human then we have a problem - you can't go around culling humans - quarantining them is hard enough. One thing that is almost impossible to measure is the number of people who have been infected with the virus, without it triggering a disease. These carriers could easily exist, and would be perfect breeding grounds for viral development.

The problem we face today is that current healthcare systems may be much better at supporting people while they get better than was the case in 1918, but they can only cope with a few people at a time. Countries do not have anything like the spare capacity needed to cope with an outbreak.

Add this together and you can see why the WHO and others are keen to tackle this hard.

The next few months will be interesting...

 

Pete Moore PhD

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 09 January 2006 20:13
To: ATCA Members
Subject: UPDATE: 14 Avian flu cases confirmed in Turkey; Response: Dr Ian Perry; ATCA: Turkey Avian flu proliferation much worse than first understood; WHO: Avian Influenza spreads to EU border

Dear ATCA Colleagues

1. We present you with an update in regard to the avian flu situation in Turkey, with 14 human cases confirmed; and
2. We are grateful to Dr Ian Perry for his extremely thought provoking questions and observations in regard to the global risk of a mutated bird 'flu pandemic.
____________________________________________________________________________

UPDATE: 14 Avian flu cases confirmed in Turkey

World Health Organisation (WHO) officials have said on Monday that 14 people have been confirmed with avian flu in Turkey. They appear to have contracted the disease, with a known high fatality rate, through contact with infected animals rather than infected humans. Avian flu cases are turning up in Turkish towns and villages hundreds of miles apart, in every section of the country except the West. Turkish officials say they are near wetlands on the paths of migratory birds, which have been carrying the disease from country to country. From the 14 confirmed cases at different locations, it may be deduced that poultry is infected around the country. Indonesia and China have each reported a new case of avian flu today.

The causative agent, the H5N1 virus, has proved to be especially tenacious. Despite the death or destruction of an estimated 150 million birds worldwide, the virus is now considered endemic in many parts of Indonesia and Vietnam and in some parts of Cambodia, China and Thailand. Health officials believe the best way to fight the spread of bird flu is the wholesale destruction of poultry in the affected area. But they often run into problems in rural areas where villagers resist turning in their animals.

Hoping for the best but preparing for the worst, the travel and tourism business is gearing up for a widespread outbreak of avian flu among humans, a much-feared event that would put travellers and travel-industry workers on the front lines of the fight against the disease. Many of the travel industry's new pandemic-prevention programs have been spawned by the spread of Severe Acute Respiratory Syndrome (SARS), which emptied hotels and forced flight cancellations in East Asia and North America in late 2002 and 2003. SARS killed 770 people and cost businesses about USD 60 billion in lost revenue, according to WHO. The avian flu could be worse if it were to be manifest as a human-to-human pandemic.

The European Commission is to adopt a decision to ban untreated feathers from Azerbaijan, Armenia, Georgia, Syria, Iran and Iraq, due to the proximity of those countries to Eastern Turkey where there is currently an outbreak of the H5N1 avian influenza virus in poultry and less than 20 bird-to-human transmission cases have been confirmed. The complete ban on any imports of live birds and poultry products from Turkey, which was adopted in early October 2005, remains in place.

The outbreaks of the highly pathogenic avian flu, which began in Southeast Asia in mid-2003, are the largest and most severe on record, according to WHO. Never before in the history of the disease have so many countries been simultaneously affected, resulting in the loss of so many birds. There may be larger fronts in terms of infected birds. It seems the disease in animals, and in particular, birds, may be more widespread than was initially envisaged according to WHO. But there is still real concern that the disease could mutate. The more human infections [of bird flu], the more there is a chance for the virus to adapt to humans. The more people contract the infection from poultry, the higher is the risk that the virus starts to adapt itself and mutate.
____________________________________________________________________________

Dr Ian Perry is a Consultant Physician. As a member of the European Aviation Licensing Medical Committee for over a decade, he was initially involved with the SARS outbreak, the associated community problems and the dissemination of the disease by aircraft. He is a Fellow of the Chartered Institute of Management, a Past Master of the Guild of Air Pilots, and an Academician of the International Academy of Aviation and Space Medicine. He has done research into medical evacuation and patient transfer by air, both on a large and small scale around the world. He is a practising Member of the Academy of Experts who specialises in aviation medicine, the medico legal problems people have at work, and the transmission of diseases between work forces across the continents. He has made numerous presentations on the problems of disease transmission, with its impact on the workforce, the economy and the damage to the social infrastructure. Dr Perry has been a regular UK soldier, who served in both the Royal Army Medical Corps and the Army Air Corps as a flying doctor. He writes:

Dear DK

ATCA has asked for my thoughts. As I was thinking, more cases seem to appear, which changed my line of thought, but on reflection however, the same basic questions apply. I do have a great interest and experience in the patterns of disease transmission, although I am not a virologist. My preliminary thoughts framed as observations and questions are as follows:

1. How many people die each year, in these locations from flu/respiratory illnesses?

2. Birds and other animals suffer from a whole range of pests/viruses, the majority of which all present, if a human being gets too close and gets infected, as a respiratory illness of some sort.

3. Psittacosis is one such illness, found not only in parrots but many other types of birds. It is identical in presentation as H5N1 when humans get infected, and it can be fatal. I know this to be a fact, as I have seen a number of cases.

4. Do the inhabitants of the alleged infected areas, have other types of birds as pets? Some types of birds may just be carriers. What else can carry H5N1?

5. What is required is some very urgent epidemiology in the regions that are affected. H5N1 may have been endemic in these areas for years [H5N1 was first detected in South East Asia in mid-2003], with no one really worrying about the local causes of the illness or death, until now.

6. I doubt very much whether there have ever been any post mortems or studies carried out on those who have died or were ill in these regions, until very recently.

7. Death has always been the will of God. I doubt if any one would permit the exhumation of people who have died in the past, to see if it was H5N1 or an H5N1 type variant that killed them. Such variants or similar viruses may have possibly been killing a number of innocent people of all ages in those areas for decades or even centuries.

8. There are so many questions that need to be answered, before every bird is slaughtered without good cause. [Over 150 million have already been slaughtered or died.]

9. Local poultry/egg and associated industries will be severely disrupted, even destroyed, possibly quite unnecessarily. Local economic hardship must be considered if preventive measures are really deemed necessary. One is reminded of the dreadful lessons learnt from the Foot and Mouth epidemic in the UK a few years ago.

10. There is so much detective work to be done before hysteria prevails.

11. The WHO will need expert virological laboratory confirmation as to the cause of these illnesses and deaths, no matter what local resources are available.

12. If these outbreaks are to be treated seriously, then many pairs of expert eyes will need to look at all of the evidence, to work out exactly what is going on, before drawing all of the wrong conclusions.

I hope this is a useful contribution.

 

Ian

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 08 January 2006 22:52
To: ATCA Members
Subject: ATCA: Turkey Avian flu proliferation much worse than first understood; WHO: Avian Influenza spreads to EU border - Confirmed cases in Turkey; ATCA: Incidents of Avian flu mount, UN: battle being lost

Dear ATCA Colleagues

The Turkish Ministry of Health has reported on Sunday that five more people have tested positive for H5N1 avian flu, including three people in Ankara, which includes the country's capital, far from the nexus of infections to date. The World Health Organisation (WHO) has served notice through GOARN (Global Outbreak Alert and Response Network) that it may need to tap member countries for additional expert assistance.

As a number of new reports of avian influenza in humans and in animals has emerged today from disparate parts of Turkey, international health officials have said that they now believe that the disease has been simmering in the Eastern part of the country for months, even though it was only first reported there in late December. United Nations Food and Animal Organisation (UNFAO) has stated that they now believe the avian flu proliferation had been occurring "for some time," starting perhaps as early as October or November.

The cluster of cases in Turkey is extraordinary and concerning, scientists have said. In all of East Asia, where the disease has been running rampant in birds for years, only about 140 people have ever become infected, according to official statistics, and there has never been the kind of grouping as seen in Turkey. Scientists are exploring various theories to explain the Turkish clusters, including biological changes in the virus and behavioural risks.

Turkish authorities have informed the WHO team of positive laboratory tests for three more people from Ankara province - two brothers, aged five and three, and an unrelated man, 65 - and two more children from Dogubayazit, a girl, aged nine and her brother, aged three. The Ankara cases have the most alarming implications since bird flu has never been reported in the region. It is a relatively well-off part of Turkey, where it is not the norm for humans and animals to live under one roof. The boys infected had contact with dead wild ducks, according to a ministry spokesman, and the man with a dead chicken.

New reports of animal outbreaks across Turkey are also rapidly increasing with 6 of 81 provinces now reporting ongoing disease in birds, up from three just a few days ago. By this evening, the Agriculture Ministry of Turkey has said the count is up to 10. In light of the nine human cases over the last four days, the failure of the Turkish officials to quickly detect and publicise animal outbreaks may be seen as deadly oversight retrospectively.

WHO's Geneva headquarters have said the agency needs more information about the tests used on the five newly identified cases to determine whether to accept the diagnoses. For the time being, the official WHO case tally in Turkey remains at four, all young children. Two have died. They bring the global count of H5N1 avian flu cases in the past two years to 146, with 76 deaths, ie, an over 50% fatality rate which is very high.

Previously the WHO only officially confirmed cases of avian flu when one of its collaborating laboratories had verified the findings. But the organisation is shifting its approach. WHO says we are moving away from the old model in which we needed samples to be verified by an external laboratory. What they are doing is moving towards a system where, if they have confidence in the laboratory, then they accept the results - which is the case with Turkey.

More than 50 people remain in hospital in Van and Ankara receiving treatment for illnesses that bear hallmarks of H5N1 infections. But experience elsewhere shows that when avian flu first appears in a country or region, increased surveillance produces a spike of suspect cases, some of which may later be ruled out. Some members of the WHO team of experts that arrived in Van late Sunday has headed to the hospital there to begin the work of helping to determine what the actual case count is. The team had hoped to make the journey on Saturday, but was forced to remain in Ankara because of a winter storm.

Meanwhile, scientists who specialise in studying H5N1's genetic makeup were expected to be mining newly completed sequence data to see if the virus samples retrieved from the Turkish cases showed signs that the virus is mutating in ways to allow it to spread more easily to and among people. The full genetic code of human and animal viruses from Turkey have been charted and posted on databases used by scientists in the WHO collaborating lab network.

[ENDS]

We look forward to your further thoughts, observations and views. Thank you.

Best wishes

For and on behalf of DK Matai, Chairman, Asymmetric Threats Contingency Alliance (ATCA)

-----Original Message-----
From: Intelligence Unit
Sent: 05 January 2006 20:38
To: ATCA Members
Subject: WHO: Avian Influenza spreads to European Union border - Confirmed cases in Turkey; ATCA: As Global incidents of Avian bird flu mount, UN announces battle being lost

Dear ATCA Colleagues

RE: Avian Influenza spreads to European Union border - Confirmed cases in Turkey

The Avian Influenza is finally knocking on The European Union's door having reached Turkey. According to the World Health Organisation and other sources:

The Ministry of Health in Turkey has confirmed its first two cases of human infection with avian influenza caused by the H5 virus subtype. Both cases were fatal.

The two Turkish cases mark the first confirmed reports of human infection with avian influenza outside East Asia. Since January 2004, a total of 142 human cases of H5N1 infection have been reported in Viet Nam, Thailand, Cambodia, Indonesia, and China. The cases in Turkey bring the number of affected countries to six, from which 144 cases have now been reported.

Most of those cases have been spread through bird-to-human contact and not human-to-human. However, there are a few cases in which the virus is believed to have possibly spread from human-to-human. Health officials have said they fear the virus could eventually mutate and spread rapidly from human-to-human, causing a worldwide pandemic.

The first case was a 14-year-old boy from the rural district of Dogubayazit, in the eastern province of Agri, which borders the Islamic Republic of Iran and Armenia. He was hospitalized in Van Province on 1st January and died the same day. The second case was his 15-year-old sister, also hospitalized on 1 January. She died on 5th January.

Earlier this week, Turkish authorities had ruled out avian influenza in these cases based on preliminary test results from samples taken from the nose and throat. Subsequent tests of additional patient specimens taken from the lungs produced positive results. Patient samples were sent today to a WHO collaborating centre in the United Kingdom for further analysis. The samples have now arrived; results are expected within the next few days.

Turkish health authorities have informed WHO that, since 1 January, a total of 11 patients (including the two confirmed fatal cases) have been hospitalized in Van Province with symptoms suggesting infection with avian influenza. Most patients are children between the ages of six and fifteen years and all reside in the Dogubayazit district. Two of the children are siblings of the two confirmed cases.

Following a request by the Ministry of Health, an initial team of experts from WHO, the European Centre for Disease Prevention and Control and the European Commission is travelling today to Turkey to collaborate with the authorities in their investigation of the situation.

Initial information about the confirmed cases suggests that the children acquired their infection following close contact with chickens. Deaths of chickens are known to have occurred in the Dogubayazit district near the end of last year. Although no poultry outbreak has been officially reported in the district, a confirmed outbreak of H5N1 avian influenza in chickens and ducks was reported on 27th December in the adjacent province of Igdir.

National authorities have informed WHO that Dogubayazit district has been placed under quarantine; no people or animals are allowed to move in or out of the district. Culling operations are currently under way.

Turkey reported its first outbreak of H5N1 avian influenza in poultry in mid-October of last year. That outbreak, which occurred in the north-western part of the country, was attributed to contact between domestic poultry and migratory waterfowl. The outbreak in Igdir and other suspected outbreaks in this part of the country are thought to have occurred following introduction of the virus by migratory birds. The region, which has several large lakes, is known to lie along migratory routes.

[ENDS]

We look forward to your further thoughts, observations and views. Thank you.

Best wishes

For and on behalf of DK Matai, Chairman, Asymmetric Threats Contingency Alliance (ATCA)

-----Original Message-----
From: Intelligence Unit
Sent: 22 December 2005 10:12
To: ATCA Members
Subject: ATCA: Doubts over key avian flu drug; Response: Dr Patrick Dixon; ATCA: As Global incidents of Avian bird flu mount, UN announces battle being lost; Michael Harrison; Stephen Clothier; Dr Ian Perry

Dear ATCA Colleagues

Serious questions are being raised about the ability to combat an anticipated bird flu pandemic following the deaths of two people who were being treated with the drug the world is stockpiling as a safeguard against the bird flu virus. The deaths have been reported in the respected New England Journal of Medicine by doctors funded by the British Wellcome Trust working in Vietnam. They urge changes to the global plans for fighting a flu pandemic and suggest other antiviral drugs are needed alongside Tamiflu, manufactured by Roche of Switzerland.

To the dismay of medical experts and concern among those responsible for the worldwide efforts to fight a pandemic, the H5N1 bird flu virus in the bloodstream of the two patients in Vietnam rapidly developed resistance to the drug, Tamiflu. One, a 13 year-old girl, appeared to be stable at first and then rapidly worsened as the virus mutated, became more aggressive, and eventually killed her.

An eminent professor at Cornell University in New York calls the report "frightening" in a commentary in the journal. Anne Moscona, from the department of paediatrics, microbiology and immunology at Weill medical college, says Tamiflu-resistant H5N1 "is now a reality", and calls for efforts to prevent individuals stockpiling the drug. Its misuse, she says - by people who, for instance, take too low a dose - will breed resistance and further undermine its effectiveness if a pandemic sweeps the world.

At a conference last month, the Chief Medical Officer of the UK, Sir Liam Donaldson, made it clear that Tamiflu was Britain's first line of defence. But he acknowledged that nobody knew for sure how the drug would work in a pandemic against a strain of flu yet to be encountered. "It doesn't cure flu, it simply reduces the severity of the attack," he said. The British government has ordered 14.6m courses of Tamiflu, enough for a quarter of the population. Its maker, Roche, cannot keep up with demand as most countries attempt to stockpile. So far, 3.5m doses have been delivered, and the rest is due by next September.

We are grateful to Dr Patrick Dixon for his personal views in regard to bird flu both in summary and detailed formats.

Dr Patrick Dixon is originally a physician by training. He is the Chairman of the trends forecasting company Global Change and described as a "Global Change Guru" by the Wall Street Journal. He is founder of the international AIDS agency ACET. He is often referenced in the media as Europe's leading Futurist and has been ranked as one of the top 20 most influential business thinkers alive today (Thinkers 50, 2005). He is author of twelve books (385,000 in print in 19 languages). Titles include Building a Better Business, Futurewise, The Genetic Revolution, The Truth about Westminster, The Truth about Drugs and The Truth about AIDS. He advises multinational company boards and senior teams on strategic implications of a wide range of global trends such as the new economy, the digital society, financial services, biotechnology, health care, geopolitical issues, lifestyle changes, marketing issues, consumer behaviour, employee motivation, public policy, business ethics and corporate social responsibility. He writes:

Dear DK,

SUMMARY OF BRIEFING: BIRD FLU OUT OF CONTROL AND SITUATION DETERIORATING

The World Bank says cost of a bird flu mutation to allow human to human spread could be up to USD 550bn in wealthy nations alone. Several countries (US, China, Australia) are now talking about plans to close borders if needed.

US government worst-case estimate is 1.9 million US deaths in first few months - see below. UK government's worst-case estimate is 800,000 deaths. UN global worst-case estimate is 60 million deaths and 2% fall in output of the global economy.

Most multinational senior teams I talk to about bird flu have not yet properly factored it into their risk assessments - this includes banks and insurance companies. Many corporation leaders are unaware of the true nature of the unfolding crisis. Markets have also not yet fully priced in the risk.

However, "worst-case" death toll remains very unlikely if appropriate action is taken at every stage, and a pandemic could turn out to be no more serious than a larger-than-usual outbreak of ordinary flu.

Greatest risk could be emotional reaction to spread. Indeed, it may only take 1,000 to 2,000 cases of rapid human to human spread with a number of deaths, to precipitate a major crisis similar to what we saw over SARS in Asia, but more so because of the severity of worst case projections. We need to keep in mind that the WHO is saying that human to human spread of a new and dangerous flu variant is now a 100% risk - only a matter of time... even if the actual death toll is small.

SALIENT POINTS OF DETAILED BRIEFING

. Why the US is now preparing for over a million possible deaths in first 20 weeks following a dangerous mutation
. Potential economic impact
. Why we remain so vulnerable to future viral attack
. Problems with vaccines
. What governments need to do
. Why emotional reaction to a humanised bird flu is likely to be far more devastating than a pandemic itself

BIRD FLU OUT OF CONTROL

The Director-General of the World Health Organization (WHO) Lee Jong-Wook said in November that the H5N1 avian influenza virus was spreading fast. "We have been experiencing the relentless spread of avian flu. Migratory birds, as they move around the world to seasonal breeding and feeding grounds, are infecting domestic poultry flocks around the world." He said it was only a matter of time before an avian flu virus, most likely H5N1, acquired the ability to be transmitted from human to human.

David Nabarro Bird Flu chief at the UN/WHO, declared in October that a human pandemic of bird flu can no longer be prevented, even though the first human to human case has yet to be verified.

This WHO prediction is based on the fact that the world has lost control of bird flu. Every time a human catches the infection from close contact with such a bird there is a small risk that the virus will mutate - if the person is already infected with ordinary human flu.

US GOVERNMENT RESPONSE - BASED ON MODELS OF SPREAD

The US has committed USD 7bn to help prepare the country for what is being increasingly seen by the government as an inevitable major flu pandemic with high mortality - whether from a bird flu mutation or a totally new viral type. "The only question is when."

US worst-case estimate is anywhere between 200,000 and 1.9 million deaths with 92 million others becoming ill. The government announced in early December 2005 that they had modelled a theoretical outbreak of human to human bird flu in Thailand, which produced an estimate of up to 722,000 cases just 6 weeks later across America, rising to 92 million cases just 10 weeks after that. Clearly spread at such speed would overwhelm health care systems, and would happen too fast for vaccines to be prepared and given.

A moderately severe pandemic on the scale of the 1968 pandemic, adjusted for the growth in US population, would cost the US economy USD 180bn not including business disruption.

The UK government has declared bird flu as public health enemy number 1. It has given a commitment to try and vaccinate the entire population of the country against the new human variant once one emerges, even though spread of such a virus could occur months before vaccinations are manufactured and given.

MANY WARNINGS FROM WHO

The World Health Organisation has warned repeatedly of significant risks to global health from new mutant viruses - of which HIV, SARS virus and Bird Flu virus are three of the many examples we have seen. I have also warned about these risks since 1987, in most presentations to corporations and also in the books Futurewise (1998/2003) and The Truth about AIDS (1987/2004).

Just one of these is the form of Bird Flu caused by virus H5N1. In mid April 2005 the Viet Nam Ministry of Health reported to WHO that 41 cases from 18 cities and provinces had been detected in since mid-December 2004. Of these cases, 16 had died and six remained under treatment. By October 17th 2005 there had been 117 human cases of which 60 had died. By mid December 2005 the numbers reported had risen to around 150 of which half had died, with growing concerns about the possibility of many other missed cases.

Human bird flu is usually only suspected when someone has a severe, unexplained flu-like illness, in an area where birds are dying rapidly. Mild cases are inevitably going to be missed, unless we start testing groups of other people for antibodies to bird flu. And outbreaks among birds can also be missed or go unreported, as was the case for more than 8 weeks in parts
of Ukraine through the Autumn.

POSSIBLE ECONOMIC IMPACT OF BIRD FLU

A human influenza pandemic could cost the world's richest nations USD 550 billion, according to the World Bank (Report November 6th 2005).

Previous studies on flu pandemics have suggested any new outbreak could kill between 100,000 and 200,000 people in the United States alone, which could translate into economic losses for the country of between USD 100 billion and USD 200 billion. This estimate includes 700,000 or more hospital admissions, up to 40 million outpatient visits and 50 million additional illnesses. However, as we have seen above, the worst-case US government estimate is of up to 1.9 million deaths.

The World Bank has extrapolated from the US figure based on only 100,000 to 200,000 deaths, to all high-income countries, with a present-value total loss of USD 550 billion. The loss for the world would be significantly larger, because of the impact in the developing world.

The Asian Development Bank warned that the economic damage in the East Asia region from a pandemic could be as high as USD 282bn (GBP 158bn), assuming 20% of the region's population falls ill.

A two percent loss of global gross domestic product during a pandemic -- like that caused by SARS in East Asia during the second quarter of 2003 -- would represent about USD 200 billion in losses in one quarter or USD 800 billion in a year.

The US government has published its own report on the possible impact of bird flu mutations on the US economy. The health costs alone of a moderately bad pandemic, not including disruption to the economy, are estimated to be USD 181 billion. This figure describes a pandemic similar to that of 1968, which killed about 34,000 Americans, a figure close to the annual average of flu deaths now in a larger US population. Yet the 1918 pandemic killed 500,000 Americans. Economic disruption, through travel limitations and a sharp rise in sick days, would be enormous. The US report predicts that a worst-case avian flu pandemic could kill from 209,000 to 1.9 million Americans. Outside estimates of a global toll have ranged as high as 50 million or 60 million.

Our world is very open to disruption by lethal mutant viruses because we still have no antiviral drugs that are as effective as penicillin and other antibiotics against bacteria.

The economic impact of an uncontrolled pandemic could be devastating to the global economy as a whole, if death rates are high, and the effects could last more than a year. Some kinds of business such as conferencing and tourism could be severely affected in some parts of the world at an early stage.

Impact is likely to be greatest on all activities which cause people to gather together, on travel and tourism, but also on parts of the food and manufacturing industries as well as other business sectors. It all depends on how many cases there are of a human form of the infection, where they are, what the death rate is and how infectious it seems to be, and what the public reaction is.

Some countries such as America have already indicated that they may close borders if a dangerous super-flu pandemic seems to be starting.

As we saw with SARS, there would only need to be a few thousand cases with a 10% mortality (bird flu at present kills 50% who get it) to cause major business and leisure disruption in different parts of the world. The cost to the regional economy of Sars was been estimated to be many billions of dollars. Despite this, in early November 2005 markets had yet to price Bird
Flu risk into their forecasts and risk assessments.

The greatest factor is likely to be emotional: worries, uncertainty, fear, loss of confidence, with postponement of expenditure until the situation is more certain.

The British government by October 2005 was working on the basis of a million infections in the UK with 50,000 deaths - four times the normal annual death toll from flu - but with a contingency plan in case the death toll was more than ten times as high.

So long as business and consumers believe that a pandemic is just a worse version of the usual flu epidemic, it is likely that impact will be relatively small in the short term. However, playing down the risk could contribute to loss of control by making it difficult to justify radical control measures.

Government leaders may be faced with difficult choices: give clear, strong warnings and get effective control, at the risk of worrying millions of people and wrecking some industries - or play down the threat and just hope for the best.

If death rates are high in the first few thousands infected, it is likely that members of the public will start to change behaviour regardless of what governments say, and leaders may come under huge pressure to implement emergency measures such as closure of schools in some areas, and restriction of all unnecessary travel. Some scenarios could include closure of some
airports. Indeed, Reuters has reported that the Chinese government will close all borders if there are proven cases of person to person spread in China.

We could see some control measures introduced because of the need to reassure public opinion even where experts believe such measures will have little or zero effect. Air travel is a good example. In 1918 some 300-400 million became infected in a few months without a single aircraft being involved. A country could try to seal all borders and still find it has a major epidemic - perhaps from unrecognised infection that has already arrived, or from unpreventable movements of people. We can expect vigorous debate about what is appropriate to do.

With every week that passes, our world becomes slightly better defended, as governments refine their infection control plans, stockpiles grow of antivirals, more aggressive efforts are made to slaughter infected birds, and more bird handlers are vaccinated against ordinary flu (to reduce risk of getting both infections and triggering mutations).

If (or when) the human mutation occurs, it will be vital to slow down spread for as long as possible in the early stages, so that the virus can be analysed, treatments tested, and vaccine production started on a massive scale.

VIRAL EPIDEMICS NOT TAKEN SERIOUSLY ENOUGH

As I pointed out in 1988 in The Truth about AIDS, and in 1998 in Futurewise, we continue to take risks by not taking viral epidemics seriously enough in terms of medical research. As a physician who has been involved in the fight against AIDS for more than 17 years, it is shocking to look back and realise that we are hardly any further forward in treating viral illness like flu than we were back in 1943 when penicillin first began to be available, and 1944 when effective treatment began for TB, syphilis, pneumonia and a host of other conditions. It is true than new antivirals are prolonging life in those with HIV, but these drugs are toxic, have to be taken until the person dies, and don't cure anyone. They just suppress the infection - and then usually only for a while.

AIDS has killed 45 million people in 20 years - and could kill 200 million more over the next 30. But flu epidemics can also be very dangerous - and far harder hitting.

1918 SPANISH FLU KILLED 30-40 MILLION - VIRUS WAS TYPE OF BIRD FLU

In 1918-1919 a virus swept around the world that caused what became known as "Spanish flu". Over 18 months it is estimated that 400 million people became infected of which 30 million died - which is 600 times the number of Americans who died in the entire 10 year Vietnam War. 675,000 Americans died of Spanish flu, of which 200,000 died in October of 1918 alone. People often died very rapidly, and many of the victims were young - in contrast to normal flu which is most dangerous to the old.

"As their lungs filled the patients became short of breath and increasingly cyanotic. After gasping for several hours they became delirious and incontinent, and many died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth. It was a dreadful business." Isaac Starr, 3rd year medical student, University of
Pennsylvania, 1919 commenting on flu deaths he saw.

The 1918 global flu pandemic spread in the age of horse, boat and train - and at a time when the world population was only a third of what it is today. If such a virus was to re-emerge, perhaps as a mutation of Bird Flu, it could spread far faster, and kill up to 100 million people.

Reports in October 2005 suggest that the genetic profile of bird flu is almost identical to that of the 1918 virus - which has been obtained from the sample of a victim preserved in permafrost.

The work involved researchers from the Armed Forces Institute of Pathology (AFIP), the CDC, Mount Sinai School of Medicine, and the US Department of Agriculture. Jeffery K. Taubenberger, MD, PhD, chief of molecular pathology at the AFIP, one of the study leaders, commented:

"These H5N1 viruses are being exposed to human adaptive pressures, and may be going down a similar path to the one that led to the 1918 virus," Taubenberger said in a news conference. "But the H5N1 strains have only a few of these mutations, whereas the 1918 virus has a larger number."

Our only real defence against viral illness like flu is the immune reaction we develop in response to infection. But if a flu virus changes shape as a result of a new mutation, our immune system fails to recognise it and has to develop a new response, which takes time. That means we go on catching flu over and over again, with little or no immunity from previous attacks unless they are recent.

If the virus is dangerous enough, you can be seriously ill or dead before your own white cells have had a chance to mobilise. And some viruses are immune to your own immune defences - like HIV - so that they kill slowly, even though the body is producing a strong reaction.

PROBLEMS WITH VACCINES

Vaccines are very effective so long as the virus causing a particular illness is stable, and we have enough time to scale up production - both of these things are true of polio for example. Immunity will then last a very long time.

However, new vaccines take time to develop, once scientists have identified a new strain of virus, it takes many months to scale up enough to treat the most vulnerable in the wealthiest nations, and years to generate enough for most people in the world, which is why governments have started stockpiling drugs that have some effect on flu illness - if taken early enough. The drugs are nothing like as powerful as antibiotics in bacterial infections, but they are all we have, and viruses can rapidly become resistant - as we are already seeing in treating early cases of bird flu in South East Asia. There are also problems in producing antiviral drugs fast enough. Some governments will not get the amount of drugs they have ordered until well into the middle of 2006.

Once a mutation is identified, a vaccine can be prepared, but as I say, making it in large enough doses to prevent a pandemic is likely to take many months, and may not arrive in time. And even if it did, the fact is that 3 billion people live in areas with low health budgets and poorly developed health care systems.

It would be impossible to vaccinate the whole world in time, because a Bird Flu pandemic could sweep around the entire globe in a few weeks or months.

However it may be that a new mutation could be similar enough to old flu viruses for existing vaccines to have some effect. We just do not know.

Many viruses mutate all the time. Many viruses are unstable and change all the time. Every time a new person or animal is infected, there is a chance of another mutation. Viruses also combine in unpredictable ways if a cell is infected with more than one virus type. The cell becomes confused about which virus it is making, and elements of both viruses get muddled up to create a new hybrid.

Take the example of a farmer who gets human flu, and at the same time has caught a virus from one of his animals which is going to kill him. It could be that the animal virus can only pass between animals, or from an animal to a human - and it might not be very infectious, so the infection will probably die out when he dies. But inside the farmer's body it is possible that the virus might mutate into one which is as infectious as human flu, and as lethal as the animal virus.

And how could you tell this has happened?

This is exactly the kind of nightmare that is keeping scientists awake at night in different research laboratories around the world.

Take bird flu: we keep seeing small numbers of human beings get infected and die, and sometimes we see clusters of cases, especially in families, which could indicate that the virus is learning how to spread between people. Of course clusters can also occur where several family members have been exposed to the same sick animal, which makes these things even harder to
monitor.

We saw a similar process happen with SARS - a highly infectious virus managed to jump from animals to humans, and was only contained with huge health control efforts. We were very fortunate that SARS did not spread to countries like Burundi in Africa, which would not have had the resources to trace contacts and impose strict isolation. If it had, we would still have a dangerous SARS epidemic in Africa today.

VIRUSES CAN BE VERY UNSTABLE

Viruses causing common cold change shape every few weeks, making vaccination impossible. Flu viruses normally change shape every year or so, which means that people have to be vaccinated each year.

HIV is highly unstable. It is possible to find up to 25,000 differently shaped versions of the virus inside a single person who is infected. That's why we are still trying to find a vaccine despite 45 million deaths, 85 million infections and an epidemic that is out of control in many parts of the world.

SO WHAT IS THE ANSWER TO BIRD FLU?

Every effort is being made to stamp out the Bird Flu epidemic by killing chickens that are sick, or could be infected. Other health measures include keeping chickens away from living areas of those that keep them, in areas where Bird Flu has been detected; educating people about not eating sick birds; teaching people about the early symptoms of Bird Flu; encouraging them to seek medical help early; treating those with Bird Flu in isolation.

Control is now very difficult in domestic birds, because the bird flu infection is spreading widely amongst wild birds, many of which migrate over long distances. That is probably the explanation for October 2005 outbreaks in Turkey and Romania.

VIRAL EPIDEMICS WILL REMAIN A CONSTANT THREAT

While we hope that Bird Flu will be brought under control, and while a "worst case scenario" global pandemic remains unlikely, the threat from mutant viruses remains and constant vigilance is needed. We will continue to see headlines about new outbreaks of lethal viruses, whether Ebola Virus, new strains of SARS, HIV, Bird Flu and so on.

Fortunately most new lethal viruses kill the few they infect very quickly, before the virus has a chance to spread widely, and the new infections die out. Other new viruses often become less virulent and dangerous as they infect more people. The most dangerous are viruses which kill a minority of those they infect, are easily transmitted, and cause little signs in people who are infectious in the early stages.

Best wishes

 

Patrick Dixon

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 21 December 2005 03:51
To: ATCA Members
Subject: ATCA: As Global incidents of Avian bird flu mount, UN announces battle being lost

Dear ATCA Colleagues

Human infections from H5N1 - the avian bird 'flu virus - have more than doubled this year, prompting United Nations health authorities to warn that more needs to be done to control outbreaks in poultry, which increase the risk of the virus mutating and causing a pandemic that may kill millions.

1. In Malawi, thousands of dead birds discovered in the central district of Ntchisi have sparked fears of avian influenza. Thousands of Fork-Tailed Drongos began dropping dead in the Mwera Hills district, and locals took the birds home to eat. The police were alerted that people are feasting on mysterious manna from heaven and when police contacted Malawi's Ministry of Agriculture and Food Security, they sent their officials to caution the people not to eat them since they may have the avian flu which has proved deadly to humans in other countries. The government has released a statement warning people not to eat dead birds and to alert officials of any mass bird deaths. Samples from the Drongos are being tested for H5N1 in South Africa, and a bird-flu task force has been assembled to deal with the possible outbreak.

2. Indonesian laboratory tests have indicated that an 8 year old boy who died on 15th December had avian influenza, making him potentially the country's 11th victim of the disease. The test results are being looked at by the World Health Organisation (WHO).

3. In the Central Russian republic of Kalmykia, 186 dead swans have been found to have died of bird flu. The reports do not mention a specific strain of bird flu. Veterinary quarantine has been imposed in the Krasinsky rural municipal entity, while surrounding areas have been declared at "high-risk" for avian-influenza outbreaks.

4. Romania has reported another potential outbreak of avian flu, this time among chickens in a village 60 miles east of Bucharest. The head of the Animal Health and Diagnosis Institute has said that preliminary tests taken from several hens in the village of Traian show suspicion for the H5 type, but the virus hasn't been isolated yet. The village has been quarantined, and all domestic birds will be culled in an attempt to stem the spread of the virus. More than 100,000 poultry in Romania have been destroyed to contain the virus since the first outbreak there was discovered on 7th October.

5. In Ukraine, agriculture officials said yesterday that a British lab had confirmed that avian flu outbreaks in 15 villages involved the H5N1 virus. Health officials have seized and destroyed more than 63,000 poultry since the virus was first detected in Ukraine.

6. Chinese authorities have shut down a university avian-flu lab because it "did not meet state regulations." The lab was run by Guan Yi, who last week was quoted by a number of media sources as criticising the Chinese government's response to avian influenza and accusing it of hiding the true extent of outbreaks within the country. Meanwhile, a US official has praised China for cooperating with the United States on research on avian flu. The WHO confirmed that China has agreed to share avian flu viral isolates from human patients.

7. In South Korea, the government has found traces of avian flu in about 50 places during an investigation from early October to mid-December.

David Nabarro, avian-flu coordinator for the United Nations has said that the world is "losing the battle" in regard to avian flu in birds. "We are losing the battle against this particular avian-flu outbreak in birds and domestic poultry. We must focus on stamping it out. This H5N1 virus is slowly changing though genetic re-assortment or mutation. The change is slow, but if this virus undergoes the change that leads to sustained human-to-human transmission, then we have a major problem. Then we probably will have the next human pandemic influenza. This is a serious risk. Virologists who study these things say do not get complacent. It is quite feasible that H5N1 could mutate. The fact that it has taken some years should not lead you to believe that we are through the worst. We believe that it is starting to spread into Africa. I do hope that the Malawi case is not H5N1. If they are, then it's very serious."

Outbreaks among birds in Ukraine, Romania and possibly Africa show the deadly H5N1 avian flu strain is spreading, David Nabarro, the UN's avian flu coordinator has said. The H5N1 virus has killed at least 71 people in Asia since 2004. There have been at least 139 human cases, including 95 this year, according to figures updated by the World Health Organization on 16th December.

The US House of Representatives has passed a defence spending bill that included funding for an avian-influenza pandemic. Some USD 3.78 billion has been approved for the fight against avian influenza at home and abroad, nearly half the total proposed by President George W. Bush in his avian-influenza pandemic speech in early November.

Also, US Customs and Border Protection officers have seized 51 shipments of counterfeit Tamiflu in San Francisco. The drugs, which had been shipped from Asia, had all been ordered for personal use from web sites. The Food and Drug Administration has announced that the seized drugs were found to be not consistent with authentic Tamiflu product manufactured by Roche of Switzerland.

[ENDS]

We look forward to your further thoughts, observations and views. Thank you.

Best wishes

For and on behalf of DK Matai, Chairman, Asymmetric Threats Contingency Alliance (ATCA)

-----Original Message-----
From: Intelligence Unit
Sent: 08 October 2005 23:26
To: ATCA Members
Subject: Response: Michael Harrison; Stephen Clothier; ATCA: 1918 'flu
pandemic virus resurrected - confirms WHO; Dr Ian Perry; Risk of mutated
bird 'flu pandemic grows - up to 150 million lives at stake

Dear ATCA Colleagues

We are grateful to Michael Harrison for submitting his personal views in regard to the resurrection of the 1918 'flu pandemic virus.

Michael Harrison is the Chairman of the UK's Protecting Critical Information Infrastructures initiative. He established HSA in 1991, which he still Chairs, following a successful career in senior management and marketing positions. Among the companies for which he has worked at the highest level are: Hawker Siddeley Dynamics as director; Eurocom Data Holdings (part of NatWest) as group director; BT Mobile Communications as director; Data Logic (part of Raytheon) as director and president; Telub Inforum Services (part of FFV Group of Sweden) as President; and L-3 Communications Network Security as President. During his career Michael has gained experience of working with US and European companies, has carried out business in some 29 countries, and spent over a year in Tokyo establishing a new company for Raytheon. He writes:

Dear DK

I do not normally comment on the erudite remarks from your contributors, but the suggestion from Stephen Clothier concerned me from two aspects and I hope that the following will be pertinent to your ATCA circulation.

Firstly his comment about "even if it resulted in some fatalities..." needs to be looked at in the context of Human Rights and the legal profession in general who would have a field day. Whilst it can indeed be argued that the few would die potentially for the many to survive - the word potentially is deliberate - I for one would not agree to "use the single needle" because the outcome could be as bad, or worse, than the alternative.

A "good guy virus" without the pathogen is capable of mutation and can thus obtain the bad characteristics - and whoever gave the order would be responsible for the deaths of millions. Let us [as humankind] not go down that road, because the next step is to say "but this will only affect the very weak, or the very elderly, or a particular ethnic group...". You can see where THAT leads.

My second point is far more in my area - his remarks about the computer virus that is seeded (having been disarmed of its worst characteristics) with the view to encourage people to update their systems. This can cause denials of service, breakdowns in vital systems, "false positives" that automatically trigger shutdowns - AND where this was used, the "black hats" [bad guys] watched the progress with keen interest and learned how to do better next time.

I suppose the answers are similar - we [as humankind] need better education and communications about both scenarios, we need to have taken the necessary policy decisions about risk and risk management for both of them, we need to have placed the appropriate resources and spent the appropriate sums. Above all we need the very top "management" to take personal ownership of the challenge, and not attempt either to delegate it or pretend it doesn't exist. Whether they are Presidents or CEOs!

So in the potential for Avian Flu Pandemics - just as for lack of Information Assurance - the buck stops at the doors of people who are either ignorant of their roles, or deliberately risking other peoples' lives/livelihoods because they don't understand the risk.

Nothing new there!

Kind regards

 

Michael

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 07 October 2005 12:15
To: ATCA Members
Subject: Response: Stephen Clothier; ATCA: 1918 'flu pandemic virus resurrected - confirms WHO concern; Dr Ian Perry; ATCA: Risk of mutated bird 'flu pandemic grows - up to 150 million lives at stake

Dear ATCA Colleagues

We are grateful to Stephen Clothier from Switzerland for his personal views in regard to the resurrection of the 1918 'flu virus.

Stephen Clothier is Chief Executive of several related Swiss companies in the emerging area of international technology outsourcing and enterprise content management, a position he has held for the past six years. He trained as a space physicist and a naval officer. His experience covers a mixture of international technical consulting and research in a wide variety of areas: from NASA and ESA to airlines, finance and defence. Until recently he was co-Chairman of the Technology Forum of the British Swiss Chamber of Commerce, and is a Chartered Engineer, Member of the British Computer Society and Fellow of the Institute of Analysts and Programmers. He writes:

Dear DK

I am not a biochemist but it strikes me, we [mankind] might develop a "good guy" version of the developing avian virus - which has a similar enough genetic make up to the "real thing", minus the pathogenic characteristic. Unlike a vaccine, this would be capable of spreading as rapidly to a pandemic as the real thing, but have milder symptoms. In this way one "vaccinates" the whole planet without a single needle. Even if it resulted in some fatalities it would be better than a 1918 scenario.

I bring this up because this mechanism has been aired in the context of computer viruses, and, indeed, actually used with success - where a "bad guy" virus has been disarmed and then seeded onto the internet as a "good guy" to push people to update their virus definitions (or even update them automatically) against the bad guy. The criterium is that the vaccine must have the same propagation characteristics as the real thing in order to keep up with it.

In the pandemic context I am sure this simplistic view has been long considered, and biological reality and politics probably mean this is not feasible but is there just a chance such a creative approach might make the difference for a lot of people?

Best wishes

 

Stephen Clothier

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 07 October 2005 00:12
To: ATCA Members
Subject: ATCA: 1918 'flu pandemic virus resurrected - confirms WHO concern; Dr Ian Perry; ATCA: Risk of mutated bird 'flu pandemic grows - up to 150 million lives at stake

Dear ATCA Colleagues

According to several sources, two teams of US government and university scientists say they have resurrected the 1918 influenza virus, the cause of one of history's most deadly global epidemics that killed up to 50 million people. The scientists have found that unlike the viruses that caused the 'flu pandemics of 1957 and 1968, the 1918 virus was actually a bird 'flu that mutated to infect humans. It appears that the bird influenza that has killed 59 people in Asia is undergoing similar mutations.

"Why resurrect such a deadly virus?", you may legitimately ask. The research scientists say it helps them better understand - and develop defences against - the threat of a future pandemic from bird 'flu. The chilling work has been published in the journals 'Nature' and 'Science' and has involved getting the complete genetic sequence of the 1918 virus, using techniques of molecular biology to synthesise it from fragments of DNA, and then using it to infect mice and human lung cells in a specially equipped, secure laboratory at the Centers for Disease Control and Prevention in Atlanta, USA.

The findings reveal a small number of genetic mutations that may explain why the virus was so lethal, and confirm the legitimacy of worries expressed by The World Health Organisation (WHO) last week about the bird 'flu H5N1 viruses now emerging in Asia.

The new studies find that today's bird 'flu viruses share some of the crucial genetic changes that occurred in the 1918 'flu. The scientists suspect that with the 1918 'flu, changes in just 25 to 30 out of about 4,400 amino acids in the viral proteins turned the virus into a killer. The bird 'flus, known as H5N1 viruses, have a few, but not all of those changes yet.

Public-health officials in many developed countries are warning that there is no strategy for protecting humans if a new, highly deadly strain of influenza develops from the Asian bird 'flu to cause a global pandemic. Once it emerges, it will take pharmaceutical companies months to develop and manufacture a vaccine to combat a virus against which humans will have no immunity.

US President George W Bush, who has been seeking a wider role for the US military in handling disasters on US soil post Hurricanes Katrina and Rita, has suggested earlier in the week that the military could be used to quarantine infected parts of the US in the event of an influenza disaster. The idea of using the military to forcibly quarantine communities being ravaged by a viral infection may not meet with welcome smiles and open arms but may be necessary in the face of a fast spreading pandemic. Isolating infected people may be the only way to prevent the spread of such a lethal virus.

The work also shows the 1918 virus is very different from ordinary human 'flu viruses. It infects cells deep in the lungs of mice, and infects lung cells that normally would be impervious to 'flu. And while other human 'flu viruses do not kill mice, this one, like today's bird 'flus, does. It is hoped that the 1918 virus will reveal what genetic changes can allow that to happen, helping scientists to prevent a new pandemic.

Many scientists across the world have said that the new work is immensely important and leads the way to identifying dangerous viruses before it is too late to find ways to disable them.

Prof John Oxford, an expert on virology based at St Bartholomew's and The Royal London hospital has said, "This is huge, huge, huge! It is a huge breakthrough to be able to put a searchlight on the 1918 virus. I can't think of anything bigger that has happened in virology for many years." The 1918 'flu showed how terrible that disease could be. It had been "like a dark angel hovering over us," Prof Oxford said. The virus spread and killed with terrifying speed, preferring the young and the healthy.

Alfred C. Crosby, author of "America's Forgotten Pandemic: The Influenza of 1918", has written that it "killed more humans than any other disease in a similar duration in the history of the world".

There are concerns about whether scientists should publish the genetic sequence of the 1918 virus. "It is something we take seriously," said Dr Fauci of the National Institute of Allergy and Infectious Diseases, which helped pay for the work. The work was extensively reviewed, he added, and the National Scientific Advisory Board for Biosecurity was asked to decide whether the results should be made public. The board "voted unanimously that the benefits outweighed the risk that it would be used in a nefarious manner," Dr Fauci said.

Some experts continue to share concerns about the use of this knowledge by extremists or adversarial nation states: Richard Ebright, a molecular biologist at Rutgers University, said he had concerns about the reconstruction of the virus and publication of procedures to reconstruct the virus. "There is a risk, verging on inevitability, of accidental release of the virus; there is also a risk of deliberate release of the virus," he said, adding that the 1918 'flu virus "is perhaps the most effective bio-weapons agent ever known."

According to other experts, the public health risk of resurrecting the virus is minimal because people developed immunity to the deadly 1918 virus after the pandemic, and a certain degree of immunity is believed to persist today.

Also, we can take small comfort in the fact that anti-viral medications are now available that were not in existence in 1918. And health care has advanced to a level that physicians and scientists could not have imagined 87 years ago.

Still, a virus that rips through the non-immune human population like wildfire, with the potential to infect hundreds of millions of people in months, will certainly overwhelm even the best hospitals. (Compiled from multiple sources)

[ENDS]

We look forward to your further thoughts, observations and views. Thank you.

Best wishes

For and on behalf of DK Matai, Chairman, Asymmetric Threats Contingency Alliance (ATCA)

-----Original Message-----
From: Intelligence Unit
Sent: 05 October 2005 00:03
To: ATCA Members
Subject: Response: Dr Ian Perry; ATCA: Risk of mutated bird 'flu pandemic grows - upto 150 million lives at stake

Dear ATCA Colleagues

We are grateful to Dr Ian Perry for his personal views in regard to the global risk of the mutated bird 'flu pandemic.

Dr Ian Perry is a Consultant Physician. As a member of the European Aviation Licensing Medical Committee for over a decade, he was initially involved with the SARS outbreak, the associated community problems and the dissemination of the disease by aircraft. He is a Fellow of the Chartered Institute of Management, a Past Master of the Guild of Air Pilots, and an Academician of the International Academy of Aviation and Space Medicine. He has done research into medical evacuation and patient transfer by air, both on a large and small scale around the world. He is a practising Member of the Academy of Experts who specialises in aviation medicine, the medico legal problems people have at work, and the transmission of diseases between work forces across the continents. He has made numerous presentations on the problems of disease transmission, with its impact on the workforce, the economy and the damage to the social infrastructure. Dr Perry has been a regular UK soldier, who served in both the Royal Army Medical Corps and the Army Air Corps as a flying doctor. He writes:

Dear DK

The WHO has recently raised the problems about "Avian Bird Flu" in Indonesia and its possible catastrophic effect on the world's population should it spread. There has been a lot of discussion about how this particular disease and its variants are transmitted between groups of people. A known fact is that some eastern groups eat all and every part of an animal or bird. Sometimes, more often than not, much of the food eaten has not been cooked properly, if at all. This raises concerns as to how easy it is for a diseased animal or bird, to pass a virus on to a human being.

History is repeating itself. The increasing risk of "Bird Flu" is now definitely due to the migration of the disease, in the migrating bird populations, particularly geese.

The WW1 pandemic came from the farms, one in particular, behind the Allied lines, where the migrating birds from the North came into contact with the domesticated local birds which fed large numbers of soldiers. The virus got there without any doubt from migrating birds, geese to be accurate, coming down from the North East, having originally come from the Far East. The wild birds mixed with the existing more domesticated farm animals and birds and passed on the disease.

Professor John Oxford, a leading virologist, has recently been looking at frozen bodies in Norway and other bodies of people who died of possible flu in 1917/18. He has found that they were all infected with an "Avian Flu", much the same make-up as the one in Indonesia and China today. This is of great importance. The virus went quickly from bird to human, and the returning soldiers introduced it to an unsuspecting population in the UK. There have been some very interesting papers and recent research on the subject. I have seen photographs of the enormous farm and military township that grew and grew behind the lines in France. Thousands were based in this camp, hence the massive transmission of the disease back to the UK.

It should concern everyone of us who can influence Governments into taking anti-viral precautions. The solution lies with vaccination of the humans rather than the destruction or isolation of the birds. At least the majority of the humans can be accounted for.

Best wishes

 

Ian

[ENDS]

-----Original Message-----
From: Intelligence Unit
Sent: 30 September 2005 10:43
To: ATCA Members
Subject: ATCA: Risk of mutated bird 'flu pandemic grows - upto 150 million lives at stake

Dear ATCA Colleagues

According to The United Nations a global 'flu pandemic could kill as many as 150 million people if the world fails to prepare for an expected mutation of the bird 'flu virus, enabling it to spread from human-to-human. The World Health Organisation (WHO) warned in a statement today that 'flu virus activity in Indonesia may increase during the country's November to April wet season.

The last major 'flu pandemic broke out in 1918 following The First World War, killing more than 40 million people. There were subsequent pandemics in 1957 and 1968 which had lower death rates but caused great disruption, according to Dr David Nabarro of WHO. Such a global influenza pandemic could come at any time and claim anywhere between 5 million and 150 million lives, depending on steps the world takes now to control the bird 'flu in Asia.

Nabarro said that he faces the challenges of persuading governments to prepare for a pandemic and to overcome their reluctance to publicly disclose an outbreak. Another major challenge will be to gear up vaccine makers to produce large quantities immediately after a pandemic starts and the exact variety of influenza is known.

So far the H5N1 bird 'flu virus has mostly infected people in close contact with birds who have the disease. The greatest fear amongst experts is that the H5N1 virus, which has the power to kill one out of every two people it infects, could set off a pandemic if it gains the ability to be passed easily among people.

The 10-strong Association of Southeast Asian Nations (ASEAN) task force meeting on bird 'flu is underway in Manila, and it will issue a regional plan that among other things will recommend a more effective surveillance system, a faster way to contain and eradicate the virus and build better communication in the ASEAN region.

Deadly bird 'flu knows no national boundaries and countries must cooperate to fight it effectively, according to the Government of Indonesia. Health officials in the world's fourth-most-populous country have said they believe at least five Indonesians have already died of the disease, and scores more have been under observation for symptoms. The virus has spread to fowl in 22 out of 33 provinces in Indonesia's sprawling archipelago, killing more than 10 million domesticated birds since 2003.

Bird 'flu has killed more than 60 people in four Asian nations since late 2003 and has been found in birds in Russia and Europe. Bird 'flu is a dangerous disease that can easily transcend national borders through animal and human migration.

[ENDS]

We look forward to your further thoughts, observations and views. Thank you.

Best wishes

For and on behalf of DK Matai, Chairman, Asymmetric Threats Contingency Alliance (ATCA)

---

ATCA: The Asymmetric Threats Contingency Alliance is a philanthropic initiative founded in 2001 by mi2g to understand and to address complex global challenges. ATCA conducts collective dialogue on opportunities and threats arising from climate change, radical poverty, organised crime, extremism, informatics, nanotechnology, robotics, genetics, artificial intelligence and financial systems. Present membership of ATCA is by invitation only and includes members from the House of Lords, House of Commons, European Parliament, US Congress & Senate, G10's Senior Government officials and over 500 CEOs from banking, insurance, computing and defence. Please do not use ATCA material without permission and full attribution.

---

Intelligence Unit | mi2g | tel +44 (0) 20 7712 1782 fax +44 (0) 20 7712 1501 | internet www.mi2g.net
mi2g: Winner of the Queen's Award for Enterprise in the category of Innovation

[ENDS]

mi2g is at the leading edge of building secure on-line banking, broking and trading architectures. The principal applications of its technology are: 1. D2-Banking; 2. Digital Risk Management; and 3. Bespoke Security Architecture. For more information about mi2g, please visit: www.mi2g.net