Thursday, May 26, 2005

World unprepared for flu

By Mark Henderson, Science Correspondent
THE world is unprepared for an influenza pandemic that would infect well over a billion people and trigger global economic disaster, leading scientists say today.

International leaders are ignoring indications that the virulent H5N1 strain of avian flu presents a severe threat, and have failed to introduce the cross-border measures essential if a worldwide outbreak is to be contained.

Such a pandemic could affect 20 per cent of the world’s population, putting 30 million in hospital and killing a quarter of them, according to even optimistic predictions. It would also lead to the collapse of international trade and cause economic and social chaos even in rich countries that can protect their populations with drugs and vaccines.

In expert commentaries published today in Nature, some of the world’s foremost authorities on flu argue that only a meticulously planned global response stands a chance of averting a catastrophe.

They call for a permanent international taskforce to prepare for a pandemic, in place of country-by-country arrangements. Urgent action is needed to develop ways of designing and manufacturing vaccines against the virus — a process that now takes six months — and to agree international guidelines for eliminating reservoirs of potentially dangerous strains in poultry and wildlife.

The calls come amid growing concern that the H5N1 virus circulating in Asia has the potential to start a human pandemic. It has infected at least 97 people in Thailand, Vietnam and Cambodia, of whom 53 have died. Most of those cases were contracted from birds, but there are emerging indications of occasional transmission between people — the key step to a pandemic. Last week, the World Health Organisation said it was concerned about possible human-to-human infection in north Vietnam, though this has not been confirmed.

Even if H5N1 does not start a pandemic, another is certain to strike: they generally happen at intervals of about 30 to 40 years, and the last took place in 1968, killing a million people. The worst on record was the Spanish flu of 1918-19, which may have caused 50 million deaths.

Michael Osterholm, of the University of Minnesota, said “bold leadership” and meaningful financial investment in vaccine research is required from the G8 industrialised countries, which are not taking the issue sufficiently seriously.

“When the G8 leaders next meet, in Scotland in July, avian flu will be on the agenda, but major commitments are unlikely,” Dr Osterholm said. “These nations urgently need to recognise the economic and security and health threat that the next flu pandemic poses, and invest accordingly. The arrival of pandemic flu will trigger a reaction that will change the world overnight.

“We must demand nothing less than an international effort. If industrial countries continue to develop vaccines for just themselves, they, and everyone else, will remain vulnerable to a global disaster. Even if nations vaccinate their entire populations, they cannot remain isolated from a pandemic shock.”

Albert Osterhaus, ofthe Erasmus Medical Centre, Rotterdam, wants a task force of experts in human and animal medicine, virology, epidemiology, pathology, ecology and agriculture. Teams would be sent to investigate outbreaks, to assess pandemic potential and institute containment measures. Such a taskforce would cost $1.5 million (£820,000) a year.

This compares with agricultural losses of up to $880 million for H5N1 outbreaks in Thailand and Vietnam.

1918-19 H1N1 ‘Spanish flu’ strain kills 50 million

1957 H2N2 virus kills up to 4 million people

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