Avian Flu Reaches North America?

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Indonesian Children Treated for Bird Flu Symptoms Die (Update4)

March 2 (Bloomberg) -- Two Indonesian children and an Iraqi woman who were treated for bird flu symptoms died, local authorities said. The World Health Organization confirmed that the virus killed an Iraqi man.

Hanif Chaya Fitri, 12, died last night after being treated for breathing problems, high fever and swollen lungs, the Moewardi hospital in Solo, Central Java, said today. Fitri's brother died a day earlier. A woman in Iraq's Nasiriya Province may have died of the H5N1 avian influenza virus, government spokeswoman Ibtisam Aziz said in a statement today.

Bird flu has killed at least 94 people since late 2003, and more than 200 million fowl worldwide have been culled or died as the virus spreads across Asia, Africa and Europe, according to the Food and Agriculture Organization. The U.S. government yesterday ordered more flu treatments for its residents in the event of a pandemic.

``If you are a bird, this is already a pandemic,'' Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention, told a congressional hearing in Washington today. ``We're dealing with a highly lethal virus that no one has immunity to.''

The Geneva-based United Nations agency confirmed a 39-year- old Iraqi man who died Jan. 27 had bird flu, after shipping problems delayed testing. Samples from additional patients from the Iraqi provinces of Sulaimaniyah, Basra and Missan are being screened, WHO said.

Pandemic Watch

People most at risk for infection are those who come into contact with poultry during slaughtering, plucking feathers or butchering. Poultry, when properly cooked, is safe to eat, according to the WHO and the Rome-based FAO, also a United Nations agency. At least 174 people are known to have been infected, WHO said.

The WHO is tracking human infections in the event the virus evolves to spread easily from person to person, sparking a pandemic such as the 1918 outbreak that killed 50 million people worldwide. The most recent pandemic in 1968, known as Hong Kong flu, killed 1 million people.

The U.S. government ordered 12.4 million courses of the antiviral drug Tamiflu from Roche Holding AG and 1.75 million of Relenza from GlaxoSmithKline Plc, raising the country's stockpile to almost 20 million courses of treatment. The government's pandemic readiness plan calls for enough Tamiflu to treat one in four Americans, or about 75 million people.

More than 60 countries have ordered Tamiflu, Roche said earlier this year. Sales of the drug more than quadrupled to almost 1.6 billion Swiss francs ($1.22 billion) last year. Roche expects Tamiflu to generate sales from pandemic orders of between 1 billion and 1.2 billion francs this year.

Possible Treatment

Etoposide, a chemotherapy drug used to treat a rare immune disorder, may help people infected with the H5N1 virus, a possibility that should be studied, according to an article in the Lancet today.

Studies of people who died from the virus showed they had similar symptoms and disease features as those suffering from hemophagocytic lymphohistiocytosis, or HLH, which causes the immune system to attack healthy tissue, wrote scientists at Karolinska Hospital child cancer research institute in Stockholm.

In Germany, the total number of bird flu cases has risen to 140, mainly swans and ducks, the Agricultural Ministry said today. Tests also confirmed that an infected cat found near the first detected dead birds on the Baltic Sea island of Ruegen was also killed by the H5N1 strain of the virus, the Federal Research Institute for Animal Health said today.

North America

Nine swans, a duck and a heron have tested positive for the H5N1 strain of bird flu in eastern France, Agence France-Presse reported today, citing the agriculture ministry.

The disease may have its first foothold in North America. The Bahamas, 100 kilometers (60 miles) from Florida, is investigating whether dead birds found there carried the H5N1 virus. Test results from the Bahamian birds may be ready in days. Experts have suggested that migration might bring bird flu to the Americas.

Canadian food authorities quarantined the eight Quebec poultry farms that imported live ducks and hatching eggs from France, which has confirmed H5N1 infections in birds, and collected samples from the farms for testing, the Canadian Press reported yesterday, citing the Canadian Food Inspection Agency. Canada has banned all live birds from France, the Press said.

``We need to expect a bird arriving in the United States with this pathogen,'' the CDC's Gerberding said today.

China, Kenya

In China, Ministry of Agriculture ordered a farm near the city of Guangzhou to destroy all its remaining chickens while an investigation is conducted into why 6,000 chickens there died, the Hong Kong-based newspaper Apple Daily reported today. The outbreak would be China's second in poultry since the beginning of February, the paper said.

Kenya invited international aid organizations and representatives from the U.S., European Union and other governments to a briefing next week aimed at garnering support for its bird flu and pandemic influenza preparations. The meeting, to be held in the capital Nairobi March 6, is part of the government's campaign to raise $91.6 million, said Philip Muthoka, who is heading Kenya's bird flu task force.

No bird in Kenya has yet tested positive for the H5N1 virus, which was first reported in Africa last month. Nigeria, Niger and Egypt have reported outbreaks among wild birds and poultry.