EULALEE THOMPSON
The current outbreak of bird flu in south east Asia will trigger the world's next pandemic.
TALKS AND activities in preparation for the next major pandemic -- influenza (flu) -- are now reaching feverish levels among epidemiologists. In fact, international health experts are no longer talking about "if" but "when" the next flu pandemic lands on the world's doorstep.
"It is not if it is going to happen. It is when, and where, and how bad," Dr. Michael Osterholm is quoted as saying in September at the first meeting sponsored by the (U.S.) Wilson Centre's new Global Health Initiative.
So serious are health experts about preparing for the next flu pandemic that the United Nations Secretary General last week appointed Dr. David Nabarro, one of the most senior public health experts at the World Health Organisation (WHO), to co-ordinate the UN response to avian influenza and a possible human influenza pandemic.
The WHO states that "the appointment is critical as the world is fast recognising the risk of an imminent human influenza pandemic, and is taking steps to reduce the risk and to get prepared. To this end, the World Health Organisation has sent all countries detailed guidance on actions they need to take. Implementing these actions requires co-ordination across UN agencies, countries, civil society, across sectors within countries and the private sector. Implementation also requires funding."
Over the last 300 years, at least 10 influenza pandemics have been recorded. In flu pandemics between 1918 and 1920, millions of people (50 to 100 millions) died worldwide. Epidemics in the early 19th century affected smaller population. Novel strains of the influenza viruses of increased virulence, easily transmitted between people where there is no pre-existing immunity are ideal conditions for a flu pandemic.
AVIAN FLU
The current, two-year-old outbreak of the H5N1 strain of bird (avian) flu in the poultry populations in Asia, seems to be the basis for the health experts' prediction of another major flu pandemic on the horizon. The H5N1 strain has already jumped from birds to human, killing at least 65 people, most of them in Vietnam and tens of millions of birds have already died. Scientists say that if this H5N1 strain mutates into a virus that is easily transmitted by people, the resulting pandemic could kill millions of people with staggering global social and economic impacts.
Dr. Lee Jong-woo, WHO Director-General, noted last week at the Pan American Health Organisation's (PAHO's) meeting of regional health ministers that the 1957 and 1968 flu pandemics followed similar pattern, originating as avian flu viruses. He also said that it was "also likely that the next flu pandemic will emerge from one of the countries that has avian flu infection in its bird population".
The flu pandemic between 1918 and 1919 was linked to a virus strain H1N1. Between 200 million and one billion people became infected with that virus and between 50 and 100 million people died then; a disproportionate number of those who died were young people.
Dr. Osterholm states that based on the 1918 to 1920 flu pandemic, it is projected that between 30 and 384 million people will die in future pandemics.
FLU VACCINE
The flu vaccine and antivirals are the main prevention strategies. However, the annual production of flu vaccine is inadequate to service the world population; it is only about 300 million doses and this production is not expected to increase significantly any time soon. The flu vaccine technology is a bit archaic anyway, with the vaccine being cultured in chicken eggs and taking at least six months to develop.
LOCAL PERSPECTIVE
Comments from the Ministry of Health with regards to its perspective and preparation for the imminent flu pandemic were not immediately available.
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