Re: Update on "Avian flu preparations, the US and Europe"

On 8/10/05 22:00, in article 4348255a$0$5397$8fcfb975@xxxxxxxxxxxxxxx,
"Runge" <philsa@xxxxxxxxxxx> wrote:

Updating you further, Grunge.

Have a nice day.

****


The Race Against Avian Flu

Public-health officials have been sounding the alarms, and now Washington
has caught the bug. Meanwhile, scientists search for a vaccine.




By Jerry Adler and Anne Underwood
Newsweek

Oct. 17, 2005 issue - In the calendar of natural calamities, flu season
follows hurricane season, peaking in midwinter. Last week, with New Orleans
still mostly uninhabitable, Washington was turning its attention to the
threat posed by an exceptionally lethal strain of flu virus that could, in
the worst case, kill as many people in a few months as AIDS has done in two
decades. This time officials were resolved not to repeat the mistakes of
Katrina, leaving the way open to make new mistakes. We now know better how
to evacuate large cities?but how much good will that do in an emergency that
calls for a quarantine instead?

At least no one could accuse the government of downplaying the threat:
President Bush himself raised the possibility of using the military to
contain a flu outbreak, while the Senate voted to spend $4 billion on
preparations. Researchers have developed a promising vaccine that is now
beginning large-scale production. But new fears arose last week when
scientists announced they had reconstructed an actual living copy of the
"Spanish flu" virus that killed 20 million to 50 million people in 1918.
Apart from the implication that a terrorist could do the same thing, the
disturbing news was that the culprit was essentially a bird virus which had
undergone only "minimal changes to infect humans directly," according to
microbiologist Terrence Tumpey of the Centers for Disease Control and
Prevention. (More common, and less lethal, flu outbreaks are caused by germs
that are a hybrid of mammalian and avian viruses.) As Tumpey points out,
that is also a pretty accurate description of the H5N1 flu virus that has
been circulating in Asia since 1997. (It is not related to the SARS outbreak
of 2003.) In the last two years H5N1 has killed 140 million birds; it has
infected just 116 people, mostly in Vietnam?but it was fatal to more than
half of them. The critical difference from 1918 is that the newer virus is
not ordinarily contagious between people. Almost everyone who has come down
with it has caught it from a bird. So far.

Most researchers think our luck won't hold?that as the trillions of flu
viruses at loose in the world replicate and mutate, it's only a matter of
time before one evolves the ability to spread by way of a cough or a
handshake. Then our fate will be decided in a race between the virus's
inherent lethality and the tendency of all germs to evolve toward a less
deadly form because their own spread depends on not killing the host?us?too
quickly. Some researchers like our odds. In 1918, millions of soldiers and
civilian refugees on the move in crammed trains and ships created an ideal
situation for spreading flu, and there was nothing like today's techniques
for surveillance and isolation of patients. "I actually have confidence
about this," says Paul Ewald, a biologist at the University of Louisville.
"It won't race around the world like a new 1918 virus."


We also have medical resources undreamed of in 1918. Last year molecular
virologist Richard Webby of St. Jude Children's Research Hospital in
Mem-phis, Tenn., announced he had "reverse engineered" a version of the H5N1
virus that could be the basis for a vaccine, keeping the parts that are
recognized by the human immune system while disabling a critical
disease-causing function. It took just "a few weeks," says Linda Lambert,
who is coordinating the government's bird-flu-vaccine program. The resulting
vaccine has been tested on 450 volunteers, and preliminary results are
promising, at least for the highest doses tested; like many vaccines, it
will probably have to be given in two shots, a month apart. On the
assumption it will work, but also in part just to get a production line up
and running, the government last month awarded a $100 million contract to
Sanofi Pasteur of France, aiming for a stockpile of 20 million doses. The
vaccine is tricky to manufacture, because it requires injecting virus into
live chicken eggs; under a separate contract, the same company is
researching a cell-based production sys-tem that could show results by the
end of the decade.

The second line of defense against avian flu is antiviral drugs, in
particular one called Tamiflu from the Swiss drugmaker Roche. Viruses
replicate by commandeering a cell's genetic machinery to copy themselves;
Tamiflu prevents the daughter viruses from escaping to infect new cells. It
has shown good results against H5N1 in cell cultures and in mice, and it
works against milder forms of the flu in humans, if they take it the first
day or two after falling ill. But the real test will come only when and if a
lot more people are infected with H5N1; one expert in infectious disease,
Michael Osterholm of the University of Minnesota, admits that "we don't
honestly know" if Tamiflu will work against avian flu, adding: "The disease
goes so quickly to high levels of infection, you might need to take it
before you get exposed."

But as of last week the United States had enough Tamiflu to treat only 2.3
million cases, with 2 million more about to be delivered and a further 8
million on order. Government plans call for a stockpile adequate to treat 20
million people with antivirals. Dr. Irwin Redlener, director of the National
Center for Disaster Preparedness at Columbia University, says the government
was too slow to order it. Much of Roche's production is now committed to
other countries that placed orders earlier. Redlener estimates that it could
take until 2008 before production can catch up with worldwide demand for the
drug. "We're playing Russian roulette with public health here," he says.

Of course, that's just what the administration doesn't want anyone to think,
which explains the flurry of activity last week. That included briefings for
congressional leaders under a top-secret security classification ordinarily
used only for highly sensitive foreign intelligence; a source familiar with
the issue who requested anonymity in discussing intelligence matters
speculated that the briefings included information about human cases in
foreign countries. The week culminated with a conference of health officials
from 80 foreign countries and a well-publicized meeting in which Bush urged
drug-company executives to speed their work on vaccines. Secretary of Health
and Human Services Michael Leavitt says Bush brought up avian flu with him
at a meeting earlier this year, and that "we've been in an aggressive mode
of planning for at least six months. Any suggestion the president hasn't
been fully engaged on this pre-Katrina would be wrong." Whether he did
enough, we may find out this winter, or next. Or, if we're lucky, not at
all.

With Mark Hosenball, Martha Brant and Pat Wingert in Washington

.

Relevant Pages

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