Will We Be Ready?

by DemFromCT

That's the title of an article in the LA Times today, regarding bird flu. The answer is no, at least not if it struck today. Although there's been yet another alarming report about 'mysterious deaths' from China, this latest scare turns out to be  a strep bacterial infection acquired from pigs.

Chinese and international health officials said Monday that they believed that the mysterious deaths of at least 17 farmers in western China were caused by a bacterial infection in pigs and not, as initially feared, by a new outbreak of the deadly avian influenza.
The spate of deaths and illnesses began about four weeks ago in southwestern Sichuan Province. The state news media have reported at least 17 deaths; 41 patients have been hospitalized. Many of the dead were farmers who had recently slaughtered sick pigs or sheep, raising concerns about avian influenza, which also can be spread through pigs.

Poor poultry hygiene in Asian countries has been associated with bird flu transmission from animals to humans, and pigs come into the mix because they are capable of harboring both human and avian flu, making them a perfect vessel for gene mixing between the two. This, in turn could make human to human transmission of the deadly H5N1 bird flu more likely.

The threat is out there, even though the Chinese story ain't it.

Across East Asia, an influenza virus known by the scientific designation H5N1 has killed at least 55 people and tens of millions of birds. As potential aggressors go, this one's about as insidious as they get — fast-moving, deadly and extremely unpredictable. Before it can mount an all-out offensive, this "bird flu" virus must change its genetic makeup so that it can jump easily from human to human. Once it has done so, the resulting germ could spread quickly, inflicting heavy casualties among a global population with no natural immunity against it.

That final shift might never happen — or it could happen next week. But scientists think that roughly three times each century nature creates an influenza virus capable of global devastation, and a "pandemic" flu sweeps the world. The prospects increase when a virus long out of circulation extends its geographic range, its hold on different animal species and its contact with humans. By those measures, H5N1 is a virus on the march.

So can it be stopped? With a few more years to prepare, American public health experts say they may be able to prevail over an outbreak of pandemic flu. But its timing absolutely defies prediction. If the attack comes this year or next, experts acknowledge they can at best slow its march, and the death toll will be grievous.

Among officials and experts tracking the building force of the H5N1 virus, the anxiety is palpable. Dr. Anthony Fauci, who directs the National Institutes of Health office that oversees preparations for pandemic flu, says the sense of urgency is intense. "I feel it every day, and my staff feels it every day."

Fauci calls pandemic flu "the mother of all emerging infections" and warns that the world is behind in building its defenses.

This is a balanced article which talks about the plans to counter the emerging  but still potential threat with vaccines.

The final line of defense lies in vaccines to prevent infection and antiviral medications to treat those infected with a flu virus. Although activity in both areas is intense, officials acknowledge that the United States is vulnerable, and could be for some time.

Of the antiviral medicines available, only one class of drugs, the best known of which is Tamiflu, may help treat a case of bird flu in humans or prevent illness if a person has been exposed to the virus. So far, 2.4 million doses of Tamiflu have been stockpiled and 2.9 million more have been ordered for the nation's emergency stores. But Tamiflu is manufactured by Roche Pharmaceuticals in a single plant in Switzerland, and a lengthy production process means it can take a year to fulfill orders. In a pandemic, with production lines stressed, deliveries interrupted and countries clamoring for more, the U.S. is unlikely to get much more. If one-fourth of the U.S. population (about 73 million) become ill with flu — an assumption seen as highly plausible — the nation's stockpile will quickly be exhausted.

That makes flu prevention key, say experts — a goal best achieved by vaccinating large numbers of Americans. Currently, about 2 million doses of vaccine against the bird flu virus are in government stockpiles, and tests of the vaccine's safety and effectiveness — at least for non-elderly adults — are expected to be complete soon.

But we will be in a rationing mode if the virus strikes soon. And the vaccine itself is still untested. In addition, p[andemic preparations go way beyomd the health field... sanitation, transpotation, business will all be affected in various ways. State and local planning is spotty; Seattle is starting discussion with businesses now, while CT has done nothing whatever.

The Flu Wiki is an atempt to jump start the process, sharing whatever plans that have been developed, and collecting information in as neutral as possible a way for all to peruse. We're still adding information; here's a recent essay on economics. In the meantime, read the LA Times article and stop by the Flu wiki for more. Preparation will take time; arming yourselves with a little more knowledge is the best thing you can do for now.

Comments

[emptywheel]

I hate to be self-interested in two threads in a row.

But I'm wondering, "when is it no longer prudent to travel to SE Asia?" I've got a trip planned for next month--including India and Thailand--and I just want someone to tell me if it's imprudent to go.

Not because I'm worried that I'll get bird flu. I'll be in cabs and office buildings and only briefly in more public places.

But because of the way folks reacted with SARS, where everyone who had been to China was quarantined. Since I travel as a consultant to and not an employee of the large corporation I'll be working with, they wouldn't be obliged to "take care" of me if I got stuck in Bangkok for a month. So where is the level of prudence? When will they start quarantining countries? Almost certainly not by next month, before I go, but really, when do you think that will start.

[DemFromCT]

not yet.... no evidence of major H2H (human to human) transmission. Stay out of Indonesia, and stay away from live pigs and fowl. Cooking the meat solves the transmission problem.

[emptywheel]

Thanks, Dem. I'll let you be my travel counselor for the forseeable future. South Africa is alright, I assume, provided that I don't have any unprotected sex?

[DemFromCT]

this link at the Flu wiki will help.

[emptywheel]

Honestly DemFrom, I have been over there. I just haven't checked in a while. Guess that shows me...