Paris meeting airs avian flu impacts, possible treatment

Jun 30, 2006 (CIDRAP News) – The First International Conference on Avian Influenza in Humans held in Paris this week brought reports on a possible new treatment for avian flu symptoms, the potential global economic impact of a pandemic, and plans for a task force to coordinate Europe's response to the disease.

Experts at the 2-day meeting at the Pasteur Institute said the world is doing a better job of preparing for the threat of a flu pandemic stemming from avian flu than it has done in the face of previous health threats, according to an Agence France-Presse (AFP) report yesterday.

But the experts said there are too many gaps in science's understanding of how wild birds spread the virus and how it might become contagious among humans, among other questions, AFP reported. The conference began yesterday and ended today.

Could statins reduce avian flu deaths?
David Fedson, MD, an internationally known vaccine expert, said cholesterol-lowering statin drugs may have the potential to mitigate symptoms of avian influenza. He called for research on the drugs' effects on people and animals infected flu.

Fedson's hypothesis, which he shared at the conference yesterday, was reported in a Bloomberg news article today. Based in France, Fedson is a former professor of medicine at the University of Virginia and former director of European medical affairs for Sanofi-Aventis.

The anti-inflammatory and immunomodulatory effects of statin drugs could decrease respiratory distress and the risk of heart attack and stroke in patients who have avian flu, Fedson told the audience. He said observational studies suggest that statin drugs may reduce death rates in patients who have sepsis or pneumonia. Fedson also published his hypothesis in the July issue of Clinical Infectious Diseases.

Given the wide distribution of statin drugs, the treatment may offer hope for patients in countries with scant supplies of antiviral medications or vaccines, wrote Fedson in CID. "If epidemiological, laboratory, and clinical studies confirm the benefits of statins for treatment of influenza, physicians everywhere will have something to offer their patients for the pandemic," he wrote.

Treatment with statin drugs would also offer a cost advantage over antiviral agents, Fedson noted. A 5-day course of the antiviral drug oseltamivir costs about $60 to $90, while a 5-day course of generic simvastatin costs as little as $1.75, he said.

"The scientific rationale for considering statins for treatment and prophylaxis of pandemic influenza is persuasive, but the public health rationale is overwhelmingly compelling," Fedson wrote.

World Bank weighs in on economic impact
Milan Brahmbhatt, lead economist for the World Bank's East Asia sector, addressing the conference yesterday, outlined the projected economic impact of an avian flu pandemic. World Bank modeling suggests that a severe pandemic—with a 1% mortality rate, or about 70 million deaths—would shrink the world's gross domestic product by about 3.1%, or about $1.25 to $2 trillion, he said.

Economic losses in developing countries would be double those in developed countries, because of higher mortality rates, Brahmbhatt said. The text of his speech was posted on the World Bank's Web site.

So far, the economic impact of avian flu has been limited because poultry production is a relatively small portion of the world's economy, he said. However, the impact on the poultry industry in outbreak areas has been severe.

Brahmbhatt said the strong recovery of Thailand's poultry industry underscores the benefits of good policy responses. The country experienced a 40% drop in poultry exports because of foreign import restrictions on uncooked poultry products in response to avian flu. "Together with Vietnam, strong control measures have resulted in no new outbreaks of the virus for the past 6 months," he said. Producers quickly switched to cooked export products, which didn't face trade restrictions, and exports rebounded, along with domestic consumer confidence.

The funding component of policy actions to combat avian influenza is producing results, Brahmbhatt said. Of $1.9 billion pledged at last January's International Pledging Conference in Beijing, $1.15 billion has been committed and $331 million has been disbursed.

Task force to guide European response
Europe is setting up a task force to coordinate the continent's efforts against avian flu, a European virologist reported at the conference. According to an AFP report, Albert Osterhaus, a professor at the National Influenza Centre and Erasmus Medical Center in Rotterdam, said the task force will be established in September or October and will likely include scientists, doctors, and animal health experts who would monitor the latest information and advise governments.

He said the task force would be located at the European Centre for Disease Prevention and Control in Stockholm.

Osterhaus called for setting up a global equivalent of the task force, saying the world's response has featured much talk, little action, and a disturbing lack of coordination among scientists, governments, and international agencies, according to AFP.

"There's not a pandemic of flu, there's a pandemic of flu meetings," he was quoted as saying.

See also:

Fedson DS. Pandemic influenza: a potential role for statins in treatment and prophylaxis. Clin Infect Dis 2006 Jul 15;43(2):199-205 [Full text]

Brahmbhatt speech: "Economic Impacts of Avian Influenza Propagation"

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