Preparing for avian flu pandemic


  • Letters
  • Sunday, 09 Oct 2005

THE avian flu has so far been centred around the South East Asian region but fears that it could result in an influenza pandemic worldwide have resulted in perhaps the greatest global effort ever made to prepare for any such eventuality. 

Some experts believe it is not “if” but “when” it would strike the US. 

The Bush administration, after the Hurricane Katrina debacle, is not taking any chances and is responding to calls to be prepared. 

Senate Democrats plan to introduce legislation to help America prepare for and protect from a possible avian flu pandemic. The Pandemic Preparedness and Response Act will provide a comprehensive approach to prepare and protect Americans from this potentially devastating virus. 

“As we continue to clean up after the federal government’s failure to effectively prepare and respond to the devastation throughout the Gulf Coast, we must make sure we do not see a repeat event with the upcoming threat of avian flu to Americans throughout the nation,” said Senator Barbara Mikulski.  

Avian flu, also known as bird flu, is a virus that to date has only been passed from birds to humans. However, experts publicly predict that it is only a matter of time before the virus mutates and can be easily spread between humans, creating a widespread public health crisis. 

In a matter of weeks, an outbreak in China, Vietnam or Cambodia could spread rapidly and trigger a worldwide outbreak facilitated by international travel and globalisation. The Pandemic Preparedness and Response Act will enable the nation to take crucial steps forward in protecting Americans from an avian flu pandemic.  

Last month, the US Health and Human Services Department (HHS) began spending US$100mil for the first large-scale production of a bird flu vaccine. After criticism that it was not stockpiling enough of the anti-flu, the US Senate passed legislation last week that would increase those purchases by US$3bil. 

The question now is how quickly drug companies can create the vaccine that currently takes months to make. 

An important step towards preparing for a pandemic was the recent unravelling of the 1918-19 influenza virus that killed an estimated 50 million across the world, including more than 675,000 in the US. 

Scientists at the Centers for Disease Control and Prevention successfully reconstructed the influenza virus strain responsible for the 1918 pandemic, a project that greatly advances preparedness efforts for the next pandemic.  

“This groundbreaking research helps unlock the mystery of the 1918 flu pandemic and is critically important in our efforts to prepare for pandemic influenza,” said CDC director Dr Julie Gerberding. 

“We need to know much more about pandemic influenza viruses. Research such as this helps us understand what makes some influenza viruses more harmful than others. It also provides us information that may help us identify, early on, influenza viruses that could cause a pandemic.”  

The work is done in collaboration with Mount Sinai School of Medicine, the Armed Forces Institute of Pathology and Southeast Poultry Research. 

Two scientific papers published provided insights into the virus that caused the most deadly influenza outbreak in modern history. 

The virus was unusual because it spread so quickly, was so deadly, and exacted its worst toll among the young and healthy.  

In just over one year, the virus infected one-third of the world’s population with death rates approximately 50 times higher than those associated with regular seasonal influenza.  

Since December 2003, a strain of influenza virus that usually infects only birds has rendered at least 116 people ill and killed 60 in Thailand, Vietnam, Cambodia, and Indonesia. 

This virus, known as H5N1 avian influenza A virus, has killed or forced the culling of more than 100 million chickens in 13 countries, infected ducks and other migratory birds, and has been transmitted to tigers, cats, and pigs. Losses have run into billions of dollars.  

The new research findings, published in the journals Science and Nature, provide critical clues to the genesis of the 1918 pandemic and why it was so lethal. The findings reveal essential information to help us speed our preparation for – and potentially thwart – the next influenza pandemic. 

The studies could have an immediate impact by helping scientists focus on detecting changes in the evolving H5N1 virus that might make widespread transmission among humans more likely. 

The findings may also lead to identification of new targets for drugs and vaccines to treat and prevent influenza, now and in the future. 

These findings have been made available to the scientific community to encourage additional research and to accelerate the ability to prevent pandemic influenza.  

Prior to this study, which is published in the Oct 7 issue of Science, flu experts had little knowledge of what made the 1918 pandemic so much more deadly than the 1957 and 1968 pandemics.  

This week’s issue of Nature also includes a related article titled “Characterization of the 1918 influenza virus polymerase genes”, which describes the final three gene sequences of the 1918 influenza virus. 

The work reported in the Nature article was done by scientists at the Armed Forces Institute of Pathology.  

The pandemic’s most striking feature was its unusually high death rate among otherwise healthy people aged 15 to 34. 

During normal seasonal flu outbreaks, severe complications and death are most common among the elderly and young children.  

Influenza pandemics occur when a new strain emerges to which people have little or no immunity. Most experts believe another pandemic will occur, but it is impossible to predict which strain will emerge as the next pandemic strain, when it will occur or how severe it will be.  

Dr Terrence Tumpey, the CDC senior microbiologist who recreated the virus said: “Influenza viruses are constantly evolving, and that means our science needs to evolve if we want to protect as many people as possible from pandemic influenza.”  

Health officials have warned for years that a virulent bird flu could kill millions of people, but few in Washington have seemed alarmed.  

At his press conference on Tuesday, President George Bush spoke at considerable length about the risks of an outbreak and the measures the administration is considering to combat one. 

Secretary of Health Services Michael O. Leavitt will next week tour Thailand, Vietnam, Laos and Cambodia, the countries most likely to be the source of an avian flu outbreak, and talk with health ministers there about a coordinated surveillance of outbreaks.  

An outbreak may be years away, or may never occur. And if a strain does jump from people to people, such a mutation may make it far less lethal than it has been to those who contracted it from birds.  

President George W. Bush said on Tuesday that he was working to prepare the United States for a possible deadly outbreak of avian flu, adding that he was concerned about what an avian flu outbreak could mean for the United States and the world.  

More than 65 countries and international organisations were to participate in discussions on Thursday at the State Department about preparations for the possibility of worsening bird flu.  

Every year, during winter when it is flu season, New York battles to get enough supplies of vaccine. Last year was particularly bad, as the main supplier in the United Kingdom had to close its facility because of contamination. This year with the potential of an outbreak of bird flu, the vaccine problem could be acute. 

 

o Johan Fernandez is Editor, North America Bureau, based in New York (e-mail: johan10128@aol.com) 

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