An Ominous Flu Season

Could this year or next year be 1918 all over again?

IS H5N1 avian flu the real deal? Surprisingly, many Americans don't fear it. They may have taken comfort from Turkey's outbreaks early this year; the disease was fairly widespread there but, as of this writing, still could not be passed easily from person to person. Health care professionals are very worried, however.

Dean Barry R. Bloom and Associate Professor of Epidemiology Marc Lipsitch of the Harvard School of Public Health write in the Harvard Public Health Review (Winter 2006) that an H5N1 variant capable of efficient transmission between humans "is likely to be much more difficult to control than SARS," which was the most recent emerging virus to prompt fear of a pandemic. People are infectious in the first or second day after infection, often before they become aware they have the flu, so the tools that worked well for SARS--isolation and quarantines--probably won't stop a virulent flu pandemic, they warn. Few of the 8,000 people infected with SARS were traveling, so border screening wasn't effective. "For flu," Bloom and Lipsitch write, "the rapid spread characteristic of a pandemic will cause just the opposite problem for border controls: many infected people will likely be traveling, with many not yet showing signs of infection. With over a million travelers entering the United States each day, stopping 95 or even 99 percent of infected people at borders would not be sufficient once a pandemic was under way in other parts of the world."

President Bush called last fall for a $7.1 billion pandemic preparedness program, which Bloom and Lipsitch consider crucial to develop an effective vaccine and the capacity to make it in sufficient amounts. They'd like to bolster flu surveillance efforts in Asia beyond what Bush's plan recommended. Other governments are at work; Bacou-Dalloz announced Jan. 9 it had signed a deal to supply about $100 million in disposable respirator masks by 2008 for the French government's avian flu pandemic preparedness, and the EU commission said Jan. 13 it would donate $100 million to countries affected by bird flu.

Could this year or next year be 1918 all over again? The 1918 flu that killed 20 million to 50 million people--Bloom and Lipsitch call it "the best model we have" for a scenario where H5N1 or another strain becomes capable of extensive person-to-person transmission while remaining highly virulent--was probably a bird flu.

This column appeared in the March 2006 issue of Occupational Health & Safety.

This article originally appeared in the March 2006 issue of Occupational Health & Safety.

About the Author

Jerry Laws is Editor of Occupational Health & Safety magazine, which is owned by 1105 Media Inc.

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