Friday, December 23, 2005

News - Global Flu Pandemic Stirs Plenty Of Fear, But Little Perspective

Time for a reality check about avian flu.

The virus already has prompted dozens of governments and thousands of U.S. and European consumers to stockpile Tamiflu, the antiviral drug from Roche that will soon be licensed to other firms.

To companies in the human-resources and workplace environmental field, the fear factor surrounding avian flu has become a business opportunity to promote pandemic action plans for corporations.

And when seasonal flu hits ? as it does every year ? folks might wonder, "Is this the big one?"

"I hear of kids having nightmares and people unsure if they should eat chicken," said Dr. David Butler-Jones, Canada's chief public health officer.

Part of that fear is driven by mathematics. There were three flu pandemics in the last century. The 1918 pandemic was followed by Asian flu in 1957 and Hong Kong flu in 1968.

The concern is that the world is ripe for another pandemic, says Dr. Arnold Monto, professor of epidemiology and a flu expert at the University of Michigan.

"Some of us speculate that because we've had no pandemic since '68, we're due for one," Monto said. "The longer you have not seen the big one, the more you think you're becoming due for the big one."

For his part, Monto says the fear is unwarranted. Butler-Jones echoes that opinion, saying that predicting a new pandemic based on historical patterns is "a mug's game."

"If you toss a coin and get five heads in a row, your chance of another heads on the next toss is still 50-50," Butler-Jones said. "Some kind of pandemic is inevitable, but this strain of flu pandemic is not inevitable."

Should it strike, he says, it won't be like the 1918 flu pandemic, which we now know was also an avian flu.

First, the world population today is healthier. There are no troops in cold, wet World War I trenches. And we know much more about nutrition and hygiene and the science of viral genetic mutation.

Another difference: In 2005, the whole world is on watch.

"In 1918, the avian virus flu could not be recognized," Butler-Jones said. "Now we're looking for it."

Even if the virus mutates from fowl to people ? then mutates again so people can transmit it to other people ? the result need not be calamitous.

"Avian flu could become like SARS in terms of its limited ability to spread," Butler-Jones said.

He should know. SARS, or severe acute respiratory syndrome, hit Canada in 2003. It was brought by travelers from Asia. The Canadian government created Butler-Jones' agency after the SARS epidemic.

For all the drama and disruption over SARS, the virus infected only 8,000 people, killing 800.

SARS was a learning experience. One thing Butler-Jones says he learned is that there's a "fine balance" between preparing for the worst and being immobilized by fear.

Preventive Medicine

While Monto says it's unlikely an avian flu pandemic will happen, it doesn't hurt to be prepared on the off-chance it does.

"You just don't have the lead time once you realize the virus has become pandemic," he said. "That's why we stockpile Tamiflu."

Speed counts when coping with a viral outbreak. One study shows that an avian flu pandemic could be contained if officials act fast with quarantines, vaccine and antiviral drugs.

That positive analysis came from the Models of Infectious Disease Agent Study, a project funded by the National Institute of General Medical Sciences.

Researchers using computer simulations calculated how 500,000 Thais might spread the virus through their daily actions. More such studies are under way.

Authorities in most countries are competent enough to handle a pandemic once one is recognized, Monto says. The wild card is whether they'll be able to recognize it early enough.

Authorities must also be willing to make public what they've learned. Some local Chinese officials have withheld information because they look at it as an "admission of guilt" that they're having problems, Monto says.

Beijing is putting a stop to that practice.

"Everyone now realizes full disclosure is important," Monto said.

Public health agencies worldwide collect and share data. In addition to Tamiflu, governments are stockpiling Relenza, an anti-viral inhalant made by GlaxoSmithKline. (GSK)

Flu vaccine manufacturers Chiron (CHIR), Sanofi-Aventis (SNY) and Glaxo are increasing capacity for seasonal and avian flu.

On Dec. 16, Sanofi-Aventis announced that early tests of its experimental avian flu vaccine showed "good immune response in a significant number of volunteers."

Monto sees another payoff from the work being done to thwart avian flu. "We can use our pandemic preparation to respond to seasonal influenza. It kills 36,000 Americans every year unnecessarily ? and many think the number is conservative."

Investor's Business Daily: Global Flu Pandemic Stirs Plenty Of Fear, But Little Perspective

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