Governments, pharmaceutical companies and scientists need to work together to hurry the manufacture of an adequate supply of anti-flu vaccines, says WHO.

Worse Than SARS

Xavier-Meslin called it a "very highly contagious disease compared to SARS," which killed 774 and infected nearly 8,000, mostly in Asia, in 2003, according to the AP report.

He was speaking to a group of officials from from Japan, China and South Korea, as well as the member nations of the Association of Southeast Asian Nations, or ASEAN -- Malaysia, Singapore, Indonesia, the Philippines, Thailand, Vietnam, Brunei, Cambodia, Laos and Myanmar -- who met to consider ways of increasing cooperation among the region's countries to combat the avian flu threat.

Klaus Stoehr, a senior WHO official, told reporters in November that governments, pharmaceutical companies and scientists need to work together to hurry the manufacture of an adequate supply of anti-flu vaccines. He said there were only 300 million doses available worldwide.

Facts on Avian Influenza

Excerpts from WHO's fact sheet on avian influenza:

"Avian influenza is an infectious disease of birds caused by type A strains of the influenza virus. The disease, which was first identified in Italy more than 100 years ago, occurs worldwide.

"All birds are thought to be susceptible to infection with avian influenza, though some species are more resistant to infection than others. Infection causes a wide spectrum of symptoms in birds, ranging from mild illness to a highly contagious and rapidly fatal disease resulting in severe epidemics. The latter is known as "highly pathogenic avian influenza". This form is characterized by sudden onset, severe illness, and rapid death, with a mortality that can approach 100%."

Genetic Changes

"All type A influenza viruses, including those that regularly cause seasonal epidemics of influenza in humans, are genetically labile and well adapted to elude host defenses. Influenza viruses lack mechanisms for the "proofreading" and repair of errors that occur during replication. As a result of these uncorrected errors, the genetic composition of the viruses changes as they replicate in humans and animals, and the existing strain is replaced with a new antigenic variant. These constant, permanent and usually small changes in the antigenic composition of influenza A viruses are known as antigenic "drift".

"The tendency of influenza viruses to undergo frequent and permanent antigenic changes necessitates constant monitoring of the global influenza situation and annual adjustments in the composition of influenza vaccines.

"Influenza viruses have a second characteristic of great public health concern: influenza A viruses, including subtypes from different species, can swap or "reassort" genetic materials and merge. This reassortment process, known as antigenic "shift", results in a novel subtype different from both parent viruses. As populations will have no immunity to the new subtype, and as no existing vaccines can confer protection, antigenic shift has historically resulted in highly lethal pandemics."

Pandemic Due

"Based on historical patterns, influenza pandemics can be expected to occur, on average, three to four times each century when new virus subtypes emerge and are readily transmitted from person to person. However, the occurrence of influenza pandemics is unpredictable. In the 20th century, the great influenza pandemic of 1918-1919, which caused an estimated 40 to 50 million deaths worldwide, was followed by pandemics in 1957-1958 and 1968-1969.

"Experts agree that another influenza pandemic is inevitable and possibly imminent."

Prevention Possible

"Tests for diagnosing all influenza strains of animals and humans are rapid and reliable. Many laboratories in the WHO global influenza network have the necessary high-security facilities and reagents for performing these tests as well as considerable experience. Rapid bedside tests for the diagnosis of human influenza are also available, but do not have the precision of the more extensive laboratory testing that is currently needed to fully understand the most recent cases and determine whether human infection is spreading, either directly from birds or from person to person.

"Antiviral drugs, some of which can be used for both treatment and prevention, are clinically effective against influenza A virus strains in otherwise healthy adults and children, but have some limitations. Some of these drugs are also expensive and supplies are limited.

"Experience in the production of influenza vaccines is also considerable, particularly as vaccine composition changes each year to match changes in circulating virus due to antigenic drift. However, at least four months would be needed to produce a new vaccine, in significant quantities, capable of conferring protection against a new virus subtype."