Several European countries have moved their pandemic preparation plans into high gear after reports this summer that the deadly avian flu from Southeast Asia unexpectedly struck birds in six regions in Russia and villages in Kazakhstan. Health officials here are worried that migrating birds will carry the disease to the unprepared Balkan countries in Eastern Europe. The migratory paths continue south, extending the threat to the Middle East and Africa. The virus already might have spread southwest to Romania and Turkey, where thousands of birds were culled or quarantined during the weekend as scientists raced to determine whether it was the same deadly strain that started in Southeast Asia. Countries such as France, Norway and the United Kingdom have ordered enough anti-virals to protect at least 20% of their populations. They are stockpiling masks for emergency workers and increasing surveillance of migratory birds and border checks for poultry products. Though most countries have pandemic plans in place, some countries such as Germany, Spain and Italy have been slow to buy anti-viral drugs. And officials acknowledge that coordination remains weak. "The pandemic plan lays out the state and federal responsibilities, but it is still somewhat confusingly organized," says German Health Ministry spokeswoman Reinhild Meinel. AP Markos Kyprianou The European union" will run a surprise drill before the end of the year to test how its 25 member nations would react in a flu pandemic. "Then we'll know how well these plans work," says Markos Kyprianou, EU health commissioner. Kyprianou's main concern is that not all of the countries "have taken steps to stockpile anti-viral medicines or signed advanced-purchase agreements for pandemic vaccines." Though the risk to Western Europeans is low, there is no human vaccine yet, and this avian virus has behaved like no other. "We've never seen a disease spread out as much as this one has in the past 18 months to two years," says Juan Lubroth, head of the emergency prevention system for the Food and Agricultural Organization, a leading agency for international coordination on animal diseases. European health officials are working to contain the virus, which so far has not infected anyone in the region. But the potential damage is clear: Since the outbreak in 2003 in Southeast Asia, more than 140 million birds have died or been destroyed, about 65 people have died, and financial losses to the poultry sector have topped $10 billion. The current virus, known as H5N1, has not yet mutated to the point at which it can easily spread from person to person. Because the disease is so unpredictable, health authorities are concerned that it could fuel the world's next flu pandemic. "We don't know which virus" will cause it, says Margaret Chan, the World Health Organization's assistant director general for communicable diseases. "Everybody's putting their bets on H5N1 now based on the probability of its occurrence. But influenza is a disease with a lot of uncertainty." And that uncertainty is creating confusion over the seriousness of the threat and what measures should be taken. "To say there will be a new viral pandemic in the human species is certain," says Didier Houssin, France's director general of health. "The question is, when? The events in Southeast Asia give the impression this moment might not be so far away."
