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Experts discuss bird flu fears, precautions
6 p.m., May 12, 2006--In response to widespread news reports about the danger of a bird flu pandemic in the United States, including a television movie titled “Fatal Contact: Bird Flu in America,” that was broadcast by ABC television network on May 9, the U.S. Department of Agriculture, the U.S. Department of Health and Human Services (HHS) and the National Chicken Council have teamed up with local experts to provide information to the public. UD experts Robin Morgan, dean of the College of Agriculture and Natural Resources, and Jack Gelb, professor of animal and food sciences and chairperson of the department, have assembled educational material about the widely publicized bird flu, known as H5N1 highly pathogenic avian influenza, which originated in Asia and has since spread to parts of Europe. Morgan said the ABC movie, which follows an outbreak of bird flu from its origins in a Hong Kong market through its mutation into a pandemic virus that becomes easily transmittable from human to human and spreads rapidly around the world, is a work of fiction and that there is no influenza pandemic in the world at this time. “It is important to remember that H5N1 avian influenza is almost exclusively a disease of birds,” Morgan said. “The H5N1 virus has not yet appeared in the U.S. Should it appear, it does not mean the start of a pandemic.” Gelb said that while the movie is fiction, it helps to raise awareness about bird flu and steps that individuals, families and communities can take to prepare. “You can keep a supply of food and medicines on hand in case you have to stay home, you can practice good public health measures like frequent hand washing and staying home when sick,” Gelb said. “It is important for all Americans to be informed about this potential public health threat and some of the steps they can take to protect themselves and their families in the event of a pandemic.” More information and government recommendations, including the HHS Pandemic Plan, are available online at [www.pandemicflu.gov]. Excerpts of information provided by HHS and the National Chicken Council: Q. What is “bird flu?” “Bird flu” is the common name for avian influenza, a respiratory disease of birds that is caused by a virus. Q. Can you get any type of avian influenza by eating chicken, turkey or other poultry products? There is no danger of acquiring avian influenza from normally and properly cooked food. Avian influenza is caused by a virus. Like all types of viruses, avian influenza is destroyed by the heat of normal cooking. Q. What about handling meat from an infected chicken or turkey? No chickens or turkeys known or suspected to be infected with the bird flu virus are processed for sale as raw meat in the United States. Washing the hands after handling raw poultry is always a good precaution, but consumers in the United States have virtually no chance of encountering meat from a chicken or turkey infected with avian influenza. More importantly, the U.S. does not have the H5N1 virus and does not import poultry from the affected Asian countries. Q. Many people in the movie are seen wearing surgical masks. Would masks protect me? Surgical masks are recommended for health care workers who are subjected to repeated exposure to multiple patients. For health care workers performing certain medical procedures on infected patients, N95 respirators are recommended. Surgical masks are also recommended for patients who are infected to help reduce the potential for spread of virus when these people cough or sneeze. HHS will continue to review and update its public health guidance on the use of masks and respirators by healthcare workers and by the general public. Q. The movie shows the virus spreading in many ways besides coughing or sneezing, such as handshakes, kissing and sharing drinks. Is that correct? Influenza virus is primarily spread by airborne droplets that reach the eyes, nose or mouth but can also spread by touching contaminated surfaces and then touching one's face. This highlights the importance of learning and practicing good personal hygiene, including:
Q. The film indicates that there would be a shortage of Tamiflu (or other antivirals) in a pandemic. Would there be? If so, what is the government doing to prevent that?
Q. In the movie, we learn that the virus is beginning to develop resistance to Tamiflu, rendering the drug useless. Could that happen? Tamiflu and another antiviral, Relenza, have shown effectiveness in treating influenza. Early evidence suggest that Tamiflu may be effective in treating those patients who have been infected with the H5N1 avian flu virus. While there have been a few reports of Tamiflu resistance developing on therapy, there has been no transmission of a resistant virus. The resistance developing on therapy has been associated with starting the drug late or using low doses of this drug. Tamiflu, when used at proper doses and started within a few days of the appearance of symptoms should be effective treatment of this infection. Relenza has not been used in treating human H5N1 cases to date, as it has been unavailable in many countries that have had people infected with H5N1. But experts expect it would be an effective treatment also. Of its antiviral purchases, the U.S. is buying approximately 80 perent of its supply as Tamiflu and about 20 percent of its supply as Relenza. This is due, in part, to product availability, but also to the need to diversify the supply so as to not rely solely on one medication. Q. In the movie officials quickly find out that there is no vaccine available when the pandemic occurs nor would any be available for many months. Would we have vaccine available if a pandemic occurs? There likely would be no vaccine initially available that precisely matches the pandemic strain when a pandemic begins. Because influenza viruses continually evolve and mutate, it is not possible to develop a vaccine until after the pandemic strain actually comes into existence. Only after the strain emerges, is isolated and characterized can a vaccine be developed and manufactured. Based upon current vaccine production processes and capacities, it would take at least 6 months to begin producing pandemic vaccine once a pandemic strain occurs. HHS has been developing and stockpiling an experimental “pre-pandemic” H5N1 vaccine that may offer some level of immune protection should the H5N1 virus mutate into a pandemic strain. Having a stockpile of this vaccine for up to 20 million people may help delay or lessen the initial impact of a pandemic while vaccine against the actual pandemic strain is developed and produced. However, HHS is making significant financial investments to improve the technology for vaccine development and to build up our domestic vaccine production capacity, to ensure more rapid availability of vaccine for the population in a pandemic. Q. Many neighborhoods were quarantined in the film. Would the government quarantine people in a pandemic? The purpose of quarantine is to separate people who have been potentially exposed to a contagious disease and may be infected but are not yet ill to stop the spread of that disease. The last large-scale quarantine measures that were imposed in this country were used in the early 20th Century to contain outbreaks of plague, yellow fever and smallpox. Today, quarantine typically refers to confining potentially infected persons to their homes or community-based facilities, usually on a voluntary basis. Quarantine can be used for a defined group of people who may have been exposed at a public gathering, or who may have been exposed while traveling, particularly overseas. In extreme cases, quarantine could apply to an entire geographic area, in which case a community may be closed off by sealing its borders or by a barricade, known as a “cordon sanitaire.” In the case of pandemic influenza, quarantine may be one of the public health tools employed in the early days of an emerging pandemic if efforts are undertaken to contain the outbreak before it spreads too widely. Once a pandemic has begun to spread, quarantine is not likely to be effective in controlling the spread. Instead, efforts may turn to “social distancing,” which includes measures to increase distance between individuals, such as staying home when ill unless seeking medical care, avoiding large gatherings, telecommuting and school closures. Q. Many essential services, such as electricity, food and water, become scarce in the film's scenario. Could that happen? An especially severe influenza pandemic could lead to high levels of illness, death, social disruption and economic loss. Everyday life would be disrupted because so many people in so many places become seriously ill at the same time. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery. In addition, a substantial percentage of the world's population would require some form of medical care. Health care facilities could be overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies. Non-traditional sites such as schools might need to be used for patient care to cope with demand. Q. In the movie, the Virginia governor's son dies because he cannot get diabetes medicine; other drugs are not available in pharmacies. Essential supplies, including medicine, may become unavailable during a pandemic. As part of effective planning, individuals and families should talk to their doctor about how to maintain adequate access to prescription medications. In a severe pandemic, it is very possible that up to 40 percent of the workforce at a business or organization would be out sick or at home taking care of sick family members. It is also possible that a small percentage of this amount would be people who are healthy but who may be too frightened to venture out into public. The numbers of health-care workers and first responders available to work can be expected to be reduced as they would be at high risk of illness through exposure in the community and in health care settings. Some may have to miss work to care for ill family members. Article by Martin Mbugua
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