The current pandemic alert phase is still at alert level 3 where a new influenza viral subtype is causing disease in humans but is not yet spreading efficiently and sustainable among humans.N/

Melillo Fenech, Tanya

OAR@UM

Current Status of Avian/Pandemic Influenza The current pandemic alert phase is still at alert level 3 where a new influenza viral subtype is causing disease in humans but is not yet spreading efficiently and sustainable among humans. 20 human cases of infection with the highly pathogenic avian influenza in Turkey have been con finned (3 have died). 18 of them were children between 4-18 years of age. Althcugh virology sampling shows that the H5N I virus is the same as in East Asia, Turkey is seeing a fatality rate of20%, which is lower than the fatality rate observed in Asia, which is around 58%. There has also been a 5th cluster of cases in Indonesia. 20 cases and 13 deaths have been reported in this country. Evidence indicates that patients acquired infection following close contact with infected poUltry. Syria and Iran have destroyed thousands of birds to create a buffer against the spread of the bird flu. Outbreaks of avian influenza in birds Financial ~g are also occurring in Romania, Ukraine, Russia and China. There was a suspected human avian case in Iraq on the 18th January 2006. In Japan, the H5N2 strain has been found in poultry. This is a low pathogenic avian influenza. A number of poUltry workers have also been found to be seropositive to this virus. On the 14th January 2006, the US Centers for Disease Control and Prevention (CDC) announced that two drugs typically prescribed to fight the virus will be ineffective this season and should not be prescribed. The CDC found that amantadine and rimantadine were ineffective 91 % of the time against H3N2 influenza, the dominant strain this season. Resistance to amantadine and rimantadine has been climbing in recent years, particularly in Asia. There has been a huge leap this year (2006) in the United States for reasons that are still unclear. In fact, 2 years ago, 2% of circulating flu viruses were resistant to the 2 drugs. During the last flu season, 11 % were resistant. This season, 91 % of virus samples tested have been found to be resistant. However, 2 other antiviral drugs, Tamiflu® (oseltamivir) and Relenza® (zanamivir) are still effective. Following a recent article in the New England Journal of Medicine, senior World Health Organization Officials have stated that some resistance to Tamiflu® is inevitable as this is expected to happen with usage of antibiotics and antivirals. However this is not alarming. More research is needed to understand whether the dosage regime is contributing towards resistance. Tamiflu® still remains an 'excellent choice' among the limited antivirals available against the HSNl virus. 8J (More regular free updates on the Avian/Pandemic Influenza can be accessed on the TheSYNAPSE Web Portal on http://www.thesynapse.netl) VAIJJES BASED, TRlJSTED FINANCIAL ADVISORS Licensed to conduct Investment Services Business by the Malta Financial Services Authority. Members of the Malta Stock Exchange 4, Marina Court, Giuseppe Cali Street, Ta' Xbiex MSD 14 Tel: 21344243,21344244 Fax: 21341202 ema il: info@bonellofinancial.com 

Current status of avian/pandemic influenza

The situation regarding avian H5N1 virus is only getting worse. Since the beginning of February 2006 affected wild birds - mainly swans - have been recorded, since the beginning of February 2006, in 14 European countries, without involvement of domestic poultry (Austria, Bosnia, Bulgaria, Croatia, Germany, Greece, Hungary, Italy, Poland, Slovakia, Slovenia, Sweden & Switzerland). In France, a commercial turkey farm, adjacent to a site where infected swans were located, has also been found infected. Other countries like Albania, Azerbaijan, China, Egypt, India, Indonesia, Malaysia, Niger, Russia and Romania have poultry affected with the virus.N/