[Martin]

HK May Restrict Bird Slaughter to Combat Flu
Sun Nov 28, 2004 10:37 PM ET

HONG KONG (Reuters) - Hong Kong said on Monday it may ban shopkeepers slaughtering poultry after world health experts issued strong warnings that the deadly bird flu virus may trigger the next pandemic.
Hong Kong scientists have been fighting to end the widespread practice of killing live chickens in markets since 1997, when the H5N1 virus first spread to humans and killed six people in the territory.

But strong opposition from the poultry industry has prevented the government from stopping stall holders from selling live chickens and ducks and slaughtering them in front of customers.

The virus emerged again in Asia this year, killing 32 people in Thailand and Vietnam and decimating poultry flocks.

Health Minister York Chow said the government would next month announce new steps to combat the virus.

A food department spokeswoman said the government might set up a central abattoir or restrict slaughtering to a few areas.

"The broad direction for the government is to separate humans from chickens. And the announcement next month will be about how we are going to do that," she said.

Hong Kong people like their food fresh and often shop in markets where they can pick the birds they want and have them killed on the spot. Many of the chickens are from mainland China.

Almost all the human bird flu victims were infected after coming into contact with sick chickens.

With the illness now endemic in poultry farms, experts fear it will only be a matter of time before the disease mutates into a form that can leap between humans and sweep through populations with no immunity.

Last week, experts at the World Health Organization warned that H5N1 would probably unleash the world's next flu pandemic and infect up to 30 percent of the world's population.

At least two U.S. companies are working on a vaccine against H5N1, but Chow said these may not match a pandemic strain that would be easily transmissable between humans.

"It's hard to make a vaccine with a new disease ... because the virus will change and the vaccine may not match one that is (transmissable from) human to human," the minister said in an interview with government-funded Radio and Television Hong Kong.

"Vaccines only offer 5 percent protection going by past pandemics ... we can't rely totally on vaccines."



http://www.reuters.com/printerFriendlyPopup.jhtml?type=healthNews&storyID=6937017

[CanadaSue]

is that HK health & govt. authorities are trying to put a stop to cultural practices which go back a long time. The nice thing about selecting your bird & having it slaughtered there & then is that you have a chance to see the bird yourself - does it appear healthy & vigorous? And... being slaughtered there & then - you KNOW it's fresh.

I fear if the practice of slaughter right in the marketplace is halted, the sale & slaughter of live poultry will simply be driven underground. If that happens, there's reduced opportunity for sampling & surveillence by health authorities. I don't see the idea of providing a central slaughter facility being of too much use but with no detail provided that's hard to judge. Would customers buy their birds, take them to the designated facility for slaughter then bring them home? If that's the case, a customer may inadvertently be transporting infected poultry through crowded communities, exposing others at the alugher house...

It's significant that after months of announcements that 2 companies are working on a prototype H5N1 vaccine, only now has the WHO & others seen fit to state the obvious - that the prototype vax strain currently being tested is not going to be close enough to a pandemic strain to offer protection - very unlikely.

The 5% protection number comes from the fact that currently only 330 million or so doses of flu vax can be produced in a year world wide - enough for roughly 5% of the world's population. We most certainly CANNOT rely on vaccines for pandemic.

[Martin]

Last Updated 30/11/2004, 06:07:25

The World Health Organisation believes domesticated ducks may be the main transmitters of the H5N1 bird flu virus that killed 32 people in Asia this year.

The W-H-O says the most devastating outbreaks occurred where duck populations were highest.

In areas where ducks and chickens were kept apart, bird flu was less prevalent.

The WHO director said evidence pointed to a bird flu pandemic among humans in the near future, warning that up to 100 million people could be killed unless preventative measures were taken.

Earlier this year 32 people were killed in Vietnam and Thailand during two outbreaks of the H5N1 variant of the virus.

The outbreaks led to the death or culling of 120 million domestic poultry birds.

http://www.abc.net.au/ra/news/stories/s1254255.htm

[CanadaSue]

Not a few days ago, they were warning of a pandemic which might kill 7 million people. Annually, WHO makes the following estimates:

http://www.who.int/mediacentre/factsheets/fs211/en/


***In annual influenza epidemics 5-15% of the population are affected with upper respiratory tract infections. Hospitalization and deaths mainly occur in high-risk groups (elderly, chronically ill). Although difficult to assess, these annual epidemics are thought to result in between three and five million cases of severe illness and between 250 000 and 500 000 deaths every year around the world. Most deaths currently associated with influenza in industrialized countries occur among the elderly over 65 years of age.***

A death toll of 7 million represented a rate of 1 in every 48k humans killed. Not too bad as far as pandemics go & look at deaths over ALL humans. But if we take this same number & work with the 1/3 of humans they 'expect' to be infected, that works out to 1 in every 286 INFECTED would die. That's a death rate of .03% That's their low end estimate.

But up the potential deaths to 100 million & the numbers become significantly more worrisome. It works out to 5% of those infected dead which is TWICE the estimated death rate of Spanish Flu. Why are numbers being so drastically revised upwards? Why now are we being told more or less - not to count on a vaccine?

Because that's the blunt, hard reality of it. Don't get me wrong. I'm not saying these things WILL come to pass or that if they do, we're toast. But I feel much better having a realistic idea what we MAY be facing, backed by solid information & REASONED guesses than I do when it's pretty clear what could happen, yet no one has the stones to openly say so. It's simply very interesting to see the WHO go from generic pandemic warnings to more hard core stuff & so quickly. What are they seeing?

They're seeing a strain of avian influenza which, 7 short years ago, jumped directly to humans with ominous results. 6 of 18 patients died & as well as displaying typical severe flu symptoms, there was involvement of their hepatic, cardiac & renal symptoms. Some of the children showed very severe digestive complaints - diarrhea of the type that made it even more difficult to treat them. After the outbreak was contained & stamped out in poultry, sampling of folks working live poultry markets, neighbours of the sticken, hospital staff & lab workers showed several others had been exposed & tested positive for antibodies... without illness.

Then the whole thing died down. There were a few isolated & small oubreaks & some outbreaks in poultry but nothing on the scale of what was seen in HK97. Fast forward to this year...

A number of countries saw outbreaks of a Highly Pathogenic strain of H5N1 in various species of poultry. These outbreaks occured in east/south east Asia among countries as diverse as Japan, South Korea, Malaysia, Laos, Vietnam, Thailand & Indonesia. With great difficulty, Japan & South Korea have so far managed to do the most thorough job of stampig ou outbreaks. In the nations with fewer resources, not only have avian outbreaks not been controlled but human cases have developed - a good 42 KNOWN cases & the fatality rate has been far hgher than in 1997.

While it's easy to brush off a high fatality rate as due to local poverty & poor health, I think it's more basic than that. By anyone's standards, no matter how dismally poor a nation may be - 70% is a whopping rate of deaths. Were we to see outbreaks here, I do feel the death rate might be far lower. Patients here DO have access to at least emergency rooms, surveillence is better & cases might be picked up on soon enough to provide the sort of supportinve care that can prevent some of the nastier complications. But jusyt how much lower would it be? We can't know & there's no point in being either blindly optimistic or overly negative.

The WHO & associated agencies are also seeing a virus that is mutating extremely quickly, even for a virus that's already known for a rate of mutation that's fast. It has, this year alone, adapted itself to infecting a nmber of species previously unknown to be infected with flu - felines were especially startling.

The area in which H5N1 has become endemic does not enjoy good health care systems or surveillence. Smuggling of goods, animals & humans are well established & almost impossible to moniter, never mind halt. Some of the nations are not transparent or report crucial information late. Many lack the capacity to do any testing for human flu strains, never mind differentiate between avian & human flu.

This area sees a lot of travel - especially to other crowded areas where identification of avian flu in people make take time. We've already been lucky once - 2 infected birds were discovered & destroyed - no harm done. How mnay might we miss in future?

Let's be blunt - if H5N1 mutates to become a human pathogen, we can't stop it spreading across the world - I maintain in 6 weeks or so. There is no vax & there won't be one. Antivirals are in short supply & have limited application. We may enjoy better health care here but haven't the surge capacity to deal with a pandemic. Secondary infections would increasingly consist of resistent bacteria & other virus we can't treat. We have a great many immunosuppressed or compromised as well as many elderly on various forms of pharmaceuatical support. As advanced as we may be, we're not holding as many aces as we'd like to think we are.

I'm expecting more nasty surprised from the WHO within a few weeks. I don't know what, but the ramped up pace of increasingly worrisome announcements has got to be going somewhere. It's really not in their best interests to panic anyone or hint so strongly at rapidly approaching problems without good reason.

[goatlady]

Remember that Russian virologist stated last week that he expected it in Russia by the end of the year and that the Russian hospitals needed to have ready 300,000 beds for patients of the flu. Maybe it's already making inroads there now from China, who we haven't heard from yet, I don't believe. Making more elderberry stuff tonight!!

[CanadaSue]

information nets we're not necessarily privy to. Extrapolate that across populations & that's like saying the US will need 600k hospital beds. In reality, I suspect you might need as many as 2 million if this hit hard & fast across the country.

But it's frustrating getting any medical news out of Russia save for general articles stating that health wise - all hell is breaking loose over there. Ain't it the truth?