Chasing The Flu

Steve Kroft Reports On Battle Against Possible Bird Flu Pandemic

(CBS) 

In the villages, people live with their chickens and ducks. “They are members of the family,” says Dr. Miller.

There are lots of things in Cambodia that kill people. Every year, thousands die from TB, malaria, tetanus and other infections. Bird flu is not yet a major concern.

“People don't believe in avian influenza,” says Dr. Miller.

She says it is possible cases of avian flu in Cambodia may have gone undetected. “It's possible that we have missed cases, because we won't pick up every single case occurring singly,” Dr. Miller says.

Asked if she thinks the surveillance system is good enough to detect when the virus makes the jump, Dr. Miller says, “We're not going to pick up the first case or the second case. I don't think we'll pick up the first jump. We're just not going to. What we're hoping to be able to do, and I'm fairly confident we should pick this up, if we get a family cluster, it will worry people. And so they'll go looking for answers. So, hopefully, in that looking for answers, they'll get to the right people and the alert will be triggered,” she says.

Dr. Miller says the quality of healthcare in many villages is primitive. “Thankfully in this village, it's not too difficult to get to a health center. I mean, whether someone is there is the big issue. And also whether they're aware of the symptoms of bird flu,” she explains.

The skill level for health care workers is rudimentary at best. Less than half the provinces have received training sessions in the WHO’s plan for flu surveillance, response and containment.

That plan, says Dr. Miller, might be workable in Cambodia. “There are a lot of logistical issues around mobilizing a lot of medicine and a lot of people in a short space of time. I mean we could get the medicine to Phnom Penh, but then how do we get the medicine from Phnom Penh airport out to the province? And one of the things we need to do with this sort of containment strategy is put a ring around the village and make sure no one goes into the village and no one goes out. Which is going to be the most difficult thing to control, because people are just used to going everywhere,” she says.

Dr. Miller says the Cambodian government is not yet fully prepared to respond to an outbreak of bird flu.

But neither is the rest of the world. If H5N1 were to become highly contagious in humans this winter it could spread to every country in the world in a matter of months. There is no way governments, health organizations, and pharmaceutical manufacturers would be able to produce sufficient amounts of the strongest anti viral drugs or vaccines to contain it.

“Right now, and we all admit that, right now if we had an explosion of an H5N1 we would not be prepared for that,” says Dr. Anthony Fauci of the National Institutes of Health. He is the nation’s point man on the avian flu.

The NIH is now testing a vaccine made from the current bird virus, but whether it would work against some future mutant strain that is contagious in humans is anybody’s guess.

This virus has been around since 1997 and there are people who say that it hasn't made the jump yet to the point where it can affect humans. Is it not going to?

“It is conceivable that this virus has already reached its dead end and these little blips of infections are just things that are manifestations of where it would like to go, but it's never going to get there,” says Dr. Fauci. “On the other hand, the more this virus is infecting and killing chickens, and the more people that get infected by it, that's going to give the virus a greater chance of doing what you hope it never does.”

The White House has proposed a $7.1 billion program to prepare for a pandemic. Plans are underway to stockpile drugs and medical supplies and to develop treatment plans, quarantine strategies, and better and quicker ways to manufacture vaccines. But what money can’t buy is time.

Dr. Fauci says he doesn’t see the preparations for the H5N1 virus as an exercise to improve capabilities of fighting off a pandemic. “Well, I don't see it as an exercise because it could be the big one. It could be. And if it is, our rushing around doing what we need to do, pushing the envelope, is not for naught or in vain.”

What, in his opinion, are the chances there could be a pandemic during this flu season?

“The probability of next month a H5N1 turning into a widely disseminated 1918 version, given where we are now, in my opinion, is low. Is it zero? No. Since it isn't, I'm assuming the worst case scenario will happen,” says Dr. Fauci.

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Dr. Fauci says it is the only way to proceed, but not the only possible outcome. It is conceivable that a human pandemic of H5N1 could emerge from the masses in Asia and turn out to be no more deadly than a bad case of the flu, which people often forget kills, on an average, 36,000 Americans every year.