Nov 4, 2005 (CIDRAP News) – The Asian Development Bank estimated this week that an influenza pandemic in Asia could kill 3 million people and possibly trigger a world recession, as the World Health Organization (WHO) geared up for a major conference on global strategy for limiting the pandemic threat.

A report by the Asian bank envisions two potential scenarios, according to an Associated Press (AP) report yesterday. Both scenarios assume that 20% of the region's population would get sick in a pandemic lasting about a year and that 0.5%, or 3 million, would die.

In one scenario, a pandemic would seriously affect economic demand for 6 months, reducing consumer spending, trade, services, and investment by $99 billion, the AP reported. In the other scenario, a pandemic would restrict economic activity for a year, leading to $282 billion in losses.

The second scenario would nearly stop Asia's economic growth and could also mean a 14%, or $2.5 trillion, reduction in global economic activity, the AP reported.

The bank's report emerged as the WHO was completing plans for a meeting of more than 400 health experts, policy makers, economists, and industry representatives in Geneva next week to work toward a "global consensus" on how to control the H5N1 avian flu virus in domestic animals and prepare for a possible human flu pandemic.

The meeting is being organized by the UN Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and the World Bank, along with the WHO. It comes on the heels of US President George W. Bush's release this week of his administration's strategy for addressing the pandemic threat.

"The Geneva meeting will first consider how to contain the H5N1 virus in birds," the WHO said in a statement today. The agenda will also include strengthening of disease surveillance systems, development of vaccines, and access to antiviral drugs.

"There is still a window of opportunity for substantially reducing the risk of a human pandemic evolving from H5N1 by controlling the virus at its source, in animals," said Joseph Domenech, the FAO's chief veterinary officer.

Meanwhile, the WHO released several updates today on aspects of avian flu and pandemic preparedness.

In a statement on the role of antiviral drugs in combating a pandemic, the WHO suggested that two older antiviral drugs, amantadine and rimantadine, could still be of some use. Researchers reported last year that H5N1 viruses in Vietnam and Thailand were resistant to amantadine, leading to a belief that M2 inhibitors would be of little use if H5N1 leads to a pandemic.

The WHO said today that the M2 inhibitors "could potentially be used against pandemic influenza, but resistance to these drugs may develop rapidly and this could significantly limit their effectiveness. Some currently circulating avian H5N1 strains are fully resistant to the M2 inhibitors, while others remain fully susceptible."

In an update on vaccine research and development, the WHO said one of the several companies developing H5N1 vaccines plans to present the results of its clinical trials to the WHO by early December. "However, if a pandemic were to begin within the next few months, no company would be ready to move immediately into commercial production," the agency said.

The statement also said current trends indicate that most developing countries "will have no access to a vaccine during the first wave of a pandemic and perhaps throughout its duration."

On food safety issues, the WHO emphasized that the H5N1 virus does not spread to humans through properly cooked food. However, the agency also said that H5N1 and other highly pathogenic viruses spread to nearly all parts of an infected bird, making proper handling and cooking imperative.

In addition, the agency said H5N1 can survive for "at least one month at low temperatures," which means that freezing and refrigeration will not kill the virus or reduce its concentration in contaminated meat. Also, in countries with outbreaks, eggs may have the virus on both the outside and inside, so eggs should not be eaten raw or partially cooked.

See also:

WHO statement on Geneva meeting

WHO statement on the role of antiviral drugs

WHO food safety statement

WHO vaccine research update

Transcript of Nov 2 press briefing on the US government's HHS Pandemic Influenza Plan

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