1. Bird Flu Build Up
Pre-Reading Activities
A: Talking And Thinking
Answer these questions in pairs.
1. In the first part of the twentieth century (1900-1920) one event caused the deaths of
20-40 million people worldwide. Do you know what it was?
2. What do you know about this event? Were any of your family (grandparents, great-
grandparents, etc.) affected by it?
3. What do you know about the 'bird flu'? Share your ideas with your partner.
B: Find Your Other Half
Your teacher is going to give you some background information on part of today's topic.
You will be given a piece of paper with half a sentence with some information about the
topic. Your part of the sentence may have a word or words that you do not know the
meaning of. Use your dictionary if you need to. Make sure you understand your part of
the sentence as you may be asked to explain it later!
Someone else in the class has the other half of your sentence. Memorize your sentence
half and then put the paper away. When your teacher gives a signal, stand up and mingle
with other students. Tell other students your sentence half and listen to theirs. Try to find
the person who has the other half of your sentence.
When you find your partner, sit down with your partner and talk about what your
sentence teaches you about the topic. When everyone in the class has found their partner,
pairs of students should stand up and say their sentence. Take turns doing this until
everyone in the class has said their sentence.
Reading Activities
A: Understanding The Main Idea
Read Part One of Article One and decide which of the following is the main idea:
1. H5N1 may start the next worldwide flu pandemic.
2. The human strain of H5N1 is showing resistance to Tamiflu.
3. Relenza may be a good alternative to Tamiflu.
4. Drug manufacturers need to make other varieties of Relenza.

2. Article One Part One
Bird flu 'resistant to main
drug'
HONG KONG, China Fri 30 Sep
(Reuters) -- A strain of the H5N1 bird
flu virus that may unleash the next
global flu pandemic is showing
resistance to Tamiflu, the antiviral
drug that countries around the world
are now stockpiling to fend off the
threat.
Experts in Hong Kong said on Friday
that the human H5N1 strain which
surfaced in northern Vietnam this year
had proved to be resistant to Tamiflu,
a powerful antiviral drug which goes
by the generic name, oseltamivir.
They urged drug manufacturers to
make more effective versions of
Relenza, another antiviral that is also
known to be effective in battling the
much feared H5N1. Relenza is
inhaled.
"There are now resistant H5N1 strains
appearing, and we can't totally rely on
one drug (Tamiflu)," William Chui,
honorary associate professor with the
department of pharmacology at the
Queen Mary Hospital in Hong Kong,
told Reuters.
Chui was referring to the Tamiflu-
resistant strain of H5N1 in Vietnam.
Chui also said general viral resistance
to Tamiflu was growing in Japan,
where doctors habitually prescribe the
drug to fight the common influenza.
"Manufacturers should think about
producing an injectable form of
Relenza because resistance to Tamiflu
has been seen in Japan and Vietnam.
Also with injections, high doses can
be given where necessary and onset
time is a lot faster," Chui said.
(Continued/...)
Glossary
pandemic - spreading rapidly through whole
countries or the world
resistance - the power to continue without being
hurt or damaged
inhaled - breathed in
Article © 2005 Reuters Limited. Lesson © 2005 www.english-to-go.com
B: Vocabulary Hunt
Read Part Two of Article One and find words that mean the following:
1. using a vein (paragraphs 1-2)
2. swallowed, through the mouth (paragraphs 1-2)
3. of the greatest importance (paragraphs 3-4)
4. the amount of a substance in a liquid (paragraphs 3-4)
5. changes in form or structure (paragraphs 5-6)
6. being greater in number than something
Article One Part Two
1. Drugs that are administered
intravenously can be better absorbed
in patients who have stomach and
acidity problems, another expert said.
2. "We don't have to worry about
absorption, injections take drugs right
5. While the H5N1 virus is now
mostly passed directly from bird to
human, health experts have warned
that it is just a matter of time before it
mutates into a form that is easily
transmissible between people. When
that happens, it may result in as many

3. in. But if the patient takes them orally,
maybe some amounts won't be
absorbed or some may be destroyed
by stomach acids," said pharmacist
Raymond Mak at Queen Mary
Hospital.
3. Intravenous Relenza would also
ensure faster onset, which would be
critical in patients who are seriously
ill.
4. "Orally taken drugs take three to
four hours to reach maximum blood
concentration and three to four hours
is very critical in severe cases. But
injectable Relenza takes only 30
minutes to reach maximum blood
concentration, this is a huge
difference," Chui said. With an
intravenous antiviral, doctors can also
vary the doses.
as 150 million human deaths.
6. Two reports in The Lancet medical
journal this month said that resistance
to anti-flu drugs was growing
worldwide.
7. In places such as China, drug
resistance exceeded 70 percent,
suggesting that drugs like amantadine
and rimantadine will probably no
longer be effective for treatment or as
a preventive in a pandemic outbreak
of flu, the reports said.
Article © 2005 Reuters Limited. Lesson © 2005 www.english-to-go.com
C: Reading And Matching
Read Parts One and Two of Article One again and match these names with the correct
information.
1. H5N1
2. Tamiflu
3. William Chui
4. Relenza
5. Raymond Mak
6 . The Lancet
a. recommends that intravenous drugs will be more
effective for patients with stomach problems
b. the antiviral drug that countries are hoping will fight
the bird flu
c. encourages drug companies to produce new versions of
antiviral drugs
d. the bird flu virus, which humans usually catch from
birds
e. another antiviral drug which the patient takes by
breathing it in
f. a journal that has reported that there is increasing
resistance to antiviral drugs
D: Complete The Summary
Read part of another article (Article Two) about the bird flu. This was written in 2004.
Use the words below to fill the gaps in the summary as you read Part One of Article
Two.

4. pandemic, influenza, unlikely, governments, The World Health Organization, avian,
dangers, Osterhaus
1.___________, concerned that the avian flu outbreak is a serious global threat, has told
2.___________ to give countries money and technical help. 3.___________ says that no
country in the world is prepared for a global 4.___________. The 1918 5.___________
pandemic killed tens of millions of people globally. Scientists have been warning of the
6.___________ of another worldwide pandemic for years. Osterhaus believes that the
latest 7.___________ virus outbreak is a warning for a pandemic outbreak. It is very
8.___________ that it will happen, but the threat still needs to be taken seriously.
Article Two Part One
PROTECTIVE MEASURES
LONDON Tue Jan 27 (Reuters) - The
World Health Organization has
described the avian virus rampaging
through Asia as a serious global threat
to human health and has urged
governments to provide funds and
technical assistance to countries.
Professor Albert Osterhaus, a leading
virologist at Erasmus University in
Rotterdam, Osterhaus says it is time to
update global pandemic preparedness
plans: "No country in the world is
fully prepared for that."
The influenza pandemic of 1918, the
biggest the world has seen, killed 20-
40 million people worldwide.
Scientists have warned about the
threat of the next global pandemic for
years.
In 1997 six people died in Hong Kong
during an outbreak of avian flu and
1.4 million birds were slaughtered.
"This is really a warning for a
pandemic outbreak," Osterhaus said,
referring the latest avian flu outbreak.
"The chances of this happening are not
very big. But even a small chance of
something as horrendous as a
pandemic flu outbreak is something
we should take seriously."
(Continued/...)
Article © 2004 Reuters Limited. Lesson © 2005 www.english-to-go.com
E: True or False
Read Part Two of Article Two and decide whether the statements below are true (T) or
false (F).
1. Migratory birds may have originally passed on a flu virus to domestic poultry. The
virus then mutated and spread.
2. Professor Anderson believes that it is necessary to set up some way of recording where
livestock are transported worldwide.
3. SARS is an example of a virus which was passed from animals to humans, killing
thousands of people.
4. Professor Anderson believes that scientists must work together to research antivirals
and vaccines.
Article Two Part Two

5. (.../Continued) Scientists are still unclear
about how bird flu emerged. Although
more in-depth research needs to be
done, Osterhaus believes it was
transmitted by migratory birds to
domestic poultry and then "heated up"
or mutated and spread from flock to
flock. Why most of its victims are
children is also puzzling but the virus
is known to be excreted in the feces of
birds which could provide some clues.
With animal illnesses posing such
serious threats to humans, Imperial's
Anderson stressed the need for better
monitoring of infectious disease
outbreaks in animals and a method of
tracking the movement of livestock
around the world.
The SARS (Severe Acute Respiratory
Syndrome) virus, which jumped from
animals to humans, killed hundreds
and infected thousands.
"We've got to invest more in
international surveillance and
cooperation and to develop research
capabilities...to develop a diagnostic
method quickly and to look for
antivirals and vaccines quickly," he
added.
Osterhaus echoed the urgency of
improving the speed with which
vaccines can be developed and
produced.
Glossary
monitoring - watching over or supervising
cooperation - working together and helping each
other
urgency - need for speed or immediate action
Article © 2004 Reuters Limited. Lesson © 2005 www.english-to-go.com
Post-Reading Activities
You may do one or more of these.
A: Test Your Memory
Here is the text that you looked at with your class in Pre-Reading Activity B. Some of the
key words have been removed. Test your memory by seeing how many you can
remember!
Influenza, also known as '__________', is a viral infection that is extremely easy to catch.
Influenza affects the respiratory system and is __________ by sneezes and __________.
A person suffering from influenza may experience symptoms such as muscle aches,
headache and eye pain, a __________ cough, fever and weakness. People with influenza
may have to go to bed for three to five __________but then recover within one or two
__________. Some people experience secondary bacterial infections or __________ after
having influenza.
__________ can occur when an existing strain of the influenza virus __________ and
develops against which people have no __________.
__________ can be developed to fight new __________ of influenza, but this takes time
and money.

6. B: Language
Part One: Read these sentences from Article Two.
"Although more in-depth research needs to be done, Osterhaus believes it was transmitted
by migratory birds to domestic poultry and then 'heated up' or mutated and spread from
flock to flock."
Although links two clauses to make one sentence and contrast two ideas. It is put at the
beginning of the less important clause with the most important clause in the other part of
the sentence. It is followed by a subject and a verb.
Here are the ideas that were linked in the sentence above.
More in-depth research needs to be done (into how the avian virus originated).
Osterhaus believes the avian virus was transmitted by migratory birds to domestic
poultry...
In the sentences below, the words have been jumbled up. Put them into the correct order
to make sentences about the bird flu.
1. develop a vaccine/ studying the / they have not yet / to fight it. / Although scientists are
/ bird flu / intensively, / been able to
2. Although scientists have / has been done / of the threat / international scientific
cooperation. / of a global / been warning people / pandemic, / not enough / to develop
systems of
3. worldwide could help / control the spread of / because of the / this move is unlikely to /
cost involved. / be supported by / most countries / Although tracking the movements of
animals / different diseases,
4. will happen. / there is a chance / avian flu has not / Although the / combined with
human flu yet, / that this
Part Two: Now complete these sentences about influenza with your own ideas.
5. Although the doctor told me to get plenty of rest when I had flu last year, I...(you
complete the sentence.)
6. Although flu vaccines are offered to the elderly in my country,...
7. Although flu is highly contagious,...
8. Although people are worried about the bird flu in my country,...

7. TEACHERS' NOTES AND ANSWER KEY
Please Note: This lesson has 3 linked reading and grammar activities for your students to do online at
http://www.instantworkbook.com. To view the exercises, click on the blue icon next to this lesson
description in the teachers' room.
Pre-Reading Activities
A: Talking And Thinking - Notes
1. Students may incorrectly answer ' World War 1'. However, this war killed around 10 million people.
This question introduces students to the topic of contagious diseases and their effect globally.
2. One Internet site with useful information on this topic is:
http://www.stanford.edu/group/virus/uda/
A: Talking And Thinking - Answers
1. The influenza pandemic of 1918-1919, which occurred in the aftermath of World War 1. (Figures vary
but estimates say that over 20 million people lost their lives in this epidemic.)
2. Answers will vary.
B: Find Your Other Half - Notes
Cut up and separate the sentences below. If you have fourteen students, give one half to each student. If
you have fewer students than this, you may remove one of the sentences and not use it. If you have an odd
number of students, you can take one of the halves yourself.
(If you need more sentences because you have more than fourteen students in your class, here are two
extras: Children are most vulnerable to the flu,... / ...but the elderly and people with lung disease are also
more at risk. / Flu viruses change each year and are often transmitted by people... / ...in places like offices,
schools and other meeting places.)
Mix the sentence halves up and then give them out with each student getting either the beginning or ending
of a sentence. Encourage them to use their dictionaries to find the meanings of unknown words as some of
these words are repeated in today's article.
Students mingle and say their sentence halves aloud to each other and find the person who has the other
half of their sentence. (They walk around and talk to other students to find out what information they have.)
They are not allowed to read them out but must have learned them off by heart. You may like to set a time
limit or allow the activity to continue until everyone has found their partner. Then students stand up in their
pairs and say their sentence to the class. Make sure each student speaks clearly and loudly so that everyone
can hear. (The sentences do not have to be said in any particular order.)
If there are any sentences that were not used from the mingling part, you could read them aloud yourself at
this stage, or ask volunteers to do it.
Alternative activity: This can be a pairwork activity with each pair getting a complete set of sentences and
then trying to match each beginning with the correct ending.
B: Find Your Other Half - Sentence Halves To Be Cut Up And Given To
Students
Influenza, also known as 'flu', is...
... a viral infection that is extremely easy to catch.
Influenza affects the respiratory system and...

8. ...is transmitted by sneezes and coughs.
A person suffering from influenza may experience symptoms such as...
...muscle aches, headache and eye pain, a dry cough, fever and weakness.
People with influenza may have to go to bed for...
...three to five days but then recover within one or two weeks.
Some people experience secondary bacterial infections...
...or pneumonia after having influenza.
Epidemics can occur when an existing strain of the influenza virus...
...mutates and develops against which people have no immunity.
Vaccines can be developed to fight new...
...strains of influenza, but this takes time and money.
B: Find Your Other Half - Answers
Influenza, also known as 'flu', is a viral infection which is extremely easy to catch.
Influenza affects the respiratory system and is transmitted by sneezes and coughs.
A person suffering from influenza may experience symptoms such as muscle aches, headache and eye pain,
a dry cough, fever and weakness.
People with influenza may have to go to bed for three to five days but then recover within one or two
weeks.
Some people experience secondary bacterial infections or pneumonia after having influenza.
Epidemics can occur when an existing strain of the influenza virus mutates and develops against which
people have no immunity.
Vaccines can be developed to fight new strains of influenza, but this takes time and money.
Reading Activities
A: Understanding The Main Idea - Answer
Idea 2. (The others are all supporting ideas.)
B: Vocabulary Hunt - Answers
1. intravenously, 2. orally, 3. critical 4. absorption, 5. mutates, 6. exceeded.
C: Reading And Matching - Answers
1. d, 2. b, 3. c, 4. e, 5. a, 6. f.
D: Complete The Summary - Answers
1. The World Health Organization, 2. governments, 3. Osterhaus, 4. pandemic, 5. influenza, 6. dangers, 7.
avian, 8. unlikely.

9. D: True Or False - Answers
1. T; 2. T; 3. F (Killed hundreds of people.); 4. T.
Post-Reading Activities
A: Test Your Memory - Answers
Influenza, also known as 'flu', is a viral infection which is extremely easy to catch. Influenza affects the
respiratory system and is transmitted by sneezes and coughs.
A person suffering from influenza may experience symptoms such as muscle aches, headache and eye pain,
a dry cough, fever and weakness.
People with influenza may have to go to bed for three to five days but then recover within one or two
weeks. Some people experience secondary bacterial infections or pneumonia after having influenza.
Epidemics can occur when an existing strain of the influenza virus mutates and develops against which
people have no immunity.
Vaccines can be developed to fight new strains of influenza, but this takes time and money.
B: Language - Notes
Part One: Students may find this quite challenging, so you could make it a pair activity.
Part Two: Check sentences for meaning and grammatical accuracy or ask students to self-edit in pairs, with
you highlighting the errors, and pairs then working to try to correct the errors.
B: Language - Answers
Part One
1. Although scientists are studying the bird flu intensively, they have not yet been able to develop a vaccine
to fight it.
2. Although scientists have been warning people of the threat of a global pandemic, not enough has been
done to develop systems of international scientific cooperation.
3. Although tracking the movements of animals worldwide could help control the spread of different
diseases, this move is unlikely to be supported by most countries because of the cost involved.
4. Although the avian flu has not combined with human flu yet, there is a chance that this will happen.
Part Two (Sample Answers only)
5. Although the doctor told me to get plenty of rest when I had flu last year, I ignored her advice and then
had to go to bed for several weeks.
6. Although flu vaccines are offered to the elderly in my country, my mother refuses to have one as she
doesn't believe that they work.
7. Although flu is highly contagious, many people with influenza do not worry about this, and do not
isolate themselves from others until they have recovered.
8. Although people are worried about the bird flu in my country, chicken meat is still available in
supermarkets and shops.