UNITED NATIONS - Bird flu in poultry and wild birds spread to 60 countries but is entrenched only in six because of improved and faster responses, experts said.
Despite those strides, the risk of a worldwide human-to-human pandemic remains as great today as it was when the hard-to-treat H5N1 flu strain first gained intense attention in mid-2005, said a new report by Dr. David Nabarro, the UN official co-ordinating the global fight against avian influenza, and World Bank officials.
"We think it will happen sometime but we don't know when or where,'' Nabarro said Thursday.
Three years ago, H5N1 was found in poultry and wild birds in nine countries, the UN bird flu chief said. The increase is thought to have resulted more from trade in infected live birds than by transmission through wild birds, whose migrations change with weather.
The upsurge in H5N1 bird flu outbreaks around the world has led to the slaughter of millions of birds across Asia since late 2003. It remains entrenched throughout Indonesia and in parts of Bangladesh, Vietnam, Egypt, Nigeria and China, posing a threat not just to those countries but the world, Nabarro said.
A health expert outside the UN said Thursday there is reason for optimism, even though the risk of pandemic remains as high as a couple years ago.
"I don't think one can ever say that the risk is lower,'' said Dr. Pascal James Imperato, a former New York City health commissioner who now directs public health at the State University of New York-Downstate Medical Center.
"But we have a wider margin of comfort, because this virus has not been able to commingle its genetic material with that of a human influenza virus and, in so doing, acquire the ability to be transmitted from person to person,'' Imperato said.
Sporadic human-to-human transmission of the H5N1 strain has been reported in Hong Kong, Vietnam and Indonesia but none of the cases has been proven and officials determined there was no epidemiological significance because the spread was not sustained.
"The virus itself is continuously evolving as it moves from bird population to bird population,'' Nabarro said.
"The virus when it does enter into bird populations has to be dealt with quickly, otherwise it spreads and leads to widespread losses of bird lives.''
The report precedes a bird flu conference hosted by the government of India in New Delhi next week that is expected to draw health and agriculture officials from dozens of countries.
Among the report's other findings:
- 144 countries said they have prepared some kind of plan to deal with bird flu.
- Veterinarians have the least capacity to deal with the H5N1 strain in Africa, East Asia and Pacific countries.
- Some means of compensating poultry owners for isolating and killing infected animals is in place in 66 per cent of the countries that have a bird flu plan.
- Countries generally still have a long way to go to improve how animals are cared for to reduce the risks of transmission and to prepare for the broader social and economic impacts of a pandemic, such as absenteeism from work.
Most people killed so far have been infected by domestic fowl, and the virus remains very hard for humans to catch; about one-half the people infected die. But experts fear it could mutate into a form that easily spreads among humans, sparking a pandemic that some have said could kill anywhere from five million to 150 million.
During the 1918 flu pandemic, the worst in history, more than 40 million people died. Subsequent pandemics in 1957 and 1968 had lower death rates but caused great disruption.
