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The World Health Organization and the U.S. Senate ratcheted up concern Thursday for a possible avian influenza pandemic as Indonesian authorities announced as many as 63 people may have the illness, with six deaths, the largest suspected outbreak on record.
The new cases are in addition to the WHO count of 60 confirmed deaths and 116 illnesses in people since December 2003, when the A-H5N1 virus began to move through poultry flocks in Asia.
In the latest Indonesian outbreak, lab tests have confirmed the virus in only four victims, three of whom died. But the additional potential cases ---some of whom remain hospitalized, while others have recovered --- are fueling alarm within Indonesia and in the industrialized world.
In Washington, the Senate voted Thursday to provide $4 billion to the Centers for Disease Control and Prevention to stockpile vaccines to protect against the disease. The proposal was tacked onto next year's $440 billion defense spending bill, which could come up for a vote next week.
If the virus mutates and develops the ability to spread from person to person, global health officials warn, it could trigger a worldwide outbreak that could kill millions of people.
The proposed CDC allocation was a victory for Democrats, who sponsored the measure, saying they fear the United States is not ready for a bird flu outbreak.
"If we have learned anything from the recent disasters on the Gulf Coast, it is that we must confidently prepare for disasters before they strike so that we are not left picking up the pieces," said Sen. Tom Harkin (D-Iowa), the sponsor.
About $3 billion would be used to buy the anti-viral medication Tamiflu --- the only drug available to fight the disease --- which is administered both as a preventive and as a treatment to alleviate severe flu symptoms. A vaccine against avian flu is in early development but authorities say it could not be manufactured in sufficient quantity for months after a pandemic begins.
Health and Human Services Secretary Michael Leavitt has called for a Tamiflu stockpile to treat 20 million Americans, yet there are only enough pills on hand to treat a few million people. Tamiflu, made in a single Swiss plant, is in short supply globally but Roche has said it plans to build additional plants in the United States.
The WHO on Thursday announced that British public health scientist Dr. David Nabarro would take the new position of "senior coordinator" of flu prevention and preparedness campaigns across the United Nations' three major health agencies.
WHO director-general Dr. Lee Jong-wook said Nabarro's New York office will unite flu campaigns that have been run from three different cities: at the WHO in Geneva, the World Organization for Animal Health in Paris and the Food and Agriculture Organization in Rome.
"The WHO has been very clear about the imminent threat of a human influenza pandemic," Lee said. "Coordination of these efforts is critical."
Confirmed bird flu in people has been reported in Indonesia, Vietnam, Thailand and Cambodia. Millions of poultry have died or have been killed to halt the disease spread, but it has advanced north into China and west as far as Russia's European borders.
Vietnam has recorded the largest number of confirmed cases and deaths so far --- 91 ill with 41 dead since 2003, according to the WHO --- but health authorities fear the potential Indonesian outbreak could become as large.
Of concern is that some of the Indonesian cases lack the link to infected birds seen among victims elsewhere. In Vietnam and Thailand especially, sickened humans had direct contact with dead or dying poultry through backyard flocks, butchering or cockfighting.
But in Indonesia, several cases have no known contact to poultry, or to waterfowl that spread the virus to chickens. In one cluster, a pet bird has been suspected of spreading the virus, and two zoos in Indonesia have been closed out of fear that captive birds spread the flu to visitors.
The Associated Press contributed to this article.
Copyright 2005 The Atlanta Journal-Constitution