Symposium warns of mounting flu pandemic
By Colleen Newvine
News Service
Since the worst influenza symptoms typically pass in a week, it's easy for some people to dismiss flu as little more than an inconvenience.
That's a big mistake, says noted U-M flu expert Arnold Monto.
Monto helped organize an international symposium Jan. 24 entitled "Pandemic Influenza: Could History Repeat Itself?" The answer from a roster of speakers was that not only could the world see a repeat of a massive flu outbreak like that of 1918, it almost is inevitable.
All the ingredients for a flu pandemic are stacking up, which could mean up to 200,000 deaths, 750,000 hospitalizations and 42 million outpatient visits in the United States, said Ed Thompson, chief of public health practice at the Centers for Disease Control and Prevention.
That is not to mention the economic strain caused by hundreds of thousands of Americans too ill to work. The World Health Organization pegged the global cost of SARS—a disease that killed far fewer than the 30,000 who die in the United States annually of flu—at about $30 billion, factoring in such things as travel restrictions and other dampers on trade.
Among the elements that could lead to a new flu pandemic are:
• a new flu virus called H5N1. It has been rapidly mutating since 1999 and creating new forms until arriving at the now-dominant Z strain, which is spreading across southeast Asia. A third wave of what's called avian influenza started in December, and a myriad of conditions in Asian countries help the flu's advance, said Malik Peiris, professor of microbiology at University of Hong Kong and chief of virology at Queen Mary Hospital in Hong Kong.
• evidence of new ways flu can be spread. In the past, the H5N1 flu was seen spreading from birds to humans, but a Jan. 27 issue of the New England Journal of Medicine (NEJM) discusses a family in Thailand where a girl appears to have transmitted the flu to her family members. Monto responded with a Perspectives piece in the NEJM, in which he concluded: "We really are not sure when, or whether, the type A (H5N1) virus will start to spread among humans, but we must be ready to stop it if we can."
• insufficient vaccine supply. Even in a year without vaccine supply problems, manufacturers do not make enough flu vaccine to cover everyone at risk of contracting the ailment. As for-profit companies, they make only what they expect to sell, and many people forego vaccination. Meanwhile, American policy is to vaccinate the elderly, who are more at risk of death from flu, rather than emphasizing the vaccination of young people, who are more likely to get the disease, and then spread it to others.
Speakers discussed ways to minimize the effects of flu, including encouraging more people to get vaccinated and stockpiling antiviral drugs used to treat flu after it starts. Much of this begins with making people aware of the very real danger of flu, and putting it in perspective with other high-profile risks like HIV
or SARS.
The symposium was co-sponsored by School of Public Health's Michigan Center for Public Health Preparedness and the Michigan Department of Community Health.
A Web cast of the event is available at http://www.mipreparedness.org.
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