Fears of a long-predicted global influenza pandemic grew stronger in 2005 as a deadly form of the virus spread among birds worldwide and killed 36 more people in the disease's Southeast Asian epicenter.  Governments and international organizations stepped up cooperative measures to isolate the disease and to deal with a possible pandemic.

The number of human deaths from bird flu more than doubled in 2005 to over 70, according to World Health Organization numbers. So far, bird flu deaths are limited to East Asia, mainly the Southeast, with Vietnam the hardest hit. The death toll accounts for half of all human cases, an alarming death rate in the view of physician Gregory Poland of the Mayo Clinic College of Medicine in Minnesota.

"If that virus gains the ability to easily transmit from human-to-human, it will be a disaster of unprecedented proportion," he said.

Fueling this fear was the global spread of infected birds from Asia, thanks to seasonal migrations. By year's end, birds with the deadly H5N1 form of avian flu had been detected in Europe and Canada. In countries where it was found, tens of thousands of poultry were slaughtered.

The first sign of this spread came in late April at central China's Lake Qinghai, a migratory fowl congregation point where more than 6,300 birds of different species perished within weeks. Until then, the disease had been seen only in domestic poultry, thought to be its source. World Health Organization (WHO) spokesman Dick Thompson said migrating birds must be tracked.

"There's an urgent need to sample and tag and track as many of these species as feasible, especially considering the narrow time frame that we've got available to do it. We need more information on the migratory routes regarding these birds," said Mr. Thompson.

To confront its outbreaks, China embarked on an ambitious effort to vaccinate all of its many billions of chickens, ducks, and geese ? 20 percent of the global total.  Vietnam, Indonesia, and Pakistan also inoculated birds against the flu.

The European Union, meanwhile, temporarily banned live bird imports.

The ongoing outbreaks raised concern about the ability of public health systems to respond to an expected influenza pandemic. About three pandemics occur per century and it has been 37 years since the last one. U.S. Health and Human Services Secretary Michael Leavitt said if it comes, it could kill up to 7.5 million people around the world.

"Pandemics happen. It is a fact of biology. When it comes to a pandemic, we are overdue and underprepared," he said.

To overcome the preparation deficit, international conferences were held in Ottawa, Canada and Geneva, Switzerland in October and November to coordinate the responses of governments and global agencies.

Together, the meetings identified five major goals -- reduce human exposure to sick animals, strengthen surveillance and reporting of disease, develop national preparedness plans, intensify rapid containment operations, and accelerate global research to overcome the shortage of vaccines, antiviral medicines, and production capacity.

Canadian Prime Minister Paul Martin emphasized the importance of global teamwork.

"Within our countries and among our countries, each of these efforts will require cooperation and coordination on a scale that is virtually unprecedented," said Mr. Martin.  "The consequences of a world that is unprepared are simply unacceptable."

The global standards were in line with President Bush's September announcement at the United Nations of the International Partnership on Avian and Pandemic Influenza. Its aim is to bring key nations together to improve global readiness by elevating the issue on their national agendas and coordinating efforts among donor and affected nations.

Within his own government, Mr. Bush asked Congress for $7 billion for flu pandemic preparations, a large portion of which would go toward new vaccine research. Other money would help other nations train personnel to expand detection and testing.

"Together, we're working to control and monitor avian flu in Asia, and to ensure that all nations have structures in place to recognize and report outbreaks before they spread beyond human control," said Mr. Bush.

The lack of medical defenses against bird flu clouds the future.  A study from the U.S. government's Centers for Disease Control (CDC) showed that worldwide resistance to influenza drugs increased by 12 percent in the last decade.  H5N1 is resistant to one of the two major classes of flu drugs, amantadine, and scientists reported signs in Asia it is learning to defy the other one, which includes Tamiflu, the major drug nations are stockpiling against the disease.

Moreover, no one knows if existing flu vaccines will work against H5N1, and a vaccine specific to it is only in the testing stage.

So University of Maryland flu researcher Daniel Perez said the slaughter of infected birds will a crucial protective measure for the time being.

"Right now, that is the only tool that is effective in controlling avian influenza," said Mr. Perez.