Anchorage Daily News

WASHINGTON -- Less than a year ago, Americans could barely turn on the television, surf the Internet or pick up a newspaper without finding a doomsday story about deadly avian flu.

By last November, President Bush had asked Congress for $7.1 billion to help develop a vaccine, stockpile antiviral medications and fund state preparations for a possible pandemic. Biologists in remote Alaska locations were swabbing bird anuses, hoping to catch any early signs of its arrival in North America.

Now, with the disease still centered in Asia and the failure of migratory birds to spread the illness, the H5N1 virus has dropped out of the media spotlight. The dearth of coverage has prompted some to think that the threat of a pandemic has passed.

Nothing could be further from the truth, however.

So far this year, a person is dying from the disease roughly every four days, compared with about once every nine days last year, according to World Health Organization data. Of the 108 confirmed human cases of bird flu thus far this year, 73 have been fatal. That's up from 97 cases and 42 deaths in all of last year.

"We're as worried now as we ever have been," said Michael Osterholm, the director of the Center for Infectious Disease Research & Policy at the University of Minnesota.

Avian flu currently is transmitted mainly from animal to animal, mostly among birds. People can contract the disease after contact with infected animals and -- in isolated cases -- infected humans.

The fact that the virus hasn't made its way to U.S. soil is of little comfort to Americans, because it could mutate into a form that spreads easily from person to person, making geographic borders meaningless.

Most bird flu deaths are clustered in Asia, where billions of wild birds, domestic birds and humans live in close contact, increasing the chances of infection.

In October, the Food and Agriculture Organization of the United Nations announced that tests on infected Indonesian poultry found that the virus wasn't mutating toward a more lethal strain.

Health officials were surprised when flocks of migratory birds that had flown south to Africa and then back to Europe last spring didn't carry the H5N1 virus as expected. Neither did birds that wintered in Asia and flew to Alaska last summer to breed. International bird monitors also found no widespread deaths from the virus among migratory birds.

Many experts now think that wild migratory birds are only bit players in the spread of the disease. More likely culprits are humans who clean, feed and house infected domestic birds and those who prepare infected birds and transport them to commercial markets, said Rick Kearney, wildlife program coordinator with the U.S. Geological Survey.

Six companies are researching a cell-based flu vaccine that allegedly could be made available to everyone in the U.S. within six months of a flu outbreak. Each company is planning a U.S. production facility, but construction is years away.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, is optimistic that the pace of vaccine science has picked up in the last year. He's particularly heartened by recent data from several studies indicating that vaccinations against one subtype of H5N1 might provide protection against other subtypes.

Health officials also hope to have 26 million courses of the antivirals Tamiflu and Relenza by year's end and 81 million courses -- enough to treat more than 25 percent of the U.S. population -- by the end of 2008. Antivirals lessen the effects of the flu. Viruses eventually can develop resistance to widely used antivirals, and that has already occurred in isolated instances with Tamiflu.

Gellin said it was unclear whether the development is clinically significant but added, "It does raise the issue of the need to look at other antiviral candidates." HHS will issue $200 million in contracts to develop more antivirals. The agency is evaluating proposals, Gellin said.