A recent commentary in ProMed Mail reflecting outbreaks through mid-August highlighted the reality that 15 nations in Latin America and the Caribbean have diagnosed highly pathogenic avian influenza strain H5N1 involving the Pacific flyway.  Moderator JH stated, “The detection of HPAI outbreaks in 15 nations in Latin America and the Caribbean is a situation never recorded before.  The moderator added, “This does not include the other countries globally also experiencing concurrent outbreaks in a variety of species.  Given the magnitude of the problem the question remains how immediately to stop the spread but to what end when spread is continuing largely unabated in wild animal populations?”  The moderator raised the question as to whether area vaccination of commercial flocks is now required as a method of prevention.