BY ARIKIA MILLIKAN
Published September 6, 2006
It could happen soon.
And if it strikes, chances are college students would be among the most affected.
The next 10 years could yield a U.S. flu pandemic, many researchers believe.
But should students be worried about falling ill to the H5N1 virus - widely known as the avian flu - while walking to class this fall?
"Everybody in the public health world is worried," said Robert Winfield, director of the University Health Service.
Winfield is responsible for planning and preparation for all pandemic-related emergencies at the University.
Unlike with the common flu - which mostly affects the very old, the very young and those with weakened immune systems - Winfield said college students would be part of the group most vulnerable to bird flu.
That means you.
What could happen
Examining clues from the past to find keys to the future, public health experts say the H5N1 virus is comparable to the Spanish flu of 1918.
During the 20th century, there were three major influenza pandemics in the United States. Most recently, mild pandemics struck in 1968 and in 1957. But the Spanish flu of 1918 was by far the most lethal.
Between 50 and 100 million people were killed, with half of them between the ages of 20 and 40, Medical School Prof. Sandro Cinti said.
When the Spanish flu entered the human body with a healthy immune system, it caused an extreme immune reaction called a "cytokine storm," in which the body's defensive proteins (cytokines) overproduced. The immune response was so intense that it caused damage to bodily organs - and death soon after. Younger people are more likely to experience this violent fate. This response is also characteristic of the H5N1 virus.
Researchers believe the current strain of avian flu virus activates the same kind of immune response as the Spanish flu virus, which would put college-aged people at great risk in the case of a pandemic. According to the World Health Organization, half of all avian flu cases thus far have occurred in people under 20, and 90 percent in people under 40.
How real is the threat?
Winfield and Cinti agree that there is a consensus in the medical world that there will be some U.S. pandemic flu in the next 10 years, but they are not sure the avian flu virus would cause it.
Only in the event that the avian influenza virus - which has killed more than 100 people and millions of chickens - were to mutate into a form that could spread easily from person to person would the threat of a pandemic emerge.
Winfield said this is unlikely, because the virus has been around since 1997 and has yet to mutate.
"But the stakes are so high," he said, "that we cannot afford to be unprepared."
University public health experts recognize the dangerous possibilities of an outbreak on campus, and they have been mobilizing a pandemic response unit since the SARS outbreak in 2003 in order to prevent large-scale infections.
The effort involves an intricate network of subcommittees prepared to work with the administration, county and state departments in the case of an emergency. These committees would facilitate communication to the public; surveillance; isolation and quarantine for those infected; and medical care, including vaccinations.
The preparations are being made in anticipation of a worst-case scenario with massive numbers of the sick and dying that would overwhelm the healthcare system. By November, University Health Service will be equipped with more than 50,000 masks. It will be prepared to open an alternate health-care system in the case that the hospital exceeds its capacity.
There are also plans to keep the University running smoothly in the event that school buildings will need to be used for the hospital's overflow. For example, some classes may have to become online correspondence courses to free up space.