Bird Flu Cases Decline, Raising New Risk: Complacency

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By Gale and Lauerman

Dec. 29 (Bloomberg) -- Bird flu infected fewer humans in the second

half of the year, prompting experts to point to a new enemy in the

fight against a possible pandemic: complacency.

The lethal H5N1 strain of avian influenza was reported in people

every two days in the first half. Since July, the number of cases has

slowed to about one a week and scientists say the virus hasn't yet

found a way to easily infect humans.

Governments should continue to track and eradicate the disease, even

as public perception shifts and a pandemic poses no immediate threat,

said Nabarro, the United Nations coordinator for avian and

pandemic influenza. The flu spread in domestic poultry and wild birds

across 38 countries in Asia, Africa and Europe since February,

offering the virus more chances to mutate into a form dangerous for

humans.

``You don't stop airport security screening because there have been

no hijacks for two years,'' Nabarro said in an interview from New

York last week. ``The danger of a pandemic is as profound now as it

was a few years ago.''

Since January, countries including the U.S. and Japan have pledged

about $2.5 billion to fund efforts to monitor, manage and eradicate

H5N1 and to prepare for a possible pandemic. Those efforts may have

helped, according to Nabarro.

``It would be nice to think that the enormous amount of work that's

been put into this is having an impact,'' he said. ``I think it's a

bit early to tell.''

Hiccups Kills More People

The flu pandemic that struck in 1918 would probably kill about 62

million people nowadays, as many as died during World War II, the

Lancet medical journal said last week.

The H5N1 bird flu strain has killed 157 people since 2003, according

to the World Health Organization. This year, 114 cases, including 79

deaths, were reported, with 88 of the new infections counted between

January and June.

While scientists agree on the need to track the virus and prepare for

a pandemic, they are divided over whether the H5N1 strain is a likely

trigger. Some say governments and doctors should focus on being

prepared for any pandemic -- not just a bird flu one -- and work to

reduce the impact of seasonal flu, which contributes to the death of

as many as 500,000 people each year.

``One could make the argument more people die of hiccups'' than of

avian influenza, says Palese, chair of Mount Sinai School of

Medicine's department of microbiology in New York. ``The virus hasn't

really gone in a major way into humans. That is a very important

fact, which makes it doubtful that H5N1 is really the next pandemic

strain.''

Spreading Undetected

It could take millions of years for H5N1 to mutate into a pandemic

form, and panic over the virus is being fanned by ``an avian flu

bureaucracy'' egging on governments to provide ever more money, U.S.

science writer Fumento wrote in an article appearing in the

Dec. 25 edition of the Weekly Standard.

Still, concern prompted some consumers to stockpile Roche Holding

AG's Tamiflu antiviral drug and spurn chicken and duck meat in the

past year. In France, Europe's largest poultry supplier, producers

hurt by a slump in demand lost about 40 percent of their income in

the first quarter, according to the World Bank.

The reduction in reported infections and a decline in media coverage

don't mean the virus is no longer continuing to circulate in many

countries, according to virologist Ilaria Capua, whose laboratory in

Padova, Italy, handles some of the avian flu screening for the World

Organization for Animal Health.

``At the beginning of the year there was a sort of race to show the

world that even Africa had the problem, and African countries were

very outspoken,'' Capua said in a telephone interview on Dec. 23.

Some outbreaks were mistakenly diagnosed, hurting trade and tourism

and making countries more reluctant to acknowledge the disease, she

said.

Ups and Downs

In February, Nigeria became the first of eight countries in Africa to

report outbreaks in poultry. Last week, the UN reported that H5N1 had

been found in 17 of Nigeria's 36 states.

``I am pretty confident that if it's widespread in some countries

like Nigeria, then it is also widespread in other countries,'' Capua

said.

More than 700 outbreaks of H5N1 among wild birds and domestic poultry

were reported to the World Organization for Animal Health this year.

``We're in a situation of low incidence, but I'm sure we're going to

see some peaks of infection in the future,'' said Roeder, an

animal health officer with the UN's Food and Agriculture

Organization, who helped Indonesia set up its bird surveillance.

``How important they will be, how serious they will be it's not

possible to say right now.''

New Virus, No Immunity

The lethal strain of H5N1 was traced to a farmed goose in the

southern Chinese province of Guangdong in 1996. It was found in South

Korea in December 2003, before spreading across eastern Asia the

following year and to Eastern Europe in 2005.

``H5N1 viruses have been around for nearly a decade and it might be

tempting to conclude that if they were going to proceed to form or

contribute to a pandemic strain, they would have done so by now,''

the influenza team at the European Centre for Disease Surveillance

and Control said in a report last week.

Still, the strain that sparked the 1918 pandemic ``had been around

for some years before it became part of a virus that could

efficiently transmit between humans,'' they said.

A pandemic can start when a novel A-type flu virus, to which almost

no one has natural immunity, emerges and begins spreading. H5N1 has

put the world closer to another pandemic than at any time since 1968,

when the last of the 20th century's three major outbreaks occurred,

according to the WHO.

``Sooner or later there will be a highly lethal form of influenza and

who knows when sooner or later is?'' Hill, a visiting

professor at the Harvard Center for Population and Development

Studies in Cambridge, Massachusetts, said in an interview last week.

``I don't think we should be complacent.''

To contact the reporters on this story: Gale in Singapore at

j.gale@... ; Lauerman in Boston at

jlauerman@... .