Published: December 25, 2005
Human Death Toll from Deadly Bird Flu Strain Still Rising
By Charlene Porter, Washington File 
Indonesia reports two more bird flu deaths, but no human contagion
The first cases of highly pathogenic avian influenza in humans occurred in December 2003, putting international health officials on notice that pandemic influenza could repeat history, sweep the world and cause millions of deaths.
The threat is real in Indonesia, which reported two more deaths from the dangerous H5N1 flu strain to the World Health Organization (WHO) December 23.
Indonesia, one of five nations where this disease has made the leap from animals to humans, now counts 11 deaths from this flu strain. Vietnam has suffered the greatest human loss from bird flu with 42 dead. Cambodia, China and Thailand also have reported cases, with 73 deaths among the five nations, and a total of 141 human cases.
Still No Evidence of Human-To-Human Transmission
Even though the first reports of human disease gave rise to warnings of pandemic influenza and the human toll has mounted, it appears that H5N1 still is not transmissible between humans.
Indonesian officials reported that they are keeping a close watch on the families and contacts of these latest disease victims to see if they too become infected. So far, two weeks after the first signs of illness in their now deceased loved ones, the family members have not shown signs of infection.
Their failure to contract the disease probably means the viral strain has not yet mutated to become a pathogen passed easily from person to person. If H5N1 develops that capability, then a pandemic becomes likely because of the lack of human immunity to this strain, which never infected humans before 1997.
In response to its mounting human toll, Indonesian authorities are beginning a campaign of house-to-house surveillance, according to news reports, on the look-out for sick poultry that could further spread infection among humans.
In Indonesia and many other Asian nations, keeping backyard poultry is common. Health officials say this practice is a significant factor in the human spread of the disease. The close proximity of birds to people also raises the likelihood that H5N1 will mutate and become a virus easily passed among humans.
Pandemic Preparedness
The first reports of human disease officially were documented by WHO in January 2004. The numbers began mounting rapidly, tripling over the next two months. Only one year after outbreaks of severe acute respiratory syndrome (SARS) in Asia, international health officials were keenly aware of how rapidly infectious disease could travel the globe.
Health officials began educating their governments and the world community about the dire human, social and economic consequences of pandemic influenza. Nations around the world gradually have come to take the warning seriously, and are intensifying preparations for outbreaks of disease.
In October, the United States convened the first meeting of the International Partnership on Avian and Pandemic Influenza with participation from almost 90 nations and all the major international organizations responsible for monitoring animal and human health. (See related article.)
The partnership is working to elevate the avian influenza issue on national agendas; coordinate efforts among donors and affected nations; mobilize resources; improve disease reporting and surveillance; and build local capacity to identify, contain and respond to an influenza pandemic.
In November, the Bush administration appealed to the Congress to provide more than $7 billion dollars in emergency funding to strengthen pandemic preparedness. The U.S. Senate favored at least that level of funding to increase stockpiles of anti-viral medications, improve the nation's vaccine manufacturing capability and assist other nations in detecting and responding to disease outbreaks. (See related article.)
The U.S. House of Representative could not agree to a $7 billion preparedness plan at a time when budget cuts were being made elsewhere. Congress went into recess for the Christmas and New Year's holidays having passed a bill with $3.8 billion devoted to pandemic preparedness. (See related article.)
Source: U.S. Department of State
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