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Biological Warfare : Biological Terrorism : Emerging Diseases

Archived News
Week ending March 14th, 2005

Experts say it is no longer a case of if but when a pandemic of bird flu hits the human population. Some countries have already started stockpiling drugs and testing vaccines to beat the virus. The UK government has been criticised for being slow on the uptake, but announced its full pandemic plan on Tuesday. We have to make up our minds now before it arrives on our doorstep

The World Health Organization (WHO) recently urged all countries to develop or update their influenza "pandemic preparedness plans" after experts estimated anywhere between two and 50 million people could die if a pandemic hits and the world is not prepared. Good health care will play a central role in reducing the impact, yet the pandemic itself could disrupt the supply of essential medicines and health care workers could fall ill.

Even in the best-case scenario, two million to seven million people would die and tens of millions would require medical attention, WHO says. Experts have used their knowledge about past pandemics, such as the 1918 Spanish flu outbreak, and their experience with the strain of bird flu that has killed 42 people in Asia since 1997, to make a prototype vaccine. If this strain, called H5N1 and which spreads from birds to humans, mutates to spread between humans, scientists believe this vaccine should help beat a pandemic. However, a different strain might mutate to cause a pandemic. By having stocks of the prototype, scientists will be able to make modifications to the vaccine so it is effective...

Officials in Vietnam announced Tuesday that a 35-year-old man and a 14-year-old girl had tested positive for a potentially lethal bird flu virus known as H5N1, which has been spreading among chickens and other birds in Southeast Asia. These are the latest cases in what many public health officials worry is the possible beginning of a worldwide outbreak of a deadly new flu.

The virus has now killed millions of birds and infected more than 50 people, killing three out of every four patients. Now there is evidence that in rare cases it can spread from person to person.  "The virus is clearly going in what we call the wrong direction for us," says Dr. Anthony Fauci, director of the National Institute of Allergies and Infectious Diseases. The big concern is that the virus will mutate even more until it reaches the point that it spreads easily from person to person. The result would be what scientists call a pandemic - a worldwide outbreak of a virus to which people have no immunity.

That situation is what happened in 1918 when 20 million to 50 million people around the world died from a new strain of flu that also originated in birds. Experts agree there will be another flu pandemic, but no one knows when. "It absolutely dwarfs all other public health problems that we can imagine...

Millions of doses of drugs to ward off a flu pandemic are to be stockpiled, the government has announced. It said without the antiviral drugs an outbreak could kill 50,000 in the UK. Experts say a pandemic is inevitable and will probably emerge in Asia if bird flu mutates with human flu, creating a highly infectious new virus.

The UK Influenza Pandemic Contingency Plan also includes quarantine measures, as well as arrangements for the emergency services. Concerts and football matches could both be banned and travel restricted in the event of an outbreak to stop the virus spreading. But the government decided against buying up vaccines as ordinary flu vaccines will not be 100% effective because the strain which would be responsible for any future pandemic has not emerged yet. It could take up to six months to develop a vaccine once a pandemic has started.

Instead, the Department of Health is to stockpile 14.6 million doses of the antiviral drug Tamiflu, which is made by Swiss drugs firm Roche and works by reducing the symptoms and the risk of a carrier passing on the virus, at a cost of 180m.

It will be enough for a quarter of the population - the World Health Organization's recommended level. Health officials will be the first in line for the drugs, with the remainder being handed out to whichever part of the population is deemed most at risk.

US - Has been stockpiling antiviral drugs and placed orders for 4m vaccine doses Italy and France - Both placed orders for 2m vaccine doses Canada and Australia - Have been buying enough antiviral drugs to cover a quarter of the population Japan and Holland - Also purchasing antiviral drugs but not on the same scale as others

Several countries, including Canada, the US and Australia, have already started building up reserves of the drugs. Other countries have also placed orders for a vaccine.

Chief Medical Officer Sir Liam Donaldson said the plan had been published as it must be assumed the government would be unable to stop a future flu pandemic reaching the UK. "When it does, its impact will be severe in the number of illnesses and the disruption to everyday life...

On a recent afternoon, Ly Sovann sat perspiring in his stuffy office and wondered if he had an epidemic on his hands. Since word spread that a Cambodian woman in a remote village succumbed to avian influenza in January, Dr. Sovann's cellphone hasn't stopped ringing as health workers call in suspected cases of the disease.

The problem: Few here know what avian flu is or how to recognize it. That makes Dr. Sovann's job as Cambodia's chief flu-hunter at the cash-strapped Ministry of Health difficult. Worse, his emergency budget for educating this country's 13 million people about bird-flu dangers is just $2,500.

"A lot of the time the reports turn out to be diarrhea or measles," Dr. Sovann said as his phone buzzed to life again.

The long-term diagnosis may not be nearly as benign. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention in Atlanta, said last week that there was a real risk of Asia's bird-flu problem transforming into a global threat, comparing the danger to the 1918 flu that killed between 20 million and 40 million people. At a conference in Vietnam last week, World Health Organization regional director Shigeru Omi went further. He said: "The world is now in the gravest possible danger of a pandemic."

A close look at Cambodia suggests a worrying complication: a critical shortage here of even the most basic tools or diagnostic skills to identify the virus in the first place, much less control or treat it.

The bird-flu strain, known to scientists as H5N1, was first spotted in Hong Kong's poultry markets in 1997. Since then, the virus has become both more lethal to birds and more widespread. When the virus appeared in Vietnam, Laos and Thailand in late 2003 and early 2004, it caused around $10 billion in damage as officials ordered the destruction of millions of chickens, ducks and other domestic poultry.

Now the virus is resurging in rural Southeast Asia. Cambodia, Thailand and Vietnam have each reported outbreaks in poultry this year. Scientists say the virus has probably become entrenched here, spread by poultry traders and wandering duck populations.

Since 2003, bird flu has killed at least 46 people, with a fatality rate of about 72%. That compares with six people who died during the 1997 outbreak in Hong Kong. The virus still doesn't easily spread from birds to humans, nor from one human to another...