From: Maggie Fox, Associated Press
Published November 2, 2004 12:00 AM

World Unprepared for Avian Flu, Experts Warn

WASHINGTON — The current U.S. flu vaccine shortage shows perfectly how poorly the world is prepared to handle the next global epidemic of influenza, health experts said Sunday.


There are few vaccines or drugs to fight the flu, and it takes months to make them, so when the pandemic comes it could wreak havoc for a long time, the experts told a conference.


"We believe with the current influenza vaccine supply issues, it illustrates perfectly the message that we'd like to get across," said Dr. Kathleen Neuzil of the University of Washington School of Medicine.


To prepare for a pandemic, countries first have to be ready for the regular yearly epidemics of influenza. That means having vaccines, drugs, and data on whom the disease sickens and kills, she told the joint meeting of the American Society for Microbiology and the Infectious Diseases Society of America.


Dr. Klaus Stohr, influenza coordinator for the World Health Organization (WHO), believes the world is overdue for a pandemic that could kill millions, and he believes the H5N1 virus now killing off tens of millions of birds in Asia is the most likely source.


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Flu pandemics — global epidemics of new strains of disease that kill an unusually high number of people — come on average every 27 years. The last one was in 1968.


"We are 36 years out. We believe that we are closer to the next pandemic than we ever were," Stohr told a news conference. "There is this new subtype in Asia circulating in poultry. It appears it is only a question of time until this subtype moves into humans."


From Poultry to People


So far the H5N1 flu has infected 44 people and killed 32 of them, Stohr said. Other studies presented to the conference show the virus has not yet acquired the ability to move from human to human.


Once it does, experts agree, it could spread quickly and kill millions.


In an average year, influenza kills between 500,000 and a million people globally, Stohr said — stressing that this is a low estimate. No figures are available from developing countries with poor health care.


Avian influenza could kill many more than that. Scientists believe most strains of influenza originate with ducks or poultry and mutate to move into people.


The best way to fight such a new flu would be to quickly vaccinate against it, Neuzil said. But only the United States is working on such a vaccine, through National Institutes of Health contracts to Aventis Pasteur Inc and Chiron Corp, under which 2.4 million doses will be produced.


Chiron's woes with standard influenza vaccine show just how badly wrong things can go. British regulators stopped Chiron from selling flu vaccine made at its plant in Liverpool earlier this month because of contamination.


That meant the United States did not get 48 million of an expected 100 million flu shots and forced government officials to scramble to scrape up a few million more doses.


Drugs that can fight flu are also in short supply. There are four: Roche's oseltamivir or Tamiflu; amantadine; rimantadine; and zanamivir, sold by GlaxoSmithKline under the brand name Relenza.


Stohr said WHO had just 120,000 doses of amantadine and rimantadine. Roche only has 4 million doses of Tamiflu available, and there are even fewer doses of Relenza.


But there could be some good news. Widespread use of Wyeth's Prevnar pneumococcal vaccine in U.S. children has meant fewer adults, especially old people, are developing deadly infections caused by the bacteria targeted by the vaccine, another group of experts told the conference.





Source: Associated Press


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