Pandemic possibilities
Scientists tell Congress flu epidemic is imminent

(Gold9472: Why isn't a story like this on the mainstream?)

By Mike Lillis, Medill News Service
Last Update: 3:30 PM ET May 27, 2005

WASHINGTON --- The doomsday scenario goes something like this: Somewhere in Asia, a new strain of the influenza virus arises from a mutation. It passes from a duck to a duck vendor. The mutation allows it to jump easily between the vendor and shoppers, some of whom hop on planes the next day. Several days later, the virus is spread around the globe.

Within months, millions are dead.

Hardly a figment of science fiction, the next flu pandemic -- or global epidemic -- is not only inevitable but also imminent, scientists told lawmakers Thursday on Capitol Hill. On top of that, America is nowhere near ready to tackle it.

"The United States is at present woefully unprepared to respond to the next flu pandemic," said Andrew Pavia, chair of the Task Force on Pandemic Influenza for the Infectious Disease Society of America. "The recent shortage of flu vaccine highlights the fragility of our vaccine supply."

And it's not only vaccines that are lacking. The U.S. government has purchased only 2.3 million doses of the antiviral drug best proven to treat influenza sufferers -- a stockpile representing less than 1% of the population.

"It is a painfully small amount to have to use," Pavia said.

The gravity of the threat, for years recognized by pathologists, is now finding ears in Washington, where federal funding earmarked for monitoring and researching a potential flu pandemic has increased dramatically in recent years. Still, most agree there is a long way to go.

U.S. Rep. Tammy Baldwin, D-Wis., said the concern is not just one of biological science but also public awareness and community cooperation. In the case of an outbreak, she said, "the chain will only be as strong as the weakest link."

Three flu pandemics struck in the last century. From 1918-19, the so-called Spanish flu killed an estimated 50 million worldwide, 500,000 in the U.S. alone, according to figures from the Centers of Disease Control and Prevention. From 1957-58, about 70,000 Americans died from the Asian flu. The Hong Kong flu, which followed in 1968-69, killed about 34,000 more.

CDC Director Julie Gerberding said that three major factors are common to all flu pandemics:

The virus must contain a mutated structure to which humans have not been exposed and therefore are not immune

It must make people sick

It must be readily passed from person to person

Though no pandemic has struck in 36 years, scientists and lawmakers are worried that a highly pathological strain circulating in Asia for the last few years has the potential to evolve into the next big killer. That strain, called the avian flu, satisfies the first two criteria but not the third. Still, officials warn that the contagious trait is just a mutation away.

If they are right, the effects would be catastrophic.

A pandemic of the same severity as the 1918 outbreak could kill between 900,000 and 2.2 million in the U.S. alone, according to CDC estimates. The cost of treatment, officials add, would run into the hundreds of billions of dollars.

"The impact of a pandemic influenza outbreak cannot be overemphasized," Pavia said.

In the world of biomedicine, viral mutations take on several faces. "Drifts" are minor mutations in viral structure -- the reason people need to update their flu shots each year. Viral "shifts," on the other hand, are major mutations that can lead to pandemics.

Though the only reported cases of the avian flu have occurred in Asia, the ease of global travel makes the threat an international one. Gerberding said that China -- with a population of 1.3 billion people, 13 billion chickens and 500 million swine -- is a volcano waiting to burst.

"We're sitting on a cauldron of flu virus incubation," she said.

All parties agree that the country's ability to handle such an event hinges directly on what Washington does in anticipation.

"It's imperative that we move quickly and decisively," Baldwin said. "We have some catching up to do."