WHO puts bird flu drug maker on alert

The World Health Organization has asked the maker of the anti-bird flu drug Tamiflu to be on alert to mobilize its global stockpile of the drug.

india Updated: May 27, 2006 23:27 IST

The World Health Organization has asked the maker of the anti-bird flu drug Tamiflu to be on alert to mobilize its global stockpile of the drug amid three new H5N1 deaths in a family cluster in Indonesia, officials said Saturday. The WHO, prompted by fears of human-to-human transmission among at least six dead relatives in Indonesia, moved for the first time to place Swiss drug maker Roche Holding AG on notice to prepare to distribute its stockpile.

The UN health organization said that a precautionary 9,500 treatment doses of Tamiflu from a separate WHO reserve, along with protective gear, were flown into Indonesia on Friday, but the shipment was not expected to be followed by movement of the global stockpile.

The WHO said the Tamiflu alert was part of its standard operating procedure when the organization has "reasonable doubt" about a situation that could involve human-to-human transmission. If the virus can pass easily among humans, it could cause a pandemic. "We have no intention of shipping that stockpile," cautioned Dick Thompson, WHO spokesman. "We see this as a practice run." Health officials continue to puzzle over why six family members from a village in North Sumatra have died after being infected by the H5N1 virus. A seventh relative who died was buried before tests could be done, but she was considered to be among those infected. Meanwhile, on Saturday, Nyoman Kandun, a director general at Indonesia's health ministry, said that a WHO laboratory in Hong Kong has confirmed five more cases of human bird flu, three of which were fatal.

All five had earlier tested positive for the H5N1 virus in a local laboratory. Bird flu has now infected 48 people in Indonesia, 36 of whom died.

The cluster has attracted huge attention because it is the largest yet reported. Experts have been unable to link the family members to contact with infected birds and tests on poultry in the village have all come back negative. No one else in the village has fallen ill and the virus has not mutated in any way, experts said. The WHO in Jakarta received word from the Indonesian Health Ministry on Monday about the human cluster in Kubu Simbelang village. That led to the organization, headquartered in Geneva, to put Tamiflu's manufacturer on alert, said Jules Pieters, director of WHO's rapid response and containment group in Geneva. "We were quite keen to inform Roche quite timely," Pieters said. "We knew Thursday would be a holiday in Europe and wanted to make sure Roche warehouses would be open."

He said Roche would remain on alert for approximately the next two weeks, or twice the incubation period of the last reported case. Roche spokesman Baschi Duerr said the stockpile, which consists of 3 million treatment courses, is ready to be shipped wherever it is needed at any time.

"We are in very close contact with WHO, even today, and our readiness is geared to be able to deliver," Duerr said. Indonesia's number of human bird flu cases has jumped rapidly this year as public awareness remains low and government commitment has not equaled that of other countries.

Vietnam, the country hardest-hit by the disease, has been hailed for controlling the virus through strong political will and mass poultry vaccination campaigns. No human cases have been reported there since November.

By contrast, Indonesia has raised high concerns that it is moving slowly and ineffectively in containing the disease. The sprawling nation of 17,000 islands has so far refused to carry out mass slaughters of poultry in all infected areas _ one of the U.N. Food and Agriculture Organization's most basic containment guidelines_ saying it cannot afford to compensate farmers. Bio-security measures are virtually nonexistent in the densely populated countryside, home to hundreds of millions of backyard chickens.

The latest confirmed deaths were a 39-year-old man from Jakarta, a 10-year-old girl from West Java and a 32-year-old man, who was the last to die on Monday in the North Sumatra cluster. He was among the extended Indonesian family-- all blood relatives-- who caught bird flu and died.

None of the poultry in the village of about 1,500 people have tested positive for the virus. Health officials have struggled to gather information or take blood samples from villagers, many of whom believe black magic is responsible for their neighbors' deaths. WHO has said limited human-to-human transmission is believed to have occurred in about four previous clusters, but this is the largest.

Bird flu has killed at least 124 people worldwide since the virus began ravaging Asian poultry stocks in late 2003. Experts fear the virus could mutate into a highly contagious form that passes easily among people.

So far, the virus remains hard for people to catch and most human cases have been linked to contact with infected birds.

First Published: May 27, 2006 23:27 IST