If it's a quarter and one percent, that's 16 million dead; if it's a half and five percent, it's 160 million dead. This is the protein represented by the letter 'H' in bird flu virus names, as in H5N1.Human influenza viruses are usually of the H1, H2 and H3 varieties. There were tests and a vaccine available, though not widely used. The number of humans confirmed killed by the bird flu strain called H5N1 topped 100 today, according to the World Health Organization (WHO). That speculation has varied widely.The current avian flu, in humans, is fatal in over 50% of confirmed cases. Species with larger migratory populations, such as the 3.4 million Northern Lapwings, got a higher risk rating. The altered viral DNA is then seeded into cells, such as monkey kidney cells or human cells, and this is then grown up in chicken eggs to produce large enough numbers for a vaccine dose. A year later, the count had jumped to 142 cases with 74 deaths, including a number of cases in three previously unaffected countries: Cambodia, Indonesia, and China. The boy lives in an area with sick chickens, and the woman is known to have visited him there.Indonesia has confirmed 9 cases of human H5N1 infection to date, of which 5 have been fatal.It all begins in Asia. | "We don't need any spies to tell us about the pandemic that's coming," noted James Pavitt, the former deputy director of operations of the US Central Intelligence Agency.If — or as many experts say, when — a pandemic hits, small countries will face the biggest economic challenge, said Robert Shapiro, who served as the US undersecretary of commerce and economic affairs in the late 1990s. So the best thing would be to develop a single vaccine to protect against all pandemics - along with normal seasonal flu viruses. While no human cases of bird flu have been seen in the U.S. or North America, the CDC is asking people who have traveled to East Asia to see a doctor if they develop flu-like symptoms. Experts warn that a human bird flu pandemic is still a threat.Experts warn that a human bird flu pandemic is still a threat.To test whether a chicken is healthy, the vendors hold it upside down and check its rear for pinkness.Washing birds might help to limit the transmission of any viruses.Experts warn that a human bird flu pandemic is still a threat. Meanwhile, one company is offering meeting delegates free flu jabs to protect against this year's regular flu strain. It causes ruffled feathers and a drop in egg production.

As far as I can tell, the prospect of millions dying from bird flu is pretty remote. (The Asian Flu pandemic occurred in 1957-8, and caused millions of cases but much lower mortality than the global "Spanish flu" of 1918-9, which killed over 20 million.) Perhaps we should pay more attention. And epidemiologists point out that a blanket ban on bird imports will fuel the illegal trafficking of exotic birds - already the third-largest black market in the European Union after guns and drugs.There is also, as yet, no sign that the H5N1 strain is swapping genes with other influenza viruses to make it easily transmissible between humans. The project aims to develop at least one vaccine for each of 16 known variations of a key influenza surface protein called haemagglutinin. The unhappy bottom-line message, as voiced by Claude Hannoun, former head of the Influenza National Reference Centre in France, is: don't expect any vaccine to be available during the first pandemic wave. And that provides far too many chances to do things the wrong way.Mark Holodniy, director of the Public Health Research and Consultation Program at the US Department of Veterans Affairs and a medical professor at Stanford University, has submitted a protocol proposal to the US Department of Veterans Affairs and the US Food and Drug Administration. But he pointed out that one mutation is not sufficient to turn H5N1 into a major threat to humans. Perhaps such plans for the total state ought to even ruffle our feathers a bit.Reading this today makes me sad, as just about all news does today, but it does remind me that the problems we face today have a long history, both the medical and political issues. And why should individuals on their own have no incentive to deal with disease? This optimistic assumption cannot be relied on. Stegemann, Dahlberg, Kröger, Gereke, Bruder, Henriques-Normark, Dr. Martin Meltzer of the Centers for Disease Control, an expert on the societal impact of diseases, warns that "There is no healthcare system anywhere in the world that can cope with even a mild pandemic like the one in 1968" Meltzer MI, Lancet Asia Forum, Singapore, May 2006

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