CDC chief says avian flu is biggest threat

Feb 21, 2005 (CIDRAP News) – The nation's top disease-control official proclaimed in a speech in Washington, DC, today that avian influenza is the single biggest threat the world faces right now, according to wire service reports.

Reuters quoted Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC), as saying, "This is a very ominous situation for the globe" and that it is "the most important threat we are facing right now."

Gerberding sounded the alarm in a speech at the annual meeting of the American Association for the Advancement of Science.

She implied that the H5N1 avian flu could trigger a human flu pandemic similar to the pandemic of 1918, which killed up to 100 million people worldwide. She also warned that if a pandemic emerged, vaccine for the virus would have to be rationed.

"I think we can all recognize a similar pattern probably occurred prior to 1918," she was quoted as saying. Experts believe the virus that sparked the 1918 pandemic probably originated in birds.

The H5N1 virus, besides killing countless birds, has caused at least 55 human illness cases in Thailand and Vietnam, 42 of them fatal, according to World Health Organization figures. The virus has not yet shown an ability to spread quickly from person to person, but the fear is that it will soon acquire that talent by mixing with other flu viruses.

Because the virus is circulating widely in Southeast Asian poultry, "There are really wonderful opportunities for this virus to either reassort with human strains of influenza or with other avian species," Gerberding said.

An Associated Press (AP) account quoted her as saying, "We are expecting more human cases over the next few weeks because this is high season for avian influenza in that part of the world. . . . Our assessment is that this is a very high threat."

The government has contracted with Sanofi Aventis to make 2 million doses of a vaccine for the H5N1 virus, but the vaccine has not yet been tested in clinical trials, and no one knows if it would work if a pandemic strain of the virus emerged.

Gerberding said the Sanofi contract would give vaccine manufacturers a head start if a pandemic began, but any available vaccine would have to be rationed.

The first doses to become available would be used in a "ring vaccination" strategy to try to stop the outbreak at its source, she said.

She noted that infected people can spread flu before they have any symptoms, making it nearly impossible to stop an outbreak by quarantining sick people, according to Reuters.

Gerberding also said flu vaccine production remains focused on ordinary seasonal flu, and it would be impossible to switch gears quickly to make a pandemic vaccine.

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