Keep an open mind. Despite intensifying efforts to track and predict the spread of the H5N1 virus and to assess the risks of a human influenza pandemic, very little new information has emerged in recent months to reduce the uncertainty the world faces about the course of future events. The landscape of possible scenarios that bio-era described in March 2005 remains wide open (see "Thinking Ahead: Using Scenarios to Understand the Risks of an Influenza Pandemic").

Not surprisingly, the disease continues to expand its geographic domain, with detection or confirmed outbreaks in 23 previously unaffected countries since February 1st. H5N1’s “slow burn” continues to disrupt the global poultry industry and deepen public concerns about the possible risks to human health. These events have significant long term consequences in their own right, including increased pressures for changes in poultry industry operations, widening use of influenza vaccines for poultry, and intensified surveillance and monitoring of migratory birds.

In this update, we describe the ongoing spread of H5N1 in Europe, the Middle East, and Africa, and discuss the short-term economic shocks being experienced by the poultry industry in the affected regions.