Monday, January 23, 2006

Are fears of a pandemic exaggerated?

The Turkish government Tuesday reported another case of bird flu in a child, the third this week, bringing to 21 the total number of people infected in that country. The World Health Organization says tests on many other suspected cases have begun.

The growing number of human cases, along with the outbreaks of the H5N1 strain in birds, have renewed global efforts to prepare for a flu pandemic.

Tamiflu maker Roche said Tuesday that it would contribute another 2 million courses of treatment of its anti-flu medicine to the World Health Organization. The medicine, which prevents or lessens the severity of flu, is to be stored in regional stockpiles for use during outbreaks.

The latest donation brings the total to 5.125 million courses of Tamiflu treatment the manufacturer has donated to WHO since 2004. One treatment course is 10 pills.

So far, there is no indication that the H5N1 virus has mutated into a form that can spread easily from person to person, WHO says. Most of the nearly 150 reported human infections have followed direct contact with poultry.

The increasing reports of human bird flu cases are worrisome, but they don't necessarily indicate that a pandemic is at hand, says internist Marc Siegel, a professor of medicine at the New York University School of Medicine.

"There has been no evidence of human-to-human transmission, which would be the beginning of a pandemic," he says.

One reason more cases are being reported, he says, is that doctors in affected countries are on high alert: "Since we're now looking for them, it's not surprising we find them."

Many more people might have contracted the virus, but they are going undetected because they're not very sick, Siegel says. In that case, "we're overstating the lethality" of the virus, he says. "We're only looking at cases of people who get sick."

In his new book, Bird Flu: Everything You Need to Know About the Next Pandemic (Wiley, $12.95), Siegel addresses basic questions about the threat:

Q: What are my chances of contracting bird flu?

A: Right now, the chances are almost non-existent for anyone who does not have extremely close contact with birds in Asia. And even for Asian bird handlers, the chances are very slim.

Q: Should I stop feeding the birds or eating chicken?

A: Bird feeders are safe. Pigeons are safe. Even in Asia, where birds freely walk the streets and outbreaks in birds continue to occur, eating cooked poultry is safe. Casual contact with birds will not give you the flu.

Q: Why not?

A: You are protected by a species barrier. It is very difficult for you to get this virus from birds, even in parts of Asia where the virus is endemic in birds.

Q: Is it safe to go to countries where people have gotten sick from bird flu?

A: Human cases have been reported in Cambodia, China, Indonesia, Thailand, Turkey and Vietnam. If you're not planning on staying on a chicken farm and interacting closely with the chickens, you're good to go.

Q: What are the chances the virus will come to the USA?

A: It is possible in birds and very unlikely in humans. There are no regular migratory bird pathways from Asia to the United States, but Pacific flyway birds can occasionally make it across Siberia to Alaska. It is conceivable that H5N1 could show up in Alaska and from there make its way down the West Coast or across Canada, (but) there is much less contact between migratory birds and poultry in the U.S. than in Asia. The chance of a bird flu circulating among our poultry is much less than in Asia.

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