Following up on the avian flu

A follow-up post to June’s discussion of the threat of an avian flu pandemic. There’s some good news and some bad news. The good news is that, according to the Financial Times’ Clive Cookson, containing the spread of a pandemic is quite feasible:

A human outbreak of avian flu could be ?nipped in the bud? preventing the deaths of millions of people in a pandemic if local public health measures are implemented quickly enough, two international research teams reported on Wednesday. The scientists, based at Imperial College London and Emory University in Atlanta, said their computer modelling revealed two key conditions that must be met to stop an outbreak at source. First, medical experts would need to identify the new viral strain a mutation of avian flu that spreads easily between humans when fewer than 40 people had been infected. Second, preventative capsules of the antiviral drug Tamiflu would have to be given to thousands of people who might have come into contact with those infected. This would require the World Health Organisation to build an emergency stockpile of 3m courses of Tamiflu to be deployed anywhere at short notice, said Neil Ferguson, head of the Imperial College team. At present the WHO holds just 120,000 courses of Tamiflu the only antiviral medicine that works well against all flu strains and can be taken by mouth but it is negotiating with Roche, the drug’s Swiss manufacturer, to expand the stockpile to 1m doses or more. The company is expected to donate some or all of the Tamiflu to the WHO.

The bad news is that the computer simulations were based on “an outbreak in rural Thailand of flu caused by the H5N1 avian strain.” I’m not sure how they would cope with where the strain has actually migrated. Douglas M. Birch explains in the Baltimore Sun:

A strain of avian influenza virus that can be lethal to humans has spread from Southeast Asia to poultry flocks in Russia and Kazakhstan, a scientific journal reported yesterday, leading a British researcher to warn that the virus may be approaching Europe. “If we are seeing an expansion in range, that is something we should be concerned about,” Ian Brown, head of avian virology at the United Kingdom Veterinary Laboratories Agency, told the journal Nature in an article published yesterday on its Web site. A Kazakh man who works on a chicken farm recently fell ill with the symptoms of bird flu, Nature reported. The man lives in a village in the Pavlodar region of northeast Kazakhstan, near the Russian border…. Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said it was too early to conclude whether the events reported in Nature represent a widening of the outbreak that has struck Southeast Asia.

If a pandemic were to spread this year, it is far from clear whether the United States or the rest of the world would be able to cope. Developing….