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U.S. Eyes Stretching Flu Vaccine

At the beginning of the year, scientists will begin testing whether they can stretch the nation's limited supply of bird-flu vaccine.

They're hoping to do this by pairing an experimental bird-flu vaccine with an immune-system booster.

The National Institutes of Health's infectious disease chief tells a Senate panel that early research with a different vaccine suggests that approach may work. Doctor Anthony Fauci says preliminary testing in 96 people showed that adding the immune-boosting chemical dramatically lowered the required vaccine dose.

Meanwhile, China reported two new outbreaks of bird flu among chickens in its northeastern province of Liaoning, bringing the total number of reported outbreaks in the past month to six.

A major barrier to stockpiling bird flu vaccine is that it requires two huge doses of the vaccine to produce a protective immune response.

Senate Majority Leader Bill Frist also said lawmakers should pass legislation by Nov. 24 to fund U.S. preparations for a possible worldwide outbreak of bird flu or some other super-influenza strain.

That timetable has important implications: President Bush has proposed stockpiling enough of the anti-flu drugs Tamiflu and Relenza for 81 million people. The nation has only enough doses for 4.3 million people in stock, and can't order more until Congress approves the money for it, said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention.

"We need it now," she told a hearing of the Senate Foreign Relations Committee.

In related developments:

  • The World Health Organization on Wednesday estimated that developing vaccines and boosting production of antivirals to fight a flu pandemic will cost about $500 million over the next three to four years. The cost will be in addition to the $1 billion that the World Bank said would be needed to control the current bird flu outbreak and prepare for a possible human pandemic, according to Dr. Margaret Chan, WHO's top official in charge of monitoring bird flu.
  • Vietnam said Wednesday the Swiss maker of Tamiflu has agreed to let the country produce the antiviral medicine early next year, and a U.N. official said a major funding increase could help stamp out bird flu. The agreement with Roche Holding AG would let Vietnam — which has reported most of the 63 known human deaths from bird flu — start as early as next January, said Nguyen Van Thanh of the Health Ministry's pharmaceutical administration department. Vietnam is believed to be the first country to make such an arrangement.
  • China's Premier Wen Jiabao warned Wednesday that the country faces a serious threat from bird flu, since the disease is still not under control despite massive nationwide efforts to stop its spread. Wen, touring the bird-flu affected province of Liaoning in northeastern China, said the effort to stop the virulent H5N1 virus from spreading to humans was "an arduous task," the official Xinhua News Agency reported.
  • Romanian authorities have canceled a fishing ban in the Danube Delta after recent tests revealed no further cases of bird flu in the region, the Agriculture Minister said Wednesday. The ban was meant to reduce the number of people coming into the delta region and was imposed last month after several birds tested positive for the H5N1 subtype of avian flu.
  • In coming days, KFC will have television commercials ready to reassure customers that its chicken is safe to eat if there is a bird flu outbreak. The chicken chain said Tuesday it hopes the spots never have to air, but it's taking no chances in the face of a potential threat to business. "As our investors would hope, we are being proactive in preparing the materials in the event that we need to use them," Jonathan Blum, spokesman for KFC's parent, Yum Brands Inc., said of the spots expected to be shot soon.
  • The European Union's health commissioner praised Thailand's efforts to combat bird flu during his second stop on a four-nation Southeast Asia tour, Thai officials said Wednesday. Markos Kyprianou's main objective on the tour is discussing the H5N1 bird flu strain, which recently spread to Europe and made a resurgence in Asia, where it has devastated poultry flocks and killed more then five dozen people since late 2003.
  • On the vaccine front, U.S. health officials already have hired two companies, Sanofi-Aventis and Chiron Corp., to produce $162.5 million worth of vaccine against the virulent H5N1 bird flu, the strain that has killed at least 63 people in Southeast Asia since 2003. The U.S. government hopes eventually to stockpile enough H5N1 vaccine for 20 million people.

    But a major barrier is that it requires two huge doses of the H5N1 vaccine to produce a protective immune response.

    Chiron recently paired an experimental vaccine against another bird-flu strain, H9N2, with an immune-boosting chemical called an adjuvant. Preliminary testing, funded by NIH, in 96 people showed that adding the adjuvant dramatically lowered the required vaccine dose, results that Fauci called encouraging.

    The next step is to test whether adding the adjuvant to the H5N1 vaccine will lower its required dose, he said.

    Also Wednesday, a World Health Organization session agreed that bird flu had to be controlled through culling and vaccination, and that countries needed to strengthen their surveillance systems to quickly detect and contain any animal or human influenza outbreaks. Countries should set up and test their own national preparedness plans and improve regional cooperation.

    "The minute there are more regions or countries with animal outbreaks or human-to-human transmission, the funding needs will increase hugely," said World Bank Vice President James Adams. He said the meeting provided a good basis for a donors' conference planned for Beijing in mid-January.

    On the closing day of the three-day meeting, the bank said 90 percent of that money should be allocated directly to countries, with the other 10 percent going to international or regional agencies.

    "Let me stress that these are indicative figures; if tomorrow one of these countries (at risk) or a new country is affected, these figures will change," Fadia Saadah of the World Bank said. She added that in the event that the bird flu virus started to mutate and transmit from human to human, "all of these figures will be multiplied by several orders of magnitude."

    Saadah said the costs were based on initial, rough estimates to help the world move ahead as fast as possible in the fight against the disease.

    The figure covers the needs of countries already affected by the bird flu outbreak and those at high risk for the disease, as well as the cost of drawing up pandemic flu plans in countries that don't yet have one.

    The bank said a process to appraise regional proposals should be developed by January.