Bird Flu Pandemic: More Than 7.5m Global Deaths?
A leading scientist warned yesterday that the avian flu virus is on the point of mutating into a pandemic disease and says that current estimates that such a pandemic could cause 7.5m deaths may understate the threat.His warnings come as experts writing in today's edition of Nature voice concerns about the world's inability to manufacture sufficient vaccines for a pandemic and warn of the impact that the virus - H5N1 - could have on the global economy.
In an accompanying editorial Nature argues that so far such warnings have "fallen on deaf ears". It backs a call by Prof Osterhaus and his colleagues at the Erasmus Medical Centre, in Rotterdam - one of the world's leading virus research labs - for a global taskforce to strengthen agencies on the ground.
There have been 90 human infections in south-east Asia, from which 54 people have died. But while culling and the vaccination of poultry appears to have slowed outbreaks in Thailand and other parts of south-east Asia, this year Vietnam has seen a worrying number of human infections in the same family groups.
According to Prof Osterhaus such clustering could mean the virus is becoming more efficient at infecting humans - a precondition for a pandemic.
Another concern are reports which emerged from China last weekend that H5N1 was responsible for the deaths of 178 migratory geese at a wildfowl reserve in the western province of Qinghai earlier this month.
Prof Osterhaus says the geese's deaths could be another indication that the virus is mutating and becoming more virulent.
The problem is that countries such as China and Vietnam are not providing animal and human health officials with enough data, leaving scientists in the dark.
According to the WHO, within a few months of the pandemic 30 million people would need to be hospitalised, and a quarter could be expected to die.
In his Nature commentary, Prof Osterhaus describes current estimates that a pandemic could infect 20% of the world's population and cause 7.5m deaths as "among the more optimistic predictions of how the next pandemic might unfold".
Such pandemic viruses emerge every 30 years or so. The most virulent was the 1918 Spanish flu pandemic, which is believed to have claimed 40 million lives worldwide.
By contrast the 1957 Asian flu pandemic and 1968 Hong Kong flu claimed less than one million lives each.
Prof Osterhaus wants the WHO, the UN Food and Agricultural Organisation and the World Organisation for Animal Health to set up global teams of vets, medics, virologists and agriculturalists to respond rapidly to outbreaks.
His comments are backed by the other experts in Nature, who also criticise the WHO and international efforts to develop vaccines against H5N1 and other strains of avian influenza.
According to Michael Osterholm of the University of Minnesota, antiquated vaccine manufacturing systems mean that countries like the US are unable to protect their populations against annual flu strains, let alone pandemic ones. [Mark Honigsbaum @ Guardian]
FLU PANDEMIC "COULD HIT 20% OF WORLD'S POPULATION"
A global taskforce should be urgently formed to tackle a potential influenza pandemic that could affect 20% of the world's population, trigger economic disaster and kill millions, experts warned today.
A report in scientific journal Nature gives a fearful assessment of the huge impact a pandemic could have on the world, with an estimate that more than seven million people could die in the first few months.
A pandemic would change the world "overnight" and could be worse than previous outbreaks because of the greater interlinked nature of modern life, experts told Nature.
Fears of a pandemic have increased because of the outbreak of the current H5N1 bird flu strain in south-east Asia, which has caused 51 confirmed human deaths.
At present, there is no evidence that the H5N1 strain can be transmitted from one person to another, but it may only be a matter of time before the virus mutates into a form that can easily pass between people.
If that were to happen it would spread rapidly around the world with devastating consequences. The fatality rate of humans infected by the virus is as high as 60%.
Experts warned in Nature that the world was now far more vulnerable to the effects of a pandemic than it was in 1918, when a deadly strain of influenza killed between 20 and 40 million people.
An 2002 outbreak of severe acute respiratory syndrome (Sars), an atypical form of pneumonia killed more than 700 people and illustrated how disease can now spread quickly to other countries, carried by international travellers.
An optimistic estimate suggests that the next influenza pandemic could cause 20% of the world's population to fall ill and within a few months, almost 30 million people would need to be hospitalised, a quarter of whom would die.
Four Dutch experts, led by Dr Albert Osterhaus from the Erasmus medical centre in Rotterdam, said in Nature that there was an urgent need for the creation of a global task force to control a future pandemic.
They said the task force should consist of leading specialists in the fields of human and animal medicine, virology, epidemiology, pathology, ecology and agriculture.
It should also include experts in translating science into policy. Management teams should be available to target specific flu outbreaks occurring anywhere in the world.
"Given the large geographical area in which the H5N1 virus has become endemic, and the greater potential for rapid virus spread, an efficient, effective, outbreak management team strategy, with centralised guidance, is urgently needed," they said.
Early detection and rapid response to bird flu at a global level would greatly reduce the cost of dealing with a full-blown outbreak, they said.
The agricultural costs alone for the H5N1 outbreaks in Thailand and Vietnam in 2003 have been estimated at £481.5m and £65.6m respectively.
An outbreak of a different bird flu strain in the Netherlands in 2003 cost £190m. In contrast, setting up and operating a global flu pandemic task force would cost less than £820,000 a year.
Professor Michael Osterholm, from the centre for infectious disease research and policy at the University of Minnesota, agreed that international cooperation was vital to minimise the impact of a pandemic flu virus.
He said there was a "critical need" for medical and non-medical planning, involving both the public and private sectors, at a level beyond anything considered so far.
"National, regional or local plans based on general statements of intent or action will be meaningless in the face of a pandemic," the professor said.
He said a global effort was needed to develop a new type of vaccine that can be manufactured quickly and which targets multiple strains.
"Unfortunately, most industrial countries are looking at the vaccine issue through myopic lenses," he said, adding that time was running out to prepare for an outbreak.
"There will be an immediate response from leaders to stop the virus entering their countries by greatly reducing and even ending foreign travel and trade, as was seen in parts of Asia in response to the ... Sars epidemic.
"These efforts are doomed to fail given the infectiousness of the virus and the volume of illegal crossings that occur at most borders.
But government officials will feel compelled to do something to demonstrate leadership. Individual communities will also want to bar 'outsiders'. Global, national and regional economies will come to an abrupt halt."
The Asian H5N1 virus that first surfaced in poultry in Hong Kong and China eight years ago has killed 37 people in Vietnam, 12 in Thailand and four in Cambodia.
Fears were raised in China this week after it was confirmed 178 migratory geese found dead in a nature reserve in Qinghai province had died of the H5N1 virus, but a report today in a government newspaper claimed the deaths were an isolated case. [Guardian]