Mar 16, 2004 (CIDRAP News) – Thailand reported its eighth fatal human case of H5N1 avian influenza today, while China announced it was lifting quarantine orders for the last two of 49 areas affected by the disease, according to news service reports.

The developments came as the World Health Organization (WHO) opened a conference in Geneva, Switzerland, on preparedness for pandemic influenza. Health experts are concerned that the widespread avian flu outbreaks could trigger a human flu pandemic.

The avian flu victim in Thailand was a 39-year-old factory worker who fell ill Mar 1 and died Mar 12, according to an Agence France-Presse (AFP) report. A disease-control official said the woman had a neighbor who raised fighting cocks, all of which died in February, according to the story.

The official said Thailand has had confirmed cases of avian flu in 12 people, of whom eight have died and four have recovered. The story said another 21 suspected cases, including eight fatal ones, are still under investigation in Thailand.

Thailand had hoped to declare itself free of avian flu this week, but plans for a declaration have been postponed until early April, according to the AFP report.

In China, quarantines were lifted in Nanning in southern China"e;s Guangxi Zhouang Autonomous Region and in Lhasa in Tibet, according to China Daily. A total of 49 areas had been under quarantine for some period since China"e;s first avian flu outbreak was reported Jan 27, and nearly 9 million birds were destroyed, the story said.

The report quoted Jia Youling, a spokesman for the Ministry of Agriculture, as saying no new outbreaks of avian flu and no human cases have been reported for 29 days. However, Jia said the disease could easily recur and continued alertness is needed.

In Geneva today, the WHO opened a 3-day meeting of more than 100 health experts to assess the avian flu situation and discuss public health interventions before and during a human flu pandemic.

"Poultry culling and other measures may have reduced the likelihood of a human pandemic influenza strain emerging soon from Asia as a consequence of avian flu," the WHO said in a Mar 12 announcement about the meeting. "However, experts believe that because these outbreaks come in cycles, a human influenza pandemic must still be expected at some time in the future."

History suggests it will take years to eliminate the virus, the WHO said. Any time the virus is circulating, a random mutation or a combination of the virus with a human flu virus could produce a virulent strain that spreads easily among humans, the agency said.

In the conference"e;s opening speech, Dr Anarfi Asamoa-Baah, the WHO"e;s assistant director-general for communicable diseases, said, "At the start of a pandemic, it may be possible to slow down spread and thus buy some time. We need to know precisely which measures are likely to work and how these should be applied." A copy of his speech was published on the WHO Web site.

Asamoa-Baah said antiviral drugs can help in prevention and treatment of flu and can be stockpiled in advance. However, the WHO needs to better understand the clinical role of antivirals in a pandemic, estimate the quantities needed, and address questions of equitable access, he added.

He said efforts to make a vaccine for H5N1 avian flu are on schedule, but officials must discuss how to provide equitable access to vaccines.

In other recent developments, the US Centers for Disease Control and Prevention (CDC) lifted its ban on importing of birds and bird products from Hong Kong on Mar 10. The decision was triggered by Hong Kong"e;s measures to prevent H5N1 avian flu and the absence of disease in Hong Kong"e;s domestic and wild birds, the CDC said.

Hong Kong reported a case of avian flu in a peregrine falcon in mid-January, but continued surveillance had revealed no other cases since then, the CDC said. The US import ban remained in effect for poultry from Cambodia, Indonesia, Japan, Laos, China, South Korea, Thailand, and Vietnam, the agency said.

The ban does not include bird products treated to make them noninfectious or pet or performing birds of US origin being returned to the United States.