Saturday, October 15, 2005

U.S. not ready for bird flu; oops, we are all going to die....

Drugs, vaccines in low supply; officials scramble to mount defense

By Jeremy Manier and Tim Jones
Tribune staff reporters
Published October 14, 2005

In the face of an uncertain threat that avian flu could cause a new pandemic, political leaders at every level are grappling with the disquieting fact that the United States has almost no ability to stop an outbreak of the disease if it strikes here soon.

No one knows if bird flu, which is more dangerous than ordinary flu because people have no natural immunity to it, will ignite an epidemic like the one that swept the world in 1918.

Hundreds of millions of birds infected with the new strain have spread through Asia in recent years, and on Thursday, European Union officials confirmed that the virus has struck birds in Turkey, the strain's first appearance in Europe. The widespread bird problem could provide a breeding ground for the virus to mutate into a form able to spread among humans.

Congress and the Bush administration are scrambling to improve the nation's scant supply of vaccines and anti-viral drugs that could fight such infections. Lawmakers said the government's sluggish response to Hurricane Katrina highlighted weaknesses in disaster readiness.

But for now, experts say the response to bird flu would consist mostly of unproven measures such as closing schools, canceling most large indoor gatherings and isolating the estimated one-fifth of the population that would fall sick. If better medications are not in place, ordinary citizens could do little beyond practicing good hygiene or wearing protective masks, epidemiologists said.

In one sign of the heightened awareness of flu--and the uncertainty over what to do about it--President Bush this month made an impromptu suggestion that the military could help quarantine entire regions of the country. Yet flu experts within and outside government said such quarantines would accomplish little because of flu's ability to spread quickly.

"Quarantine will be playing a very limited role," said Michael Osterholm, an adviser to the U.S. Department of Health and Human Services and director of the University of Minnesota's Center for Infectious Disease Research and Policy.

"Influenza is such an infectious disease that unlike some diseases where quarantine can work, with this one it will not," he said.

The most effective preparation, according to Osterholm and other experts, is for citizens to pressure politicians into taking the threat seriously. Last month the Senate allocated $3.9billion to build a stockpile of anti-viral drugs--a move that would have been unthinkable a year ago, many advocates said. In June, Illinois appointed the state's first full-time pandemic response coordinator.

HHS chief visiting Asia

This week HHS Secretary Michael Leavitt is meeting with health officials in Southeast Asia, where the avian flu virus has killed 60 people. Most victims caught the virus from ducks or other animals. Although the bug cannot yet spread among humans, officials in Leavitt's office said the U.S. wants to help detect any outbreak in its earliest stages--which could be the only way to prevent wider spread.

Rep. Jim Leach (R-Iowa), who heads the House subcommittee on Asia and the Pacific, said disease control has surpassed war and terrorism as the nation's top priority.

"Everything else pales in significance," Leach said.

Few other lawmakers were focused on the issue last March, when Sen. Barack Obama (D-Ill.) proposed $25 million in foreign assistance to help prevent an outbreak.

Obama said he was concerned in part because as a child he lived for five years in Indonesia, which recorded its first human cases this year.

"I knew that part of the world and was familiar with how the livestock operations are--they're in people's back yards," Obama said. He said the problem in Southeast Asia is urgent because wherever a pandemic starts, it's likely to arrive in the U.S. within four to six weeks.

No one knows whether a new flu outbreak would kill as many as the 50 million killed by the 1918 pandemic worldwide, though some estimates are that the toll would be far higher. Daniel Lee, the new pandemic coordinator for Illinois, said models from the federal Centers for Disease Control and Prevention suggest the virus would kill up to 9,000 people in the state and sicken as many as 4.5 million.

Previous influenza pandemics have started when a virus from birds or another animal mutated to infect humans and spread from person to person.

Limits in production capacity mean it's unlikely that a vaccine against such a newly mutated strain would be available for at least the first year of a pandemic, experts said.

Lacking a vaccine, stopping an outbreak at its source may offer the best chance to prevent a pandemic. Two studies published in August suggested that giving millions of doses of anti-viral drugs such as Tamiflu to people in the region of an outbreak could stop the disease from spreading.


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