Sunday, October 31, 2004

The Coming Pandemic

Getting away from the election for one moment (although with the way the Bush Administration treats science and screwed up the flu vaccine, maybe we're not), USA Today is reporting that:
The flu vaccine shortage shows how unprepared the world is for what could be a global flu epidemic percolating in Asia, experts said here Sunday.

Since December, a strain of bird flu has spread through poultry flocks from Japan to Thailand, despite efforts to contain it by mass killing of chickens. The virus also has infected and killed humans, though it doesn't appear to spread easily to people.

That could change, experts warn, sparking a pandemic — an epidemic that could sweep around the world.

"We believe we're closer to a new pandemic than ever," said Klaus Stöhr of the World Health Organization. "It's only a matter of time. ... We have a window of opportunity now to prepare ourselves."

The flu viruses that circulate each winter in the USA are variations of viruses that have been seen before. A pandemic strain, though, is one that has never been known to humans, so everyone is susceptible to it.

Scientists here at a meeting of the American Society for Microbiology said the best defense against flu, whether a pandemic strain or the regular variety, is vaccine.

Yet this year's vaccine shortage points out the weakness of the vaccine supply system. It "has to make us wonder about our limited ability to respond to a pandemic," says Wendy Keitel of Baylor College of Medicine in Houston.
To scare you a little more, a quick Google search uncovered a Newshour transcript from 1997 about the 1918 flu pandemic. The scariest part:
ELIZABETH FARNSWORTH: How many people now--I reported more than 20 million [died]--but how many do you think in the latest research?

DR. JEFFREY TAUBENBERGER: The conservative estimate is 21 million people, but people suggest that it may be forty to fifty million people actually died worldwide. Some current research suggests that almost 20 million people died in India alone.
And finally, this little bit of horror from an August 27, 2004 AFP story:
A key weapon in the medical arsenal that will combat any future pandemic of killer flu may be worryingly at risk to resistance by the influenza virus, according to an early Japanese study published in The Lancet.

The drug is oseltamivir, one of only two medications in a class of treatments called neuraminidase inhibitors. They work by blocking an enzyme that the virus uses to escape from an infected cell and then spread around the body.

The research probed oseltamivir resistance among 50 Japanese children who were being treated for flu.

The scientists took blood samples from the young patients and carried out a DNA analysis of the flu virus to see how much it had mutated -- the phenomenon that enables a microbe to thwart a drug.

Nine out of the 50 samples -- 18 percent of the total -- showed mutations at two points in the genome that had previously been suspected to cause resistance. The children had the H3N2 viral strain.

The team were also surprised to find that even five days after treatment with oseltamivir, children could still be infectious.
- - - -
US paediatrician Anne Moscona said this was a wakeup call about a potential threat to neuraminidase inhibitors, especially in the light of Asia's H5N1 bird flu outbreak, a phenomenon that some fear could breed a vicious and infectious viral form.

"Widespread influenza is the deadliest plague in human history and transmission of avian influenza to human beings probably started the global pandemic of 1918, which killed 50 million people," Moscona commented.

Oseltamivir and its cousin zanamivir would be vital weapons in the fight against any such future peril.

They are highly regarded because they target a feature common to all types of flu viruses and so would be as effective all strains. They are a treatment, not a prevention against infection.

That role is given to vaccines. However, it would be almost impossible to stockpile a vaccine engineered for a specific virus and then distribute it quickly before that virus spreads around the world by jet passenger travel.

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