As winter – and flu season – approaches, a deadly new strain of influenza is evolving in Southeast Asia. Known as Avian Bird Flu, this new virus has health experts worldwide fearing a repeat of the Spanish Flu pandemic of 1918, which killed 25 million worldwide. The Department of Health and Human Services believes that this new flu strain “has a greater potential to cause rapid increases in death and illness than virtually any other natural health threat.” For many experts, the occurrence of a pandemic is already a foregone conclusion. Robert Webster, a world-class influenza researcher, warns that an Avian Flu pandemic “is just inevitable. One of these is just going to blow.” It’s not a question of if, but a question of when.

Sarah Royce

The Avian Influenza has historically been a virus that originates in birds. When a strain can jump from birds to humans, and from human to human easily, the necessary conditions for a pandemic are fulfilled. The virus in question, classified H5N1, was first diagnosed in 18 humans in 1997 in Hong Kong. Figures released last week by the World Health Organization put the tally at 115 total cases in Southeast Asia resulting in 59 fatalities – an astonishingly high mortality rate.

Health organizations have indicated that this impending pandemic will be handled in an entirely different way from its predecessors. Past pandemics have always come as surprises. In this case, the strain and geographic location of the virus are known. While global integration has made transmission of human diseases much more dangerous and rapid, the upside is that government and health organizations are better able to coordinate worldwide resources to contain pandemics. The WHO has been the most prominent organization collaborating these efforts and, at the beginning of September, sent a strategic preparedness plan to all member nations. The document observes that “During 2005, ominous changes have been observed in the epidemiology of the disease in animals” and that not only are “human cases continuing to occur” but “the virus has expanded its geographical range.” Russia reported days later that it had lost more than 100,000 birds to Avian Flu, showing that another dangerous facet of the virus is cross-continental bird migration.

In the report, the WHO found that weak early detection systems, the unpredictability of the virus and an insufficient number of vaccines and antiviral drugs are the major weaknesses facing its ability to fight an outbreak. The WHO recommends containment and stockpiling retroviral drugs as the best approach to stop a global pandemic

In terms of vaccinations, the American pharmaceutical company MedImmune Inc. has joined with the National Institute of Health in the development of a vaccine for H5N1, while Sanofi-Aventis was awarded a $100 million contract to produce an undetermined number of vaccines. Broader international cooperation will be crucial. In a White House meeting with Thai Prime Minister Thaksin Shinawatra last week, President Bush expressed his concern about Avian Flu and said “All of us need to be mindful of this potentially devastating disease.” But being mindful just won’t cut it.

For the first time in history, we have the infrastructure and advanced warning to effectively fight a global pandemic. During the next few months, we will see how governments around the world respond to this dire threat. Large amounts of money and supplies will need to be transferred from the developed nations to poorer countries in Southeast Asia for effective containment. The greatest risk is that advanced countries try to hedge their bets by spending money solely on drugs for domestic populations. The potential speed at which a pandemic could spread with modern high-speed travel makes this strategy dangerous. Finally, this strategy hinges on the ability of the U.S. government to spare millions of dollars for such an effort while simultaneously rebuilding New Orleans and funding a war. The world often looks to the United States to set an example, and we can’t afford to fail in this capacity during what may be the greatest threat to humans in almost a century.

 

Slade can be reached at bslade@umich.edu.

 

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