Whilst authorities stress the risk is low, Dutch farmers have been ordered to keep poultry locked up inside, British doctors have been briefed on a nightmare scenario of a human pandemic and France is stockpiling drugs to protect its population.

The H5N1 strain of avian influenza, which surfaced in Hong Kong eight years ago, has killed more than 60 people in Asia, led to the destruction of millions of birds, and has now started to spread west.

What scares experts most is that it could mutate and pass easily between humans -- possibly sparking a pandemic to rival the killer global flu outbreaks of the last century.

Spanish flu -- its origin unknown, but thought to have come from wild birds -- broke out in 1918 and killed 40 million people worldwide. The last major flu pandemic killed some four million in the 1960s and scientists say another is long overdue.

Concerns in Europe have been raised by the recent spread of the disease in birds to Russia and Kazakhstan, although no human cases have been reported there. There are fears the virus could now be carried to Europe by migratory wildfowl.

Memories are still alive of "mad cow" disease that devastated the livestock industry in the 1990s and killed more than 100 people, mostly in Britain.

French politicians, among others, have called for urgent, co-ordinated action on an international scale.

"Would our citizens forgive us, after the mad cow crisis, if we did not learn the lessons from that painful experience and if we could not show we were capable of mounting an effective response?" said French Foreign Minister Philippe Douste-Blazy.

BALKAN GATEWAY

The U.N. Food and Agriculture Organisation (FAO) has said that wild water-birds could be expected to carry the virus over long distances to the Middle East, Europe, Asia and Africa.

It said birds flying from Siberia could carry the disease to the Caspian and Black Sea regions, which along with the Balkans, would form the "gateway to central Europe for the virus".

It said bird migration routes also ran across Azerbaijan, Iran, Iraq, Georgia, Ukraine and some Mediterranean countries, where outbreaks were possible.

The FAO urged countries at risk, particularly along migration routes, to step up surveillance of domestic poultry and wild birds, and to prepare national emergency plans.

"FAO is concerned that poor countries in southeast Europe, where wild birds mingle with others from northern Europe, may lack the capacity to detect and deal with outbreaks of bird flu," FAO's chief veterinary officer Joseph Domenech said.

The European Commission has banned imports of poultry meat and birds from Asia and Russia, and after a meeting in August of veterinary officials, called for increased monitoring.

It said that while the risk of migratory birds carrying the virus to Europe was low, they were likely to fly to countries bordering the Black Sea and possibly Romania and Bulgaria.

But in the Netherlands, home to some of Europe's most intensive farming, the government acted unilaterally and banned poultry from outdoors to minimise any contact with wild birds.

The country, one of the world's biggest meat exporters, suffered an outbreak of the milder H5N7 strain of bird flu in 2003, but the episode still left 30 million birds dead at a direct cost of more than 150 million euros (101 million pounds).

The Commission said member states did not need to follow the Dutch example, but did urge them to boost drug stockpiles.

France has said it would build up stocks of vaccines as soon as they are available and other medicines now, and reinforce airport checks.

"Reserves of anti-viral medicines, vaccines and protective measures for the population will be increased to the levels required to ensure the health of all French citizens," it said.

It said it would also boost stocks of protective face masks from 50 million to 200 million.

French media have said the government had already acquired 5 million doses of the antiviral drug Tamiflu, produced by Swiss pharmaceutical giant Roche, and was planning to raise the level to 14 million by the end of the year.

The drug helps fight flu. The fewer people have the disease, the lower the chance of avian flu mutating and spreading.

Roche has also donated enough Tamiflu to the World Health Organisation (WHO) to treat 3 million people. The stocks are not country-specific but can be used wherever an outbreak occurs.

In Britain, doctors will get information packs this month which will include a 50-page technical guide to help identify bird flu cases in humans and guidelines on containing outbreaks.

Poland has called on the EU to help Russia stop the spread of the virus after its veterinary authorities said it could be soon brought to the country by wild birds.

VACCINE AWAITED

The world's top vaccine firms are making progress in the hunt for a shot that could fight any future spread of a lethal form of bird flu, but it will take time.

Sanofi-Aventis SA of France, the world's largest vaccine maker, is generally viewed as well ahead in the race to disarm the H5N1 strain, following the release of promising clinical trial results last month.

Those tests, carried out in conjunction with the U.S. government, showed its vaccine was effective at stimulating the immune system to fight the bird flu strain.

But other companies, including GlaxoSmithKline and U.S.-based Chiron Corp are also active in the field, along with a number of smaller biotechnology firms and several Asian pharmaceutical companies.

But their products are unlikely to generate windfall profits. Industry analysts believe production constraints and laborious manufacturing procedures will curtail revenues for the foreseeable future.

Source: Reuters - 6th September 2005