U.S. Bird Flu Scenario Eyed

An infectious disease expert says a doomsday scenario is awaiting the nation if it experiences an avian flu pandemic.

Michael Osterholm, head of the University of Minnesota's Center for Infectious Disease Research and Policy, warns an avian flu pandemic in the U.S. could claim many more lives than Hurricane Katrina.

"It is not if it [avian flu] is going to happen," he said. "It is when, and where, and how bad," Osterholm said at the Woodrow Wilson International Center for Scholars in Washington.

So far, avian flu has killed about 60 humans in Asia, while being mostly restricted to birds. But experts expect the virus to change enough to spread from human to human. Osterholm said it would likely claim around 1.7 million Americans in the first year, as vaccine was slowly produced.

Canadian medical journalist Helen Branswell said she feels no one, including the World Health Organization, is ready to deal adequately with an avian flu pandemic.

"Welcome to my nightmare," she said at the conference.

The World Health Organization is prepared to begin distributing large-scale quantities of an antiviral drug to treat bird flu in humans "if and when a pandemic starts," a top WHO official said Wednesday.

Dr. Shigeru Omi, director for WHO's Western Pacific region, said the U.N. agency was ready to open its stockpile of oseltamivir, an antiviral drug, to help avert a global pandemic of the disease.

The announcement came as Indonesian Health Minister Siti Fadila Supari on Wednesday warned of a possible bird flu epidemic just hours after the death of a 5-year-old girl who was hospitalized with symptoms of the disease.

A bird flu outbreak there could quickly turn into an epidemic, the health minister warned.

Bird flu has killed at least four people in Jakarta and is suspected of sickening several others, prompting Agriculture Minister Anton Apriyantono to declare a mass cull of chickens in areas found to be "highly infected" with avian influenza.

WHO currently maintains a stockpile of about 80,000 treatment courses of oseltamivir, known commercially as Tamiflu, Omi told reporters outside a WHO conference in New Caledonia.

Asked if WHO was prepared to send tamiflu to Indonesia, Omi replied: "If and when a pandemic starts, we can send this (drug)."

The organization regards a pandemic as a multi-country outbreak of bird flu, in which the disease has been passed from human to human.

The H5N1 strain of bird flu has swept through poultry populations in large swaths of Asia since 2003, killing at least 63 people and resulting in the deaths of tens of millions of birds. Most of the human deaths have been in Thailand, Vietnam and Indonesia. Health officials in parts of Russia and Kazakhstan are also monitoring its spread.
Omi also echoed the organization's repeated calls for wealthy nations to make some of their stockpiles of Tamiflu available to poorer nations.

Last month, Swiss-based Roche Holding AG announced it would donate 3 million treatment courses of Tamiflu to a WHO-managed stockpile, but the first million courses will not be ready until early next year and the remaining 2 million will not be ready until mid-2006.

Branswell said several key lessons should have been learned following Canada's recent experience with the deadly SARS (Severe Acute Respiratory Syndrome).

"In the modern world, infectious diseases travel at jet speed," she said. "Pandemic planners tell us we may have up to three months before a pandemic virus hits North America. I have no idea why they are so optimistic. SARS was raging in Toronto hospitals before it even had a name, before the WHO warned anybody to be on the lookout for the disease."

"In general terms, we are not much better able to handle acute respiratory distress syndrome, in any number of cases today, than we were in 1918," when as many as 100 million people died worldwide, Osterholm said.

But he takes heart that President Bush mentioned bird flu last week at the United Nations, and then again this week, saying the nation "needs to be mindful of this potentially devastating disease."

Last month, Health and Human Services Secretary Mike Leavitt said on bird flu is "the pandemic we're worried about currently."

"We're doing things that I believe are common sense," he told co-anchor Harry Smith. "We're increasing the amount of surveillance or early warning that we have in other countries."

Wednesday, health ministers and policy makers from more than 30 countries meeting in Noumea, New Caledonia, endorsed an Asia-Pacific strategy to contain emerging diseases, including H5N1.

Addressing the assembly, Omi said Asian countries must change the way they raise animals if future pandemics are to be averted.

"Every year we have (had) new emerging diseases for the last 20 years. Some are from Africa, some from Asia, (but) every one are zoonoses, animal diseases," Omi told the assembly.

Zoonoses are animal diseases that can cross species.

Omi said preliminary research into the spread of avian influenza in birds and humans had shown the disease had a greater prevalence in regions with higher population densities and larger numbers of domestic birds.

Outbreaks of bird flu in areas of Europe had been successfully contained in part because of more stringent controls on farming practices, he said.

"Unless we address these factors we have to expect more emerging diseases, especially zoonoses," Omi said. "If we are lucky to avoid this pandemic (bird flu), the next will come certainly."

The Asia-Pacific Strategy for Emerging Diseases calls on governments to enact local action plans or pass legislation to reduce the prevalence of animal-borne illnesses.

In particular, Omi said Asian governments must educate farmers about the risks of keeping ducks — which can carry H5N1 without showing any symptoms — and chickens in close proximity.