H5N1

Influenza A virus subtype H5N1 Genetic structure Infection Human mortality Global spread in 2004, 2005, 2006, 2007 Social impact Pandemic

Influenza A virus subtype H5N1, also known as A(H5N1) or simply H5N1, is a subtype of the Influenza A virus which can cause illness in humans and many other animal species. Influenzavirus A is a Genus of the Orthomyxoviridae family of Viruses Influenzavirus A includes only one Species: Influenza A virus Influenza A virus subtype H5[[Neuraminidase N1]], also known as A(H5N1 or simply H5N1, is a subtype of the Influenza A virus which can cause H5N1 genetic structure is the molecular structure of the H5N1 virus's RNA. Transmission and infection of H5N1 from infected avian sources to humans is a concern due to the Global spread of H5N1 that constitutes a Pandemic threat Human mortality from H5N1 or the human fatality ratio from H5N1 or the case-fatality rate of H5N1 refer to the ratio of Human and bird cases 1959-1997 A highly pathogenic strain of H5N1 caused Flu outbreaks with significant spread to numerous farms See also Global spread of H5N1, The global spread of (highly pathogenic H5N1 in Birds is considered a significant pandemic threat See also Global spread of H5N1, The global spread of (highly pathogenic H5N1 in Birds is considered a significant pandemic threat See also Global spread of H5N1, The global spread of (highly pathogenic H5N1 in birds is considered a significant pandemic threat See also Global spread of H5N1, The global spread of (highly pathogenic H5N1 in Birds is considered a significant pandemic threat Financial According to the New York Times, due to the H5N1 threat as of March 2006 "governments worldwide have spent billions planning Note For information about the content tone and sourcing of this article please see the tags at the bottom of this page Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses Sialidase 1 (lysosomal sialidase, also known as NEU1 or neuraminidase, is a human Gene. Influenzavirus A is a Genus of the Orthomyxoviridae family of Viruses Influenzavirus A includes only one Species: Influenza A virus ^[1] A bird-adapted strain of H5N1, called HPAI A(H5N1) for "highly pathogenic avian influenza virus of type A of subtype H5N1", is the causative agent of H5N1 flu, commonly known as "avian influenza" or "bird flu". A pathogen (from Greek πάθος pathos "suffering passion" and γἰγνομαι (γεν- gignomai (gen- "I give birth to" infectious Transmission and infection of H5N1 from infected avian sources to humans is a concern due to the Global spread of H5N1 that constitutes a Pandemic threat For the H5N1 subtype of Avian influenza see H5N1. Avian influenza, sometimes Avian flu, and commonly Bird flu refers It is enzootic in many bird populations, especially in Southeast Asia. One strain of HPAI A(H5N1) is spreading globally after first appearing in Asia. Human and bird cases 1959-1997 A highly pathogenic strain of H5N1 caused Flu outbreaks with significant spread to numerous farms It is epizootic (an epidemic in nonhumans) and panzootic (affecting animals of many species, especially over a wide area), killing tens of millions of birds and spurring the culling of hundreds of millions of others to stem its spread. In Epizoology, an epizootic (from Greek epi- upon + zoion animal is a Disease that appears as new cases in a given animal population Culling is the 'selection' (removal and killing of surplus animals from an animal population Most references to "bird flu" and H5N1 in the popular media refer to this strain. ^[2]

Overview

HPAI A(H5N1) is an avian disease. There is no evidence of efficient human-to-human transmission or of airborne transmission of HPAI A(H5N1) to humans. In Medicine, transmission is the passing of a Disease from an infected individual or group to a previously uninfected individual or group In almost all cases, those infected with H5N1 had extensive physical contact with infected birds. Still, around 60% of humans known to have been infected with the current Asian strain of HPAI A(H5N1) have died from it, and H5N1 may mutate or reassort into a strain capable of efficient human-to-human transmission. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism Reassortment is the mixing of the genetic material of two similar Viruses that are infecting the same cell In 2003, world-renowned virologist Robert Webster published an article titled "The world is teetering on the edge of a pandemic that could kill a large fraction of the human population" in American Scientist. For the New South Wales parliamentarian see Robert James Webster For the two-time Olympic gold medalist in diving see Bob Webster Robert G American Scientist (ISSN 0003-0996 (not to be confused with Scientific American) is an illustrated bimonthly Magazine about Science and He called for adequate resources to fight what he sees as a major world threat to possibly billions of lives. ^[3] On September 29, 2005, David Nabarro, the newly-appointed Senior United Nations System Coordinator for Avian and Human Influenza, warned the world that an outbreak of avian influenza could kill anywhere between 5 million and 150 million people. Events 522 BC - Darius I of Persia kills the Magian usurper Gaumâta securing his hold as king of the Persian Empire. Year 2005 ( MMV) was a Common year starting on Saturday (link displays full calendar of the Gregorian calendar. Dr David Nabarro (born in 1949 works as the Senior UN System Coordinator for Avian and Human Influenza at United Nations Headquarters in New York ^[4] Experts have identified key events (creating new clades, infecting new species, spreading to new areas) marking the progression of an avian flu virus towards becoming pandemic, and many of those key events have occurred more rapidly than expected. A clade is a taxonomic group comprising a single Common ancestor and all the descendants of that ancestor

Due to the high lethality and virulence of HPAI A(H5N1), its endemic presence, its increasingly large host reservoir, and its significant ongoing mutations, the H5N1 virus is the world's largest current pandemic threat, and billions of dollars are being spent researching H5N1 and preparing for a potential influenza pandemic. Virulence (also called pestiferousness) refers to the degree of Pathogenicity of a Microbe, or in other words the relative ability of a Microbe In Biology, a host is an organism that harbors a Virus or Parasite, or a mutual or Commensal Symbiont, typically providing nourishment Note For information about the content tone and sourcing of this article please see the tags at the bottom of this page ^[5] At least 12 companies and 17 governments are developing pre-pandemic influenza vaccines in 28 different clinical trials that, if successful, could turn a deadly pandemic infection into a nondeadly one. A Vaccine is an Inoculation designed to increase immunity against a specific disease Full-scale production of a vaccine that could prevent any illness at all from the strain would require at least three months after the virus's emergence to begin, but it is hoped that vaccine production could increase until one billion doses were produced by one year after the initial identification of the virus. ^[6]

H5N1 may cause more than one influenza pandemic as it is expected to continue mutating in birds regardless of whether humans develop herd immunity to a future pandemic strain. Note For information about the content tone and sourcing of this article please see the tags at the bottom of this page Herd immunity (or community immunity) describes a type of immunity that occurs when the Vaccination of a portion of the Population (or herd ^[7] Influenza pandemics from its genetic offspring may include influenza A virus subtypes other than H5N1. Influenzavirus A is a Genus of the Orthomyxoviridae family of Viruses Influenzavirus A includes only one Species: Influenza A virus ^[8] While genetic analysis of the H5N1 virus shows that influenza pandemics from its genetic offspring can easily be far more lethal than the Spanish Flu pandemic,^[9] planning for a future influenza pandemic is based on what can be done and there is no higher Pandemic Severity Index level than a Category 5 pandemic which, roughly speaking, is any pandemic as bad as the Spanish flu or worse; and for which all intervention measures are to be used. The 1918 flu pandemic (commonly referred to as the Spanish flu) was an Influenza Pandemic that spread to nearly every part of the world The Pandemic Severity Index (PSI is a proposed classification scale for reporting the severity of Influenza pandemics in the United States. The 1918 flu pandemic (commonly referred to as the Spanish flu) was an Influenza Pandemic that spread to nearly every part of the world ^[10]

Genetics

The H in H5N1 stands for "Hemagglutinin", as depicted in this molecular model. Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses

The first known strain of HPAI A(H5N1) (called A/chicken/Scotland/59) killed two flocks of chickens in Scotland in 1959; but that strain was very different from the current highly pathogenic strain of H5N1. The dominant strain of HPAI A(H5N1) in 2004 evolved from 1999 to 2002 creating the Z genotype. eVolution is the third Album by eLDee, it was due to be released in 2008 ^[11] It has also been called "Asian lineage HPAI A(H5N1)".

Asian lineage HPAI A(H5N1) is divided into two antigenic clades. An antigen (from antibody-generating) or immunogen is a substance that prompts the generation of Antibodies and can cause an immune response "Clade 1 includes human and bird isolates from Vietnam, Thailand, and Cambodia and bird isolates from Laos and Malaysia. Vietnam (ˌviːɛtˈnɑːm Việt Nam) officially The Kingdom of Thailand (ˈtaɪlænd ราชอาณาจักรไทย, râːtɕʰa-ʔaːnaːtɕɑ̀k-tʰɑj The Kingdom of Cambodia ( formerly known as Kampuchea (, transliterated: Preăh Réachéanachâkr Kâmpŭchea) is a country in South East Laos (ˈlɑːoʊs or /ˈlaʊs/ officially the Lao People's Democratic Republic, is a Landlocked country in Southeast Asia, bordered by Burma For the biogeographical region see Malesia Malaysia (məˈleɪʒə or /məˈleɪziə/ is a country that consists of thirteen states and Clade 2 viruses were first identified in bird isolates from China, Indonesia, Japan, and South Korea before spreading westward to the Middle East, Europe, and Africa. China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National The Republic of Indonesia ( (Republik Indonesia is a Country in Southeast Asia. For a topic outline on this subject see List of basic Japan topics. South Korea, officially the Republic of Korea and often referred to as Korea ( Korean: 대한민국 tɛː The Middle East is a Subcontinent with no clear boundaries often used as a synonym to Near East, in opposition to Far East. The clade 2 viruses have been primarily responsible for human H5N1 infections that have occurred during late 2005 and 2006, according to WHO. Genetic analysis has identified six subclades of clade 2, three of which have a distinct geographic distribution and have been implicated in human infections: Map

• Subclade 1, Indonesia
• Subclade 2, Europe, Middle East, and Africa (called EMA)
• Subclade 3, China"^[12][13][14]

A 2007 study focused on the EMA subclade has shed further light on the EMA mutations. "The 36 new isolates reported here greatly expand the amount of whole-genome sequence data available from recent avian influenza (H5N1) isolates. Before our project, GenBank contained only 5 other complete genomes from Europe for the 2004–2006 period, and it contained no whole genomes from the Middle East or northern Africa. Our analysis showed several new findings. First, all European, Middle Eastern, and African samples fall into a clade that is distinct from other contemporary Asian clades, all of which share common ancestry with the original 1997 Hong Kong strain. Phylogenetic trees built on each of the 8 segments show a consistent picture of 3 lineages, as illustrated by the HA tree shown in Figure 1. Two of the clades contain exclusively Vietnamese isolates; the smaller of these, with 5 isolates, we label V1; the larger clade, with 9 isolates, is V2. The remaining 22 isolates all fall into a third, clearly distinct clade, labeled EMA, which comprises samples from Europe, the Middle East, and Africa. Trees for the other 7 segments display a similar topology, with clades V1, V2, and EMA clearly separated in each case. Analyses of all available complete influenza (H5N1) genomes and of 589 HA sequences placed the EMA clade as distinct from the major clades circulating in People's Republic of China, Indonesia, and Southeast Asia. "^[15]

Terminology

H5N1 isolates are identified like this actual HPAI A(H5N1) example, A/chicken/Nakorn-Patom/Thailand/CU-K2/04(H5N1):

• A stands for the species of influenza (A, B or C).
• chicken is the species the isolate was found in
• Nakorn-Patom/Thailand is the place this specific virus was isolated
• CU-K2 identifies it from other influenza viruses isolated at the same place
• 04 represents the year 2004
• H5 stands for the fifth of several known types of the protein hemagglutinin. Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses
• N1 stands for the first of several known types of the protein neuraminidase. Sialidase 1 (lysosomal sialidase, also known as NEU1 or neuraminidase, is a human Gene.

(Other examples: A/duck/Hong Kong/308/78(H5N3), A/avian/NY/01(H5N2), A/chicken/Mexico/31381-3/94(H5N2), and A/shoveler/Egypt/03(H5N2)). The shovelers, formerly known as shovellers, are four species of Dabbling ducks with long broad spatula-shaped beaks Red Shoveler, ^[16]

As with other avian flu viruses, H5N1 has strains called "highly pathogenic" (HP) and "low-pathogenic" (LP). Avian influenza viruses that cause HPAI are highly virulent, and mortality rates in infected flocks often approach 100%. Virulence (also called pestiferousness) refers to the degree of Pathogenicity of a Microbe, or in other words the relative ability of a Microbe LPAI viruses have negligible virulence, but these viruses can serve as progenitors to HPAI viruses. The current strain of H5N1 responsible for the deaths of birds across the world is an HPAI strain; all other current strains of H5N1, including a North American strain that causes no disease at all in any species, are LPAI strains. All HPAI strains identified to date have involved H5 and H7 subtypes. The distinction concerns pathogenicity in poultry, not humans. Normally a highly pathogenic avian virus is not highly pathogenic to either humans or non-poultry birds. This current deadly strain of H5N1 is unusual in being deadly to so many species, including some, like domestic cats, never previously susceptible to any influenza virus. The Orthomyxoviridae (Derivation of name orthos is Greek for straight myxa is Greek for Mucus) are a family of RNA viruses that

Genetic structure and related subtypes

The N in H5N1 stands for "Neuraminidase", as depicted in this ribbon diagram. Sialidase 1 (lysosomal sialidase, also known as NEU1 or neuraminidase, is a human Gene.

H5N1 is a subtype of the species Influenza A virus of the Influenzavirus A genus of the Orthomyxoviridae family. Influenzavirus A is a Genus of the Orthomyxoviridae family of Viruses Influenzavirus A includes only one Species: Influenza A virus A genus (plural genera from Γένος Latin genus "descent family type gender" is a low-level Taxonomic The Orthomyxoviridae (Derivation of name orthos is Greek for straight myxa is Greek for Mucus) are a family of RNA viruses that Like all other influenza A subtypes, the H5N1 subtype is an RNA virus. An RNA virus is a Virus that has RNA (ribonucleic acid as its Genetic material. It has a segmented genome of eight negative sense, single-strands of RNA, abbreviated as PB2, PB1, PA, HA, NP, NA, MP and NS. In classical genetics the genome of a Diploid Organism including Eukarya refers to a full set of chromosomes or genes in a Gamete, thereby Ribonucleic acid ( RNA) is a Nucleic acid that consists of a long chain of Nucleotide units

HA codes for hemagglutinin, an antigenic glycoprotein found on the surface of the influenza viruses and is responsible for binding the virus to the cell that is being infected. Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses An antigen (from antibody-generating) or immunogen is a substance that prompts the generation of Antibodies and can cause an immune response Not to be confused with Peptidoglycan. Glycoproteins are proteins that contain Oligosaccharide chains ( Glycans) covalently attached NA codes for neuraminidase, an antigenic glycosylated enzyme found on the surface of the influenza viruses. Sialidase 1 (lysosomal sialidase, also known as NEU1 or neuraminidase, is a human Gene. Enzymes are Biomolecules that catalyze ( ie increase the rates of Chemical reactions Almost all enzymes are Proteins It facilitates the release of progeny viruses from infected cells. ^[17] The hemagglutinin (HA) and neuraminidase (NA) RNA strands specify the structure of proteins that are most medically relevant as targets for antiviral drugs and antibodies. Antibodies (also known as immunoglobulins, abbreviated Ig) are Gamma globulin Proteins that are found in Blood or other Bodily HA and NA are also used as the basis for the naming of the different subtypes of influenza A viruses. This is where the H and N come from in H5N1.

Influenza A viruses are significant for their potential for disease and death in humans and other animals. Influenza A virus subtypes that have been confirmed in humans, in order of the number of known human pandemic deaths that they have caused, include:

• H1N1, which caused "Spanish flu" and currently causes seasonal human flu
• H2N2, which caused "Asian flu"
• H3N2, which caused "Hong Kong flu" and currently causes seasonal human flu
• H5N1, the world's major current pandemic threat
• H7N7, which has unusual zoonotic potential and killed one person
• H1N2, which is currently endemic in humans and pigs and causes seasonal human flu
• H9N2, which has infected three people
• H7N2, which has infected two people
• H7N3, which has infected two people
• H10N7, which has infected two people

Low pathogenic H5N1

Low pathogenic avian influenza H5N1 (LPAI H5N1) also called "North American" H5N1 commonly occurs in wild birds. H1[[Neuraminidase N1]] is a subtype of the species Influenza A virus. The 1918 flu pandemic (commonly referred to as the Spanish flu) was an Influenza Pandemic that spread to nearly every part of the world See also Influenza Human flu refers to a subset of Orthomyxoviridae that create Influenza in Humans and are endemic in humans H2N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus H3N2 is a subtype of the influenza A virus. Its name derives from the forms of the two kinds of Proteins on the surface of its coat Hemagglutinin (H and A pandemic (from Greek παν pan all + δήμος demos people is an Epidemic of Infectious disease that spreads through H7N7 is a subtype of the species Influenza A virus (sometimes called bird flu virus A zoonosis (ˌzoʊəˈnoʊsɨs or zoonose is any Infectious disease that is able to be transmitted (by a vector) from other Animals both wild and domestic H1[[Neuraminidase N2]] is a subtype of the species Influenza A virus (sometimes called bird flu virus H9N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus H7N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus H7N3 is a subtype of the species Influenza A virus (sometimes called bird flu virus H10N7 is a subtype of the species Influenza A virus (sometimes called bird flu virus In most cases, it causes minor sickness or no noticeable signs of disease in birds. It is not known to affect humans at all. The only concern about it is that it is possible for it to be transmitted to poultry and in poultry mutate into a highly pathogenic strain.

• 1975 – LPAI H5N1 was detected in a wild mallard duck and a wild blue goose in Wisconsin.

• 1981 and 1985 – LPAI H5N1 was detected in ducks by the University of Minnesota conducting a sampling procedure in which sentinel ducks were monitored in cages placed in the wild for a short period of time.

• 1983 – LPAI H5N1 was detected in ring-billed gulls in Pennsylvania.

• 1986 - LPAI H5N1 was detected in a wild mallard duck in Ohio.

• 2005 - LPAI H5N1 was detected in ducks in Manitoba, Canada.

"In the past, there was no requirement for reporting or tracking LPAI H5 or H7 detections in wild birds so states and universities tested wild bird samples independently of USDA. Because of this, the above list of previous detections might not be all inclusive of past LPAI H5N1 detections. However, the World Organization for Animal Health (OIE) recently changed its requirement of reporting detections of avian influenza. Effective in 2006, all confirmed LPAI H5 and H7 AI subtypes must be reported to the OIE because of their potential to mutate into highly pathogenic strains. Therefore, USDA now tracks these detections in wild birds, backyard flocks, commercial flocks and live bird markets. "^[18]

Properties of H5N1

Infectivity

Highly pathogenic H5N1
	→  Countries with poultry or wild birds killed by H5N1.
	→  Countries with humans, poultry and wild birds killed by H5N1.

H5N1 is easily transmissible between birds facilitating a potential global spread of H5N1. Human and bird cases 1959-1997 A highly pathogenic strain of H5N1 caused Flu outbreaks with significant spread to numerous farms While H5N1 undergoes mutation and reassortment, creating variations which can infect species not previously known to carry the virus, not all of these variant forms can infect humans. H5N1 as an avian virus preferentially binds to a type of galactose receptors that populate the avian respiratory tract from the nose to the lungs and are virtually absent in humans, occurring only in and around the alveoli, structures deep in the lungs where oxygen is passed to the blood. Galactose (Gal (also called brain sugar) is a type of Sugar which is less sweet than Glucose. An alveolus (plural alveoli, from Latin alveolus, "little cavity" is an anatomical structure that has the form of a hollow cavity Therefore, the virus is not easily expelled by coughing and sneezing, the usual route of transmission. ^[19][20][21]

H5N1 is mainly spread by domestic poultry, both through the movements of infected birds and poultry products and through the use of infected poultry manure as fertilizer or feed. Poultry is the category of Domesticated Birds which some humans keep for the purpose of collecting their eggs, or kill for their Meat and/or Humans with H5N1 have typically caught it from chickens, which were in turn infected by other poultry or waterfowl. Migrating waterfowl (wild ducks, geese and swans) carry H5N1, often without becoming sick. See also UK Wildfowl and Wetlands Trust USA Ducks Unlimited For duck as a food see Duck (food; for other meanings see Duck (disambiguation. Goose (plural geese) is the English name for a considerable number of Birds belonging to the family Anatidae. Swans are Birds of the family Anatidae, which also includes geese and Ducks Swans are grouped with the closely related geese in ^[22][23] Many species of birds and mammals can be infected with HPAI A(H5N1), but the role of animals other than poultry and waterfowl as disease-spreading hosts is unknown. ^[24]

According to a report by the World Health Organization, H5N1 may be spread indirectly. The report stated that the virus may sometimes stick to surfaces or get kicked up in fertilizer dust to infect people. ^[25]

Virulence

H5N1 has mutated into a variety of strains with differing pathogenic profiles, some pathogenic to one species but not others, some pathogenic to multiple species. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism In biology strain is a low-level Taxonomic rank used in three related ways Each specific known genetic variation is traceable to a virus isolate of a specific case of infection. Through antigenic drift, H5N1 has mutated into dozens of highly pathogenic varieties divided into genetic clades which are known from specific isolates, but all currently belonging to genotype Z of avian influenza virus H5N1, now the dominant genotype. Antigenic drift is the process of random accumulation of Mutations in viral genes recognized by the Immune system. ^[26][27] H5N1 isolates found in Hong Kong in 1997 and 2001 were not consistently transmitted efficiently among birds and did not cause significant disease in these animals. Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders In 2002 new isolates of H5N1 were appearing within the bird population of Hong Kong. These new isolates caused acute disease, including severe neurological dysfunction and death in ducks. For duck as a food see Duck (food; for other meanings see Duck (disambiguation. This was the first reported case of lethal influenza virus infection in wild aquatic birds since 1961. ^[28] Genotype Z emerged in 2002 through reassortment from earlier highly pathogenic genotypes of H5N1^[2] that first infected birds in China in 1996, and first infected humans in Hong Kong in 1997. Reassortment is the mixing of the genetic material of two similar Viruses that are infecting the same cell China ( Wade-Giles ( Mandarin) Chung¹kuo² is a cultural region, an ancient Civilization, and depending on perspective a National Hong Kong ( officially the Hong Kong Special Administrative Region, is a territory located on China 's south coast on the Pearl River Delta, and borders ^[29][26][27] Genotype Z is endemic in birds in Southeast Asia, has created at least two clades that can infect humans, and is spreading across the globe in bird populations. Mutations are occurring within this genotype that are increasing their pathogenicity. ^[30] Birds are also able to shed the virus for longer periods of time before their death, increasing the transmissibility of the virus.

Transmission and host range

Influenza A virus, the virus that causes Avian flu. Influenzavirus A is a Genus of the Orthomyxoviridae family of Viruses Influenzavirus A includes only one Species: Influenza A virus Transmission electron micrograph of negatively stained virus particles in late passage. A micrograph, microphotograph or photomicrograph is a Photograph or similar image taken through a Microscope or similar device to show (Source: Dr. Erskine Palmer, Centers for Disease Control and Prevention Public Health Image Library)

Infected birds transmit H5N1 through their saliva, nasal secretions, feaces and blood. For the band see Saliva (band; for the village in Azerbaijan see Səliva. In vertebrates mucus is a slippery secretion produced by and covering Mucous membranes It is a viscous Colloid containing Antiseptic enzymes (such as Feces, faeces, or fæces (see spelling differences) is a waste product from an animal's digestive tract expelled through the Anus Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells ��such as nutrients and oxygen—and transports Waste products Other animals may become infected with the virus through direct contact with these bodily fluids or through contact with surfaces contaminated with them. H5N1 remains infectious after over 30 days at 0 °C ( 32. 0 °F) (over one month at freezing temperature) or 6 days at 37 °C ( 98. 6 °F) (one week at human body temperature) so at ordinary temperatures it lasts in the environment for weeks. In Arctic temperatures, it doesn't degrade at all.

Because migratory birds are among the carriers of the highly pathogenic H5N1 virus, it is spreading to all parts of the world. H5N1 is different from all previously known highly pathogenic avian flu viruses in its ability to be spread by animals other than poultry.

In October 2004, researchers discovered that H5N1 is far more dangerous than was previously believed. Waterfowl were revealed to be directly spreading the highly pathogenic strain of H5N1 to chickens, crows, pigeons, and other birds, and the virus was increasing its ability to infect mammals as well. See also UK Wildfowl and Wetlands Trust USA Ducks Unlimited The chicken ( Gallus gallus, sometimes G gallus domesticus) is a domesticated Fowl which is traditionally believed to have descended from The true crows are large Passerine Birds that comprise the Genus Corvus in the family Corvidae. From this point on, avian flu experts increasingly referred to containment as a strategy that can delay, but not ultimately prevent, a future avian flu pandemic.

"Since 1997, studies of influenza A (H5N1) indicate that these viruses continue to evolve, with changes in antigenicity and internal gene constellations; an expanded host range in avian species and the ability to infect felids; enhanced pathogenicity in experimentally infected mice and ferrets, in which they cause systemic infections; and increased environmental stability. "^[31]

The New York Times, in an article on transmission of H5N1 through smuggled birds, reports Wade Hagemeijer of Wetlands International stating, "We believe it is spread by both bird migration and trade, but that trade, particularly illegal trade, is more important". ^[32]

On August 22, 2007, a 28-year-old Indonesian chicken trader was the 2nd person to die of bird flu on the island of Bali, after 4 days of hospitalization, raising the death toll due to the disease in Indonesia to 84. The Republic of Indonesia ( (Republik Indonesia is a Country in Southeast Asia. Bali is an Indonesian Island located at, the westernmost of the Lesser Sunda Islands, lying between Java to the west and Lombok to Tests in 2 local laboratories were positive for the H5N1 strain of the disease. 194 people — the majority of them in Indonesia -- have died since 2003, according to the World Health Organization. ^[33]

The H5N1 bird flu virus can also pass through a pregnant woman's placenta to infect the fetus, researchers reported on Thursday 27 September 2007. Events 489 - Odoacer attacks Theodoric at the Battle of Verona and is defeated again Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. They also found evidence of what doctors had long suspected -- that the virus not only affects the lungs, but also passes throughout the body into the gastrointestinal tract, the brain, liver, and blood cells. ^[34]

High mutation rate

Influenza viruses have a relatively high mutation rate that is characteristic of RNA viruses. An RNA virus is a Virus that has RNA (ribonucleic acid as its Genetic material. The segmentation of its genome facilitates genetic recombination by segment reassortment in hosts infected with two different influenza viruses at the same time. In classical genetics the genome of a Diploid Organism including Eukarya refers to a full set of chromosomes or genes in a Gamete, thereby Genetic recombination is the process by which a strand of genetic material (usually DNA; but can also be RNA) is broken and then joined to a different DNA molecule Reassortment is the mixing of the genetic material of two similar Viruses that are infecting the same cell ^[26][27] A previously uncontagious strain may then be able to pass between humans, one of several possible paths to a pandemic.

The ability of various influenza strains to show species-selectivity is largely due to variation in the hemagglutinin genes. Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses Genetic mutations in the hemagglutinin gene that cause single amino acid substitutions can significantly alter the ability of viral hemagglutinin proteins to bind to receptors on the surface of host cells. In biology mutations are changes to the Nucleotide sequence of the Genetic material of an organism In Chemistry, an amino acid is a Molecule containing both Amine and Carboxyl Functional groups In Biochemistry, this In Biochemistry, a receptor is a Protein molecule embedded in either the Plasma membrane or Cytoplasm of a cell to which a mobile signaling Such mutations in avian H5N1 viruses can change virus strains from being inefficient at infecting human cells to being as efficient in causing human infections as more common human influenza virus types. ^[35] This doesn't mean that one amino acid substitution can cause a pandemic, but it does mean that one amino acid substitution can cause an avian flu virus that is not pathogenic in humans to become pathogenic in humans.

H3N2 ("swine flu") is endemic in pigs in China, and has been detected in pigs in Vietnam, increasing fears of the emergence of new variant strains. H3N2 is a subtype of the influenza A virus. Its name derives from the forms of the two kinds of Proteins on the surface of its coat Hemagglutinin (H and Swine Flu (or Swine influenzavirus (SIV flu) refers to a subset of Orthomyxoviridae that creates Influenza in Pigs and are endemic The dominant strain of annual flu virus in January 2006 was H3N2, which is now resistant to the standard antiviral drugs amantadine and rimantadine. H3N2 is a subtype of the influenza A virus. Its name derives from the forms of the two kinds of Proteins on the surface of its coat Hemagglutinin (H and Amantadine is the Organic compound known formally as 1-aminoadamantane Rimantadine ( INN, sold under the trade name Flumadine) is an orally administered Antiviral drug used to treat and in rare cases prevent Influenzavirus The possibility of H5N1 and H3N2 exchanging genes through reassortment is a major concern. If a reassortment in H5N1 occurs, it might remain an H5N1 subtype, or it could shift subtypes, as H2N2 did when it evolved into the Hong Kong Flu strain of H3N2. H2N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus H3N2 is a subtype of the influenza A virus. Its name derives from the forms of the two kinds of Proteins on the surface of its coat Hemagglutinin (H and

Both the H2N2 and H3N2 pandemic strains contained avian influenza virus RNA segments. H2N2 is a subtype of the species Influenza A virus (sometimes called bird flu virus H3N2 is a subtype of the influenza A virus. Its name derives from the forms of the two kinds of Proteins on the surface of its coat Hemagglutinin (H and For the H5N1 subtype of Avian influenza see H5N1. Avian influenza, sometimes Avian flu, and commonly Bird flu refers "While the pandemic human influenza viruses of 1957 (H2N2) and 1968 (H3N2) clearly arose through reassortment between human and avian viruses, the influenza virus causing the 'Spanish flu' in 1918 appears to be entirely derived from an avian source". ^[11]

Humans and H5N1

The earliest infections of humans by H5N1 coincided with an epizootic (an epidemic in nonhumans) of H5N1 influenza in Hong Kong's poultry population. In Epizoology, an epizootic (from Greek epi- upon + zoion animal is a Disease that appears as new cases in a given animal population This panzootic (a disease affecting animals of many species, especially over a wide area) outbreak was stopped by the killing of the entire domestic poultry population within the territory. A panzootic (from Greek παν pan all + ζόιον zoion animal is an Epizootic (an outbreak of an Infectious disease of animals

Confirmed human cases and mortality rate of avian influenza (H5N1)
As of April 30, 2008

Country	Report dates																		edit this table Total
	2003			2004			2005			2006			2007			2008
	cases	deaths		cases	deaths		cases	deaths		cases	deaths		cases	deaths		cases	deaths		cases	deaths
Azerbaijan										8	5	63%							8	5	63%
Cambodia							4	4	100%	2	2	100%	1	1	100%				7	7	100%
PR China	1	1	100%				8	5	63%	13	8	62%	5	3	60%	3	3	100%	30	20	67%
Djibouti										1	0	0%							1	0	0%
Egypt										18	10	56%	25	9	36%	7	3	43%	50	22	44%
Indonesia							20	13	65%	55	45	82%	42	37	88%	16	13	81%	133	108	81%
Iraq										3	2	67%							3	2	67%
Laos													2	2	100%				2	2	100%
Myanmar													1	0	0%				1	0	0%
Nigeria													1	1	100%				1	1	100%
Pakistan													1	1	100%				1	1	100%
Thailand				17	12	71%	5	2	40%	3	3	100%							25	17	68%
Turkey										12	4	33%							12	4	33%
Vietnam	3	3	100%	29	20	69%	61	19	31%				8	5	63%	5	5	100%	106	52	49%
Total	4	4	100%	46	32	70%	98	43	44%	115	79	69%	86	59	69%	31	24	77%	382	241	63%
Source: World Health Organization Communicable Disease Surveillance & Response (CSR)

Symptoms in humans

Further information: Pneumonia

Avian influenza hemagglutinin bind alpha 2-3 sialic acid receptors while human influenza hemagglutinin bind alpha 2-6 sialic acid receptors. Transmission and infection of H5N1 from infected avian sources to humans is a concern due to the Global spread of H5N1 that constitutes a Pandemic threat For the H5N1 subtype of Avian influenza see H5N1. Avian influenza, sometimes Avian flu, and commonly Bird flu refers Influenza A virus subtype H5[[Neuraminidase N1]], also known as A(H5N1 or simply H5N1, is a subtype of the Influenza A virus which can cause 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Events 313 - Roman emperor Licinius unifies the entire Eastern Roman Empire under his rule 2008 ( MMVIII) is the current year in accordance with the Gregorian calendar, a Leap year that started on Tuesday of the Common Azerbaijan ( English; Azərbaycan officially the Republic of Azerbaijan (Azərbaycan Respublikası is the largest and most populous country in the South The Kingdom of Cambodia ( formerly known as Kampuchea (, transliterated: Preăh Réachéanachâkr Kâmpŭchea) is a country in South East Talk People's Republic of China) PEOPLE'S REPUBLIC OF CHINA ARTICLE GUIDELINES Djibouti ( جيبوتي Jībūtī, Somali: Jabuuti) officially the Republic of Djibouti, is a country in the This article is about the country of Egypt For a topic outline on this subject see List of basic Egypt topics. The Republic of Indonesia ( (Republik Indonesia is a Country in Southeast Asia. For a topic outline on this subject see List of basic Iraq topics. Laos (ˈlɑːoʊs or /ˈlaʊs/ officially the Lao People's Democratic Republic, is a Landlocked country in Southeast Asia, bordered by Burma Burma, officially the Union of Myanmar ( pjìdàunzṵ mjàmmà nàinŋàndɔ̀ is the largest country by geographical area in mainland Southeast Asia. Nigeria, officially named the Federal Republic of Nigeria, is a federal Constitutional republic comprising thirty-six states and one Federal Pakistan () officially the Islamic Republic of Pakistan, is a country located in South Asia, Southwest Asia, Middle East and The Kingdom of Thailand (ˈtaɪlænd ราชอาณาจักรไทย, râːtɕʰa-ʔaːnaːtɕɑ̀k-tʰɑj Turkey (Türkiye known officially as the Republic of Turkey ( is a Eurasian Country that stretches Vietnam (ˌviːɛtˈnɑːm Việt Nam) officially Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses Sialic acid is a generic term for the N - or O -substituted derivatives of Neuraminic acid, a Monosaccharide with a nine- Carbon backbone Hemagglutinin (HA or haemagglutinin ( British English) is an Antigenic Glycoprotein found on the surface of the Influenza Viruses Usually other differences also exist. There is as yet no human form of H5N1, so all humans who have caught it so far have caught avian H5N1.

In general, humans who catch a humanized Influenza A virus (a human flu virus of type A) usually have symptoms that include fever, cough, sore throat, muscle aches, conjunctivitis, and, in severe cases, breathing problems and pneumonia that may be fatal. Influenzavirus A is a Genus of the Orthomyxoviridae family of Viruses Influenzavirus A includes only one Species: Influenza A virus See also Influenza Human flu refers to a subset of Orthomyxoviridae that create Influenza in Humans and are endemic in humans Fever (also known as pyrexia, from the Greek pyretos meaning fire or a febrile response, from the Latin word Febris In Medicine, a cough ( Latin: tussis) is a sudden and often repetitively occurring defence Reflex which helps to clear the large breathing passages See also Strep throat. Pharyngitis (ˌfarɪnˈdʒʌɪtɪs is in most cases a Painful inflammation of the Pharynx, and is Myalgia means " Muscle Pain " and is a symptom of many diseases and disorders Conjunctivitis (commonly called " Pink Eye " or " Red Eye " in North America and " Madras eye " in India) is an inflammation Pneumonia is an inflammatory illness of the Lung. Frequently it is described as lung Parenchyma / alveolar inflammation and abnormal The severity of the infection depends to a large part on the state of the infected person's immune system and whether the victim has been exposed to the strain before (in which case they would be partially immune). An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor No one knows if these or other symptoms will be the symptoms of a humanized H5N1 flu. Transmission and infection of H5N1 from infected avian sources to humans is a concern due to the Global spread of H5N1 that constitutes a Pandemic threat

The reported mortality rate of highly pathogenic H5N1 avian influenza in a human is high; WHO data indicates that 60% of cases classified as H5N1 resulted in death. Transmission and infection of H5N1 from infected avian sources to humans is a concern due to the Global spread of H5N1 that constitutes a Pandemic threat For the H5N1 subtype of Avian influenza see H5N1. Avian influenza, sometimes Avian flu, and commonly Bird flu refers However, there is some evidence that the actual mortality rate of avian flu could be much lower, as there may be many people with a milder symptoms who do not seek treatment and are not counted. ^[36][37]

In one case, a boy with H5N1 experienced diarrhea followed rapidly by a coma without developing respiratory or flu-like symptoms. In Medicine, diarrhea, also spelled diarrhoea (see spelling differences) is frequent loose or liquid Bowel movements Acute diarrhea In Medicine, a coma (from the Greek koma, meaning deep sleep is a profound state of Unconsciousness. ^[38] There have been studies of the levels of cytokines in humans infected by the H5N1 flu virus. Cytokines are a category of signalling Proteins and Glycoproteins that like Hormones and Neurotransmitters, are used extensively in cellular Of particular concern is elevated levels of tumor necrosis factor-alpha, a protein that is associated with tissue destruction at sites of infection and increased production of other cytokines. Tumor necrosis factor ( TNF, cachexin or cachectin and formally known as Tumor necrosis factor-alpha) is a Cytokine involved in systemic Flu virus-induced increases in the level of cytokines is also associated with flu symptoms including fever, chills, vomiting and headache. Tissue damage associated with pathogenic flu virus infection can ultimately result in death. ^[3] The inflammatory cascade triggered by H5N1 has been called a 'cytokine storm' by some, because of what seems to be a positive feedback process of damage to the body resulting from immune system stimulation. Inflammation ( Latin, inflamatio, to set on fire is the complex biological response of vascular tissues to harmful stimuli such as Pathogens A cytokine storm is a potentially fatal immune reaction consisting of a Positive feedback loop between Cytokines and Immune cells with highly elevated Positive feedback, sometimes referred to as "cumulative causation" is a Feedback loop system in which the system responds to perturbation in the same direction An immune system is a collection of mechanisms within an Organism that protects against Disease by identifying and killing Pathogens and Tumor H5N1 induces higher levels of cytokines than the more common flu virus types. ^[39]

Treatment and prevention for humans

Flu

Influenza Virus Avian influenza Flu season Research Vaccine Treatment Genome project H5N1 strain

There is no highly effective treatment for H5N1 flu, but oseltamivir (commercially marketed by Roche as Tamiflu), can sometimes inhibit the influenza virus from spreading inside the user's body. Transmission and infection of H5N1 from infected avian sources to humans is a concern due to the Global spread of H5N1 that constitutes a Pandemic threat Oseltamivir ( INN) (ɒsəlˈtæmɨvɪr is an Antiviral drug that is used in the treatment and Prophylaxis of both Influenzavirus A and Influenzavirus F Hoffmann–La Roche Ltd is a Swiss global health-care company which operates world-wide under two divisions Pharmaceuticals and Diagnostics. This drug has become a focus for some governments and organizations trying to be seen as making preparations for a possible H5N1 pandemic. ^[40] On April 20, 2006, Roche AG announced that a stockpile of three million treatment courses of Tamiflu is waiting at the disposal of the World Health Organization to be used in case of a flu pandemic; separately Roche donated two million courses to the WHO for use in developing nations that may be affected by such a pandemic but lack the ability to purchase large quantities of the drug. A stockpile is a pile or storage location for bulk materials forming part of the Bulk materials handling process Developing countries are countries that haven't reached Western-style standards of democratic government free market economy industrialization social programs and human rights guaranties ^[41]

However, WHO expert Hassan al-Bushra has said:

"Even now, we remain unsure about Tamiflu's real effectiveness. As for a vaccine, work cannot start on it until the emergence of a new virus, and we predict it would take six to nine months to develop it. A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease For the moment, we cannot by any means count on a potential vaccine to prevent the spread of a contagious influenza virus, whose various precedents in the past 90 years have been highly pathogenic". ^[42]

There are several H5N1 vaccines for several of the avian H5N1 varieties, but the continual mutation of H5N1 renders them of limited use to date: while vaccines can sometimes provide cross-protection against related flu strains, the best protection would be from a vaccine specifically produced for any future pandemic flu virus strain. A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease Dr. Daniel Lucey, co-director of the Biohazardous Threats and Emerging Diseases graduate program at Georgetown University has made this point, "There is no H5N1 pandemic so there can be no pandemic vaccine". Georgetown University is a Jesuit Private university located in Georgetown Washington D A pandemic (from Greek παν pan all + δήμος demos people is an Epidemic of Infectious disease that spreads through A vaccine is a biological preparation which is used to establish or improve immunity to a particular disease ^[43] However, "pre-pandemic vaccines" have been created; are being refined and tested; and do have some promise both in furthering research and preparedness for the next pandemic. ^[44][45][46] Vaccine manufacturing companies are being encouraged to increase capacity so that if a pandemic vaccine is needed, facilities will be available for rapid production of large amounts of a vaccine specific to a new pandemic strain.

Animal and lab studies suggest that Relenza (zanamivir), which is in the same class of drugs as Tamiflu, may also be effective against H5N1. Zanamivir ( INN) (zəˈnæmɨvɪr is a Neuraminidase inhibitor used in the treatment of and Prophylaxis of both Influenzavirus A and Influenzavirus In a study performed on mice in 2000, "zanamivir was shown to be efficacious in treating avian influenza viruses H9N2, H6N1, and H5N1 transmissible to mammals". ^[47] While no one knows if zanamivir will be useful or not on a yet to exist pandemic strain of H5N1, it might be useful to stockpile zanamivir as well as oseltamivir in the event of an H5N1 influenza pandemic. Neither oseltamivir nor zanamivir can currently be manufactured in quantities that would be meaningful once efficient human transmission starts. ^[48]

In September, 2006, a WHO scientist announced that studies had confirmed cases of strains resistant to Tamiflu and Amantadine. ^[49]

An experiment conducted at a London laboratory recently showed that an enzyme mixture, created by the Icelandic company Zymetech killed the H5N1 strain with a 99% success rate. In scientific inquiry an experiment ( Latin: Ex- periri, "to try out" is a method of investigating particular types of research questions or A laboratory (informally lab) is a facility that provides controlled conditions in which scientific Research, Experiments and Zymetech ehf is an Icelandic Company that specializes in the research of Enzymes derived from Marine organisms An Experiment conducted Influenza A virus subtype H5[[Neuraminidase N1]], also known as A(H5N1 or simply H5N1, is a subtype of the Influenza A virus which can cause The mixture kills the virus in less than 5 minutes without damaging healthy cells. The cell is the structural and functional unit of all known living Organisms It is the smallest unit of an organism that is classified as living and is often called ^[50]

Preparations for pandemic

Cumulate Human Cases of and Deaths from H5N1
As of April 11, 2007

Notes:

• Source WHO Confirmed Human Cases of H5N1
• "[T]he incidence of human cases peaked, in each of the three years in which cases have occurred, during the period roughly corresponding to winter and spring in the northern hemisphere. Influenza A virus subtype H5[[Neuraminidase N1]], also known as A(H5N1 or simply H5N1, is a subtype of the Influenza A virus which can cause Events 491 - Flavius Anastasius becomes Byzantine Emperor, with the name of Anastasius I. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. If this pattern continues, an upsurge in cases could be anticipated starting in late 2006 or early 2007. " Avian influenza – epidemiology of human H5N1 cases reported to WHO
• The regression curve for deaths is y = a + e^k x, and is shown extended through the end of April, 2007.

"The United States is collaborating closely with eight international organizations, including the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE), and 88 foreign governments to address the situation through planning, greater monitoring, and full transparency in reporting and investigating avian influenza occurrences. The United States of America —commonly referred to as the The Office international des épizooties ( OIÉ, French for "International Epizootic Office" now known as the World Organisation for Animal Health ( The United States and these international partners have led global efforts to encourage countries to heighten surveillance for outbreaks in poultry and significant numbers of deaths in migratory birds and to rapidly introduce containment measures. The U.S. Agency for International Development (USAID) and the U.S. Department of State, the U.S. Department of Health and Human Services (HHS), and Agriculture (USDA) are coordinating future international response measures on behalf of the White House with departments and agencies across the federal government". The United States Agency for International Development (or USAID) is the United States federal government organization responsible for most non- military The United States Department of Health and Human Services ( HHS) is a Cabinet department of the United States government with the goal of protecting ^[51]

Together steps are being taken to "minimize the risk of further spread in animal populations", "reduce the risk of human infections", and "further support pandemic planning and preparedness". ^[51]

Ongoing detailed mutually coordinated onsite surveillance and analysis of human and animal H5N1 avian flu outbreaks are being conducted and reported by the USGS National Wildlife Health Center, the Centers for Disease Control and Prevention, the World Health Organization, the European Commission, and others. The United States Geological Survey ( USGS) is a scientific agency of the United States government. The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated The European Commission (formally the Commission of the European Communities) is the executive branch of the European Union. ^[52]

Effect on human society

Main article: Social impact of H5N1

H5N1 has had a huge effect on human society, especially the financial, political, social, and personal responses to both actual and predicted deaths in birds, humans, and other animals. Financial According to the New York Times, due to the H5N1 threat as of March 2006 "governments worldwide have spent billions planning Human beings, humans or man (Origin 1590–1600 L homō man OL hemō the earthly one (see Humus A society is a Population of Humans characterized by patterns of relationships between individuals that share a distinctive Culture and Institutions The field of finance refers to the concepts of Time, Money and Risk and how they are interrelated Politics Politics is the process by which groups of people make decisions Definition In the absence of agreement about its meaning the term "social" is used in many different senses referring among other things to attitudes Death is the termination of the biological functions that define living Organisms It refers both to a specific Birds ( class Aves) are bipedal endothermic ( Warm-blooded) Vertebrate animals that lay eggs. Human beings, humans or man (Origin 1590–1600 L homō man OL hemō the earthly one (see Humus

Billions of U.S. dollars are being raised and spent to research H5N1 and prepare for a potential avian influenza pandemic. The United States dollar ( sign: $; code: USD) is the unit of Currency of the United States; it has also been For the H5N1 subtype of Avian influenza see H5N1. Avian influenza, sometimes Avian flu, and commonly Bird flu refers A pandemic (from Greek παν pan all + δήμος demos people is an Epidemic of Infectious disease that spreads through Over ten billion dollars have been lost and over two hundred million birds have been killed to try to contain H5N1.

People have reacted by buying less chicken causing poultry sales and prices to fall. ^[53] Many individuals have stockpiled supplies for a possible flu pandemic. One of the best known experts on H5N1, Dr. Robert Webster, told ABC News he had a three month supply of food and water in his house as he prepared for what he considered a reasonably likely occurrence of a major pandemic. For the New South Wales parliamentarian see Robert James Webster For the two-time Olympic gold medalist in diving see Bob Webster Robert G

International health officials and other experts have pointed out that many unknown questions still hover around the disease^[54]

Dr. David Nabarro, Chief Avian Flu Coordinator for the United Nations, and former Chief of Crisis Response for the World Health Organization has described himself as "quite scared" about the potential of H5N1's potential impact on humans. Dr David Nabarro (born in 1949 works as the Senior UN System Coordinator for Avian and Human Influenza at United Nations Headquarters in New York Nabarro has been accused of being alarmist before and on his first day in his role for the United Nations he proclaimed the avian flu could kill 150 million people. In an interview with the International Herald Tribune, Nabarro compares avian flu to AIDS in Africa, warning that underestimations led to inappropriate focus for research and intervention. The International Herald Tribune is a widely read English language international Newspaper ^[55]

However it has been pointed out that media often focuses on "worst case" and "what if?" scenarios, which often promotes a climate of fear and "a fertile ground for speculation and rumours". Fear is an Emotional response to Threats and Danger. It is a basic survival mechanism occurring in response to a specific Stimulus, such as Availability of reliable information is tanatamount according to WHO public health official Robert Brown. Brown downplays the significance of bird flu compared to other global public health issues:

In terms of death statistics so far, human avian influenza is not a huge public health issue. As Brown put it, there are 40 million people living with HIV around the world. More people die of traffic accidents in Vietnam than of avian flu. But a mix of fear, disaster and the unknown makes avian flu a topic of concern. Other factors add to this -- that avian flu marks the arrival of a new emerging infection has a large impact on the poultry industry, a high mortality rate, and the potential to cross national boundaries.

However, Brown concedes that "there are still huge gaps in our knowledge of the virus" and there has been dearth of significant breakthroughs in research since 2003. Progress stagnation can be attributed to an unwillingness for international parties to share resources and knowledge. ^[56]

See also

• Antigenic shift
• Influenza research
• Fujian flu
• Global spread of H5N1
• H5N1 clinical trials
• ICEID
• National Influenza Centers
• Reporting disease cases
• Zoonosis

Sources and notes

External links

Official - international

• UN United Nations
  • WHO World Health Organization
    • The United Nation's World Health Organization's Avian Flu Facts Sheet for 2006
    • Epidemic and Pandemic Alert and Response Guide to WHO's H5N1 pages
    • Avian Influenza Resources (updated) - tracks human cases and deaths
    • National Influenza Pandemic Plans
    • WHO Collaborating Centres and Reference Laboratories Centers, names, locations, and phone numbers
  • FAO Avian Influenza portal Information resources, animations, videos, photos
    • FAO Food and Agriculture Organisation - Bi-weekly Avian Influenza Maps - tracks animal cases and deaths
    • FAO Bird Flu disease card
    • FAO Socio-Economic impact of AI Projects, Information resources
• OIE World Organisation for Animal Health - tracks animal cases and deaths
  • Official outbreak reports by country
  • Official outbreak reports by week
  • Chart of outbreaks by country

Official - United States

• PandemicFlu.Gov U. The United Nations ( UN) is an International organization whose stated aims are to facilitate cooperation in International law, International security The Office international des épizooties ( OIÉ, French for "International Epizootic Office" now known as the World Organisation for Animal Health ( The United States of America —commonly referred to as the S. Government's avian flu information site
• USAID U. S. Agency for International Development - Avian Influenza Response
• CDC Centers for Disease Control - responsible agency for avian influenza in humans in US - Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus
• USGS - NWHC National Wildlife Health Center - responsible agency for avian influenza in animals in US
• HHS U. S. Department of Health & Human Services - Pandemic Influenza Plan

Official - United Kingdom

• Exotic Animal Disease Generic Contingency Plan — DEFRA generic contingency plan for controlling and eradicating an outbreak of an exotic animal disease. The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located The Department for Environment Food and Rural Affairs ( Defra) is the United Kingdom government department responsible for environmental protection PDF hosted by BBC (a government entity).
• UK Influenza Pandemic Contingency Plan — NHS (a government entity). Contingency planning for an influenza pandemic. PDF hosted by BBC

Technical

External links dealing with technical aspects can be found here. H5N1 genetic structure is the molecular structure of the H5N1 virus's RNA.

News and General information

External links dealing with news and general information can be found here. Human and bird cases 1959-1997 A highly pathogenic strain of H5N1 caused Flu outbreaks with significant spread to numerous farms