Sep 9, 2005 (CIDRAP News) ?The World Health Organization (WHO) this week stepped up its warnings about the risk of an influenza pandemic, while Thailand reported four new outbreaks of avian flu on poultry farms.

According to a Reuters report, Dr. Jai P. Narain, director of the WHO´s communicable diseases department, told reporters at a health conference in Sri Lanka on Sep 7, "We may be at almost the last stage before the pandemic virus may emerge." He was referring to the risk that avian flu in Asia will lead to a human flu pandemic.

Narain said it is no longer a question of whether a pandemic will occur, but only when it will erupt.

"So far there is only one country in Southeast Asia with a pandemic preparedness plan . . . Thailand," he was quoted as saying. He added that Thailand has a stockpile of antiviral drugs.

The recent spread of the H5N1 avian flu virus to birds in Siberia and Kazakhstan has stirred concern that migratory birds may spread it on to Europe, the Middle East, and Africa, thereby increasing the threat of a human pandemic.

Thailand has had four new outbreaks of avian flu in poultry since Sep 1, according to the latest government report to the World Organization for Animal Health (OIE), published today. Three outbreaks were in Saraburi province and one was in Kampaengphet province.

The report said 109 chickens died of the infection and another 76 were killed to contain the outbreaks. All the birds were free-ranging or in backyard flocks with minimal biosecurity.

Thailand has identified 33 avian flu outbreaks in five provinces since Apr 12 of this year, which marked the end of country´s "second wave" of H5N1 outbreaks, according to the report. The country has been conducting nationwide surveillance for the disease since Jul 1. Thailand has had no human cases of H5N1 infection this year, but there were 17 cases with 12 deaths last year.

In other developments, the Associated Press reported today that the Netherlands has ordered 5 million doses of antiviral drugs to prepare for a flu pandemic, enough to treat more than 30% of its population of 16 million. The country´s Vaccine Institute has contracts with Roche to provide raw materials to make oseltamivir (Tamiflu) and with GlaxoSmithKline to make zanamivir (Relenza), the story said.

The majority of the order is for oseltamivir, which will cost between $37 and $87 per dose, government spokesman Bas Kuik told the AP. He said about half of the order will be ready this year and the rest by the end of next year. The government already has 220,000 doses of oseltamivir, the report said.