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Biological Warfare : Biological Terrorism : Emerging Diseases

Archived News
Week ending May 29th, 2006

A third of Americans could become ill and overburdened hospitals might have to set up clinics in hotels and other public buildings to handle the sickened masses if a flu pandemic hits the United States.

Schools and churches might close. Air travel would be limited to emergencies only. Parents could temporarily lose their day care.

If the avian flu turns into a global epidemic, it could disable the U.S. economy, resulting in a loss of $600 billion of national income.

These scenarios, which at least one public health expert said aren't even the worst case, are part of a detailed, 234-page report released Wednesday by the Bush administration.

"This plan goes much deeper in identifying more specifically what needs to happen in a pandemic, in just about every area you could think of, from human health to animal health to infrastructure," said Jeff Levi, executive director of Trust for America's Health, a Washington, D.C., advocacy group that follows government disaster prepare plans. "I think it is a further demonstration of how serious the government is taking a potential pandemic. It's an unprecedented level of detail in terms of its planning and performance."

The report cites avian flu, the dreaded H5N1 strain that is carried by birds and has infected 205 people worldwide, as a potential source for the next pandemic, although it has yet to mutate into a form that can be spread from person to person. The report warns that even if the avian flu never becomes a global health threat, "another novel influenza virus will emerge ... and threaten an unsuspecting human population."

Based on records from the last major pandemic, in 1918, the report projects that a modern flu pandemic could infect 30 percent of the global population -- and up to 40 percent of children in schools -- and kill up to 2 percent of those sickened...

The government on Thursday awarded more than $1 billion to five drug manufacturers that are developing technology for speedier mass production of vaccines in case of a pandemic.

The money comes from the $3.8 billion that Congress approved last year. The goal is to be able to distribute vaccine to every American within six months of a pandemic striking. Currently, flu vaccines are produced in specialized chicken eggs, but that technique does not allow for speedy mass vaccination.

"The hard truth is that, at this moment, the capacity simply does not exist in the United States to produce vaccines with sufficient speed and quantity to reach everyone out there. That's true of countries all over the world, but that's about to change," said Mike Leavitt, secretary for the Department of Health and Human Services, before signing the contracts

The companies are GlaxoSmithKline, $274.8 million; MedImmune Inc., $169.5 million; Novartis Vaccines and Diagnostics, $220.5 million; DynPort Vaccine Co., $41 million; and Solvay Pharmaceuticals Inc., $298.6 billion. The contracts cover a five-year period.

Leavitt said vaccines are America's best line of defense if there is a pandemic.

Such an outbreak can occur when people have little immunity to a particular strain of flu that spreads across the globe. Leavitt often refers to the pandemic of 1918 as an example of a worst-case scenario...

A medical reality is complicating federal preparations for the next pandemic: Flu spreads in ways that make it extremely unlikely the U.S. could avoid being hit.

Even shutting U.S. borders against outbreaks abroad offers little reassurance, because people can spread flu a full day before they show symptoms. With 1.1 million people legally entering the country every day, that means a super-strain would probably be incubating here by the time it was diagnosed abroad.

The government's latest national response plan, obtained by The Associated Press, acknowledges the difficulty as it warns that states, cities and businesses shouldn't count on a federal rescue if a super-strain of influenza strikes ┠and that people may have to rely on creative if not scientifically proven ideas such as staying 3 feet away from co-workers and not shaking anyone's possibly contaminated hand.

President Bush last fall announced a $7.1 billion strategy to fight the next flu pandemic, focusing largely on public health preparations such as how to rapidly produce a vaccine once the next super-flu strikes. On Wednesday, the White House will formally release Step 2 of that strategy ┠a list of actions that different branches of government need to take to prepare.

"This would really be a road map," White House spokesman Scott McClellan said Tuesday. "It will cover both the government and non-government actions that are being taken to plan and prepare for any potential pandemic."

It's an incremental step, one already drawing political attacks that the Bush administration isn't moving fast enough.

"Other nations have been implementing their plans for years ..

A mostly unprepared United States could do little to slow pandemic flu if it hits anytime soon, according to a new computer model.

And Britain is only a bit better off, the same study suggests.

If the U.S. government does nothing, a deadly global flu outbreak is likely to strike a third of the population, according to the results of a computer simulation published in Thursday's journal Nature.

If government acts fast enough and has enough antiviral medicine to use as a preventive -- and the United States doesn't right now -- the number could drop to about 28 percent of the population, the study found.

"Both cases we came up with were very pessimistic," said lead author Neil Ferguson of the Department of Infectious Disease Epidemiology at Imperial College in London. "There is no single magic bullet for stopping pandemic flu."

So far this year H5N1 bird flu -- which doesn't move easily from person to person -- has infected 204 people and killed 113, according to the World Health Organization. Most of the human cases and deaths have been in Asia, but birds with the disease have hit Europe.

Combining use of the antiviral Tamiflu with school closings could reduce the disease's toll a bit, Ferguson said. But efforts to stop flu from entering U.S. borders -- usually on planes with sick passengers -- won't work, he said. At most, such efforts can buy a couple of weeks' delay before the disease sets in...

At first glance, an outbreak of diarrhea among passengers on board a cruise ship in Alaskan waters in the summer of 2004 seemed to be relatively harmless.

Health officials theorized it might be the Norwalk virus, a bug that often affects people living in close quarters, such as in nursing homes, hospitals and cruise ships. While certainly annoying, Norwalk usually doesn't cause serious illness.

But then the lab reports started trickling in, and it showed that indeed a more serious problem was at hand - many of the afflicted the passengers had eaten raw oysters raised in Alaska that were infected with a type of cholera-like bacteria, Vibrio parahaemolyticus, that normally grows on shellfish harvested in much warmer waters.

The finding not only signaled a dangerous new risk to the Alaskan seafood industry, it also highlighted how surprisingly and directly global warming can affect human health, particularly in terms of infectious diseases, experts say.

"Depending on the warming trend that unfolds in the years ahead, we have to accept that habitats will change - new bugs can be expected to settle in. Every organism will find a niche," said epidemiology professor Colin Soskolne, of the University of Alberta in Canada. "With the tampering of the environment, we really can't predict with much certainty exactly what those changes ...

Today is Africa Malaria Day, which is intended to raise public awareness of a disease that each year kills more than a million pregnant women and children under five. We suspect many readers are plenty "aware" of this health travesty already. The good news is that private individuals have begun to attack the disease after years of official aid and policy failure.

In his new book, "The White Man's Burden," economist William Easterly says medicine that would halve the number of malaria deaths world-wide costs just 12 cents a dose; a bed net that wards off malarial mosquitoes costs $4; and "preventing five million child deaths over the next 10 years would cost just $3 for each new mother." But despite spending $2.3 trillion on foreign aid in the past half century, the West hasn't managed to get 12-cent medicines and $4 bed nets to poor people.

A big part of the blame can be laid to bureaucratic incompetence at international aid agencies such as the World Bank. Eight years ago the Bank launched an ambitious campaign to halve malaria deaths by 2010. Yet according to Amir Attaran of the University of Ottawa, malaria cases have actually risen in recent years...