U.S. Health Secretary Signs Bird Flu Deals with Laos, Cambodia

WASHINGTON, DC, October 14, 2005 (ENS) - In an effort to avert a global flu pandemic, U.S. Secretary of Health and Human Services Michael Leavitt has signed multi-million dollar agreements with Cambodia and Laos to help strengthen their defenses against avian influenza.

Leavitt and other top officials from U.S. health agencies are on a five nation tour in Asia to raise awareness about the threat of a flu pandemic and the need for the global community to join in a cooperative effort to prevent it.

Director General of the World Health Organization (WHO) Lee Jong-Wook is accompanying the U.S. delegation on the trip to Thailand, Cambodia, Laos, Vietnam and Indonesia.

Leavitt and King

U.S. Health and Human Services Secretary Mike Leavitt (left) confers with the King of Cambodia Norodom Sihamoni on Wednesday. (Photo courtesy HHS)
In the agreement, signed October 11 in Phnom Penh, Cambodia, the United States pledged to provide $1.85 million in assistance to help the Cambodian Ministry of Health bolster the public-health sector and prepare for a potential outbreak of bird flu.

Cambodia is one of four nations where the highly pathogenic avian flu virus H5N1 has crossed the species barrier from birds to humans. Four cases of respiratory infection have ended in four deaths attributed to H5N1.

In Laos, Leavitt signed an agreement for the United States to provide $3.4 million in assistance, with an emphasis on improving capabilities for disease surveillance.

These grants are part of a $25 million assistance plan that the United States has enacted to help improve bird flu prevention and control.

Vietnam, Thailand and Indonesia also have experienced the cross-species leap of H5N1 for a total of 117 confirmed human cases since December 2003, and 63 deaths.

Widespread outbreaks through the region among birds have led to the death or destruction of an estimated 150 million birds, a number that continues to mount.

In most human cases, health officials say people became ill because they had contact with diseased birds. So far, the virus is not easily passed among humans. If H5N1 gains that capability, a global pandemic could result because of the lack of human immunity to the disease.

“It’s a function of having people trained to recognize the signs so that if it happens in a remote village in Laos or in Vietnam, or it happens in the United States for the first time, we are able to see it and respond to it quickly,” Leavitt said in a CNN interview from Vientiane, the capital of Laos.


HHS Secretary Leavitt, Thai Minister of Public Health Charoenrattanakhun Suchai and WHO Director General Dr. Lee speak to reporters at the United Nations facility in Bangkok, Thailand. (Photo courtesy HHS)
Unless there is a rapid response, health officials predict that a mutated form of the avian flu could spread rapidly around the world, with as many as seven million deaths, according to a WHO prediction. Other predictions of the death toll have been much higher.

“There are also consequences for economic growth as well as regional and global security,” said Under Secretary of State for Global Affairs and Democracy Paula Dobriansky, who met with health officials in Singapore October 12.

Dr. Samlee Plianbangchang, WHO Regional Director for the South-East Asia Region, told an audience in New Delhi, India October 6, ”The threat of a pandemic is very real. It is no longer a question of if it will occur. It is now only a question of when? When this happens, human casualties could be in the order of millions, and severe economic losses would result.”

While it is not possible to predict the exact numbers who could be affected in a pandemic influenza outbreak, the three epidemics of the last century provide cause for serious concern.

Dr. Samlee said that two of three pre-requisites to start any influenza pandemic, have already been met. These are emergence of a new virus to which all are susceptible and that the new virus is able to replicate and cause disease in humans. The third pre-requisite, which has not yet happened, would be the ability of the new virus to be transmitted efficiently from human-to-human.

Dr. Samlee said “Low income countries, which are ill equipped to handle a pandemic are likely to be the worst affected.”

Not only would a pandemic make people sick, it would probably overwhelm health care systems, with an urgent need for unprecedented numbers of hospital beds, doctors, health care workers, vaccines and medicines, he said. "This would also likely bring to a grinding halt, normal life, affecting work places, industry, schools, tourism, travel, everything. The economic and social cost it would exact would be truly devastating."

Asian nations are a breeding ground for new influenza viruses, experts say, because of a traditional rural lifestyle that puts humans and domestic birds such as chickens and ducks in close proximity.

The environment provides many opportunities for a virus to be exchanged among species and that creates greater opportunity for a virus to mutate.


Health Secretary Mike Leavitt speaks to reporters after vising a commercial poultry farm in the Saraburi province of Thailand. He is flanked by WHO Director General Dr. Lee Jong-Wook (left) and Dr. Tony Fauci, director of the National Institute of Allergy and Infectious Diseases. (Photo courtesy HHS)
Leavitt and his delegation, which includes Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, are visiting rural locations where the disease has appeared to see the conditions that can give rise to the disease that has killed or caused the culling of 150 million birds in Asia since December 2003..

While international agreements have urged changes in Asian methods of poultry raising, the U.S. delegation will likely see how difficult it will be to bring about such wide-scale change in traditional ways.

WHO confirmed October 13 that 1,700 domestic turkeys in Turkey that died of avian flu had the same deadly strain. Samples collected from the sick turkeys in Kiziksa, Balikesi in Turkey and sent to the OIE Reference Laboratory for Avian Influenza in Weybridge, UK were confirmed to contain the avian influenza virus H5N1. The virus isolated seems to be very close to one of the viruses isolated in Siberia.

Bird deaths in Romania have been attributed to the H5 subtype of avian influenza as further testing is conducted to determine whether the strain is the highly pathogenic H5N1.

These reports verify the steady westward movement of the virus. The virus made its first movement toward Europe in July and August with confirmations of H5N1 in Russia and Kazakhstan.

WHO continues to recommend that travellers to areas experiencing outbreaks of highly pathogenic H5N1 in poultry should avoid contact with live animal markets and poultry farms. Large amounts of the virus are known to be excreted in the droppings from infected birds. Populations in affected countries are advised to avoid contact with dead migratory birds or wild birds showing signs of disease.

Direct contact with infected poultry, or surfaces and objects contaminated by their droppings, is considered the main route of human infection. Exposure risk is considered highest during slaughter, defeathering, butchering, and preparation of poultry for cooking. There is no evidence that properly cooked poultry or poultry products can be a source of infection.