The waiting game

If the pochard duck in Lyon, France is confirmed to have died from H5N1 (and most believe this will happen), we will have the virus in birds in the seventh EU nation in the last two weeks, a remarkable spread. The disease is now reported from Europe's east to its west and from north to south. The UK is bracing for what seems an inevitable discovery soon. Meanwhile, reports from the Nandurbar district of Maharashtra in India remind us that this virus is flying everywhere.

When and if birds in North and South America become infected is still an open question as the exact mode of predominant spread is still a matter of contention. It is clear migratory birds can carry the disease and most believe they can spread it over long distances. But there remain certain inconsistencies and unknowns here, and it is also quite clear that poultry movements and trade are also a major means for spreading the virus.

Public health people, however, are now anxiously waiting for the other shoe to drop. If Europe starts to see human cases, we would be in a qualitatively different phase, no longer able to maintain it is the peculiarly close relationship with poultry in China, southeast asia, Indonesia and Turkey that has made these localities the site of human outbreaks.

The waiting game begins in earnest.