Bird flu has gone global in the past year, spreading beyond East Asia to Europe, Middle East and Africa.

"The virus seems to be very embedded in the environment and, in our view, the risk of a pandemic continues unabated," said Richard Nesbit, WHO's acting regional director for the Western Pacific, speaking to reporters prior to the agency's regional meeting. The fifty-seventh session of the World Health Organization Regional Committee for the Western Pacific will be held in Auckland, New Zealand, from 18 to 22 September 2006.

In the worst-case scenario, 70 million people could die in a flu pandemic.

Bird flu is expected to be a main topic on the meeting's agenda. The H5N1 avian influenza virus has killed at least 144 people since late 2003, and it tends to become more active during the cooler winter months.

New outbreaks among poultry in Cambodia and Thailand, along with continuing problems in Indonesia, are fueling worries. Indonesia reportedly has detected the virus in 260 of its 444 districts. Southeast China is another area of concern. Still, a best-case scenario in which the virus does less harm than in past years is possible.

Vietnam, for example, has made significant progress in combating bird flu, Nesbit noted. Although it is second only to Indonesia in the number of fatalities on record, there has not been a human case of H5N1 in Vietnam since November 2005. The country attributes its success to mass vaccination of poultry and strong political will.

China and Indonesia have stepped up efforts to improve monitoring of animal health in recent months.

At present, bird flu is not highly communicable to humans. Most cases have been the result of direct contact with infected birds. The great fear is that the virus could mutate into a form that easily transmits from one infected person to another. Although this warning has been delivered for so long that people may be tiring of hearing about it, the threat is undiminished, Nesbit emphasized.

A severe flu pandemic could cost the global economy up to US$2 trillion, the World Bank estimates. Developing countries would be worse hit, with mortality rates expected to double those of high-income countries. The World Bank announced a US$15 million grant to Indonesia to help counter the threat there.