Bird Flu Timeline

Feb. 21, 2006
The swans tested in Hungary are confirmed to have the H5N1 strain of the bird flu.

Croatia discovers another case of H5N1 in a dead swan.
The Tower of London moves its famous ravens indoors to protect them from bird flu.

Feb. 18. 2006
France confirms that a wild duck found dead near Lyon was infected with the H5 strain.

Feb. 17, 2006
Egypt finds its first cases of H5N1 in dead swans. The Egyptian Health Ministry carries out tests on people living nearby, but no human cases are found.

Feb. 16, 2006
Tests of dead birds found in Germany confirm they had H5N1.

Feb. 15, 2006
Swans in Hungary test positive for the H5 strain of bird flu. Although the N1 subtype is not confirmed, experts suggest it is likely.

Feb. 14, 2006
Germany, Iran and Austria detect possible cases of deadly bird flu in wild swans.

Iraqi authorities declare a bird-flu alert in the southern province of Maysan and security forces are ordered to prevent people from carrying birds in and out of the area.
France orders that all poultry be kept in doors as bird flu spreads across Europe.

Feb. 13, 2006
The 12th case and 8th fatality due to the bird flu is reported in China. The cases occurred in areas that had previously reported no bird-flu outbreaks in poultry.

Indonesia reports its 25th case and 18th fatality caused by H5N1.

Feb. 12, 2006
Testing in Slovenia confirms H5N1 in a dead swan.

Feb. 11, 2006
Researchers in Bulgaria, Greece and Italy all confirm H5N1 has been found in wild swans.

Feb. 9, 2006
Azerbaijan confirms H5N1 has been found in migratory birds.

Feb. 8, 2006
Nigerian authorities confirm H5N1 has been found in some chickens. This is the first detection of the virus on the African continent.

Feb. 6, 2006
The Lithuanian health ministry reports that an Indian sailor who died in the Lithuanian port of Klaipeda may have been infected with bird flu.

According to a source in the Kurdish health ministry, Mohammed Sur Abdallah, the uncle of Iraqi Kurdish teenager Abdul Quader who died of bird flu, also died of the deadly H5N1 strain, according to laboratory tests in Cairo.
International researchers identify several different genetic strains of the avian flu virus, H5N1, in different bird populations in Southeast Asia. They note that any one of them could trigger a pandemic.

Feb. 5, 2006
A 22-year-old banana vendor, who died on Jan. 26 in Jakarta, and a 15-year-old boy who died on Feb. 1 in Bandung (capital of West Java province) are confirmed as having been infected with the bird flu virus by WHO officials.

Feb. 3, 2006
Bulgarian authorities report that a dead swan, found on the country's border with Romania, is suspected of having the bird flu virus. Samples are sent to Britain for further tests.

Feb. 2, 2006
Three people in Hong Kong are tested after they eat a bird-flu infected chicken, which was smuggled into Hong Kong from China's mainland. Both test negative for the disease.

U.S. scientists develop a vaccine that reportedly protects mice from several deadly strains of the H5N1 virus.

Jan. 30, 2006
Tests of Abdul Qader, who died on Jan. 17, return from Egypt and confirm she was infected with the bird flu, specifically H5N1. The girl died in the village of Ranya, Iraq, which is located about 60 miles south of the Turkey border, and 15 miles west of Iran.

Jan. 27, 2006
Hamasour Mustapha, the 50-year-old uncle of Abdul Qader, and who was caring for her throughout her illness, dies of severe respiratory illness. Tests are begun to try and discover the source of his infection.

Jan. 23, 2006
China announces its 10th human case of bird flu infection.

Indonesia announces two more bird flu-related deaths.

Jan. 18, 2006
Testing confirms that the Indonesian toddler who died on Jan. 17 had bird flu.

A 54-year-old Iraqi woman is hospitalized for a severe respiratory infection. She is from the same area as the 15-year-old girl who died the previous day. Her illness is under investigation by WHO as a possible bird-flu infection.
WHO and UN officials expect bird flu spread in Turkey to slow as massive numbers of birds are culled, and poultry farmers quickly adapt to improved hygiene standards.

Jan. 17, 2006
The 3-year-old brother of the Indonesian girl who died on Jan. 14, dies.

Abdul Qader, a 15-year-old Iraqi girl dies of a severe lung infection in the village of Raniya.

Jan. 16, 2006
Tests confirm that Fatma Ozcan died from bird flu, making her Turkey's fourth death related to the illness.

Turkey kills 764,000 fowl in an attempt to control the virus' spread.
The WHO asks the Turkish Government for permission to track the virus' spread in humans.

Jan. 15, 2006
Twelve-year-old Fatma Ozcan of Dogubayazit, Turkey, dies in hospital, but preliminary tests show she is negative for bird flu.

Jan. 14, 2006
A 13-year-old Indonesian girl dies of bird flu, bringing the country's bird flu death toll to 13.

The girl's 5-year-old sister and 3-year-old brother are tested for bird flu, but results are inconclusive.

Jan. 13, 2006
The World Health Organization confirms Indonesia's 12th bird flu fatality.

Turkish health authorities launch an investigation to determine if 2-year-old Sahibe Yetistiren is Turkey's fourth death from bird flu. Experts say this is unlikely, as she had a bacterial lung infection rather than a viral one, and that she had no history of contact with birds.

Jan. 12, 2006
Analysis of virus samples from two of the Kocyigit children detects a change in one gene in one of two samples tested, but WHO says it is too early to tell whether the mutation is important.

Jan. 11, 2006
Two brothers, 4 and 5 years old, test positive for the H5N1 virus, but neither shows symptoms of the disease. They are closely watched at Kecioren Hospital in Turkey's capital of Ankara, as doctors are unsure if the boys have human bird flu in its earliest stages, or if the infection does not necessarily lead to illness.

WHO reports two more bird-flu deaths in China.

Jan. 9, 2006
A total of 14 people have been diagnosed with bird flu in Turkey, but UN health experts say there is still no evidence to suggest it is spreading between humans.

The European Union bans the import of untreated feathers from six countries neighboring, or close to, Turkish borders.
Another bird flu outbreak is reported in the Crimean peninsula.

Jan. 7, 2006
Hulya Kocyigit becomes the third person in Turkey to die of the bird flu.

Jan. 6, 2006
A study in Vietnam suggests the bird flu virus is more widespread -- and spreads between humans -- more easily than most experts surmise, but that it also probably doesn't kill half its victims. The study is not considered definitive, but experts call the information "compelling."

Jan. 5, 2006
Turkey's second known human case of bird flu, 15-year-old Fatma Kocyigit, dies in the early morning. Health officials say that these cases are not the beginning of a pandemic.

Jan. 4, 2006
Mehmet Ali Kocyigit, who died on Jan. 1, is confirmed to have died of bird flu, contradicting the initial report that the boy had died from pneumonia.

The boy's 15-year-old sister, Fatma Kocyigit, also tests positive for the H5N1 virus.
A third case, 11-year-old Hulya Kocyigit, is pending. Fatma, Mehmet, Hulya and their family lived with and raised, poultry at their Dogubeyazit, Turkey home. These are the first known human cases of bird flu in Turkey.

Jan. 3, 2006 – Bogus bird flu drugs begin to flood the internet.

Jan. 1, 2006 – A 14-year-old boy named Mehmet Ali Kocyigit, from Dogubeyazit, Turkey, dies, but health officials say bird flu was not the cause, instead attributing the death to pnuemonia.

Dec. 29, 2005
China announces its seventh human case of bird flu and its third fatality.

Dec. 23, 2005
Further testing of blood samples of Zhou confirms she died of complications arising from the H5N1 avian flu strain. This brings the total number of bird flu related fatalities for December 2005 to six; the worst since March 2005, when seven people died.

Dec. 21, 2005
Zhou, the 41-year-old Chinese factory worker, dies in a hospital in the southeastern province of Fujian, China. Doctors fear bird flu may be responsible.

Dec. 22, 2005
Romania reports its 21st outbreak among poultry.

Indonesia's number of human deaths related to bird flu rises to 11.

Dec. 15, 2005
Turkey reports an oubreak of bird flu in poultry located nine miles from its border with Iran. Three hundred fifty-nine fowl are destroyed in an attempt to contain the infection.

Dec. 13, 2005
Zhou's blood samples test negative for the H5N1 virus when tested by the Fujian Provincial Center for Disease Control and Prevention (CDC).

Dec. 9, 2005
The agriculture minister of Turkey, Mehdi Eker, announces there is no longer any bird flu in Turkey. This causes some controversy when it is later revealed that bird flu was detected in the laboratories of the Agriculture Ministry on this very same day.

Dec. 8, 2005
A 31-year-old farmer, who fell ill on Oct. 30 with high fever and pneumonia-like symptoms, is confirmed as China's fifth human case of bird flu after falling sick following contact with dead birds. She has since recovered.

The Ukrainian birds that were tested earlier in the month are confirmed to have the H5N1 strain of bird flu.
A 41-year-old female factory worker, surnamed Zhou, is admitted to the hospital with symptoms of fever and pneumonia.

Dec. 5, 2005
Romania quarantines two more villages in the southeastern part of the country's Danube delta amid fears of a bird flu outbreak there.

Dec. 4, 2004
Cioacile becomes the fourth village in eastern Romania's Braila county to be quarantined in a week after three chickens test positive for the bird flu H5 virus. New samples are sent out to determine whether these strains are H5N1.

A Vietnamese doctor concludes that Tamiflu does not work after he unsuccessfully treats 41 H5N1 victims with the drug.

Dec. 3, 2005
More than 1,600 dead birds in southern Ukraine's Crimea peninsula test positive for the H5 strain of the bird flu virus. Representatives announce that test results, indicating whether the lethal strain was H5N1, should be released Dec. 8.

World Health Organization tests confirm that a 25-year-old Indonesian woman who died last week was the country's eighth bird flu victim.
China announces a new research program to discover new bird flu treatments by combining Chinese traditional medicine and Western knowledge.
Vietnam's agriculture ministry reports that more chickens and ducks are dying in the country's two northern provinces due to fresh bird flu outbreaks, and birds are also dying in a third area.

Dec. 2, 2005
Abnormalities found in the X-rays of 14 Vietnamese bird flu patients mean the procedure can be used to predict whether the disease will be fatal.

Indonesia calls for local governments to set up health posts in all villages in an attempt to create an early bird flu warning system to reach even the most remote corners of the country.
China announces it will set up at least 300 monitoring stations across the country to form a long-term monitoring network that will help prevent a possible outbreak of wildlife diseases, including bird flu from migratory birds.
The widespread sale of fake vaccines threatens to undermine China's plan to vaccinate 14 billion fowl.
Some pneumonia patients in Vietnam inexplicably develop serious lung damage in a short space of time, raising fears that a new, more virulent strain of bird flu may have arrived in the country.
A senior health official in Thailand reports that the latest two bird flu cases in the country might have been caused by human-to-human transmission.
International health experts warn that the official numbers of bird flu deaths may be too low, and governments may be greatly underestimating the problem.
At a three-day Pan-American conference on the bird flu, experts and authorities from across the Americas announce their intention to work together to prevent bird flu outbreaks and collaborate if the disease hits Latin America.

Dec. 1, 2005
Eight new cases of bird flu are reported in the remote village where the H5N1 virus was detected in October.

A study by Dutch researchers demonstrates that bird flu vaccines are effective in preventing the transmission of the virus between birds, in addition to helping them survive the disease.
China lifts the quarantine on the areas in northeastern Liaoning province that were affected by bird flu.
India announces plans to create an emergency stockpile of one million doses of anti-flu drugs to combat the bird flu.

Nov. 30, 2005
Regulatory bodies, such as the U.S. Food and Drug Administration and World Health Organization (WHO) announce plans to meet early 2006 to discuss how to speed up production of a bird flu vaccine.

The United Nations Food and Agriculture Organization (FAO) warn that culling wild birds in urban areas in countries affected by bird flu will not help prevent a pandemic.
The Ministry of Agriculture and Rural Development in Vietnam announces it will only destroy poultry in infected areas, as well as cordon them off and disinfect the farms, rather than cull the country's entire poultry stock.
The Thai News Agency reports that only one area in Thailand is still under close surveillance for a potential bird flu outbreak.
Chinese Health Minister Gao Quiang says that the Chinese government is honestly reporting the country's bird flu situation, but concedes that doctors and hospitals in rural areas may not always be capable of diagnosing the disease.

Nov. 29, 2005
China reports two more flu outbreaks in the country's northwestern Xinjiang region and in the central Hunan province.

Thailand Tamiflu manufacturer Roche announces that Thailand and the Philippines are not bound by patent restrictions, and may make their own versions of the drug.
The Indonesian government begins random checks on birds in several areas, in concert with civilian tip-offs, to detect bird flu outbreaks early.
The Russian Ministry of Agriculture announces that only two villages, one in the Kurgen region and one in the Astrakhan region, are still infected by bird flu.

Nov. 28, 2005
A 16-year-old Indonesian boy (the country's 12th human case of the disease) is said to be on the road to recovery.

Chinese Ministry of Health announces that the H5N1 virus that caused China's human cases of bird flu was a mutated version of the strain found in Vietnam's human cases.

Nov. 23, 2005
China announces its second human death related to the bird flu virus, a 35-year-old farmer identified only by her surname, Xu.

Nov. 21, 2005
After a duck from a poultry farm near Abbotsford, British Columbia is discovered to carry the low pathogenic H5 strain of bird flu, the United States places an interim ban on poultry exports from the Canadian province.

Nov. 10, 2005
China quarantines 116 people in northeastern Liaoning province after two new outbreaks of bird flu occur there.

Nov. 1, 2005
The WHO's official count of human cases of H5N1 reaches 122, with 62 deaths, in Vietnam, Thailand, Indonesia and Cambodia.

October 2005
H5N1 is reported in poultry in Turkey and Romania and in wild birds in Greece and Croatia.

July 21, 2005
Indonesia reports its first human case of H5N1 bird flu.

April 30, 2005
China reports that wild birds are dying at a lake in central China. The lake is a major stop along migratory pathways. Within weeks, more than 6,300 wild birds are dead.

Feb. 2, 2005
Cambodia reports its first human case of H5N1 bird flu. It is fatal.

Oct. 11, 2004
H5N1 infection spreads among tigers in a Thai zoo.

Feb. 20, 2004
Thailand reports H5N1 infection of domestic cats in a single household.

Feb. 1, 2004
Vietnam investigates a family cluster of H5N1 cases. Person-to-person spread cannot be ruled out, but the virus is not spreading among humans.

February 2004
The last HPAI outbreak among U.S. poultry occurs. A flock of chickens in Texas comes down with an H5N2 virus. A quick response by state and federal officials keeps the virus from spreading beyond this one small flock. There are no human cases.

Jan. 23, 2004
Thailand reports human H5N1 bird flu infections.

Jan. 11, 2004
Humans in Vietnam come down with H5N1 bird flu caught from poultry. There is a high death rate among infected people, but the disease does not spread from person to person.

Dec. 26, 2003
Authorities in the Republic of Korea report the spread of H5N1 infection to chicken and duck farms in five provinces. Altogether, more than 1.3 million chickens and ducks have died or been destroyed.

Dec. 17, 2003
Authorities in the Republic of Korea formally report an epidemic of highly pathogenic avian influenza, caused by the H5N1 strain of the virus, at the chicken farm. This is the first time that highly pathogenic avian influenza has ever been reported in the country. No symptoms are reported in farmers in close contact with the infected chickens.

Dec. 12, 2003
The sudden death of chickens at a farm in Eumsung district, near the capital city of Seoul, prompts suspicions of an epidemic of highly pathogenic avian influenza in the Republic of Korea. Tests are initiated. Of the 24,000 chickens on the farm, 19,000 died between Dec.5 and Dec. 11. The remaining 5,000 were culled.

December 2003
Tigers and leopards in a Thailand zoo die of H5N1 bird flu after eating fresh chickens. It's the first time bird flu has been seen in large felines.

Mid-2003
H5N1 bird flu spreads in Asia, but it is either undetected or unreported.

April 2003
The Netherlands reports H7N7 bird flu in over 80 human cases with the death of one veterinarian.

Feb. 12, 2003
Thailand confirms its sixth case, a 13-year-old boy.

Vietnam confirms its 19th case, which was fatal in a 19-year-old man who had been hospitalized in Ho Chi Minh City.
The total number of confirmed cases in these two countries combined is 25, of which 19 have been fatal.
The first clinical and epidemiological data on 10 cases in the Vietnam outbreak is made public by WHO.

Feb. 11, 2003
In the investigation of possible human-to-human transmission in Vietnam, results from the analysis of virus isolated from the second sister in the family cluster show that the virus is of avian origin and contains no human influenza genes. – WHO issues guidelines for global surveillance aimed at monitoring spread of H5N1 infection in human and animal populations.

The number of farms in China with confirmed H5N1 outbreaks increases from 19 to 23.

Feb. 10, 2003
Chinese authorities report a suspected H5N1 outbreak at a chicken farm in Tianjin Municipality. Spread to additional farms within other provinces is also reported. Altogether, H5N1 infection is suspected or confirmed on 39 farms in 14 of the country's 31 provinces, autonomous regions and municipalities. Of the outbreaks at 39 farms, 19 are confirmed as caused by H5N1.

Avian influenza is detected at a second farm in Delaware. Some 72,000 birds are destroyed. Japan, China, Poland, Malaysia, Singapore and the Republic of Korea ban poultry imports from the United States.

Feb. 9, 2003
Vietnam reports three additional cases, two of which were fatal.

The total number of cases in the two affected countries, Vietnam and Thailand, is now 23 cases, of which 18 were fatal.
In Vietnam, 57 of the country's 64 provinces have been affected by H5N1 in poultry. Around 27 million birds have died or been destroyed.

Feb. 8, 2003
U.S. authorities report an outbreak of avian influenza at a farm in Delaware. H7 is detected in the initial tests. Further tests are initiated to determine if the H7 subtype is highly pathogenic. Some 12,000 birds are destroyed.

OIE reports that half a million birds have been culled at nine farms in China where H5N1 infection has been confirmed.

Feb. 6, 2003
A GOARN international team arrives in Cambodia. Members of the GOARN team are drawn from the Institut de Vielle Sanitaire, and the Institut Pasteur Network in France.

China confirms further spread in poultry. Altogether, H5N1 infection is confirmed or suspected at farms in 13 of the country's 31 administrative districts.
In Vietnam, 56 of the country's 64 provinces are now affected by H5N1 disease in poultry.
As part of the investigation of possible human-to-human transmission in a family cluster in Vietnam, virus from one fatal confirmed case is fully sequenced. All genes are of avian origin. This finding does not, however, entirely rule out limited human-to-human transmission. If this occurred, the chain of transmission reached a dead end with the death or recovery of all family members in the cluster.

Feb. 5, 2003
Vietnam reports two further cases, both fatal, in young adults.

Thailand confirms the country's fifth case. The patient, a child, died on Feb. 2.
In Thailand, 40 of the country's 76 provinces have reported H5N1 disease in poultry.
The Republic of Korea confirms H5N1 infection at an additional two farms in Asan, south of Seoul, suggesting that the epidemic in birds is not fully under control.

Feb. 4, 2003
Chinese authorities report the spread of H5N1 infection in poultry to farms in two additional provinces.

In Vientiane, Laos, 17 out of 18 farms (including one duck farm) test positive for the H5 subtype.

Feb. 3, 2003
Thailand's one surviving case, reported on Jan. 23, dies. To date, Thailand has reported four cases, all fatal.

Vietnam reports an additional three cases, one fatal, all in young adults.
Authorities in Vietnam report that 52 of the country's 64 provinces have been affected by H5N1 in poultry.
Thai authorities estimate that around 26.9 million chickens have been culled nationwide, with slaughtering continuing in seven provinces. Altogether, 36 of the country's 76 provinces have been affected.
Tests confirm that the poultry outbreaks in Indonesia are caused by H5N1. In 1995, highly pathogenic avian influenza was declared to be present throughout the country.

Feb. 2, 2003
Thailand reports its fourth confirmed case of H5N1 infection in a 58-year-old woman from Suphanburi Province, who died on 27 January. Of the country's four cases, three have been fatal.

Chinese authorities report that H5N1 infection is now confirmed or suspected in 10 of the country's 31 provinces, autonomous regions, and municipalities.
A WHO investigation of a family cluster in Thai Binh Province, Vietnam, fails to reveal a specific event, such as contact with sick poultry, or an environmental source, to explain these cases and concludes that limited human-to-human spread is one possible explanation.
Indonesia reports an outbreak of highly pathogenic avian influenza in poultry, subsequently confirmed as H5N1. This is the first time that highly pathogenic avian influenza has ever been reported in the country.

Feb. 1, 2003
Vietnam confirms two further cases, both fatal, in sisters, aged 23 and 30 years. Of the country's 10 cases, eight have died, one has recovered, and one remains hospitalized.

Jan. 30, 2003
Chinese authorities confirm H5N1 infection in poultry at farms in an additional two provinces, Hunan and Hubei. Suspected outbreaks are reported in Anhui and Guangdong provinces and in Shanghai municipality.

Jan. 28, 2003
Pakistan reports an outbreak of highly pathogenic avian influenza. Testing detects the H7 subtype. The report states that 1.7 million hens have either died or been destroyed.

Jan. 27, 2003
Thailand's third case, reported on Jan. 26, dies. Of the three cases, one remains alive.

Vietnam reports its eighth case. The child has fully recovered and been discharged from hospital.
The Ministry of Health in China confirms the presence of highly pathogenic H5N1 avian influenza in poultry at a duck farm in the Guangxi Zhuang Autonomous Region in the south.
Laos reports poultry deaths at a farm near the capital city of Vientiane. The report states that 2,700 hens in a flock of 3,000 have died. Initial tests identify H5. Arrangements are made to test for H5N1.
Cambodia reports positive influenza A results from geese at a farm near Phnom Penh.

Jan. 26, 2003
Authorities in Thailand report laboratory confirmation of the country's third case, also in a young child. One of the two previously confirmed cases dies.

Jan. 25, 2003
WHO staff and a GOARN international team, with support from Health Canada, arrive in Thailand.

Jan. 24, 2003
Vietnam reports two more cases of H5N1 infection in children hospitalized in Ho Chi Minh City – the first cases from the south. One child dies, and the second remains hospitalized in critical condition. The country has now reported seven cases, six of which were fatal.

Vietnam reports that the H5N1 outbreak in poultry has spread to 23 of the country's 64 provinces. Nearly 3 million chickens have either died or been destroyed.
Cambodia reports H5N1 in chickens in a farm near Phnom Penh.

Jan. 23, 2003
Authorities in Thailand report an outbreak of highly pathogenic avian influenza, caused by the H5N1 strain, at a farm in Suphanburi Province. This is the first time that highly pathogenic avian influenza has ever been reported in the country. Nearly 70,000 birds have died or been destroyed. Japan, the EU and other major export markets immediately ban all Thai poultry products.

The Ministry of Public Health in Thailand informs WHO of two laboratory confirmed cases of H5N1 infection in humans. The cases, from Suphanburi and Kanchanburi provinces, are young boys. Both are alive.
Influenza network laboratories report that human H5N1 viruses from Vietnam are resistant to one class of antiviral drugs, the M2 inhibitors amantadine and rimantadine.

Jan. 22, 2003
Network laboratories determine that H5N1 viruses in the current human and avian outbreaks are significantly different from H5N1 viruses in outbreaks in Hong Kong in 1997 and 2003, indicating that the virus has mutated.

Jan. 20, 2003
Laboratories in the WHO Global Influenza Surveillance Network accelerate work needed to develop an H5N1 vaccine for humans.

Jan. 19, 2003
A fifth fatal case of H5N1 infection is confirmed in Vietnam, also in Hanoi.

A single peregrine falcon is found dead near a residential development in Hong Kong. Testing begins immediately. Two days later, H5N1 is confirmed in samples taken from the bird.
WHO staff and a GOARN international team arrive in Vietnam. Members of the team are drawn from the Centers for Disease Control and Prevention (CDC), USA; the European Commission (DGAL – Ministère de l'agriculture, de l'alimentation, de la pêche et des affaires rurales, France); European Programme for Intervention Epidemiology Training (EPIET) Network; Health Protection Agency, UK; Institut de Vielle Sanitaire, France; Institut Pasteur Network, France; Institute for Infectious Disease Control (SMI), Sweden; National Institute of Infectious Diseases, Japan; RIVM, the Netherlands, and the Robert Koch Institute, Germany.

Jan. 14, 2003
WHO sends an urgent request for assistance to GOARN to identify experts to support the Vietnamese health authorities and the WHO office in Hanoi. Immediate objectives are to reduce the risk of transmission from birds to humans and to support health authorities in the epidemiological investigation and containment of human cases. Expertise is also requested to increase laboratory capacity, advise on hospital infection control and strengthen surveillance for human cases.

Jan. 15, 2003
A fourth case of human infection with H5N1 is confirmed in Vietnam. All four cases, which had been hospitalized in Hanoi, were fatal.

Jan. 13, 2003
Authorities in the Republic of Korea announce the spread of H5N1 infection to an additional farm, dashing hopes that the epidemic had been brought under control. To date, about 1.6 million birds have died or been destroyed.

Sequencing of virus from one of the fatal cases in Vietnam reveals that all genes are of avian origin.

Jan, 12, 2003
Hong Kong's National Influenza Centre confirms infection with H5N1 in a third fatal case in Vietnam, the 30-year-old mother of the 12-year-old girl.

Vietnamese health authorities and WHO announce laboratory confirmation of the three cases of human infection with avian H5N1.
Confirmation of these three cases marks the third time in recent years that the H5N1 strain has jumped from its avian host to infect humans. The previous human infections occurred in Hong Kong in 1997 (18 cases, six of which were fatal) and again in Hong Kong in February 2003 (two cases, one of which was fatal). The 1997 outbreak coincided with highly pathogenic H5N1 avian influenza in Hong Kong's poultry farms and live markets. The two cases in 2003 had returned to Hong Kong following travel in southern China.
Authorities in Japan report an outbreak of highly pathogenic avian influenza, caused by the H5N1 strain, at a farm in Yamaguchi prefecture. This is the first report of highly pathogenic avian influenza in the country since 1925.

Jan. 11, 2003
Since the Jan. 5 report, Vietnamese officials have identified two further cases of severe respiratory illness (another child and the first adult), bringing the total since the end of October in Hanoi's hospitals to 13.

Tests on samples from two fatal cases in Vietnam (the 12-year-old girl and a 10-year-old boy), performed by Hong Kong's National Influenza Centre, confirm infection with the H5N1 avian influenza virus strain.
WHO alerts its partners in the Global Outbreak Alert and Response Network (GOARN).

Jan. 8, 2003
Authorities in Vietnam report outbreaks of highly pathogenic avian influenza, caused by the H5 subtype (later confirmed as the H5N1 strain), at farms in the southern provinces of Long An (two farms) and Tien Giang (one farm). Around 70,000 birds died or were destroyed. This is the first time that highly pathogenic avian influenza has ever been reported in the country.

Jan. 7, 2003
WHO informs public health officials worldwide through its electronically distributed Outbreak Verification List.

Jan. 6, 2003
A member of the press informs the WHO office in Hanoi of rumored chicken deaths in southern Vietnam. The regional office in Manila is alerted.

Jan. 5, 2003
Health authorities in Vietnam inform the WHO office in Hanoi of an outbreak of severe respiratory illness in 11 previously healthy children hospitalized in Hanoi, with the most recent hospital admission on Jan. 4. Seven cases were fatal and two patients remain critically ill. A 12th case, a sibling of one of the Hanoi cases, died of a respiratory illness in a provincial hospital.

Included in this report are six children, aged 9 months to 12 years, who died in a Hanoi hospital of respiratory illness of unidentified cause between Oct. 31 and Dec. 30, 2003. For the first five cases, no samples are available for analysis. Samples are available for the 6th case, a 12-year-old girl who was admitted to hospital on Dec. 27 and died three days later. All of these cases were identified retrospectively based on hospital records.
It is not known whether all cases were caused by the same pathogen. The pathogen is unknown, but thought to be an influenza virus or an adenovirus. Arrangements are made for testing.
WHO assistance in responding to the outbreak is requested. WHO headquarters and the regional office in Manila are alerted.

November-December 1997
There are 18 new human cases of H5N1 bird flu in Hong Kong, 12 with direct contact with infected poultry. Six people die. Officials destroy 1.4 million chickens and ducks.

May 1997
The first person known to catch H5N1 bird flu dies in Hong Kong. The virus has been causing an epidemic among poultry in the city.

1996
HPAI H5N1 bird flu is isolated from a farmed goose in Guangdong, China.

1988
Wiley, Wilson and Skehel determine the location of the antigenic sites on the hemagglutinin molecule by X-ray crystallography.

1983
The second HPAI outbreak occurs in the U.S. Caused by an H5N2 virus, it does not spread among humans. However, this severe poultry epidemic strikes chickens, turkeys and guinea fowl in Pennsylvania and Virginia. It is finally brought under control after the destruction of 17 million birds.

1977
Mild Russian influenza epidemic occurs.

1976
Swine flu breaks out among a handful of soldiers stationed at Fort Dix, N.J. One dies. It's an H1N1 virus, and health officials worry that they are seeing the return of the 1918 H1N1 Spanish Flu pandemic. As the virus is circulating among U.S. pigs, President Gerald Ford calls for a crash vaccination program. Despite delays, a vaccine is made and a quarter of the U.S. population is inoculated. There were 25 deaths from a rare paralytic complication of the vaccination (Guillain-Barre syndrome). Nobody else died of swine flu, which never caused an epidemic.

Mid-1970s
Researchers realize that enormous pools of influenza virus continuously circulate in wild birds.

1968-1969
The "Hong Kong Flu" causes the last flu pandemic. It was caused by an H3N2 virus and killed some 34,000 Americans. The relatively low death toll is thought to have been due to two factors. First, the virus contained the N2 protein humans had been exposed to before. Second, an H3 virus circulated around the turn of the century, giving some immune protection to elderly people who had caught the flu back then.

1957-1958
The "Asian Flu" causes the second pandemic of the 20th century. Caused by an H2N2 virus, it begins in China and kills one million people worldwide, including 70,000 Americans.

1955
Sir Christopher Andrewes, along with Burnet and Bang, coins the term "myxovirus" for the influenza family.

1941
George K. Hirst discovers that influenza causes hemagglutination of red blood cells, thus providing a new method of assaying for the virus

1940
Frank Macfarlane Burnet grows influenza on a laboratory growth system (embryonated chicken eggs).

1933
Sir Christopher Andrewes, Wilson Smith and Sir Patrick Laidlaw isolate the first human influenza virus.

Late 1920s
Richard Shope shows that swine influenza can be transmitted through filtered mucous, implying that influenza is caused by a virus.

1924
The first outbreak of HPAI avian influenza -- bird flu -- in the U.S. It does not spread among humans.

1918-1919
The "Spanish Flu" circles the globe (though some experts think it may have started in the U.S.). Caused by an H1N1 flu virus, it is the worst influenza pandemic (and subsequently, epidemic) to date. There are more than half a million U.S. deaths; worldwide death estimates range from 20 million to 100 million. According to WebMD, "The pandemic comes before the era of antibiotics -- which are now essential in treating the secondary bacterial infections that often kill flu-weakened patients -- so it's difficult to say whether this flu would have the same dreadful impact in the modern world. But it is a very frightening disease, with very high death rates among young, previously healthy adults."

1900
Major epidemic.

1889-1890
The "Russian flu" spreads through Europe and reaches North America in 1890.

1878
A disease causing high mortality in poultry becomes known as the "fowl plague." Fowl plague is now called HPAI avian influenza.

1847-1848
Influenza sweeps through the Mediterranean to southern France and then continues across in Western Europe.

1831, 1833-1834
Influenza pandemics hit.

1830
Major epidemic causing high mortality among the elderly spreads across Russia from Asia.

1781
Major epidemic causing high mortality among the elderly spreads across Russia from Asia.

1700s
Influenza pandemics in 1729-1730, 1732-1733, 1781-1782.

1580
First recorded influenza pandemic begins in Europe and spreads to Asia and Africa.

1485
"Sweating sickness," a flu-like malady, sickens hundreds of thousands of people in Britain. The Lord Mayor of London, his successor and six aldermen die. The Royal Navy cannot leave port due to the sickness of sailors. Doctors prescribe tobacco juice, lime juice, emetics, cathartics and bleeding as treatments for the disease.

1357 AD
The term, “influenza,” from the Italian word meaning "influence," was coined. Popular belief at that time blamed the development of flu on the influence of the stars.

412 BC
Major epidemic of a disease (which, although not called influenza, probably was influenza) recorded by Hippocrates.