The big news this week mostly came from China, with avian outbreaks in several areas and with three cases believed to represent bird-to-human transmission of highly pathogenic avian influenza H5N1 (HPAI H5N1). 

That doesn't represent any ACTUAL change in the virus' genetics or epidemiology. China is thought to have special POTENTIAL for future viral mutations, though, because of China's dense human and animal populations.
Avian influenza control in China involves bird vaccination, bird culling, and separation of potentially infected animals from flocks believed to be uninfected.  Surveillance is a challenge, though.  Animal and human disease information isn't consistently reported to regional and national public health authorities.  Chinese health officials are trying to improve surveillance and response systems.

In Thailand, the national authorities are praising the central province of Lopburi for excellent public-private cooperation in avian influenza control. Local residents voluntarily suspended cockfighting matches and cooperated
with agricultural quarantines.  These measures reportedly controlled a recent avian influenza outbreak very rapidly.
Intense global surveillance and intense media interest assure great publicity for any unknown phenomenon that can be connected in any way to any strain of "avian flu".  In a large and diverse world, that means a lot of news stories.  When first published, they look dramatic and ominous.  With perspective, most of the "bird flu" news comes to appear less surprising and more technical.
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Scientists remain uncertain about prospects for a pandemic variant of HPAI H5N1.  This week's issue of Science magazine has an article, "Avian Influenza: Pandemic Skeptics Warn Against Crying Wolf", by Dennis Normile. Everyone quoted agrees that pandemic preparations are crucial and that an effective H5N1 vaccine is needed quickly, but no H5 virus has ever caused a known human pandemic and there is a vigorous debate about how likely an H5N1 pandemic might be.

 Immunologist/virologist Paul Offit, from the University of Pennsylvania, says scientists should tell the public "not that we're going to protect you from the bird flu pandemic, but that we're going to be protecting you from a pandemic which may be 20 years from now."

AAPHP Webmaster Kim Buttery, MD, MPH says the "Pandemic Skeptics" article "should be required reading for any public health physician who may be asked questions by elected officials or other MD's."  Hardcopy may be found at:
Science 2005 Nov 18;310(5751):1112-1113. 

Paid subscription is required to view the full article on the Web at
http://www.sciencemag.org/cgi/content/summary/310/5751/1112. 
E-News readers without other access to Science magazine may request individual copies of the "Pandemic Skeptics" article as a PDF file (one megabyte) from cundiff@reachone.com.

The British journal The Lancet notes a global consensus for preparedness, then editorializes, "Even before a pandemic emerges, panic is a danger. The recent growth in momentum for action against avian influenza has been
flanked by a rise in anxiety about the pandemic risk.  These fears are perpetuated by politicians' misplaced instincts to withhold information instead of talking openly about the disease.  And, worryingly, experience shows that widespread fear can lead to social and economic consequences as serious as the disease itself."

The Lancet editorialist notes that it is particularly tempting for leaders to withhold information about scant supplies of anti-influenza drugs -- but comments that full information must still be shared, partly because all of the most effective measures are education-based rather than drug-based anyway.  Free registration is required to view the full editorial at
http://www.thelancet.com/journals/lancet/article/PIIS0140673605677069/fulltext.