The pandemic just off-stage: waiting for mutations

By Austin McPherson

Task forces around the nation have been putting together prevention and response plans in preparation for avian influenza reaching the United States.              

Some scientists feel it is only a matter of when, not if it will be confirmed in America.  The deadly strain of avian influenza, H5N1, has killed 59 percent of confirmed human cases. 

Dr. Hon S. Ip, a diagnostic virologist working for the United States Geological Survey at the National Wildlife Health Center in Madison, Wisconsin, tests around 1,000 wild birds each week for the deadly H5N1 strain. 

Ip said a sample from each bird is injected into a chicken embryo where it grows, and then is tested for avian flu.

“We have tested over 16,000 samples, and each one has been negative,” Ip said.  “One to five percent will be positive for some type of avian flu, but we are looking for H5N1.”

The majority of cases of avian influenza have been in Southeast Asia, but because of migratory wild birds that carry the virus, H5N1 can be spread worldwide.

The H5N1 strain has yet to mutate into a virus that can travel from person to person, but if it does, it may spread rapidly. If this happens, there are no predictions about how many humans will get sick, or die.            

“The odds of getting bird flu are low, but if you do get it your odds of survival are not very good,” Ip said. “When people read scary stories about how we are all going to die, I think that is irresponsible from the reporter if they do not put it into perspective.”

Wild birds are collected from all over the country and tested in his lab in Madison.  The majority of the birds come from Alaska and California, because they are the closest to Southeast Asia.            

“Around the world, it is surprising that so few cases have been reported,” Ip said.            

There have only been around 250 cases confirmed worldwide.  Ip said the key is segregating wild birds from domestic poultry.  Because so many organizations are working collectively, and are preparing as best they can, avian influenza should be quickly detected if it comes into the United States.           

“I think this was a situation worth making policy makers sit up and listen and provide us with a good defense,” Ip said.  “It is very easy to contain poultry production now.”      

If an outbreak is detected at a poultry plant, then all production is immediately halted at that plant until further testing can be done.           

The Pacific coast is more likely to be an avenue for wild birds that are carrying the infection, but the Eastern flyway is a possible source as well.  In Virginia, government departments have been preparing for the avian influenza pandemic for more than three years.  The Virginia Department of Health has developed a 210 page Pandemic Flu Plan in case of an outbreak of any kind.        

Dr. Diane Woolard, Director of the Division of Surveillance and Investigation for the VDH, says they are following national recommendations for pandemic flu planning. VDH’s Emergency Operations Plan for Pandemic Influenza is almost identical to The United States Department of Health and Human Services Pandemic Influenza Plan.            

“I don’t see any magic bullet with pandemic flu,” Woolard said.            

Antiviral medication may be available to people to help shorten the duration of their illness.  Vaccines can only help before a person has contracted the virus.  The vaccines will be produced at the national level, but it is up to the state to determine whom to distribute the vaccines to.           

“Health care workers are number one,” Woolard said.  “They may be the only ones to receive vaccinations for a while.”           

Next on the priority list are young children and people with chronic illnesses.  Vaccines will most likely be unavailable to the general population for as long as six months because a vaccine can not be developed until the H5N1 strain is actually gathered.         

Dr. Lynne Deane works at the University of Richmond Health Center, and is a member of the Virginia Pandemic Influenza Advisory Council with Woolard.                        

“Avian flu can get across the country in three days,” she said. “It’s almost mind-boggling when considering all the scenarios that could occur.”