[Mb-civic] Some More Info

[Michael Butler]

LBN-SPECIAL BONUS: THE BIRD FLU - 10 BASIC FACTS BY ELIZABETH M. WHELAN:
 
PUBLIC awareness about the possibility of a pandemic of avian flu has
soared, but so has misinformation. Here are the top 10 things you need to
know. 
 
1) There are currently no known cases of avian flu traced to
person-to-person transmission. The only transmission is between birds and in
a small number of people who have had close contact with birds. A pandemic
would occur only if the current virus mutated in such a way that it could be
transmitted between and among humans. There is no need to panic, only to
prepare. 
 
2. The media daily tout hypothetical threats -- claiming, for instance, that
trace levels of pesticide residues in food pose hazards -- but bird flu is
not a run-of-the-mill phantom risk. There is sound scientific evidence
suggesting a pandemic could evolve.
 
3) There are major differences between the deadly 1918 flu pandemic and one
that might occur in modern times. Today we have anti-viral drugs that can
mitigate the effects of the infection, and we have antibiotics to treat
secondary infections and complications.
 
4) There are, however, challenges that remain essentially the same as they
were nearly 100 years ago. Influenza is highly contagious. Unlike SARS or
smallpox, influenza can be spread one or two days before symptoms appear.
During the SARS epidemic, the disease was kept in check by keeping travelers
with fevers from boarding planes. Carriers of influenza may show no such
signs of disease. 
 
5) As President Bush stressed in a speech last week, the first step in
preparedness is surveillance, tracking and documenting the frequency of
infection in birds and in people working with birds -- and reporting
immediately any person-to-person transmission. This will involve a
concerted, worldwide effort.
 
6) Vaccine production is complicated given that (a) we cannot develop an
effective vaccine until human to human transmission has occurred and we have
identified the new virus, and (b) there is currently little incentive for
pharmaceutical companies to make vaccines given the liability risks they
face and the uncertainty that sales revenue would justify the staggering
production costs. Some advocate stockpiling "pre-pandemic" vaccines designed
to protect from the H5N1 strain now infecting birds, recognizing that a new
strain allowing person to person transmission would be different but arguing
that a pre-pandemic vaccine might at least offer some protection. Others say
it is a misuse of limited resources to allocate over $1 billion to produce a
vaccine of unknown efficacy. Medical professionals agree, though, that we
must develop quicker, more efficient means of making vaccines, while giving
companies incentives to produce them -- including liability protection and
guarantees of purchase.
 
7) Government stockpiling of medicines to treat influenza -- anti-virals and
antibiotics -- is essential. At the moment, Tamiflu is the No. 1 choice in
treating influenza, but the drug is in short supply and is licensed only to
Roche. With the right incentives, Roche would team up with other companies
to dramatically increase production. (Stocking up on Tamiflu now for
personal use, though, is unwise and unnecessary.)
 
8) State and local health departments should create an infrastructure that
would allow for storage and distribution of both vaccines and treatments --
and the possible sudden increase in need for hospital beds and
isolation/quarantine programs.
 
9) Advance preparation should avoid "quick fixes" that could backfire.
Proposals to allow governments to violate patents on drugs like Tamiflu --
ignoring laws that protect intellectual property -- would be disastrous,
discouraging the pharmaceutical industry from developing desperately-needed
new anti-virals. 
 
10) As with any crisis, hucksters will try to make a quick buck. Already,
dozens of Internet sites sell what is almost certainly imposter "Tamiflu"
and surgical masks that offer little or no protection against the flu virus.
Buyer beware. 
 
Dr. Elizabeth M. Whelan is president of the American Council on Science and
Health (www.ACSH.org, www.HealthFactsAndFears.com).