Scientists check for arrival of avian flu from Asia
Virus may kill 60,000 in California despite new drug, study says
By DAVID WHITNEY BEE
WASHINGTON BUREAU
Last Updated: August 14, 2005, 04:26:59 AM PDT
WASHINGTON — They know it's coming. Hospitals already are monitoring for its arrival with every patient who checks in. Now scientists are swabbing wild bird bottoms in California and elsewhere in a hunt for the first signs of the deadly virus.
What has scientists worried is not the fact that the avian flu virus H5N1 already has killed at least 60 people overseas. Or that it has spread from Southeast Asia to China and Russia.
What has them convinced about the diminishing odds of escaping a worldwide health catastrophe — one study estimates that fatalities in California could top 60,000 — is that wild birds overseas no longer seem to be dying.
That means the virus is mutating, and scientists fear it has now adapted so that it can survive the annual migration of wild birds from Asia to North America without killing its hosts.
"That's a real danger sign," said veterinarian Carol Cardona of the University of California at Davis.
Cardona is part of the growing army of scientists and health care professionals gearing up to fight what could become the first flu pandemic since 1918, when a Spanish flu virus — also believed to have been spread by birds — killed between 20 million and 40 million people around the world.
More Americans died in that outbreak than were killed in World War I. And already the projections are that the next pandemic, perhaps just months away, will kill similar numbers of people.
So far, the virus has not mutated or combined with other influenza viruses so that it can spread from human to human.
"The great fear is that we will see a version of H5N1 that will spread very easily from person to person," said David Daigle of the Centers for Disease Control and Prevention in Atlanta.
Migrating birds may bring flu
"Most experts believe it is not a question of if, but when," he said.
According to a recent report by the Trust for America's Health, the U.S. toll could surpass 540,000.
In California, the report said, deaths could top 60,000 and hospitalizations could exceed 273,000 — unfathomable given that number is four times the amount of hospital beds in the state, according to the California Hospital Association.
Ken August, spokesman for the California Department of Health Services, said that if the nightmare scenario develops, mass quarantine of infected patients and other mandatory steps to stop the virus' spread could be inevitable.
"We could face asking the public to take some extraordinary measures," August warned.
Already, he said, hospitals throughout the state have been asked to begin monitoring for patients reporting unexplained respiratory illness and who have traveled recently to Southeast Asia.
"What we're concerned about is the flu virus mutating into something that no one has experienced and that would cause severe illness and death," he said.
While scientists and health officials stress that there is no evidence of an Asian variety of the H5N1 virus in the United States now, it could arrive at almost any time with passengers unloading from an overseas flight from Thailand, China or Russia.
Or it could arrive on the wings of an infected bird.
UC Davis' Cardona is helping oversee in California a national effort to detect the virus' avian arrival.
This year, she said, about 2,000 nonmigratory wild birds will be checked to see if they have any signs of the Asian H5N1 virus. The nonmigratory birds are easier to locate and swab, she said, and they are likely to pick up the disease from waterfowl and other birds migrating down from Alaska on the Pacific Flyway.
The goal is to keep the virus from poultry farms in the Central Valley and Southern California before they become breeding grounds for a deadly form that can be transmitted from human to human.
"We all believe that wild birds are not likely to cause a pandemic without an intermediate host for the virus," she said. "And poultry are likely to be that host."
Already, she said, poultry growers and backyard farmers are being urged to keep the water and feed for their chickens and ducks protected from wild birds so that the virus can't be passed along.
The deadly strain of the H5N1 virus was first detected in Southeast Asia more than two years ago. Tens of millions of domestic ducks and chickens have been slaughtered and burned to stop its spread, but the virus quickly migrated.
More than 60 people who have come into contact with sick birds have died.
While there have been no reports of the virus being transmitted between people, British researchers reported finding the H5N1 virus in the spinal fluid of a young Vietnamese boy earlier this year, indicating that the virus is mutating to the point it can infect the human brain.
Researchers working on a drug to fight the virus have been surprised by its mutation.
Recently there have been reports from the National Institutes of Health that a drug known commercially as Tamiflu has shown promise in studies involving rats that it could suppress the spread of the virus.
"That's very encouraging," said August of the California Department of Health Services. "But to produce enough for all Americans and then to distribute it to all who need it would be an enormous challenge."
That point was highlighted by the Trust for America's Health report. It said that if the 5.3 million doses of Tamiflu in federal possession were distributed on the basis of population, only about 639,000 of California's 30 million people would get the medicine.
The report's conclusions are grim.
"Overall, U.S. pandemic preparedness is inadequate," it said. "Both the federal pandemic plan and various state pandemic plans are insufficient for a national response to a pandemic influenza."
California is better off than most states.
Two years ago, the trust praised California for the way it had spent $160 million it had received for bioterrorism preparedness, citing it as one of the top four states in terms of preparation.
"One of the benefits of our preparedness for bioterrorism isthat we have an improved network of laboratories, we've improved our system for identifying outbreaks and we've strengthened our communication between public health, law enforcement and public officials," August said.
"But we can never be fully prepared for a pandemic."
By DAVID WHITNEY BEE
WASHINGTON BUREAU
Last Updated: August 14, 2005, 04:26:59 AM PDT
WASHINGTON — They know it's coming. Hospitals already are monitoring for its arrival with every patient who checks in. Now scientists are swabbing wild bird bottoms in California and elsewhere in a hunt for the first signs of the deadly virus.
What has scientists worried is not the fact that the avian flu virus H5N1 already has killed at least 60 people overseas. Or that it has spread from Southeast Asia to China and Russia.
What has them convinced about the diminishing odds of escaping a worldwide health catastrophe — one study estimates that fatalities in California could top 60,000 — is that wild birds overseas no longer seem to be dying.
That means the virus is mutating, and scientists fear it has now adapted so that it can survive the annual migration of wild birds from Asia to North America without killing its hosts.
"That's a real danger sign," said veterinarian Carol Cardona of the University of California at Davis.
Cardona is part of the growing army of scientists and health care professionals gearing up to fight what could become the first flu pandemic since 1918, when a Spanish flu virus — also believed to have been spread by birds — killed between 20 million and 40 million people around the world.
More Americans died in that outbreak than were killed in World War I. And already the projections are that the next pandemic, perhaps just months away, will kill similar numbers of people.
So far, the virus has not mutated or combined with other influenza viruses so that it can spread from human to human.
"The great fear is that we will see a version of H5N1 that will spread very easily from person to person," said David Daigle of the Centers for Disease Control and Prevention in Atlanta.
Migrating birds may bring flu
"Most experts believe it is not a question of if, but when," he said.
According to a recent report by the Trust for America's Health, the U.S. toll could surpass 540,000.
In California, the report said, deaths could top 60,000 and hospitalizations could exceed 273,000 — unfathomable given that number is four times the amount of hospital beds in the state, according to the California Hospital Association.
Ken August, spokesman for the California Department of Health Services, said that if the nightmare scenario develops, mass quarantine of infected patients and other mandatory steps to stop the virus' spread could be inevitable.
"We could face asking the public to take some extraordinary measures," August warned.
Already, he said, hospitals throughout the state have been asked to begin monitoring for patients reporting unexplained respiratory illness and who have traveled recently to Southeast Asia.
"What we're concerned about is the flu virus mutating into something that no one has experienced and that would cause severe illness and death," he said.
While scientists and health officials stress that there is no evidence of an Asian variety of the H5N1 virus in the United States now, it could arrive at almost any time with passengers unloading from an overseas flight from Thailand, China or Russia.
Or it could arrive on the wings of an infected bird.
UC Davis' Cardona is helping oversee in California a national effort to detect the virus' avian arrival.
This year, she said, about 2,000 nonmigratory wild birds will be checked to see if they have any signs of the Asian H5N1 virus. The nonmigratory birds are easier to locate and swab, she said, and they are likely to pick up the disease from waterfowl and other birds migrating down from Alaska on the Pacific Flyway.
The goal is to keep the virus from poultry farms in the Central Valley and Southern California before they become breeding grounds for a deadly form that can be transmitted from human to human.
"We all believe that wild birds are not likely to cause a pandemic without an intermediate host for the virus," she said. "And poultry are likely to be that host."
Already, she said, poultry growers and backyard farmers are being urged to keep the water and feed for their chickens and ducks protected from wild birds so that the virus can't be passed along.
The deadly strain of the H5N1 virus was first detected in Southeast Asia more than two years ago. Tens of millions of domestic ducks and chickens have been slaughtered and burned to stop its spread, but the virus quickly migrated.
More than 60 people who have come into contact with sick birds have died.
While there have been no reports of the virus being transmitted between people, British researchers reported finding the H5N1 virus in the spinal fluid of a young Vietnamese boy earlier this year, indicating that the virus is mutating to the point it can infect the human brain.
Researchers working on a drug to fight the virus have been surprised by its mutation.
Recently there have been reports from the National Institutes of Health that a drug known commercially as Tamiflu has shown promise in studies involving rats that it could suppress the spread of the virus.
"That's very encouraging," said August of the California Department of Health Services. "But to produce enough for all Americans and then to distribute it to all who need it would be an enormous challenge."
That point was highlighted by the Trust for America's Health report. It said that if the 5.3 million doses of Tamiflu in federal possession were distributed on the basis of population, only about 639,000 of California's 30 million people would get the medicine.
The report's conclusions are grim.
"Overall, U.S. pandemic preparedness is inadequate," it said. "Both the federal pandemic plan and various state pandemic plans are insufficient for a national response to a pandemic influenza."
California is better off than most states.
Two years ago, the trust praised California for the way it had spent $160 million it had received for bioterrorism preparedness, citing it as one of the top four states in terms of preparation.
"One of the benefits of our preparedness for bioterrorism isthat we have an improved network of laboratories, we've improved our system for identifying outbreaks and we've strengthened our communication between public health, law enforcement and public officials," August said.
"But we can never be fully prepared for a pandemic."
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