Bird flu: World is on the edge

Dr Shigeru Omi, of the World Health Organisation, said at the opening of a three-day United Nations conference on bird flu that the virus has "tightened its grip" on the region and is capable of springing major surprises.

Cases of human infection have been reported in Vietnam, with others likely in Cambodia and Indonesia, while fears are growing that infected migratory birds in China could spread the virus to India and Pakistan.

"We believe we are at the tipping point. Either we ... reverse this trend or things will get out of hand," Dr Omi said. "We must have an all-out war against this virus."

The flu, which has killed 54 people in Asia, currently appears to spread to people only when they come into close contact with sick poultry.

But medical experts fear that the H5N1 bird flu strain could mutate into a form that easily passes between people and trigger a global pandemic because people have developed no resistance to the strain.

"The virus has behaved in ways that suggest it remains as unstable, unpredictable and versatile as ever," Dr Omi said.

The pandemic threat has been enforced by its re-emergence in China's Qinghai province, where it killed 6,000 wild migratory birds last month.

Mr Omi said China must investigate outbreaks in Qinghai more rigorously and show more transparency about the reported misuse of an anti-viral drug on poultry.

Officials there must determine whether apparently healthy birds might have been infected without showing symptoms, Mr Omi said.

China has said it would conduct such testing, but needs international help.

Health experts have warned that migratory geese and gulls in Qinghai could spread the virus when they fly south this summer, possibly to places such as India and Pakistan.

Another concern in China is the use of amantadine, a human anti-viral drug, by farmers on poultry, possibly reducing its effectiveness to treat bird flu in people.

China said last month it was dispatching experts to stop the practice, but has not said how widely the drug - meant to treat humans only - is being misused.

Joseph Domenech, the Food and Agriculture Organisation's chief veterinary officer, said Chinese officials were not being open enough about the situation. "We are asking Chinese authorities to be more trans-parent and give more details," he said.

Dr Omi noted that there have been 64 human cases of bird flu in Asia this year, mainly in Vietnam, compared to 44 cases in 2004. Of the 64, 22 died, compared to 32 fatalities for all of last year, he said.

Vietnam is now "chronically infected," while Cambodia and possibly Indonesia also have reported their first human cases, he said.

Dr Omi said that mass vaccinations of poultry and more efforts to develop new poultry vaccines were needed in order to avoid a human pandemic.

"Avian influenza is not just an Asian problem," Mr Domenech said. "No poultry-producing country is safe from the occurrence of the avian influenza as long as there are pockets of infections in Asia."

Mr Domenech told the conference that Asia needs about 57 million over the next two years to fund a viable programme to fight bird flu, but so far only one-tenth of that amount has been raised.

He said pledges from donors such as the European Union and the United States were "still not enough and still not coming quick enough."

In most of rural Asia, poultry, domestic animals and farmers live in close proximity, often sharing the same room, increasing the chances of the virus jumping species.

Efficient inspections were also recommended to eliminate sick birds from live markets.