Scientists Warn Of Coming Flu Outbreak

AP/Yahoo ^ | 12-13-2003 | Malcomb Ritter

[blam]

Scientists Warn of Coming Flu Outbreak

By MALCOLM RITTER, AP Science Writer

NEW YORK - As bad as this year's flu season is, it hasn't brought the worldwide outbreak known as a pandemic. But experts warn that a pandemic is coming, it's just a question of when.

"It's going to happen," said Dr. Greg Poland of the Mayo Clinic. "For the American public in particular, I think it will be horrific."

Many Americans haven't experienced the overwhelming crush of patients at hospitals and doctors' offices and the widespread fear a flu pandemic could bring. And by historical pattern, Poland said it's about time for the next one.

There have been three in the past 100 years, igniting in 1918, 1957 and 1968. There's no way to predict when the next one will appear, but the pattern does give experts pause.

It's all up to a virus that is variable and fickle, constantly changing its genetic makeup, and the time when it hits upon a combination that lets it take off worldwide is a "roll of the genetic dice," said Dr. William Schaffner of Vanderbilt University.

So the lack of a pandemic in the past 35 years basically means "the genetic dice haven't been rolled that way," Schaffner said. "While we're grateful for that, it makes us nervous."

There's plenty to be nervous about. It's estimated that in the industrialized nations alone, the next pandemic is likely to send 1 million to 2.3 million people to the hospital and kill 280,000 to 650,000, according to the World Health Organization (news - web sites). Its impact will probably be greatest in developing countries.

As a practical matter, flu shots probably could not be counted on to prevent a pandemic. For one thing, pandemic virus strains emerge unexpectedly, and there would probably not be enough time to recognize the threat and then provide vaccines that target them, Schaffner said. What's more, many countries outside the United States wouldn't have the means to give enough flu shots to stop the spread, Poland said.

Dr. Robert Couch of the Baylor College of Medicine noted that health authorities are making major efforts to prepare for controlling a pandemic, including putting an emphasis on developing and manufacturing vaccines faster and in greater quantities.

The pandemic of 1918-19, known as the Spanish flu, sickened an estimated 20 percent to 40 percent of the worldwide population, with a death toll believed to exceed 20 million. In the United States alone, some 500,000 people died. An ordinary flu epidemic kills an average of 36,000 Americans.

The next pandemic, the Asian flu of 1957-58, killed about 70,000 in the United States, while the 1968-69 Hong Kong flu led to about 34,000 deaths in the United States.

New strains of the flu virus, and so potential pandemics, get their start in rural Asia, where the various strains that infect chickens and other birds, pigs and humans can mingle. That gives them a chance to swap genetic information as well as mutate on their own.

The potential spark for a pandemic occurs when that environment produces a new virus that infects people and bears surface proteins that people's bodies have never seen before. That means people have no natural defense against it.

In contrast, ordinary outbreaks like this year's come from a virus that has changed only slightly from previous ones, so that the population it enters still has some natural immunity from encounters with the previous germs.

But the genetic shift alone is not enough to launch a pandemic. In addition, the new virus must acquire the ability to pass easily from person to person, either by random genetic change or by picking up genetic material from a previous human flu virus.

The world has had some close calls in the past few years, says Richard Webby of St. Jude's Children's Research Hospital in Memphis. In 1997, a bird flu in Hong Kong jumped to people, killing six. But the virus never developed the ability to pass easily from person to person, Webby said. Hong Kong authorities slaughtered 1.4 million chickens to end the threat.

Just this year, authorities became alarmed when a father and son in Hong Kong were hospitalized because of a bird flu virus, and when flu virus infected some workers in the Netherlands who had slaughtered infected chickens. The Netherlands outbreak was contained by anti-flu drugs and fast vaccination, and slaughter of the poultry, Webby said.

Scientists have been noticing a lot of flu virus in chickens and pigs globally, and a lot of variety in the strains, which is worrisome, Webby said. It's impractical to develop vaccines against all the animal strains in case they jump to humans, and there's no reliable way to identify the most hazardous ones, he said.

When the next pandemic shows up, experts say, it will find a population with many more vulnerable people like the elderly, infirm and those with weakened natural defenses than were living 35 years ago. It will also find a trimmed-down hospital system with fewer beds to handle a surge of patients. And while today's anti-flu drugs will probably attack the new strain, that's not yet clear. Supplies of the drugs and vaccines would be strained.

But still, with the improvements in health care since the last pandemic, might the next one be less serious?

"I want to believe that," Poland said, "but we won't know until it happens."

[Batrachian]

I don't know why we keep hearing so much about this. Does any one really believe that it will be the Spanish Flu all over again? Call me paranoid, but I think this is some kind of bizarre stealth attack against Bush.

[GOP_Proud]

Wasn't the '68 thing the Hong Kong Flu? I don't remember it being a disaster.

[blam]

"Wasn't the '68 thing the Hong Kong Flu? I don't remember it being a disaster."

My only child was born that year and I don't remember anything peculiar about it.

[DoughtyOne]

Another 'sky is falling' rant. The actual facts about this flu season aren't that much worse than any other year. It's as if the public health departments are trying to scare the bejesus out of people. What I am trying to figure out, is why?

This is one of the first years in a long time when influenza virus vaccines were in plentiful supply. Then, mid-stream, the public health departments instigated a frenzy of ill-advised statements which paniced people into getting a flu shot. Now there's a shortage.

The outbreak of flu that has been so talked about this year, is a variety that IS NOT covered by the influenza vaccine designed, manufactured and distributed this year. Still the public health officials promote the vaccine because "it may help". LOL, now there's a resounding endorsement. If that were true it wouldn't matter much if we anticipated and designed vaccines for new varieties each year would it.

It almost makes one wonder if there's a homosexual ACLU and socialist gene being implemented in with the actual vaccine. If not, what's this bum's rush all about?

[netmilsmom]

I don't know that it is against Bush, more that it is a push to have all of us get flu shots every year. I heard some lady on the radio state that if we could get everyone to get a flu shot, we could eliminate flu. HA! This year's flu strain that is so bad is not even covered by the shot.
The last time I got a shot, I was fine that year. The next year, I skipped it. I got every disease that came down the pike including Mono at 42. I don't think I built up any natural immunities.
This year I got the shot and I have been sick ever since. I think we got a bad batch in this area. I did not get the shots for the girls and I'm trusting in God to keep them safe.

[maridee]

I do remeber the Hong Kong flu, I got that one. I rememeber the caugh lasted a month when it was over.
I also rememeber my dealings calling New York City offices. They were empty. So many people were sick.
My flu lasted about 5 days. It was bad.
Also whenever you had dealings with anyone on the phone,you would hear heavy caughing. That was the clue that they had gotton the Hong Kong flu.
It must have been bad, because I rarely ever get even a cold, which I do have now. :-)

[maridee]

I guess I should have done a spell check. Sorry for the errors.
In a hurry.

[spectre]

"The outbreak of flu that has been so talked about this year, is a variety that IS NOT covered by the influenza vaccine designed, manufactured and distributed this year. Still the public health officials promote the vaccine because "it may help". LOL, now there's a resounding endorsement."

Right. So we got inoculated for the wrong flu. But it just may give us some protection..LOL.

sw

[onyx]

A good and timely post, blam. My husband is a physician, and we're keeping out 4-year-old gdaughter out of pre-school for the entire month of December and we might extend it through January. This flu strain is serious.

[GOP_Proud]

Since I'm fairly susceptible to respiratory illnesses (due to being seriously burned as a child...almost died of pneumonia), I almost always get the flu shot and haven't had it since I started shots. I've never suffered any effects from the shot either. I was at the doctor's office yesterday (ear infection) and talked to him about it. He says the vaccine is always hit and miss and this years may not be a hit. He told me to be alert for it and gave me symptons to look for as to when I should come in if I get sick.

[Cobra64]

I'm waiting for the media to mention the words "flu" and "George W. Bush" in the same sentence.

[Severa]

Got my flu shot the week it was available this time round. Fat lot of good it did me. This week has been one of the most miserable weeks of my life. We (the kids and I) are a coughing sniffling sneezing mess.

[DouglasKC]

I don't know why we keep hearing so much about this. Does any one really believe that it will be the Spanish Flu all over again? Call me paranoid, but I think this is some kind of bizarre stealth attack against Bush.

It's like the press thinks it's 1918 again and that most people in the US don't have heat, plumbing, or access to over the counter medicines.

[Dysart]

I met with the first person diagnosed with nasty bug in Dallas county. She was in Parkland for two weeks,barely hanging on. She said she had only finished eating an hour earlier,when she was stricken by what she thought was food poisoning. Within an hour or so,she was almost incapacitated,and spent quite a bit of time on a ventilator.

She works out at Love Field and has extensive contact with the flying public. Makes you wonder how this has spread so far,so quickly, doesn't it?

I'm normally very skeptical--well about everything--but this outbreak is nothing to sneeze at.

[ladylib]

Maybe they can put together a sentence containing SUV, George W. Bush, and flu.

[LasVegasMac]

a coughing sniffling sneezing mess.

I do hope you and kids get well soon - but I just had to laugh at what you said. That sounds like it needs to be an advertisement on TV for some medicine.

My boy just had his tonsils and adenoids removed this past Wed. Even though he had the shot, the doc's beat it into our heads, "Do not let him outside for 7 days - no matter how good he feels - DO NOT! If he gets the flu he is in for a very hard time."

Adice heeded and my 9 yr old is about fit to be tied.

LVM

[Allegra]

Wasn't the '68 thing the Hong Kong Flu? I don't remember it being a disaster.

I think so. It was some kind of Asian flu. I was a kid living in Italy (military brat) at the time and I caught it right around Christmas time. I don't remember it being any big deal and I think I got over it pretty quickly.

[Gritty]

I'm waiting for the media to mention the words "flu" and "George W. Bush" in the same sentence.

Wait no longer.

Bush blamed for flu vaccine shortage