http://www.latimes.com/news/nationwo...,3010223.story

New bird flu cases revive fears of human pandemic
Hong Kong, believed to have been free of H5N1, is forced to cull thousands of poultry after an outbreak. Two avian flu deaths are reported in Egypt and Indonesia.
By Mary Engel

January 4, 2009

Just when you thought you could scratch bird flu off your list of things to worry about in 2009, the deadly H5N1 virus has resurfaced in poultry in Hong Kong for the first time in six years, reinforcing warnings that the threat of a human pandemic isn't over.

India, Bangladesh, Vietnam and mainland China also experienced new outbreaks in December. During the same period, four new human cases -- in Egypt, Cambodia and Indonesia -- were reported to the World Health Organization. A 16-year-old girl in Egypt and a 2-year-old girl in Indonesia have died.

The new cases come after a two-year decline in the number of confirmed human deaths from H5N1 bird flu and as fewer countries are reporting outbreaks among poultry. A United Nations report released in October credits improved surveillance and the rapid culling of potentially infected poultry for helping to contain and even prevent outbreaks in many countries.

Yet H5N1 has continued to "at the very least smolder, and many times flare up" since the chain of outbreaks began in 2003, said Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis.

The year-end uptick is a reminder of how quickly the situation can turn as long as the H5N1 virus is still out there, Osterholm and other scientists said. "What alarms me is that we have developed a sense of pandemic-preparedness fatigue," he said. ...