Wednesday, August 02, 2006

Prepare now for flu pandemic, officials warn

Prepare now for flu pandemic, officials warn

By Rebecca Vesely, STAFF WRITER
Inside Bay Area

DUBLIN — Avian flu could arrive in California as early as this fall via migrating birds, and while that doesn't spell a flu pandemic, local communities need to do more to prepare, health officials warned at a day-long conference Tuesday.
"The truth is, we are largely on our own," said Dr. Anthony Iton, Alameda County's health officer.

This first countywide pandemic flu preparedness forum, held at the county's Office of Homeland Security and Emergency Services, brought together law enforcement, firefighters, community groups, school leaders and officials from hospitals and city governments.

The emphasis on pandemic flu preparedness stems from worries about the H5N1 virus, an avian flu strain that has spread to 51 countries, infected 230 people and killed 132.

Although a new study by the Centers for Disease Control and Prevention released Monday suggested that H5N1 may not mutate easily into a rapidly spreading strain, avian flu is making its way around the globe.

Avian flu will arrive via birds on the Alaskan flyway soon, said Dr. Peter Lichty, medical director of occupational medicine at Lawrence Berkeley National Laboratory. Infected birds have been found as close to the West Coast as Siberia, whose border is three miles from Alaska.

"I'm expecting infected birds in Cali-fornia by the end of this year," Lichty said. "That's why we decided to do this (conference) now."

But the presence of H5N1-infected birds doesn't necessarily equal a human pandemic. A pandemic is defined as infecting at least 25 percent to 30 percent of the population over a prolonged period.

"There's no way to say when there will be a pandemic," said Dr. Howard Backer, California's public health officer. "We know it will happen, but we don't know when." Some researchers had predicted avian flu in North America during spring's migratory season, which didn't come to pass.

Even so, decisions about quarantines, school closures, vaccine priorities, hospital diversions, supply allocation and resource coordination largely will be left up to local jurisdictions, according to federal and state flu pandemic preparedness plans.

This year's state budget includes $214 million to handle any so-called "surge capacity" in the health system, such as supplies, drugs, field hospitals and training in the event of a flu pandemic. An additional $40 million has been allocated for antiviral drug stockpiling, disease surveillance, training and response teams.

The county has been running a preparedness program on Comcast Cable, developing a pandemic flu pocket guide and building a volunteer database to draw on in case disaster strikes.

The health department is using emergency preparedness and bioterror funds for this effort. About $100,000 was allocated this fiscal year to the county for pandemic flu, and $400,000 in future years, but the county hasn't yet received the funds, Iton said.

"Our lesson from (Hurricane) Katrina is you start with people most likely to be impacted," Iton said.

The county needs to make stronger connections with others that would be touched by a flu pandemic, including the Port of Oakland, veterinarians, environmental health officials, the military and schools, Iton said.

The H5N1 virus could develop into a pandemic if it mutates to become easily transmissible between humans. Today, reports of human-to-human infections have been scattered.

The virus would likely first come via migrating birds or animals trafficked or smuggled into the country, not from local poultry populations or from people traveling by airplane from infected areas, officials at the conference said.

An infectious disease outbreak can lead to many unexpected issues, said Dr. Robert Kosnick, an occupational physician at the University of California, San Francisco. Kosnick was working at St. Michael's Hospital of the University of Toronto during the 2003 SARS outbreak, and developed the hospital's patient and worker safety protocols.

During the SARS outbreak, the hospital had to cancel elective surgeries and clinics, and close all but one entrance and exit point for workers, where they were screened for possible infection.

Fear of the virus and uncertainty about the epidemic's duration made establishing protocols essential. The Toronto epidemic lasted three months, and during that time, 375 people were infected and 44 people died.

"The logic at the time was, 'If you touch it, you will get it, and you will die,'" Kosnick said.

The absence of a viable vaccine to combat avian flu makes community-wide preparedness even more important, officials said.

Last week, drug maker GlaxoSmithKline reported positive results from a clinical trial of its avian flu vaccine. The company said it could produce the vaccine in large quantities by next year. The vaccine uses an inactive strain of H5N1 isolated in Indonesia last year.

Contact Rebecca Vesely at

''There's no way to say when there will be a pandemic. ... We know it will happen, but we

don't know when."

Dr. Howard Backer



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