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Bird flu virus
[This may be somewhat sensationalistic reporting, but it is not a trivial concern.
lrgoudy provided the following link on the Yahoo mb for GTCB (msg # 17285):
http://content.nejm.org/cgi/reprint/NEJMp048343v1.pdf ]

http://tinyurl.com/4y5ah

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A Killer Virus Spreads
Robert Langreth, 01.24.05, 2:35 PM ET

Researchers have confirmed two cases of human-to-human transmission of the killer bird flu virus, a stark reminder that the world could be just a few viral mutations away from the start of the next deadly worldwide flu pandemic.

The bird flu, so-called H5N1, has top epidemiologists across the world on edge because of its potential to mutate into a new strain that no one would be immune to and that could easily spread among humans. Since first emerging in 1997 in Hong Kong, the bird flu has spread across poultry flocks in nine East Asian countries. It has killed 34 of 47 people who haven gotten it--a terrifying 72% mortality rate.

Until now, the vast majority of the confirmed human cases were people who had contact with infected animals. But in the current issue of The New England Journal of Medicine, Thai doctors report two cases of apparent human-to human transmission of the bird flu.

The cluster started with an 11-year-old girl who played and slept near infected chickens. Early last September, she developed a high fever and respiratory distress and was brought to the hospital. There, the girl passed the infection to her 26-year-old mother and a 32-year-old aunt, who each spent more than 12 hours at the girl's beside. Only the aunt survived.

Neither the mother nor aunt spread the disease to anyone else, an indication that the virus still can't spread efficiently among humans, the Thai researchers reported. And lab tests showed that the virus that infected the family had not mutated from its avian form, the researchers said.

But that may be just a matter of time. "There is so much transmission going on between birds and humans [in Asia] that the likelihood of a genetic reassortment that would make the virus able to be transmitted in humans grows every day," says University of Minnesota infectious disease epidemiologist Michael Osterholm.

Whether this will happen is anybody's guess. But if it does, all 6.4 billion people on the planet would need a flu shot--many times the current capacity of about 300 million doses annually. A special vaccine would also have to be made, a laborious process that involves incubating flu virus in chicken eggs. To get a jump-start on the process, the U.S. National Institutes of Health has contracted with Sanofi-Aventis (nyse: SNY - news - people ) and Chiron (nasdaq: CHIR - news - people ) to produce a prototype bird flu vaccine for human trials that are expected to begin any time now in healthy adults.

The U.S. flu shot supply is particularly vulnerable because Chiron had to throw out its entire supply last fall because of factory snafus. That left Sanofi-Aventis as the only approved flu-shot supplier. GlaxoSmithKline (nyse: GSK - news - people ), a major producer of flu shots aboard, hopes to enter the U.S. flu vaccine market next fall, pending regulatory approval.

The biotech firm MedImmune (nasdaq: MEDI - news - people ) sells a nasal spray flu vaccine, but it is not approved for very young kids or the elderly. Wyeth (nyse: WYE - news - people ) exited the flu shot business a few years ago, while Merck (nyse: MRK - news - people ) sells other types of vaccines, but not influenza shots.

Past influenza pandemics have hit in 1918, 1957 and 1968. The 1918 pandemic, the worst ever, killed an estimated 50 million people. In a commentary accompanying the New England Journal report, epidemiologist Arnold Monto notes that the bird origins of past pandemic viruses were discovered only after the fact. "This time," he says, "we have been given a warning."
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