The Business Development Group / 109 Bushaway Road, Wayzata, MN, 55391, Phone: 952-473-3831, www.bdgpartners.com / copyright: 5/1/06

Avian Influenza & Human Pandemic
Overview of the H5 Virus and Sub-Strains ( page 5)
Current Status on the AI Virus (page 39)
Global Impact on the Economy, Domestic Impact and Implications (page 47)
Impact on Corporations, Institutions & Organizations (page 52)
Polls and Surveys (page 56)
Vaccines, Antivirals, Supplies and Research (page 59)
Getting Prepared (page 67)
Regulatory and Legal Issues (page 72)
Planning (page 73)
Conclusion (page 75)
Report Card (page 79)
References (page 82)

Overview
What is Avian Influenza?
How Does Avian Influenza Differ From a Human Pandemic Influenza
Compare the Mortality Rates
History of the Virus & It’s Evolution
How it Infects Birds, Mammals, Humans
Wave Theory
Outbreaks
What are Human Pandemics
Timelines & Map
Impact on Wildlife, Biodiversity
The Poultry and Food Industry
Signs and Symptoms / Birds & Humans

What is Avian Influenza?
Avian influenza is a viral disease which originated in fowl. It is characterized in birds by respiratory distress, depression and the reduced intake of food and water. It is sometimes referred to as the Bird Flu by the media.
There are two pathotypes: Low (LPAI) and highly pathogenic or highly virulent (HPAI), the virus is also nonpathogenic in some cases. HPAI is highly contagious and mutates rapidly.
There are 16 hemagglutinins (H) and 9 neuraminidases (N) (protein groups) comprising this virus which make for many subtypes. The HPAI virus currently the focus of attention is being classified as either a H5 or a H7 strain. The H strain ranges from H1 to H16 and the N strain ranges from N1 to N9. These groups are constantly rearranging. Mutations are rapid, unpredictable and easily evolve beyond existing vaccines and antiviral regiments. Current strains are moving in two directions: very lethal and low lethality. The virus is assumed to be seeking an efficient method for expanding its infection scope.

What is Avian Influenza? continued
The LPAI virus has existed in the U.S. since the early 1900’s. These strains pose no threat to humans. In birds they may cause illness or death. The HPAI strains are often fatal to birds and more easily transmitted to other mammals. Some scientists believe at least one or more strains of HPAI are already in the U.S. These strains may not be as deadly to host mammals as the H5N1 strain now in Asia and Europe.
Most commonly discussed strains in the media are the H5N1, H7N3, and H7N7 currently spreading throughout the world from Asia.
The Asian strain of H5N1 is the primary concern to the global poultry and egg industries around the world and the strain that is likely going to move into the U.S.
Some documents suggest HPAI has been detected up to three times in the U.S.: 1924, 1983, 2004. These documents are unconfirmed at this time.
What is Avian Influenza? continued
Waterfowl and shorebirds are the major natural reservoir of influenza viruses. Many of the strains circulating in wild birds are either nonpathogenic or low pathogenic for poultry and other animals. HPAI strains evolve by mutation or reassorment of less virulent strains.
In addition commercial live bird & swine facilities, back yard lots, etc… are considered high risk environments for the virus.
Outbreaks have occurred at irregular intervals on all continents for many years.
There is no effective treatment for birds with HPAI, only prevention techniques.

What is a Pandemic?
A pandemic is a widespread epidemic that effects people on a broad scale across many countries and continents.
Some sources refer also to a pandemic as a disease that also effects mammals across many countries and continents. This definition is not considered accurate.
An epidemic is a disease that spreads more rapidly among a population in a localized area than expected.
A human influenza pandemic may be the result of a mutated avian virus, but it will not be the same virus found in wild birds, it will be a new strain or a sub strain. The Avian virus strains that infect poultry, wild birds and other animals should be less harmful to humans. Only those strains that mutate from the existing AI strains could develop into a highly contagious virus harmful to humans. AI strains are constantly in mutation.
Compare the Mortality Rates
March 28, 2006 / Human Cases: 191 confirmed, 107 deaths confirmed. This number of cases not considered a pandemic or an epidemic.
Bird population destroyed: 200 plus million (est.)
Estimated deaths based on models of a H5N1 mutation to a human transmittable virus: 2 (two) to 3 (three) % of the world’s population or approx. 150,000,000 would die. This would be considered a pandemic.
How does this compare to common influenza (flu) mortality rates? Globally 250,000 to 500,000 annually die, in the U.S. there are 36,000 deaths and 200,000 individuals hospitalized from the flu. Cost to the U.S. is $37.5 billion annually.
History of the Virus & Evolution
The Avian virus has likely been around for centuries. In 1878 the first identified avian influenza was found in Italy in birds.
Recent findings indicated the 1918 Spanish Flu, a pandemic that killed millions, mutated from an avian strain called H1N1. It later disappeared or became less aggressive through mutation. Some similarities exist between the current circulating AI, Asian-H5N1 strains and the 1918 strain which killed humans. These similarities are what most concern the world health organizations. Humans have limited or ineffective immune defenses for this virus.
In Hong Kong in 1997 the H5N1 strain (now spreading) was first documented.
The current H5N1 strain, however does not appear to have been a reassortment from the circulating (H1N1 or H3N2) common human flu genes, but a mutation of the Avian Flu virus strain discovered in Hong Kong. The current H5N1 virus strain can infect a variety of mammals / animals ( i.e. small animals, cats, dogs, and humans).

History of the Virus & Evolution
Recent evidence of rare person-to-transmission raise the level of concern about a potential 1918-type of pandemic.
There is some speculation that global warming causes an increase in the outbreak of disease, especially in areas like Asia and Africa where health & medical support, biosecurity controls and public health management are minimal.
For very detailed data on Avian Influenza and concise daily updates an excellent website to visit is the one hosted by CIDRAP (The Center for Infectious Disease Research & Policy): www.cidrap.umn.edu/

How it Infects (the Avian strain)
Birds: through droppings, nasal discharge, and bodily fluids.
Humans: contact with dead or infected birds.
Human to human (differs or unknown, believed body fluid or fecal matter.
Epidemiology indicates infections in poultry are spread by wild birds, where as swine, a silent host of AI, appear to be part of the infection pattern in turkeys. Airborne transmission may occur if birds are close in proximity. The infection sites are often the conjunctiva sac, nares or the trachea. The incubation period is 3 to 7 days in birds.
Humans are prone to the development of a severe rapid onset of pneumonia. Unfortunately, a healthy immune system may the leading reason for death causing the body to overreact with immune defenses, filling the lungs with fluids, suffocating the patient.
These x-rays show how human lungs fill with fluid causing a patient to drowned.

Wave Theory
John M. Barry describes the 1918 pandemic outbreak in the book The Great Influenza as spreading like a series of waves, each getting bigger.
The first wave was a warning, the second 6 months later bloomed into a full pandemic. The virus had become more efficient with time and eventually burned out.
It is likely future human and bird populations will see the same “wave effect” with either the avian influenza or a new human pandemic influenza.

What are Human Pandemics?

Human pandemic influenza is different from the avian influenza you read about and see on the nightly news.
Experts believe a human pandemic influenza would likely be a new sub-type virus and has not previously been identified.
Influenza pandemics are recurring events. They are difficult to stop, but can be managed through harsh controls and the use of vaccines and antivirals, etc…, like those experienced in the recent SARS epidemic.
The world may be on the brink of another pandemic, there is no way to predict this, the concern over the Avian Flu stems from the fact that poultry and birds are so widespread, in close contact with humans and host a virus with genetics already associated with a previous pandemic (1918 Spanish Flu) .
All countries will be affected if a pandemic occurs.
Pandemics range greatly in scope and death toll.
Human Pandemics continued
Widespread illness will occur and according to models and a report supported by the National Institute of Health. The report showed that with no intervention a pandemic with low contagiousness could peak after 117 days and would infect about 33% of the U.S. population. A highly contagious virus could peak after 64 days and infect about 54% of the population. Models also suggested no community would go untouched. For more details go to: www.nigms.nih.gov/News/Results/FluModel040306.
Medical supplies will be inadequate and the ability to get new vaccines developed in time for a pandemic is insufficient.
Large number of deaths will occur primarily in young and healthy individuals.
Economic and social disruption could be significant.

Timelines & Map H5N1
Wave 1
1996: AI H5N1 was first detected in the Province of Guangdong, China in a goose. Outbreaks were reported in poultry and open markets in Hong Kong, 1997
2003: First known human death, Hong Kong in February. Mid 2003 H5N1 begins spreading throughout Asia. Virus now being referred to as the Asian H5N1.
2004: Reports of H5N1 outbreaks in poultry in Japan and Thailand begin making news.

Timelines & Map continued
Wave 2
Mid June & July 2004: Infections spreads to China , Vietnam and Indonesia in poultry.
July 13, 2004: Research shows that H5N1 has become progressively more lethal and can now kill waterfowl long considered disease-free.
Fall of 2004: WHO reports poultry culls increasing, human death toll on the rise.
October 29, 2004: Ducks are confirmed as a silent host reservoir for H5N1.
Timelines & Map continued
January 2005: Research indicates that a girl in Thailand passed the virus to her mother, fatally infecting her.
Mid year 2005: Thousands of wild birds in China begin dying in the Qinghai Lake area where the worlds migratory birds congregate.
July 6 & 14, 2005: Research indicates that the virus may be carried along winter migratory routes. The virus is evolving and is now more lethal to wild birds and experimentally infected mice.
October 2005: Virus spreads into Turkey, Croatia and Romania.
Timelines & Map continued
December 5, 2005: Ukraine reports their 1st AI outbreak.
February 2006: Iraq,Iran Austria Germany Nigeria, Azerbaijan, Bulgaria, Greece, Italy, and Slovenia report outbreaks.
March 2006: Additional human and bird deaths are reported in Asia by the WHO.
The virus is now slowing but could easily regain strength as the wave theory suggests.

Impact on Wildlife, Biodiversity
A report by Hider Rizvi of Curitiba Brazil states: “the threat of AI is looming over a wide range of species, including rare and endangered ones.”
Animals eating infected meat or in contact with fecal matter, etc… may have an increased ability of becoming infected . Humans that hunt may be at an increased risk. Children that come in contact with dead animals will be at an increased risk. Zoos will be at an increased risk as well as non-commercial and hobby farmers.
In countries where the poultry is culled, locals will begin consuming other species reducing wild animal populations.
Over 80% of the wild bird population is potentially threatened.
Also at risk are rabbits, primates, viverrids, weasels, and related wild cats. The list continues to expand.
The fear of loosing such a large population of predators is because the loss of diversity will allow some select animal (i.e. rat) populations to explode and further spread disease.
The Poultry and Food Industry
Because the current avian virus is primarily of immediate concern to the food industry the following information will address food and poultry industry issues which could impact other economic segments of the U.S. economy.

The U.S. food and poultry industries have had significant experience with both food safety and security measures, perhaps more so then other industries. They are heavily regulated and monitored.
Most food production companies in the U.S. are required to comply with FDA and, USDA food safety and security (FSIS) regulations.
The CDC, the U.S. Department of Health and Human Services, in conjunction with a number of key government regulatory agencies and trade associations have prepared planning guides, checklist, and response protocols to aid food manufactures , organizations and institutions in the event of an outbreak of Avian Flu in both animals and humans or in the event of a human pandemic. The programs for the food industry are well managed and comprehensive, less so for human pandemic management.
The Poultry and Food Industry continued
Much of the U.S. commercial poultry industry manages flocks in enclosed and highly controlled environments; sanitation / security measures are in place to reduce the potential for birds to become easily infected. The U.S. is not like Asia in it’s poultry management and our flocks do not have the same risk levels.
Birds labeled “free range” and the environments they live in, as well as those workers that manage and handle them are in greater danger if the Avian Flu spreads into their markets via migrating birds. These birds are raised in the open and exposed to wild bird populations on a regular basis increasing risk of exposure.
The U.S. Department of Labor (OSHA) has issued an Avian Flu biosecurity practice guideline for all companies with poultry workers. These guidelines are in wide spread use within the commercial poultry /egg production sectors. Most poultry in the U.S. is raised commercially and unlike Asia and parts of Europe is highly controlled.

The Poultry and Food Industry continued
Animals, fruits, vegetables, eggs, etc… all have bacteria, viruses, and organisms inherently associated with them and they can spread disease or create health problems when not properly handled. Proper cleaning and cooking will prevent all but a few of these diseases from cross-contamination and illness occurring in humans. Poultry and wild birds with AI could be consumed if properly cleaned and handled.
The food industry has done a poor job of relating the avian virus to these other disease carrying foods because they do not want to scare the public.
Individuals that travel to infected areas and or work on farms should use the CDC travelers guidelines: www.pandemicflu.gov/travel/
The Poultry and Food Industry continued
AI awareness is extremely high within the food industry at this time. A campaign to promote avian health through biosecurity called “Biosecurity for the Birds” is being sponsored by the USDA & APHIS Veterinary Services. Trade industries have aggressively been monitoring the AI status and have developed a variety of security plans for food production and farming practices.
The dead bird report line is: 1-866-536-7593. This number is not well known by smaller farmers or the public. There is a need by the public to know who they should call. Birds that have died and found may be confused with natural death events or West Nile Virus and should be reported to clarify the event that caused the death. Billboards and advertising of contact numbers will expand the dead bird monitoring programs and AI watch increasing the security net for the U.S.
Properly handled and prepared poultry is considered safe at this time. The public needs to be informed of this, research indicates that they are not.
The U.S. will have localized outbreaks of AI and will be forced to cull flocks and vaccinate birds. Massive outbreaks could occur if the country and the food industry does not remain prepared. The potential of a national culling of flocks is unlikely unless the public demands it or the current virus mutates and can spread into commercial containment buildings through the air, or current poultry AI vaccine supplies are not available.
The Poultry and Food Industry continued
The U.S. food industry (4/25/06) impact risk levels from existing AI strains in animals as rated by the BDG:

Infections of wild bird populations: Medium to High
Infection of back yard poultry: Medium to High
Infection of contained poultry: Regionally / Low Infection of other livestock: Low
Infection of workers with animals: Very Low (commercially) to None
Infection of general population with the existing AI virus: Extremely Low to None, but subject to rapid and unpredictable change.
Signs & Symptoms
Signs and symptoms in poultry and some wild birds are:
Sudden death without warring signs
Lack of coordination
Purple discoloration of the wattles, combs and legs
Soft-shelled or misshapen eggs
Lack of energy and appetite
Diarrhea
Swelling of the head, eyelids, comb wattles, and hocks
Nasal discharge
Decreased egg production
Coughing, sneezing
Signs & Symptoms

Human symptoms: have ranged from typical influenza-like symptoms (e.g., fever, cough, sore throat, and muscle aches) to eye infections (conjunctivitis), pneumonia, acute respiratory distress, viral pneumonia and other life-threatening complications.
Infected individuals have often died from flooding of the lungs and massive organ failure. The time from transmission to death is approximately two weeks. Recent studies indicate respiratory infection has been confined to the lower lung sections reducing the spread of the virus through coughing and sneezing. Future mutations may alter this.

Signs & Symptoms
The AI virus in humans at this time is rare and less transmittable. In order for the virus to become more virulent it will need to mutate into an upper respiratory disease that can be transmitted in droplets from a cough or sneeze or nasal discharge onto the hands. If this happens it would be a new sub-strain or new strain of the virus altogether, and like SARS or the common flu easily passed among individuals in close contact.
Current Status on the Virus
Impact on the Midwest Example
15 Days in March 2006
Infected Animal and Human Counts
Policy and Strategic National Strategy
How Much Warning Time Exists
Poultry AI outbreaks in the U.S.
Human Pandemic in the U.S.

Impact on the Midwest Example
The Midwest is still considered one of the most important food production regions in the world. The impact of AI in the Midwest will impact all of the U.S. food chain at some point in time. The loss of farm animals is not the concern at this time; the future loss of farmers would make it extremely difficult to maintain the food supply to the nation.
The poultry, hunting and food industries in the Midwest are part of the migratory flyways and connected to wild bird migration patterns from the West Coast and Alaska. Over the next 8 months these states will be exposed to various infected wild bird populations. Wild geese and crow populations are considered a threat to the Midwest agricultural industry and need to be monitored. These states could avoid early wave infections, but would have difficulty avoiding later waves if the AI virus spreads. Enclosed commercial poultry facilities could potentially avoid all waves of AI but must be closely monitored.
If the Avian Flu mutates into a human pandemic influenza, calculations using FluAid software projects, by example, a pandemic in Minnesota alone would impact up to 35% of the human population. To access the FluAid on-line calculator for each state go to: www2.cdc.gov/od/fluaid/default.htm

15 Days in March
A good way to look at the speed the virus is spreading is to take a 15 day period in March and see what occurred.

March 29th: second Egyptian died of H5N1,New H5 strain discovered in Sweden in mink populations,the Czech Republic confirms virus in wild birds, Denmark, India, Israel confirms more outbreaks.
March 27th: Iraq reports 1 suspected death and Indonesia and Egypt confirmed 2 were hospitalized with H5N1virus.
March 27th: A girl that died in Cambodia cannot be traced back to infected birds. Czech Republic finds AI flu in swan.
March 24th: Fifth death in Cambodia, One death in China.
March 21st: Israel and Pakistan announce outbreaks and the spread of H5N1. Kazakhstan reports the death of a swan and outbreaks in poultry, Afghanistan reports the H5 virus in chickens
March 15th: Sweden and Denmark confirm outbreaks of H5N1in wild ducks, Azerbaijan reports an infected dog was found. Myanmar kills 5,000 chickens

Infected Animal and Human Counts
As of March 28, 2006: Human Cases: 191 confirmed, 107 deaths confirmed.
Bird population destroyed: 200 million (est.)
Current events and data: www.pandemicflu.gov/

Policy and Strategic National Strategy
On November 1, 2005 President Bush presented the U.S. with a directive to begin a national pandemic strategy.
The FDA and USDA have had strategies in place for a number of years, as it relates to food safety, security and a pandemic. These plans are currently being updated to consider issues related to AI.
The National Strategy has the following components:
Preparedness and Communication
Surveillance and Detection
Response and Containment
Roles and Responsibilities
This Strategy can be found at: www.whitehouse.gov/homeland/pandemic-influenza.html#section3
How Much Warning Time Exists
For the poultry industry in the U.S. most experts believe: it will take 2 to 8 months for AI to arrive. Import restrictions are presently in place to reduce the virus spreading from Asia and Europe. A very few experts dispute the current H5N1 strains will not get here.
Currently the U.S. government is monitoring the flyways and placing sentinel birds in key locations to identify the first emergence of the Avian Flu in wild bird populations.
Humans H5N1 (Asian strain) or other AI virus infections: Not predictable, The U.S. may avoid the currently identified H5N1 Asian strains infections with humans since we do not have the close contact with birds as seen in Asia . If AI does infect humans in the U.S. it will likely be limited unless it is a mutation of the current virus.
Experts believe the start of a human pandemic influenza will likely originate in Asia or Africa and move to the U.S. over a period of weeks.
How Much Warning Time Exists continued
A review of the mumps epidemic in the Midwest indicates that management of contagious diseases in the U.S. is still difficult. Iowa, considered a state with considerable funding and public health management skill is experiencing 50 cases of mumps per day and has admitted the system has not stopped the spread of the disease. Using mumps as a model we can see the difficulty public health official will face in the early stages of a pandemic.
Dr. Michael Osterholm, one of the world’s foremost infectious disease experts and Director of The Center for Infectious Disease & Policy, believes a pandemic is inevitable and that up to 180 million individuals could die from a pandemic. He believes that the world is not prepared for a pandemic and that the ability to predict a pandemic’s timing is difficult. He believes that Public health officials can not accurately predict how long it takes a virus to become lethal to humans and turn into a pandemic, only that we know a pandemic will occur at sometime in the future and the AI virus has a potential to become pandemic.
How Much Warning Time Exists continued
Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, believes that the AI virus is not likely to change very quickly into a form that can spread quickly from person to person. He believes that the series of genetic changes required could make the virus less virulent, and the the virus is inherently programmed to never efficiently travel from human to human. He stated the epidemic in birds may burn itself out before it evolves. He did not discount the potential of a pandemic.
These kinds of statements indicate that scientist do not know and cannot determine evolutionary time frames for either the AI virus in birds or a human pandemic. Most agree that a pandemic will occur sometime in the near future.
Global Impact on the Economy
Global Economic Impact related to poultry production and a pandemic.
Anticipated Local Economic Impact
1918 Historical Correlation
Correlations to Mad Cow
Correlations to SARS

Global Economic Impact
Recent historical data on the economic impact to a regional economy indicates that poultry prices fall rapidly after the Avian Flu is confirmed in a country. In Italy consumption plunged by 70%. Early indicators have demonstrated that after three to six weeks markets rebound as the media moves on to other topics.
The impact on Asian countries is the most profound where the need to cull flocks, monitor the virus, and provide medical treatment has overwhelmed some governments. The World Health Organization (WHO) and the CDC are currently providing needed support to offset some of the monitoring costs.
Global Economic Impact
In general the impact of the AI virus on global poultry production and pricing will have a smaller effect on the Asian economy than earlier anticipated.
China’s poultry farms, which raise a quarter of the world’s chickens and 65% ducks, make up only a small fraction of the countries economy and can manage through the recover stage while supporting much of the Asian economic growth. Poultry production recovery will take 6 to 12 months.
Should a large scale human pandemic occur the economy of the world is expected to be impacted by a loss of productivity of 3% to 6% in the first year. Recover periods could take decades for many industries.
A flight to liquidity, specifically cash or gold would lead to temporary declines in asset prices and widening of credit spreads. Commodity prices would decline due to weaker demand, and this would be offset by supply disruptions (such as oil and other energy).
Communication systems (internet, phones) would be significantly effected.
Based on previous epidemic and pandemic economic impact studies, food distribution, health care, police, fire departments and logistic systems would go through temporary and long term disruptions. These disruptions would have a variety of hardships on local economies and would likely increase crime rates.
Corporations and organizations that provide critical supplies would likely be controlled by government agencies and come under the control of martial law regulation.

Global Economic Impact continued
Based on the SARS experience, direct foreign investment planning may change little according to the IMF.
Financial systems, “high touch” technology and food, medical and energy infrastructure will likely be disrupted.
Absenteeism & quarantines of communities would create significant local economic stress.
The IMF’s emergency fund (ENDA) is believed to have sufficient liquidity to survive a large scale global disaster.
If the pandemic were similar to the 1918 Spanish flu the 15 to 40 year olds would be hardest hit resulting in a lasting impact on demographics and economic activity. Birth rates would plunge, decreases in demand for housing,cars and durable goods would occur. Labor shortages would remain for years. Disruptions in supplies from cheap Asian markets would decline and may disappear for a number of years. Some industries would flourish such as health care, nanny and daycare providers, funeral service providers, etc… While other industries would crash temporarily such as travel, group entertainment, places where people meet (churches, schools). Long term changes in retail buying, savings and personal investing would occur.
Global Economic Impact continued
A review of the impact on local and global economies from SARS and Mad Cow outbreaks indicates that economies can recovery quickly when the disease is controlled.
When Europe had an outbreak of Mad Cow it took several years for the countries to return to a normal consumption of beef. In contrast when Canada and the U.S. had outbreaks little loss of domestic consumption occurred. The public was hardened and believed that the governments could control the outbreak. Little attention was paid to the infected herds of deer and elk. Hunting did decrease and consumption of these animals decreased in the U.S. for several years, it is now again on the increase.
It is likely that an outbreak of AI (confined to birds or smaller animals) will travel a similar pattern of lack of confidence and then confidence and economic recovery as seen with Mad Cow or SARS in the U.S. This is, however a dangerous and difficult issue for regulatory agencies. With decreased public pressure on government organizations based on safety concerns, critical funding for controls and management of AI will leave the country exposed to greater threats from a second wave from a mutated or spreading AI virus world wide or other potential pandemic or animal diseases. This could leave the U.S. open to greater economic strife in years to come.
Impact on Corporations & Organizations

What is the impact if the Avian Flu remains
isolated to bird populations or if the Avian Flu
reassembles and infects Humans populations?
What is the impact on:
Shareholders
Employees
Vendors
Customers
Community

Impact on Corporations & Organizations continued
The U.S. food industry remains relatively secure in its belief that an outbreak of the Avian Flu would have only a temporary effect on poultry consumption and little or none on other protein foods. The poultry industry believes that some outbreaks will occur, few in commercial environments, but they can be contained, and using existing security and safety measures most birds will not be exposed to the AI virus.
If these assumptions are correct then there is little to be concerned about. If these assumptions are wrong however, the impact on all stakeholders will be more significant and could increase legal liabilities for companies and organizations. For this reason a serious discussion about the impact on companies and organizations should occur in every company and organization in the U.S.
In the event of a pandemic or wide spread epidemic any organization, institution or company that promotes group gatherings will find that it may be forced to temporarily close the doors. The impact to parents of school children would be significant and would have a roll-over effect on businesses.
Impact on Corporations & Organizations continued
Companies, organizations and institutions need a workable plan for communication, security, and need to understand all aspects of keeping their workforce safe as well as their staff employed. They need a plan to hold onto the value of assets and to keep customers and vendors loyal. The difference between an AI outbreak and a pandemic must be clearly understood.
It is estimated that only 18% of all U.S. companies have any plans in place to meet the issues of an outbreak of the Avian Flu as it relates to a human pandemic influenza or fear of a pandemic.
If the Avian Flu gets to the U.S. it may well have only a minor impact to the stakeholders. If it mutates into a human pandemic influenza, the economy will likely become paralyzed. Workers will stop coming to work, travel will stop, school and public venues will close, unemployment insurance and government support services will be difficult to access, infrastructure will deteriorate, banking, food supplies, the internet and phone services will be disrupted. It is estimated a pandemic could cause up to 30% of all small businesses to go into bankruptcy. Using Katrina as an example the number could go higher.
Impact on Corporations & Organizations continued
An AI outbreak in the U.S. will have little impact on most individuals, a human epidemic in the U.S. or overseas will impact a greater number and create fear and disruptions on a global basis. A pandemic will and could be biblical in global devastation. It would impact the U.S. military, police and other security aspects of our daily life. Few if anyone would not be touched by death and sickness.
There is speculation that pandemics and epidemics are natures way of creating a balance in the ecosystem and a pandemic or epidemic occurs when the populations of a specie(s) creates imbalance in the ecosystem and are culled to a sustainable level.
Polls and Surveys

Concern & knowledge about the virus
Antiviral Treatments
Quarantines
% of Individuals that would stop eating poultry
Effect of vaccines
Polls and Surveys continued
57% of Americans reported concern about the spread of Avian Flu.
15% said they were very concerned
20% believe they or a relative will get the Avian Flu.
75% said they would avoid travel.
71% said they would avoid public events
68% would get an antiviral
68% would keep their child home
46% said they would not eat poultry
Over the next 12 months 24% polled believe the flu will spread to poultry, 14% to humans and 28% to wild birds.

Polls and Surveys continued
45% of the polled population has heard of Tamiflu and 25% of this group believes an antiviral (i.e. Tamiflu) would be effective as a treatment.
Most Americans are supportive of quarantine measures (96%).
77% of American know a seasonal vaccine will not stop the AI or mutated virus.
Vaccines, Antivirals, Supplies, Research
Animal Vaccines
Use in poultry
Current status
Human Vaccines
Current Status
Antivirals
Use in animal populations
Use in human populations
Critical Supplies
Food Production, office, and work locations
Home
Vaccines, Antivirals, Supplies, Research
Animal Vaccines
Inactivated, quality assured, oil-emulsion vaccines have been demonstrated to be effective in reducing mortality or preventing AI in chickens and turkeys. They may not, however, prevent the infection in all birds. Several kinds of vaccines exist. The U.S. has stockpiled AI vaccines and will distribute them if an outbreak in birds occurs. This vaccine cannot be used in humans.
A recombinant fowl pox virus containing the gene codes for the H5 antigen has recently been licensed and is expected to shortly be tested in a number of trials. The ability to do large scale production does not exist anywhere in the world at this time for a recombinant vaccine.

Vaccines, Antivirals, Supplies, Research continued
Asian and the French governments are currently using AI vaccines to protect flocks. The UK and French are both using Interet’s Noblils Influenza vaccine. The U.S. has it’s own vaccine.
Vaccines by themselves are not considered effective alone in protecting poultry. A strong biosecurity plan is essential.
Tests in Hong Kong have indicated that a vaccination program stopped the circulation of this disease on farms within 18 days when combined with quarantine, depopulation, and other biosecurity measures.
Because the ability to vaccinate all poultry or other birds in the world is not possible the concern that a more lethal or human transmittable virus may develop remains high.

Vaccines, Antivirals, Supplies, Research continued
Several Human vaccines are currently in development or clinical trials. As the AI virus changes, the need to constantly identify the new mutations makes creating new vaccines difficult.
Solvay Pharmaceuticals has developed a vaccine based on the most recently identified H5N1 virus strain, it is yet unproven.
A U.S. vaccine tested in March has shown limited success. The ability to produce this vaccine once an outbreak occurs and based on global production capacity indicates that approximately 1.25 % of the world population could be fully immunized once an outbreak occurred and the virus was identified.
On 2/3/06 FDA approved new assay testing of A/H5 which could speed up identification of the virus allowing antivirals and vaccines to be used during a period when they are most effective.
Existing drug regiments and treats require immediate response to be effective (one to two days from infection).
Vaccines, Antivirals, Supplies, Research continued
Antiviral drugs are not a substitute for a vaccine and are used only as an adjunct to a vaccine in the control of influenza.
Several antiviral drugs exist: Symmetrel, Flumadine, Relenza, Tamiflu (Tamiflu is the best known).
Antivirals have been used for both animals and humans and have been shown effective if used early in the infection. Insufficient data is available to know if human applications will have significant benefits on large populations.
The U.S. government recently announced it would ban the use of antivirals on poultry.
Access to antivirals in the U.S. is limited or non existent as hospitals and governments stockpile them. Producers of antivirals are currently limiting supplies sent to the U.S. Several manufacturers are licensing production rights to other producers. Antivirals are now considered one of the worlds most counterfeited drugs.
There are not sufficient antiviral anywhere in the world to manage a human pandemic. Use of antivirals in farm animals is being limited since they have the potential to create drug resistant virus strains.
Vaccines, Antivirals, Supplies, Research continued
Critical Supplies
The government is currently recommending families and business stockpile critical
supplies before a human pandemic occurs. These supplies should last from 3 weeks to 3
months depending on the impact to the logistics of a community.
Non refrigerated or heated foods
Water
N95 Masks, Respirators and body suits are required in food processing plants
Goggles & gloves
Prescription drugs
Hand Sanitizers
Toilet paper, tampons, diapers, baby food and items necessary to survive several weeks in quarantine.
Items stocked for severe weather (batteries, etc. )

Most experts agree it is not possible for large populations and lower economic
groups to stockpile for the event of a pandemic. This increase the burden on local
governments.
Vaccines, Antivirals, Supplies, Research continued
Companies need to create work at home plans and provide key employees with “Flu Kits” if the virus migrates into a human transmittable strain.
Because there may be interruptions in money supplies and laid-off workers might not be able to get unemployment insurance, companies may want to consider their own unemployment insurance programs to keep a workforce in place. Experience with Katrina indicates that a workforce will relocate if they do not have access to capital and emergency supplies. Supplies like bottled water, masks, goggles and gloves will experience rapid store runs if an AI outbreak or epidemic occurs. Gouging and hording will likely occur.
It is estimated mask & antivirals along with other critical products will become nonexistent within several days of a human outbreak.

Vaccines, Antivirals, Supplies, Research continued
Research indicates that the outside the body the Avian Virus is fragile and can be destroyed with heat, soap & water and a variety of cleaning products.
The virus is also in a state of change and what works today to kill it may not work tomorrow.
At the present time the virus is not known to easily move from human to human and may never acquire this ability.
Research indicates eating infected poultry is safe if handled properly. Teaching this handling will be more difficult. Wild birds handled and consumed by hunters is a concern. Children touching dead wild bird is also a concern. Schools and the media need to focus on information regarding the issue of dealing with live or dead birds.
Getting Prepared
Everyone needs to be prepared:
Have a strategy
Have a crisis team
Develop guidelines
Develop checklists
Have a communication plan (KEY)
Have supplies on hand for periods of shortages
Be prepared for a series of waves with the infection in both poultry and humans.
A pandemic event could last 12 to 18 months
Manage based on moral, legal and regulatory responsibilities
Test, test, test your procedures

Getting Prepared continued
Families and individuals need a plan of action for the advent of both mammal and human outbreaks of the Avian Flu. Farmers with animals need to recognize they are an early line of defense.
A variety of planning programs exist for the poultry industry from the Chicken and Turkey Council, The FDA, the CDC and related associations.
Family and individual plans are available from the CDC and can be accessed on their website: www.pandemicflu.gov/.
Other planning support can be accessed through The Center for Infectious Disease, Research & Policy (CIDRAP) www.cidrap.umn.edu/

Getting Prepared continued
Employees working around animals are they aware of the issues, trained, can they be isolated?
Vendors, customers, staff, constituents, what do you want them to know?
Environmental issues, lots of things to think about ranging from disposal of dead birds to control and management of human medical waste in homes.
Family and Individuals: know the impact on their lives. Katrina and 9/11 have provided a number of studies to aid organizations and governments in the management of a crisis.
Communities, institutions and companies: Be prepared for some difficult times. Don’t expect the federal government to be there for you.

Getting Prepared continued
Security plans: are you following government regs.?
Prevention and monitoring plans: are they being monitored, on going?
Control and containment plans: who is in charge, who makes the call what are the legal implications?
Communication plans: who is in charge, are they approved, what are the legal implications?
Shut down and worker relief plans: do they exist are they legal, do they meet your stakeholder obligations?
Re-start plan: when, who, how?
Test of plans: if you don’t test it won’t work?

Getting Prepared continued
Remember …. SSCR
Strategy, Structured Plans, Communication and Rapid Response
Regulatory and Legal Issues
Discussion needed by all organizations and institutions (how would either the avian influenza or a human pandemic) effect your company, institution, agency as related to the:
Privacy Act (and HIPAA)
Robinson-Patman, Sherman and Clayton Act
Price gouging (FTC, States)
Wage & price controls
Export and quarantine issues
Worker comp, layoff, discrimination,and unemployment issues
Disclosure issues & advertising
Quarantines, control of public or private stock or food medicine, etc…
Insurance, disability, long term care, life, business interruption, etc…
OSHA
Planning
Planning is a critical component of controlling and managing an outbreak of AI or any infectious outbreak in mammals or humans.
Take sufficient time to review with your staff the critical components required to effectively plan for an AI outbreak with birds or farm animals and for a potential human pandemic.
The chart on the following slide will aid the development of planning discussions.

Conclusion
If or when the Avian Flu reaches North America there will be a media frenzy that will likely have an impact on poultry prices and consumption. With prices already depressed for eggs and birds the food industry will be negatively impacted. Based on the history of Asian and European markets the public will rebound relatively soon after an initial outbreak. Exports will stop and unless the poultry markets are corrected, the U.S. will see a short term oversupply of bird parts ( dark meat). Producers of birds, eggs, feed products and related supporting industries will be weakened and some companies may be forced out of business correcting market prices.
If the Avian Flu spreads into commercial flocks around the country regulatory agencies will quickly control the outbreak. Once the virus is in the U.S. wild birds will keep the virus active for a number of years and reoccurrences will continue to show up. The public will likely learn to properly handle and prepare infected poultry and wild game. Consumers will learn to live with the AI issues as poultry producers already have.
If the outbreaks spread and management of the AI virus with bird populations cannot be controlled effectively, the cost of eggs and poultry will likely increase and shortages of products that contain eggs (bakery, etc…) and poultry meat (soups, etc…) will occur on a periodic basis. This will drive many food categories up in price and also impact both biodiversity, hunting and creating a potential for limited pet and human infection and or deaths from the AI virus found in birds or other animals.
Conclusion continued
The potential for the Avian Flu to mutate into a Human Pandemic Influenza is considered by public health officials to be significantly higher than other current virus outbreaks.
Lack of preparation by a public that sees the Avian Flu in birds come and go is of significant concern. Looking at SARS and Mad Cow we see that the media and the public have moved on in awareness and interest related to these diseases. It is likely this will occur with AI as well. Dropping our guard with the AI virus on a global scale could be a dangerous move by the world governments.
The issue the North American population faces is that a pandemic will likely begin in a third world country where little control or effort can be generated to stop it. The spread will be so fast and so devastating, and medical supplies so sparse no individual will remain untouched if it occurs.
The poultry and egg industries in the U.S. are OK. Where the U.S. is at risk is in the ability on a national and local level to stop and control a human virus spreading rapidly. We face many issues in the U.S. and this one is very, very significant.
There is no way to predict when a pandemic will occur, only that they do occur, and we are as a nation unprepared for one at this time.
Conclusion continued
If or when the Avian Influenza virus hits the U.S. markets (it has already been in the Asian and European markets) most business owners should see no dramatic economic effect unless they support the food sector. If AI spreads, travelers may see delays at airports during biosecurity checks.
If a human epidemic in Europe or Asia occurs travel will be delayed. Overseas sales will likely drop as quarantines occur and schools are closed.
If a human pandemic influenza reaches the U.S. schools and public venues will close within weeks and may remain closed for up to six months or more.
Many companies will need to shut down and manage cash on a conservative basis until their economic sector restarts. The buying population each company serves will vary in death rates. Organizations / Companies that provide products / services to individuals ages 18 to 40 will be greatly impacted. Companies should expect to lose a significant portion of their staff due to relocation and sickness. Small businesses, medical clinics, hospitals, and farmers will be hardest hit.
Products produced by 3rd parties may be nonexistent or in short supply.
Public institutions will be short of cash and communities will see reduced tax revenues. With limited revenues not all currently funded or budgeted projects will be completed.
The ability for many companies / organization to survive and or start up again after a long term shut down from a pandemic is always questionable.
Conclusion continued
If a pandemic occurs the rapid migration of individuals to smaller communities will spread a pandemic virus and overwhelm small town medical facilities, elevating deaths and illness. Smaller communities need to be as well prepared as larger communities.
Pandemics and epidemics do burn out and humans as well as other animals do develop immune defenses to a disease. Survival is part of the genetic plan for a species and humans have survived previous pandemics.
As a country we face serious and immediate issues ranging from global warming to global dimming, war, poverty, famine, and energy shortages. Pandemics and the impact of AI on poultry are difficult for the public to believe they can control or have room for on their list of personal and family concerns. Governments need to remain alert to the issues of public health and fund them equally with other key mandates such as the environment if our species is to remained safe.
Report Card
The following report card is focused on global Avian Influenza preparedness for the poultry and the food industry. It was created using publicly available information. This report card is constantly changing and viable for this period in time only. It was developed by the Business Development Group of Wayzata, Minnesota, USA. It is based on the ability to monitor the virus, stockpiles of vaccines, antivirals, public and government preparedness plans, security and regulatory controls and poultry containment measures.

Avian Influenza (Poultry), Global Preparedness as of 4/25/06:
Asia / China: D to a C
Pacific Rim: D
Africa: F
Southern Europe: C+
Central Europe: C+
Northern Europe: B+
Canada: B+
United States: A-
South / Central America: D
Report Card continued
The following report card is focused on the global human pandemic influenza preparedness by country groups. These grades rated the preparedness plans, medical supplies, availability of human vaccines and antivirals, economic support to withstand a pandemic, government regulations, monitoring systems, public awareness and public health programs related to a human pandemic stemming from a mutated AI virus. Because a country has a strong grade it does not mean the population will not be significantly effected.

Human Pandemic Influenza, Global Preparedness as of 4/25/06:
Asia / China: F to D-
Pacific Rim: F
Africa: F
Southern Europe: D+
Central Europe: D+
Northern Europe: D+
Canada: D+
United States: C-
South / Central America: D-

Report Card continued
Notes to Report Card
Over 70% of the grade was weighted on the availability of vaccines, antivirals and availability of general medical supplies, medical facilities and medical support staff. The next key weighted grade was based on the funding provided for planning purposes and funds for stockpiling critical supplies. Following this was a grade for research and development, monitoring and controls for an outbreak, public communication to date.
A number of countries had no public information available. In these cases the BDG used World Health Organization data or articles available on the internet. Lack of an effective vaccine for an AI human related pandemic and the ability to manufacture large numbers of dosages is the biggest single reason for the failing or low grade for all countries.
A surprising amount of planning has been completed around the world and this is important for the execution steps in preparing for a pandemic. By itself planning did not increase grades significantly but should impact future grades.