Analysis: Avian Flu Virus Requires Calm, Educated Concern

Published January 1, 2006

The scare of the day–if not the entire coming year–is the avian flu virus.

Is the fear exaggerated? Yes.

Should we be cautiously concerned? Yes.

Are the United States and the world properly prepared for the worst-case scenario? No.

Can we calmly gear up to ensure averting a worldwide epidemic (pandemic) on the proportions of the pandemic that killed 50 million people in 1918? Absolutely.

Starts with Birds

All strains of influenza virus, if traced back to their origins, come from birds. They mutate slightly each year, thus we always need a new vaccine. We manage to fend off most flu strains in most years.

Since 1997, however, a new avian virus has moved west within bird populations originating in Vietnam. While it is rare for an avian virus to cross over directly to humans without first mutating, it appears this new virus has infected approximately 130 people worldwide in the past eight years. More than 50 percent of those infected individuals have died. That compares to 2 percent mortality for the 1918 Spanish flu, which killed 500,000 people in the U.S. and 50 million worldwide.

The new avian flu virus is spreading across continents along the flyways of birds. It left southeast Asia in the spring of 2005, moving to China and Russia and then on to the east-west flyway. Migrating birds are spreading it to poultry crops of chickens and turkeys.

The reason for the growth of bird flu in Asia is undoubtedly the continent’s increasing bird population. In 1968, China had only 12 million chickens and turkeys, whereas today it exceeds 13 billion–compared to the 9 billion raised in the United States.

Flu Dangers

The avian flu virus does not appear to be mutating: All confirmed cases of the disease in humans have been traced directly to infected birds. But the concern remains that this flu–which is significantly more dangerous than other strains because it strikes deep within the lungs, making treatment more difficult–may eventually be transmitted rapidly from human to human. If the avian flu virus begins jumping from human to human, and thereby spreads much more rapidly than it has in the past eight years, the world will face a significant health problem.

Each year, influenza kills one million people in the world, 36,000 in the United States alone. Our common flu viruses kill one in a thousand infected persons (.1 percent), usually the elderly.

Flu Fighters

Avian flu often can be cured with large doses of existing medications such as Tamiflu. At present rates of production, however, it would take a decade to make enough Tamiflu to treat a fifth of the world’s population.

That situation may improve soon as the number of manufacturers and their vaccine output is increasing rapidly. In October, the White House announced a $7.1 billion initiative to fight the threat of a flu pandemic, with a large portion of the money allocated for development and production of vaccines.

Sally Pipes, head of the Pacific Research Institute, said in a November radio interview this taxpayer expense could have been avoided.

“Fifty years ago, 26 companies supplied the market for standard children’s vaccines. Now only four companies do,” Pipes told National Public Radio (NPR). “Three decades ago, at least 10 U.S. firms manufactured vaccines to treat seasonal flu. Today, the entire U.S. flu vaccine market depends on just two companies, one American and one French. And that’s because our government has destroyed all the incentives.”

Pipes explained companies must spend hundreds of millions of dollars on research and development for a single new vaccine due to strict U. S. Food and Drug Administration safety screening. Then there are costly, time-consuming hurdles–such as legal claims against vaccine makers that can be disproved, but not before they run the manufacturers out of business. (See “Litigation Raising Health Care Costs, Study Says,” page 9.)

Better Prepared

Nevertheless, we are more ready today for the task of combating the new avian flu virus than ever before, because of the World Health Organization’s work around the world, which brought SARS to its knees a few years ago. The worldwide alert to the current strain of avian flu virus could find us better prepared to fight it than our annual battle with the latest flu mutation.

“There are two ways we can respond to this threat,” said Robert Egge, project director for the Center for Health Transformation. “On the one hand, in certain key sectors we can consciously choose to back away from efficiency in favor of resiliency. And so it makes good sense for us to consider building up inventories of key medical supplies to treat victims of a pandemic.

“But the other option,” noted Egge, “is to emphasize twenty-first century strategies such as building electronic health record and biosurveillance networks and capitalizing on genomics and other breakthroughs to create new diagnostics, vaccines, and therapies.”

Our government needs to be prepared for a pandemic, Egge says. “A pandemic, much like biosecurity threats in general, falls between the organizational divide of the Department of Homeland Security and the Department of Health and Human Services. Both departments say their plans make it very clear who has responsibility for what–and on paper I’m sure it is pristinely delineated. But that’s a far cry from trying to coordinate activities in the midst of a fast-moving pandemic.”

Jay Lehr ([email protected]) is science director for The Heartland Institute.