By Gareth Jones ANKARA, Jan 4 (Reuters) - Turkey said on Wednesday two people had been diagnosed with bird flu in the east of the country, the first human cases outside Southeast Asia and China.

The news was announced by Health Minister Recep Akdag.

The deadly H5N1 strain of bird flu has killed more than 70 people in east Asia since 2003 and forced the slaughter of millions of birds.

Turkey, which lies on the path of migratory birds that are believed to spread the virus, has suffered two outbreaks of the highly contagious disease among poultry in the past three months.

Veterinary experts across Europe have been on alert, culling birds and taking other precautionary measures since October outbreaks in Turkey and Romania.

Most of Europe imposed a ban on imports of Turkish live birds at the time, but the measure was subsequently eased.

Experts say a bird flu pandemic among humans could kill millions around the globe and cause massive economic losses.

The virus remains hard for people to catch, but there are fears it could mutate into a form easily transmitted among humans. (Editing by Ralph Gowling) - alertnet.org

BEIJING, Jan 4 (Reuters) - China confirmed a bird flu outbreak in the southwestern province of Sichuan, a Food and Agriculture Organisation official said, adding cold weather and Chinese New Year holidays could mean more cases to come.

More than 1,800 poultry were found dead on Dec. 22 on a farm in Sichuan's Dazhu county and Agriculture Ministry officials sent to the area confirmed the birds had the H5N1 strain of the virus.

Since then, 12,900 poultry in the region had been culled to try to contain the virus, which is found mostly in birds but which scientists fear could mutate into a form that can pass easily between people, leading to a pandemic.

In response to the latest outbreak, Hong Kong's government said it had stopped processing requests to import live poultry and poultry meat from Sichuan.

Scientists are worried because the virus, although hard for humans to catch, has killed more than half the people reported to have been infected.

Since late 2003, more than 70 people have died in Asia from bird flu and the virus is endemic in poultry flocks in parts of the region, highlighting the urgency in trying to control the disease and prevent more human infections.

"In wintertime, we really are concerned because the risk is higher. The more the environment is ideal for the virus the more outbreaks we are expecting," said Noureddin Mona, China representative for the UN Food and Agriculture Organisation.

China has confirmed seven human cases of bird flu, including three deaths.

Last year, the country had more than 30 outbreaks of bird flu in poultry and culled and vaccinated millions of birds, but officials say the preponderance of small family farms, a lack of well-trained local officials and the world's biggest poultry population will make it hard to contain the disease.

"The problem in China is about 50-60 percent of the poultry is operated on small-scale farms in the backyard, which provides the ideal life for the virus to jump between different species of poultry," Mona said.

He also repeated warnings from the Agriculture Ministry that the risk of the virus spreading could be higher during the Chinese Lunar New Year, which falls at the end of January this year, as meat consumption and the transport of live poultry increases. (Additional reporting by Tan Ee Lyn in Hong Kong) - alertnet.org

ANKARA, Jan 4 (Reuters) - A 14-year-old Turkish boy has died of the H5N1 strain of bird flu, a doctor said on Wednesday, confirming the first human death from the disease outside China and southeast Asia.

Doctors had originally said Mehmet Ali Kocyigit died of pneumonia on Sunday in Van hospital in eastern Turkey.

"He died of the H5N1 strain of bird flu," Huseyin Avni Sahin, head doctor at Van hospital, told a televised news conference. The boy's sister, Fatma, has also been diagnosed as having the disease and remains seriously ill. - alertnet.org

GENEVA, Jan 4 (Reuters) - A senior World Health Organisation (WHO) official said on Wednesday that a 14-year-old Turkish body had probably died of the H5N1 bird flu virus.

"We are pretty confident that unfortunately it is a human case of H5N1," Guenael Rodier, special adviser on communicable diseases at the WHO's European office, told Reuters. - alertnet.org

ISTANBUL, Jan 5 (Reuters) - A second Turkish child from the same family has died from bird flu at a hospital in eastern Turkey where she was being treated, the CNN Turk news channel said on Thursday.

Officials announced on Wednesday that 14-year-old Turkish boy Mehmet Ali Kocyigit had died of the H5N1 strain of bird flu, confirming the first human death from the disease outside China and southeast Asia. Newspapers said his dead sister, Fatma, was 15-years-old. - alertnet.org

By Daren Butler ISTANBUL, Jan 5 (Reuters) - A second Turkish child from the same family died from bird flu on Thursday, officials and doctors said, in the first human cases of the disease outside China and Southeast Asia.

"We lost Fatma Kocyigit this morning," Niyazi Tanilir, governor in the eastern province of Van, said on the CNN Turk news channel. The 15-year-old girl died in hospital at around 6:30 a.m. (0430 GMT).

Her brother, 14-year-old Mehmet Ali Kocyigit, died at the weekend.

Turkish officials said on Wednesday that the cause of death was the H5N1 strain of bird flu.

A top World Health Organisation official said he could not yet confirm this but it was probably correct -- which would mark a dramatic shift westwards for the deadly disease to the threshold of Europe.

Tanilir said one further patient from the family was in a particularly critical condition.

Turkish Health Minister Recep Akdag gave no specific details on the boy's death, in comments before the second fatality, but said samples had been sent to the WHO and Britain for more tests.

If the deaths are officially confirmed as being the result of H5N1, they would be the first outside eastern Asia where more than 70 people have been killed by the disease since 2003.

The virus remains hard for people to catch, but there are fears it could mutate into a form easily transmitted among humans. Experts say a pandemic among humans could kill millions around the globe and cause massive economic losses.

SEVEN FURTHER PATIENTS

Ahmet Faik Oner, a doctor at the hospital in Van near the Iranian and Armenian borders, said that after the latest death seven other people were being treated with similar symptoms.

It was not known yet whether any have bird flu.

Fatma's sister, Hulya, was in a particularly bad condition, Oner told state-run Anatolian news agency.

Doctors had originally said Mehmet Ali died of pneumonia on Sunday in the Van hospital, about 800 km (500 miles) east of the capital Ankara.

In the wake of the bird flu announcement, the hospital tightened up its precautionary measures and closed its children's department to other patients.

All those receiving treatment in Van had come from the same district of Dogubayazit on the Armenian border, the health minister said. People in the remote, rural area live mainly from raising poultry and other livestock.

Turkey, on the path of migratory birds that are believed to spread the virus, has had two outbreaks of the highly contagious disease among poultry in the past three months.

Veterinary experts across Europe have been on alert, culling birds and taking other precautionary measures since October outbreaks in Turkey and Romania.

Most of Europe imposed a ban on imports of Turkish live birds at the time, but the measure was subsequently eased.

In Asia, measures against the disease have included the slaughter of millions of birds. - alertnet.org

ANKARA, Jan 5 (Reuters) - Six people have been sent to hospital in a second province in eastern Turkey with suspected bird flu, NTV commercial television reported on Thursday.

The news follows the death of two teenagers, a brother and sister, in Van hospital in eastern Turkey overnight in the first human cases of bird flu outside China and Southeast Asia.

NTV said the six patients were from Igdir province on the Armenian border, just to the north of Agri province where the two dead children came from. Seven other people from Agri are also being treated in Van hospital for suspected bird flu. - alertnet.org

BRUSSELS, Jan 5 (Reuters) - The European Union has sent a veterinary expert to Turkey to help it tackle bird flu after the disease was found to have killed two teenagers in a remote rural area, the European Commission said on Thursday. Two Turkish teenagers died from bird flu in recent days in a remote rural district near Turkey's border with Armenia, where people live in close proximity with livestock and poultry.

There was the possibility of more suspected cases of bird flu in humans in the area, the Commission said in a statement.

Although experts say more tests are needed to be certain of the virus, all evidence points to it being the H5N1 strain -- appearing to mark a major shift westwards to the edge of Europe of a disease that has killed 74 people in Asia since 2003.

Samples of the diseased poultry would now be sent to the EU's reference laboratory in Weybridge, near London, for tests to be carried out, the Commission statement said.

The Turkish authorities are also sending samples from the human cases to a separate World Health Organisation reference laboratory in Britain to confirm the identity of the virus. - alertnet.org

By Richard Waddington GENEVA, Jan 5 (Reuters) - The World Health Organisation (WHO) on Thursday sent a team of experts to Turkey to help investigate the deaths of two teenagers from suspected bird flu, a senior official said.

The team, which had been requested by Ankara, included epidemiologists who would try to verify the source of the deadly virus which is believed to have killed a brother and sister in a remote rural district of Turkey near the Armenian border.

WHO officials say that there is little doubt that the deaths were due to the feared H5N1 avian virus, making them the first human cases to occur outside China and Southeast Asia.

On Thursday, a second test in Istanbul had supported the findings of an Ankara laboratory that H5N1 was responsible, said Guenael Rodier, special adviser on communicable diseases at the Geneva-based World Health Organisation (WHO).

While a final diagnosis would only come after samples were examined at a laboratory in Britain later this week, the Istanbul lab had used a genetic technique that was as good as a fingerprint of the virus, he added.

"I have no reason not to trust the result," he told Reuters by telephone from the WHO's European headquarters in Copenhagen.

But the WHO, which had been expecting human cases after the virus was detected amongst wild birds and poultry in Turkey and parts of south-east Europe late last year, said that this did not mean a worldwide flu pandemic had become more likely.

Scientists fear that the deadly virus, which still rarely escapes to humans from birds and poultry, could mutate and become more easily transmissable. In this case, it could trigger a global epidemic in which millions of people could die.

H5N1 has killed 74 people in China and southeast Asia since 2003, but virtually all the cases involved people, as in Turkey, who had been in close contact with infected poultry.

Turkish newspapers said officials suspected the 14-year-old boy and his 15-year-old sister were infected by chickens they kept at home.

Tracing the source of the infection would be the job of the epidemiologists, Rodier said, adding their conclusions could be expected within the next five days.

The official said that the United Nations' health agency had no reason yet to raise its global pandemic alert from the current three on a six-point scale.

For the WHO to move to level four, there would need to be evidence of human-to-human transmission, and there was none yet.

"From a distance it looks like we have no need to be concerned as it (the Turkish case) looks very like what happened in Asia, but let the investigators do their job," Rodier said. - alertnet.org

KIEV, Jan 5 (Reuters) - Ukraine suspects a new outbreak of bird flu in the Crimean peninsula, a regional official was quoted as saying on Thursday.

Mykola Kolesnichenko, head of the emergency commission at the Crimean government, told the Fifth television channel, that poultry were found dead on a farm in Solnechnoe village in Crimea. He said officials suspected bird flu but would wait for laboratory tests for confirmation.

Ukraine reported its first outbreak of bird flu in a dozen villages in Crimea, a major stopover point for migratory birds, in late November. Tests from laboratories in Russia and Britain showed it was the deadly H5N1 strain.

Since then more than 62,000 birds have been destroyed in house-to-house checks in about 30 villages across the Crimean peninsula. Officials declared the bird flu outbreak over and lifted the state of emergency at the end of December.

The highly pathogenic H5N1 strain of bird flu is endemic in poultry in parts of Asia where it has killed more than 70 people. Though hard for people to catch, experts fear it could mutate into a form which passes easily from person to person. - alertnet.org

By Mustafa Yukselbaba DOGUBAYAZIT, Turkey, Jan 6 (Reuters) - A third Turkish child from the same family died of bird flu on Friday as the virus which has killed 74 people in east Asia reached the threshold of Europe.

Hulya Kocyigit, 11, was the sister of Mehmet Ali, a 14-year-old boy who died last weekend, and of Fatma, 15, a girl who died on Thursday.

The children lived in a remote rural district of eastern Turkey near the Armenian border. Their six-year-old brother is also being treated for the same disease in the hospital.

Huseyin Avni Sahin, the head doctor at Van hospital where the children died, told CNN Turk 23 people were now being treated at his hospital for suspected bird flu.

The authorities said on Thursday that the victims being treated came from more than one province in eastern Turkey. "Fifteen of them are in bed, one in a critical condition. Eight are able to move about. Most of the patients are children," he said.

The deadly H5N1 bird flu virus remains hard for people to catch but there are fears it could mutate into a form easily transmitted among humans. Experts say a pandemic among humans could kill millions and cause massive economic losses.

The disease has killed 74 people in China and Southeast Asia since 2003. Like the east Asian victims, the Turkish children who died are known to have lived in close proximity with poultry.

In the dead children's home town of Dogubayazit, near the Iranian and Armenian borders, an anxious crowd gathered outside the state agricultural offices to dump sackfuls of dead poultry or to ask for their poultry to be culled.

"After the deaths everybody is scared. We are all getting rid of our chickens and nobody dares eat their meat," said local trader Devlet Kaya.

Agriculture officials wearing face masks and protective white suits carried the sacks away to be culled and dumped in the municipal rubbish tip outside the town, where they are buried in a deep pit and covered with lime.

CULLING CONTINUES

One official said 3,500 poultry had been culled in the district so far and this figure was expected to reach 5,000 by the time the operation was completed on Saturday. However, officials said some families were trying to conceal some of their poultry. Rauf Ulusoy, the state's representative in the town, said 14 people had been sent from the town for treatment in neighbouring Van since the outbreak first emerged at the end of December.

He said the authorities had prepared a leaflet for locals detailing the precautionary measures which they should take against the spread of bird flu and this was being distributed in the town.

Authorities have sent extra supplies of the Tamiflu medicine used against the disease to Van, which is about 800 km (500 miles) east of the capital Ankara.

The World Health Organisation (WHO) has provisionally backed the diagnosis that the children died of the H5N1 strain of bird flu but has said that more tests need to be carried out.

The WHO sent a team of experts to Turkey to help investigate the deaths at Ankara's request and the European Commission said it had sent a veterinary expert to help tackle the outbreak. Samples from Turkish patients were being analysed in Britain.

The WHO, which had been expecting human cases after the virus was first detected among wild birds and poultry in Turkey and parts of southeast Europe late last year, said the latest cases did not mean a worldwide flu pandemic had become more likely. - alertnet.org

JAKARTA, Jan 6 (Reuters) - Indonesia needs nearly $1 billion over two years to fight bird flu, which has killed 11 people in the world's fourth most populous nation, chief social welfare minister Aburizal Bakrie said on Friday.

Officials also said the government planned to set up surveillance posts at every village across the sprawling archipelago to detect any signs of the deadly H5N1 bird flu virus among humans and poultry.

"We estimate we will need around 9 trillion rupiah ($940 million) and the funds will not necessarily come from Indonesia, but from donor countries," Bakrie told reporters.

"Naturally we hope the support will not be in loans, but rather in grants."

Since July, Indonesia has had 11 confirmed deaths from bird flu and five cases where patients have survived.

The H5N1 virus cannot move easily between humans at the moment, but experts fear it could develop that ability and set off a global pandemic which might kill millions of people.

I Nyoman Kandun, director general of disease control at the Health Ministry, told reporters the government planned to have every village covered with surveillance.

He gave no timeframe.

Millions of chickens have died from the disease in Indonesia or been killed to prevent its spread.

Indonesia has many millions of chickens and ducks, with many raised in rural and urban backyards.

The virus has been found in poultry in two-thirds of Indonesia's 33 provinces.

The H5N1 virus has killed more than 70 people in Southeast Asia and China since 2003. It has recently killed three Turkish children, taking the virus in humans to the edge of Europe.

Most victims have died from contact with infected fowl. - alertnet.org

BAKU, Jan 6 (Reuters) - Turkey's eastern neighbour Azerbaijan is to conduct tests to establish if bird flu caused the deaths of poultry in the south of the country, officials said on Friday.

Dead birds were taken for laboratory tests in the capital Baku from the Massaly region after about 200 birds died in two villages, said a spokeswoman for the Ecology Ministry. She said the results should be known on Saturday.

The Massaly region is near Azerbaijan's border with Iran and about 500 km (300 miles) southeast of the remote Turkish district where a bird flu outbreak in humans has killed three children.

"We have received no reports from the relevant authorities about the discovery of bird flu, in the country as a whole or in the Massaly region," Ziyaddin Kazimov, a departmental chief at the State Sanitary Service, told Reuters.

"We are taking all necessary measures to prevent the appearance or spread of this disease in the country," he said.

Azerbaijan has banned poultry imports from Turkey and Iran on public health grounds. - alertnet.org

ANKARA, Jan 6 (Reuters) - Final tests have confirmed two Turkish children who died in recent days were suffering from bird flu, official said on Friday.

Three Turkish children from the same family have died this week. The three have been diagnosed with bird flu according to preliminary tests, but a second set of tests is carried out at a World Health Organisation (WHO) laboratory.

Turkey said earlier that the WHO tests had confirmed three cases of bird flu.

A Turkish health ministry official later told Reuters that one of the three victims tested as positive by the WHO was still alive and came from another family, clarifying the earlier statement.

"Two of the children whose samples tested positive are dead. The third, a girl, is still sick in hospital. She is from a different family but lives in the same area (as the three children who died)," the official said.

WHO spokeswoman Maria Cheng confirmed that was the case. Cheng said further test results from samples taken from other suspect cases in Turkey were expected next week. - alertnet.org

WASHINGTON, Jan 6 (Reuters) - There is no vaccine and drugs are in short supply but Americans may be able to ride out any bird flu pandemic if they stock up on supplies and keep their children clean, the U.S. government said on Friday.

The Health and Human Services Department's checklist illustrates just how little can be done to prevent widespread illness and disruption if H5N1 avian influenza causes a pandemic -- a global epidemic -- this year.

The virus still mostly affects birds, but the deaths of three children in Turkey, if confirmed to have been caused by H5N1, means the virus has now infected people in six countries. The World Health Organization has confirmed 142 cases and 74 deaths from bird flu since 2003.

Experts fear it could mutate into a form that passes easily from person to person, sparking a pandemic that could kill millions. It would cost billions and HHS says it could kill 2 million Americans, close schools for days or weeks on end and disrupt industry and commerce.

Experts say the best way to wait out a pandemic, which could last for months, is to stay away from other people and keep close to home.

"During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters," the HHS guide says.

HHS's "Pandemic Flu Planning Checklist for Individuals and Families", available on the agency's Web site at www.pandemicflu.gov/planguide/checklist.html, advises:

-- Teaching children to wash hands frequently and appropriately, covering coughs and sneezes with tissues, and modeling the correct behavior

-- Having ready-to-eat canned meats, fruits, vegetables, soups, bottled water and cleaning supplies on-hand for an extended stay at home.

-- Having any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes and vitamins.

-- Talking with family members and loved ones about how they would be cared for if they got sick or what will be needed to care for them in another home. - alertnet.org

CHICAGO, Jan 6 (Reuters) - American zoos will act as sentinels to track the spread of avian flu if the lethal virus arrives on U.S. shores, zoo officials said on Friday.

Chicago's Lincoln Park Zoo will bring together about 30 public health and zoo officials on Monday to organize the effort, zoo spokeswoman Kelly McGrath said.

"The reason zoos make good sentinels is because zoos are in every (U.S.) state," she said. "The idea is to be able to project its (avian flu's) path, to track the way the disease is moving."

Zoos played a similar role at the outset of the West Nile virus outbreak a few years ago, she said.

In 2002, West Nile virus killed three Lincoln Park Zoo birds -- two red-breasted geese and a turkey vulture -- and infected two bald eagles that survived.

While zoo animals are somewhat isolated, they are exposed to the public and just as susceptible to disease as any bird, McGrath said.

Officials from the U.S. Centers for Disease Control and Prevention and the departments of Agriculture and Interior will attend the four-day meeting in Chicago, McGrath said.

Avian flu outbreaks have infected birds primarily in Asia and some in Europe, resulting in the extermination of flocks.

More than 70 people, including three recently in Turkey, have died from the illness. Health authorities fear the virus could mutate into a form that could pass from human to human and trigger a pandemic. - alertnet.org

ANKARA, Jan 6 (Reuters) - Turkey's farm minister said on Friday bird flu had been detected in two wild ducks near the capital, Ankara, nearly 1,000 km (700 miles) west of infected areas where three children died of the disease in recent days.

"The disease has been identified in two wild ducks near a dam at Nallihan (about 100 km west of Ankara)," Agriculture Minister Mehdi Eker told a televised news conference called to brief reporters on the situation in eastern Turkey.

The discovery suggests migratory birds may be spreading the disease across the large country, as experts had warned.

Bird flu first surfaced in Turkey last October in a corner of western Turkey near the Sea of Marmara, further west than Nallihan, but authorities declared that infected area clear of the disease last month after imposing quarantine measures. - alertnet.org

By Umit Bektas DOGUBAYAZIT, Turkey, Jan 7 (Reuters) - Turkish Prime Minister Tayyip Erdogan urged people not to hide poultry to escape bird flu culls while residents in the east where three children died of the disease pleaded on Saturday for more help.

A team of World Health Organisation (WHO) doctors who flew to Turkey to investigate the first human bird flu fatalities on the threshold of Europe were stuck in Ankara due to fog.

The European Commission said its laboratory at Weybridge, England, had confirmed that the strain of bird flu found in Turkey is the deadly H5N1 form of the virus.

The virus killed 74 people in east Asia before it claimed the lives of the three children from the same family in eastern Turkey this week. Some of the victims had played with the severed heads of infected birds, doctors said.

Experts plan to study the outbreak for signs the virus was passing from person to person, mutating into a form easily transmitted among humans. Experts say a pandemic among humans could kill millions and cause massive economic losses.

Erdogan urged people not to hide their poultry and promised compensation. He said the government was taking all necessary measures and allocating funds to combat the spread of the disease, CNN Turk reported.

"Peoples' losses will be compensated. Nobody will be allowed to suffer losses," he told reporters on Friday.

"We should not panic. Our people should not be making efforts to hide chickens, turkeys or geese," he said.

GOVERNMENT NOT DOING ENOUGH

The Ministry of Environment and Forests banned hunting of all wild birds throughout Turkey and asked hunters to avoid contact with them.

Despite government efforts, residents complain that even after they ask for assistance, chickens are not being taken away for days. Some say they do not have money to pay for trucks to bring poultry to the city centre for culling.

"We apply to the officials but they don't come to take our chickens. I cannot bring them myself. I have no money," a middle-aged man said in Dogubayazit, the town where the dead children lived, near the Armenian and Iranian borders.

A Reuters reporter saw chickens still walking on the streets, and some escaping just before they were carried in large bags to be buried alive in pits.

Turkish television reported that a prosecutor in the eastern town of Kars had begun an investigation into culling poultry by burning in holes because causing pain to animals is illegal.

Four members of a family from Sanliurfa, near the Syrian border, who fell ill after eating a sick chicken, were in hospital for observation, an official said.

A family of seven people, including five children, from the eastern town of Ardahan, was sent to hospital in Istanbul on Saturday, also on bird flu suspicions.

Elsewhere, people say hospitals are overcrowded and doctors do not examine and treat them adequately, sending them home after brief examinations.

SCEPTICAL

In some areas, trade in poultry continued as normal and people expressed doubts the disease even exists.

A Reuters stringer in southeastern Diyarbakir said people still slaughter chickens on the streets in front of children.

"We don't have bird flu in this city," a man who bought a turkey from a street seller said, showing the bird to cameramen.

A poultry seller complained the government pays 7-9 lira ($5.25-$6.75) compensation for a turkey, which is normally sold for 30 lira in the market, and that is why they do not want to give their poultry to officials for culling.

"These bird flu rumours are produced intentionally to raise lamb sales. There is no problem with our poultry," a street seller said.

(Additional reporting by Selcuk Gokoluk and Mustafa Yukselbaba) - alertnet.org

GENEVA, Jan 7 (Reuters) - The World Health Organisation (WHO) said on Saturday it had confirmed that two children hospitalised in Turkey had contracted the deadly H5N1 strain of bird flu.

A WHO spokeswoman said the children, a 5-year-old and an 8-year-old, were from the same region where three other children died from bird flu this week. She declined to give further details. "A 5-year-old and an 8-year-old have been confirmed with the H5N1 virus, these are children that are already hospitalised," said WHO spokeswoman Maria Cheng.

The virus killed 74 people in east Asia before it claimed the lives of the three children from the same family in eastern Turkey this week.

WHO had confirmed that the two elder children of the family died from bird flu. But, Cheng said, said there was "further testing going on" on blood samples from the third case, an 11-year-old girl who had died.

A team of WHO doctors are in Turkey to investigate the deaths -- the first human bird flu fatalities on the edge of Europe -- but were stuck in the Turkish capital due to fog.

Experts plan to study the outbreak for signs the virus was passing from person to person, mutating into a form easily transmitted among humans. Experts say a pandemic among humans could kill millions and cause massive economic losses. - alertnet.org

ANKARA, Jan 8 (Reuters) - Turkey announced on Sunday that three people had tested positive for bird flu in the Turkish capital, Ankara, marking a further westward advance of the infection towards the frontiers of Europe.

Ankara Governor Kemal Onal told the state-run Anatolia news agency that two children and one adult had been diagnosed with the infection; but it was not clear if they were suffering from the deadly H5N1 strain that has killed three people in the remote east of the country.

The agency said a five-year old boy had been admitted to hospital with suspected bird flu in Corum in central Turkey. The virus had been spreading since October among flocks in Turkey, having advanced from Southeast Asia; but no people in Turkey had been reported infected until last week.

The emergence of human cases of the flu in the Van area, near the borders of Iran and Armenia, raised fears the disease might advance to major Turkish population centres and to Europe.

It seems highly likely that the children who died in Van region caught the virus directly from chickens. But world health authorities are concerned that human exposure to the bird flu could lead to emergence of a mutation allowing easier transmission between humans and raising the prospect of a pandemic. - alertnet.org

By Selcuk Gokoluk ANKARA, Jan 8 (Reuters) - Three Turks were reported to be infected with a deadly strain of bird flu in the capital Ankara on Sunday, a new step in the westward march of the virus from its eastern Asian origins.

The first case of the virus jumping from birds to humans in western Asia emerged in Turkey last Wednesday. Three children in the remote eastern Van region died of the highly potent H5N1 strain that has killed 74 people in east Asia.

Ankara Governor Kemal Onal told the state-run Anatolian news agency that two children, aged 5 and 2, and a 60-year-old adult had been diagnosed with the infection in the capital, about 400 km (250 miles) east of Istanbul, Turkey's densely populated largest city, and the Mediterranean area.

The agency said a 5-year-old boy had also been admitted to hospital with suspected bird flu in Corum in central Turkey.

Two children have already tested positive for the H5N1 strain in Van, about 800 km (500 miles) east of Ankara.

The two infected children in hospital in Ankara were brought from nearby Beypazari after contact with dead wild birds.

Their parents tested negative for the disease, doctors said. A separate family sent to hospital in Istanbul on Friday displaying bird flu symptoms also tested negative.

It seems highly likely the children who died in Van region also caught the virus directly from chickens. But world health authorities worry that human exposure to the bird flu could lead to the emergence of a mutation allowing easier transmission between humans -- and raising the prospect of a global pandemic.

A team of World Health Organisation doctors is in Turkey to help investigate the deaths and look for any signs of transmission between humans. But harsh wintry weather in the Van region is hampering their movements, the WHO said.

Moscow raised the prospect of economic damage to Turkey's vital tourist industry, warning Russians against travelling to Turkey after the human infections.

IRAN SHUTS BORDER GATE

Iran, which borders the Turkish region worst affected by the outbreak, closed one of its border crossings, forcing many Turks travelling there for this week's major Muslim holiday marking the Feast of the Sacrifice to return home, Anatolian said.

Prime Minister Tayyip Erdogan has appealed to Turks to help in a mass cull aimed at stemming the advance of the virus and promised adequate compensation to farmers and families who rely on poultry for their living.

But in the Dogubayazit district hit by the virus, local people have accused the authorities of being slow to act.

A Reuters reporter saw chickens still walking on the streets and some escaping as they were about to be carried in large bags to be buried alive in pits.

The father of the three dead children in eastern Turkey, Zeki Kocyigit, 38, told Reuters they had not known bird flu was still a threat after authorities said they had successfully suppressed an outbreak among poultry in the west of the country.

"Nobody warned us... We thought the bird flu had passed," he said, adding that it was the custom in rural Turkey for families to kill and eat sick birds.

The virus spreads quickly among chickens, killing them in a day, and the best way to control it is immediately to slaughter all poultry in an affected area. This can be difficult in places where, as in eastern Turkey, people keep small backyard flocks.

Poverty also greatly hampers the fight against the disease.

"I did not have the two lira ($1.5) to get Mehmet Ali (their eldest boy) to hospital," his mother Marifet sobbed.

After finally reaching a hospital, the parents watched their eldest son, the first human victim of the disease outside China and southeast Asia, fade fast.

"He died looking at me. He gave me a final kiss just before his death," the father said at their tiny one-room cottage.

"I am the kind of man who says his prayers. Their death was the will of God."

(Additional reporting by Umit Bektas and Baris Atayman in Dogubayazit) - alertnet.org

Sun Jan 8, 2006 5:05 PM GMT By Umit Bektas and Baris Atayman

DOGUBAYAZIT, Turkey (Reuters) - Mehmet Ali helped support his family in this impoverished, bleak corner of eastern Turkey by making candyfloss and selling it to schoolmates. Now the 14-year-old boy is dead, along with his sisters Fatma, 15, and Hulya, 11, the first human victims of bird flu outside China and southeast Asia, and their grieving parents wonder how they can now make ends meet.

"When Mehmet Ali first fell sick, we did not even have the two lira ($1.30) to take him to hospital," his mother, Marifet, sobbed in her native Kurdish. Many women in this mainly ethnic Kurdish region speak little or no Turkish. She thought initially the boy had caught cold because he lacked suitable shoes and clothes for the severe wintry weather. After finally scraping together a few coins to get Mehmet Ali to hospital, doctors gave him syrup and sent him home again, not suspecting he had contracted the deadly H5N1 strain of bird flu which has killed 74 people in east Asia since 2003. His condition worsened, and his siblings also fell sick.

The parents began to suspect that the sick chickens the children had killed and eaten might be to blame. Doctors say the children had also played with the heads of the dead poultry.

"It is our custom here to kill and eat sick birds... Nobody warned us (about the risks)," Zeki Kocyigit, the 38-year-old unemployed father, told Reuters in the small concrete mountain shack that is their home.

The house has no running water and they rely on a spring. A partitioned section of the backyard serves as a toilet.

Their eight chickens had lived in a small coop next to the house, in the Turkish tradition. Some experts speculate that the reason children account for many of those testing positive for the virus now in Turkey is because children traditionally tend the poultry and can squeeze into the coops, unlike the adults.

"We heard that bird flu problem had struck in Manyas (in western Turkey) but that it was over," said Kocyigit.

Authorities declared Turkey free of bird flu in December, two months after reporting the country's first outbreak in Manyas, more than 1,000 km (600 miles) west of Dogubayazit. They culled thousands of poultry, but no humans fell sick.

"WILL OF GOD"

Mehmet Ali died on New Year's Day. Fatma died on January 5, Hulya on January 6. Only their six-year-old brother, Ali Hasan, has survived.

"He died looking at me. He gave me a final kiss just before his death," Mehmet Ali's father said.

His wife Marifet said she especially mourns her eldest daughter Fatma. "I am left alone. She was my everything. She was my friend, she helped with all the housework," she said.

Although health workers have been culling poultry in the town of Dogubayazit since Mehmet Ali died a week ago, chickens can still be seen near the Kocyigit family home. Some local people are hiding their poultry, even though the government has promised full compensation for those culled. Other birds have simply escaped capture.

The locals stare in amazement at the veterinary experts and journalists from distant Ankara and Istanbul dressed in special white overalls, boots, gloves and face masks as a precaution. Zeki said he hoped the government would help find him a job so that he can provide properly for their surviving child. In his grief, he also sounded a stoical note.

"I am the kind of man who says his prayers. Their death was the will of God," he said. - reuters.co.uk

Last Modified: 8 Jan 2006 Source: ITN

Three cases of the lethal strain of bird flu have been confirmed in the Turkish capital Ankara.

Scientists say this is a new stage in the westward sweep of the disease from its east Asian origins towards major economic centres in Turkey and Europe.

The first case of the virus jumping from birds to humans outside China and southeast Asia occurred last week in rural eastern Turkey, where three children from the same family died after contracting the highly potent H5N1 strain.

As doctors confirmed that two children and a 60-year-old man were being treated in Ankara for the virus, Russia raised fears of the disease impacting Turkey's economy by warning its citizens against visiting the popular holiday destination.

Doctors said the infected children, aged 5 and 2, came from Beypazari west of Ankara and had caught the virus after contact with dead wild birds. Their parents tested negative.

Ankara is about 250 miles east of Istanbul, Turkey's densely populated commercial and tourism hub, and from the continent of Europe.

Officials said the culling of birds had begun in the Ankara districts hit by bird flu. - channel4.com

09 January 2006 - A reported proposal that the most dangerous prisoners should remain locked away and left to take their chances if an Asian bird flu pandemic hit New Zealand has been attacked by civil libertarians.

The proposal is contained in Corrections Department contingency plans to deal with the country's 7500 prisoners in the event of a pandemic, it was reported yesterday. The plans included releasing low-security prisoners but leaving the most dangerous inmates at the mercy of the disease, which has killed 70 people worldwide since 2003. Also under consideration was sealing entire prisons for six weeks, with no one allowed in or out and the dead being buried in mass graves.

New Zealand Council for Civil Liberties chairman Michael Bott said he had not been aware of the proposals so could not comment in detail. But, as a matter of principle, the state had an obligation to look after those in its care.

"The state had a moral obligation to look after the people in its charge, and that includes prison inmates," he said. "It cannot just wash its hands because there's a natural disaster. The right to life is fundamental."

Mr Bott also said it made sense during a natural crisis to release inmates who were less of a threat to the community. That could pose a legal problem, however, because it was ordinarily the Parole Board that made the decision to free inmates.

Bevan Hanlon, president of the Corrections Association, the prison officers union, said a "brainstorming" document proposed that prisoners who might be freed included those nearing the end of their sentences. Others might be those convicted of relatively minor crimes such as drink-driving, he said.

Another option was to isolate entire prisons, with prison officers being locked in with inmates, and only medical staff allowed to come and go. Mr Hanlon said the Corrections Association wanted prison officers to be on the list of those guaranteed supplies of the anti-viral drug Tamiflu.

Because inmates were close together, disease spread quickly through prisons, he said.

The Health Ministry has estimated that, in the most severe scenario involving Asian bird flu, up to 40 per cent of New Zealanders could contract the disease, resulting in up to 33,000 deaths. - stuff.co.nz

[from this source]

The U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention have developed a checklist for businesses to use when preparing a pandemic plan.

Here are a few points from that list.

* Identify a pandemic coordinator and a team with defined roles and responsibilities for preparedness and response planning. The planning process should include input from labor representatives.

* Identify essential employees and other critical inputs such as raw materials, suppliers, subcontractor services and products, and logistics that are required to maintain business operations by location and function during a pandemic.

* Determine potential impact of a pandemic on company business financials using multiple possible scenarios that affect different product lines and/or production sites.

* Determine potential impact (quarantines, border closures, etc.) of a pandemic on business-related domestic and international travel.

* Find up-to-date reliable pandemic information from community public health, emergency management and other sources and make sustainable links.

* Establish an emergency communications plan and revise periodically. This plan includes identification of key contacts (with back-ups), chain of communications (including suppliers and customers) and processes for tracking and communicating business and employee status.

* Implement an exercise or drill to test your plan, and revise the plan periodically.

* Forecast and allow for employee absences during a pandemic due to factors such as personal illness, family member illness, community containment measures and quarantines, school and/or business closures, and public transportation closures.

* Implement guidelines to modify the frequency and type of face-to-face contact (i.e. hand-shaking, seating in meetings, office layout, shared work stations) among employees and between workers and customers (refer to CDC recommendations).

* Encourage and track annual influenza vaccinations for employees.

* Establish policies for employee compensation and sick-leave absences unique to a pandemic (i.e. nonpunitive, liberal leave), including policies on when a previously ill person is no longer infectious and can return to work after illness.

* Establish policies for flexible work site (such as telecommuting) and flexible work hours (including staggered shifts).

* Anticipate employee fear and anxiety, rumors and misinformation, and plan communications accordingly.

* Provide information for the at-home care of ill employees and family members.

For the complete checklist, visit the Web site www.pandemicflu.gov/plan/pdf/businesschecklist.pdf

Mon Jan 9, 7:08 AM ET ANKARA (AFP) - Five more people have tested positive for the lethal H5N1 strain of bird flu in Turkey, raising to 14 the number of people confirmed as infected with the disease.

A senior ministry official told AFP on the condition of anonymity that the tests at Turkish laboratories had identified the five as carriers of the H5N1 strain, which is potentially deadly to humans.

Two children have already died of the disease in eastern Turkey. Four of the new confirmed infections, all children or teenagers, come from the northern provinces of Samsun, Kastamonu and Corum. The fifth comes from the eastern province of Van, Turan Buzgan, the head of the ministry's basic health services department, told Anatolia news agency. The two cases from Kastamonu -- two siblings, aged four and five, currently hospitalized in Ankara -- have not yet shown any sign of illness, Buzgan told Anatolia. A five-year-old from Corum, initially treated for pneumonia, was brought to the same hospital in Ankara and is now improving. A 12-year-old, who had been in close contact with sick poultry, is currently undergoing treatment in Samsun, Buzgan said. The fifth patient, aged 18, was hospitalized in Van, where two children in the same family died from the H5N1 virus last week. A third child from the same family also died but the cause of her death is yet to be established. news.yahoo.com

9th Jan 2006 - DOGUBAYAZIT, Turkey (Reuters) - There are no signs that the bird flu virus spreading in Turkey is being passed among humans, the World Health Organization (WHO) said on Monday.

The WHO has confirmed four human bird flu cases in Turkey, including the deaths of two siblings last week from Dogubayazit in the poor eastern part of the country.

"At the moment there is no element in this village indicating human-to-human transmission. It's typically similar to what we have seen so far (in Asia)," Guenael Rodier, heading the WHO's mission to Turkey and a specialist on communicable diseases, told Reuters Television.

The WHO team is visiting eastern Turkey to investigate the situation and to advise on measures to combat the disease.

Turkey has reported a spike in suspected bird flu cases among people across the country, fanning fears the deadly disease is sweeping westward toward mainland Europe.

Health Minister Recep Akdag said 14 people had so far tested positive for the virus, including the three dead children. "The more humans are infected, the more chance the virus has to adapt itself to humans, that's why we need to minimize the human cases, and the best way to do that is to control the disease in animals," Rodier said.

He said villagers and children had been infected after close contact with chickens carrying the deadly virus, similar to how the H5N1 virus has jumped from birds to humans in Asia since late 2003. news.yahoo.com

Jan 9th 2006 - A 39-year-old man has died of bird flu in Indonesia, the government has said.

Local tests showed the man died of the H5N1 virus last week, after being in contact with dead chickens.

The World Health Organization has yet to confirm the result, but if it does, the country's bird flu human death toll would now stand at 12.

Bird flu has killed more than 70 people in Asia since its resurgence in late 2003 - and the disease has now spread outside the region. Turkey is the latest addition to a string of countries which have suffered human fatalities through bird flu. At least two children have recently died of the H5N1 strain in the east of the country.

Some experts fear bird flu could mutate into a form that is transmitted easily between humans, leading to a pandemic.

Indonesia's government said last week that the country needed nearly $1bn in the next two years in its fight against bird flu. BBC

Mon Jan 9, 2006 NEW YORK (Reuters Health) - Although human bird flu infection is believed to be a rare, life-threatening disease, a study in Vietnam suggests that the infection rate may be higher than was previously thought, often causing relatively mild respiratory symptoms.

In a report in the Archives of Internal Medicine, Dr. Anna Thorson and her associates note that high death rates are derived from avian flu patients admitted to hospitals in major cities. The researchers believe that the true occurrence and mortality rates are unknown, since there have been no studies assessing exposure to the virus and disease in a population-based setting.

The authors conducted a survey in Bavi, a rural district in Vietnam in which there had been confirmed outbreaks of severe bird flu among poultry. Included in the study were 11,942 households with 45,478 inhabitants, interviewed between April 1 and June 30, 2000.

Subjects were asked about the occurrence of cough and fever during the previous six months as well as contact with poultry. A total of 8,149 reported having had a flu-like illness.

Having contact with sick or dead poultry was strongly associated with flu-like-illness. Among young and middle-aged adults direct contact with such poultry more than doubled the risk of a flu-like illness.

Thorson, from the Karolinska Institute in Stockholm, and her team estimate that between 650 and 750 cases could be attributed to direct contact with sick or dead poultry.

SOURCE: Archives of Internal Medicine, January 9, 2006. - reuters

From Suna Erdem in Istanbul

Attempts to halt the spread of the avian virus are being met with ignorance and hostility

CHICKENS splash in the mud among the rain-soaked shanties of the Kucukcekmece district of Istanbul. They face death in municipal gas chambers - if anyone can catch them.

A team of 20 men in special suits moves purposefully among the buildings, collecting domestic fowl to be culled, but many remain at large as night falls. Not all the owners are co-operative - one man tore off the head of his pigeon rather than hand it over, while another chased his hens away as the culling team approached.

"If they want my birds they can pay for them," mutters a burly man, part of the large crowd watching the operation, reluctant to surrender his livelihood so easily. "Do you want your children dead then?" a young woman reprimands him.

The cull is part of measures to rid Turkey's largest city of the bird flu virus which has been recorded as spreading rapidly across the country since three children in eastern Turkey died of the disease last week, becoming the first human victims of the deadly H5N1 avian flu virus outside East Asia.

Several children are among the 12 people being treated for confirmed avian flu across the country. There are another 78 suspected cases. The virus's appearance in Istanbul brings it to the easternmost point of the European landmass.

There are no human cases so far here, but the capital Ankara was hit at the weekend: a pensioner who kept chickens and two young boys are in hospital. The boys have proved positive for the virus, even though they show no symptoms. They appear to have contracted it after playing with gloves used by their father and uncle to handle two infected dead wild ducks. Dozens more are under observation in hospitals - from the eastern city of Van, where the children died, to northwestern Istanbul. Several hundred panicky people have been to hospital "just in case".

There was some good news for the Kocyigit family from eastern Dogubeyazit province, who lost three children to bird flu: their six-year-old son, Ali Hasan, has been declared free of the virus.

So far more than 100,000 birds have been killed in 11 eastern provinces, but yesterday it was the turn of Istanbul, where around a sixth of the population lives. Muammer Guler, the governor, has declared a quarantine zone and mass culls in three districts, including Kucukcekmece, while a further six districts around water reservoirs are under observation. "We urge you not to touch domestic fowl in the areas marked out for culling. Shut up their coops and wait for the culling teams to arrive," Mr Guler said.

Although health officials are nervously watching for any signs that the virus has mutated into a form that can pass from human to human, so far all cases in Turkey involve direct contact with infected birds.

The way to stop the spread, they say, is seemingly simple but almost impossible to implement: to put an end to the haphazard method of rearing birds in backyards, streets, even in homes, which can be seen mainly in rural Turkey but also in shanty suburbs such as Kucukcekmece. The belief is that such free-ranging birds can easily come into contact with the migrant birds thought to have brought the disease to Turkey.

"Since our country is on the migration route we may well come across this issue in the years to come. Therefore we must consign the idea of 'village hens' and 'village eggs' to history," Recep Akdag, the Health Minister, said.

Advice is plentiful. The Agriculture Ministry has prepared a public information film giving warning of the dangers of keeping and slaughtering one's own birds. Newspapers are overflowing with advice urging people to avoid all contact with birds, to buy pre-packaged poultry products only and to look out for symptoms of the flu.

The press has been full, too, of shocked articles about people from impoverished areas still handling chickens and turkeys. The coverage has scared some into drastic action, including families who shoved their live chickens into bags and threw them into the street and those who hurled dead poultry into a stream.

Birds are widely feared. In the town of Sakarya, residents were stranded outside when a small duck got into the stairway of their flats. The residents refused to enter until a municipal official removed the bird. One district after another is banning the sale of unpackaged bird meat and eggs, but local markets are slow to put this into practice. Those buying and rearing their birds in this way are invariably poor.

The Kocyigit family from Dogubeyazit said they killed their sick chickens and ate them because they could not afford anything else.

The cull has sparked defiance in some, reluctant to destroy their source of food and income, and distrustful of official pledges of compensation.

So many birds have been hidden from culling teams that creative measures have to be taken. Two men were fined in Igdir province, while in Dogubeyazit a local governor has resorted to bribing children to reveal where their parents have concealed poultry. The mayor visited weddings to urge guests in Turkish and Kurdish to co-operate with the culling teams for the sake of their children.

In Zonguldak, a northern province on the Black Sea, a district agriculture official berated villagers who had failed to shut up their hens. "You had better all drop dead then!" he yelled in his frustration. "You drop dead," the men yelled back.

A man from Van told one newspaper that he would rather hand over his wives than his chickens. - times online

Further human cases are expected; USAID works on preparedness

By Charlene Porter Washington File Staff Writer

Three children are dead in rural eastern Turkey, setting off alarms about the appearance of human cases of bird flu on Europe's doorstep.

The three deaths struck the same family in the rural community of Dogubayazit, with three siblings dying in less than a week. A fourth child in the family has survived a bout of the illness. A total of 14 human cases of disease caused by the highly pathogenic avian influenza virus known as H5N1 have been confirmed in Turkey, according to a January 9 update from the World Health Organization (WHO).

In Van province, where the young siblings died, 38 more people are being treated for what could be H5N1. Turkish and international officials are working together to achieve confirmation. Outbreaks in poultry are occurring in several parts of the country at the same time, and the WHO statement says suspected human cases of H5N1 infection are expected to increase.

Turkey is the sixth nation to discover human cases of H5N1, the first outside East Asia, where this dangerous pathogen first started killing poultry two years ago. The number of human cases has crept upward steadily over the last few months, at 146 as of January 7, with 76 deaths, according to WHO.

The WHO statement said there is no evidence so far that the virus has become contagious among humans. The latest victims – the dead and the ailing – almost all have what WHO describes as "a documented link to dead or diseased poultry."

As human cases of bird flu have mounted over the past year, international health officials have warned that this flu strain may have the potential to spread across the globe to become an influenza pandemic comparable to that which killed tens of millions in 1918-1919.

As first news of the human cases emerged from Turkey, U.S. Health and Human Services (HHS) Secretary Michael Leavitt reiterated the U.S. commitment to work with the international community to combat disease.

"We will continue our vigorous efforts in concert with the WHO Secretariat, its regional offices and other international partners," Leavitt said in a January 5 HHS statement, "to track the global spread of the H5N1 influenza virus and to detect human cases as early as possible."

The WHO statement on Turkey is available on the WHO Web site.

PANDEMIC PREPAREDNESS

The discovery of human bird flu cases in a nation thousands of kilometers from where the disease originated highlights the virus's ability to spread.

Though still apparently not contagious among humans, the virus finds many means of travel – in flocks of migratory wild birds, in shipments of infected birds in agriculture trade or in the mud and dust that travel on a truck from an infected farm. Just as the virus has spread, so has awareness among world governments of the need to prepare for the possibility of pandemic and improve their ability to understand and control diseases that may pass from animal to human populations.

The U.S. Agency for International Development (USAID) is engaged with many governments to support and enable these activities. USAID worked in December 2005 to provide training for 5,000 veterinarians and volunteers in Vietnam, a nation with 93 human cases of H5N1, the highest number of any single nation by far. These groups are learning to recognize the connections between animal and human health and the need to remain alert for signs of disease moving among species. That is the key advice that international health authorities have issued on how to detect, contain and prevent disease spread to avert a pandemic.

In January, USAID will support community-based activities that offer village demonstrations on methods for preventing and containing disease in 16 at-risk provinces in Vietnam and Cambodia, according to a December 19 summary of its activities. (See summary on USAID Web site.)

Experts say that avian influenza has hit Asian nations so widely because traditional methods of raising and selling poultry provide significant opportunities for the disease to pass among animals and people.

The potential of avian influenza to arrive in Africa is another grave concern because infrastructure for both animal and human health care is below international standards there. Systems for disease detection and surveillance among animals or humans are weak, giving diseases a chance to spread rapidly through people, their livestock or both. USAID is supporting a program to improve surveillance in Ethiopia, one of the countries that is considered at greatest risk because of populations of migratory birds that fly in from the north.

The U.S. agency is providing assistance to the ministries of agriculture and health in their work to develop better laboratory and communications capacity.

In Tanzania, health officials are taking what the USAID document describes as "aggressive measures to stop potential bird flu cases." The Tanzanian government is enforcing a ban on poultry and poultry products from affected countries. A program to examine migratory birds for signs of H5N1 also is under way with USAID support.

Additional information is available on the USAID Web site.

U.S. PREPAREDNESS

In the United States, HHS Secretary Leavitt is spreading the preparedness message far and wide as he works through a schedule of meetings with state and local officials in all 50 U.S. states.

At a meeting in Arizona January 6, Leavitt released a new citizens' guidebook, Pandemic Influenza Planning: A Guide for Individuals and Families, a tool to help Americans understand the threat of pandemic influenza and specific actions they can take to protect themselves and their families. - usinfo.state.gov

By Andrew Jack Financial Times Jan. 9, 2006

HSBC, the world's third largest bank, is estimating that up to half of its staff could fall ill or be absent from work at the peak of the next flu pandemic, as Europe began to come to terms with the first human cases of the H5N1 bird flu virus on its doorstep. The 50 per cent figure is double the rate forecast in draft guidelines for businesses being drawn up by the World Health Organisation. They will advise planning for 25 per cent absence, and the HSBC estimate is the most explicit warning yet that governments may be underestimating possible disruption.

The projections from HSBC – which the bank's head of crisis management expects to be the template for other multinationals – come as the WHO on Monday confirmed at least two human deaths from the current H5N1 bird flu strain in Turkey.

They are the first cases in Europe and fuel fears of a mutation of the virus that has now claimed at least 76 lives in six countries. Turkish officials on Monday said 14 cases of bird flu had been identified from at least 30 suspected cases believed to have been contracted from birds in the east of the country.

The tabular content relating to this article is not available to view. Apologies in advance for the inconvenience caused.The WHO said it is treating them as "preliminarily positive" subject to confirmation from an international laboratory.

Bob Piggott, head of group crisis management at HSBC, told the Financial Times he was devising ways to cope with as little as 50 per cent of normal staff during a pandemic wave that could last for up to three months. "None of us knows the virulence of the virus, but I would rather be prepared for the worst," Mr Piggott said. He said severalother banks were "moving towards" similar estimates for absences, as they began to step up their preparations for a flu pandemic.

The figures are important as a rare public insight into estimates made by a top company – one that has considerable experience, given its activities across 77 countries including those in Asia and Canada affected by the Sars crisis in 2003. They stand in sharp contrast to official calculations, with the UK government recently downgrading its estimate to an average of 8 per cent of the workforce absent at any one time and 25 per cent cumulatively throughout the pandemic.

Mr Piggott said HSBC has devised plans to boost working from home, teleconferencing and office cleaning once an hour in an effort to limit infection. He added that, alongside employees who stayed at home for at least a week with the flu, many would be off recovering from secondary infections. Others would be absent caring for family members and children taken out of school, or avoiding transport and work to avoid infection.

While recent surveys have indicated that employers are beginning to perceive a flu pandemic as a risk to their operations, few have yet made formal contingency plans on how to respond. FT.com via msnbc

By Zhang Feng (China Daily) Updated: 2006-01-10 06:07

China's Ministry of Health yesterday announced the country's eighth human case of H5N1 bird flu. The infected patient was a 6-year-old boy surnamed Ouyang in Guiyang County of Central China's Hunan Province, according to a report released by the ministry.

The infected boy is being hospitalized and his condition is stable, the ministry said. Investigation found domestic foul raised by Ouyang's family had died before he showed symptoms of fever and pneumonia on December 24, the ministry said.

Ouyang's samples tested positive for the H5N1 virus by the Centre for Disease Control and Prevention of China, said the ministry. Ouyang has been confirmed to be infected with bird flu in accordance with the standards of the World Health Organization and the Chinese Government, the ministry said.

Trial of made-in-China vaccine

The first round clinical trial of the made-in-China human vaccine against the H5N1 strain of avian flu is expected to be completed this April, an expert announced yesterday. The clinical trial will let doctors know whether the vaccine is effective and safe, Lin Jiangtao, a doctor from the Beijing-based China-Japan Friendship Hospital, said.

Dr Lin is in charge of carrying out the first round trials, which started on December 21, 2005, in his hospital among 120 volunteers. These healthy volunteers, aged between 18 and 60 and all from Beijing, will be separated into four groups. In each group, six people will be given the vaccine first. If they show no adverse symptoms, like serious allergy, the other 24 people of the group will be administered with the drug.

Currently, all the volunteers in the first group and the first six people from the second group have taken the vaccine and have not shown any adverse results, Lin noted. The other 24 people of the second group will take the vaccine this week. All the volunteers will take the vaccine within two months if there are no unhealthy indications observed during the process. Before April, 2006, a test will be performed on blood samples taken from all the volunteers. The test will aim to check whether an antibody has developed in the bodies of the volunteers, Lin noted. - china daily

By Nigel Hawkes Jan 10th 2006 -

THE symptoms of flu start quickly and include headache, chills, dry cough, aching body, fever, a stuffy nose and a sore throat. Avian flu is little different, but it may also include symptoms such as eye infections, pneumonia and severe breathing difficulties.

Flu is generally a more serious infection than people realise. So many minor infections, such as that caused by respiratory syncytial virus, are commonly self-diagnosed as flu that most patients have forgetten what real flu is like.

In Britain at present, avian flu is non-existent, and ordinary seasonal flu very uncommon. For the sixth winter in a row, flu activity has been very mild and this year has not come close to exceeding the baseline of 30 cases per 100,000 population.

This time of year is normally the peak, so it will soon be possible to say that another flu season has passed without serious levels of disease. Not since the winters of 1999-2000 and 2000-01 has there been a hint of an epidemic. This neglects the fact that the flu circulating has changed relatively little from season to season, and is generally well-matched by the vaccine. But a new pandemic strain deriving from avian flu - if it emerged - would be different and far more dangerous. The low level of seasonal flu may be partially attributable to flu vaccination, which reached higher levels than ever this year.

The vaccine would not protect against a pandemic strain, for which a totally new vaccine would need to be produced at top speed. Whether this is possible is still in doubt - and even if such a vaccine could be made, production capacity could satisfy only a small fraction of the world's population. - times online