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DewDiligence

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Re: DewDiligence post# 8218

Monday, 02/28/2005 3:30:59 AM

Monday, February 28, 2005 3:30:59 AM

Post# of 252493
Bird flu FAQ

[From Monday’s WSJ. See #msg-5566019 for a partial list of companies working on a vaccine.]

http://online.wsj.com/article/0,,SB110953352506065194,00.html?mod=todays_us_marketplace

>>
A Primer on the Threat of Avian Flu

How Does Bird Flu Jump to People?
What Is Being Done to Stop It?
The Answers Aren't All Comforting

By GAUTAM NAIK
Staff Reporter of THE WALL STREET JOURNAL
February 28, 2005

Q: What is the avian flu and how is it different from a seasonal flu that affects people?

A: Avian flu affects birds and is caused by a virus adapted to them. But in recent years, the bug appears to have jumped the species barrier and infected some people.

By contrast, the seasonal flu bug is specifically adapted to humans. Unlike avian flu, it easily jumps from person to person and kills hundreds of thousands of people each year.

Q: Is avian flu common in birds?

A: A low-pathogenic version of avian flu -- which can cause mild sickness in birds but doesn't easily jump to humans -- is extremely widespread in fowl such as ducks and geese. But a high-pathogenic version -- the type that could endanger humans -- is rare and usually only found in domesticated poultry. Since 1959, there have been a half-dozen or so large outbreaks of the high-pathogenic variety, including one in Pennsylvania in the early 1980s. In terms of geographic scale and the total number of birds it has affected, the current high-pathogenic bird flu virus in Asia is unprecedented in the last century.

Q: How many humans have caught avian flu so far and how?

A: The virus is often found in bird droppings, and poultry farmers can get infected if they inhale the bug. Transmission of the virus from person to person is extremely rare. Roughly 50 people have been infected starting with the first wave of recent human cases in December 2003, and about 80% of them have died, all of them in southeast Asia.

Two more waves of human cases appeared, in the summer of 2004 and in the first two months of this year. Vietnamese officials confirmed yesterday that a 69-year-old man died from bird flu, the 14th person to succumb to the disease this year. There is no clear sign, however, that the rate of increase in human cases is accelerating.

Q: So what makes avian flu virus so dangerous to humans?

A: If the virus gradually mutates in such a way that it can jump from one person to another, it could result in widespread disease. Alternatively, the avian virus could infect someone already infected by the garden-variety flu virus. If the avian and human viruses then swap genes in such a manner that the bug is able to jump from person to person, that might trigger a new flu pandemic. A pandemic that starts this way is more worrying because it would likely emerge quickly, giving health authorities less time to respond. Either way, almost no one would have natural immunity to the new bug, which would travel around the world in six months.

Q: Have there already been instances where it passed from person to person?

A: Fewer than half a dozen such cases have been recorded so far, including cases in Vietnam and Thailand. Human-to-human transmission depends on the infectious dose. While it's easier to inhale the virus from bird droppings -- where the virus is present in large quantities -- it isn't so easy to pick it up from the feces of an infected person, where it is present in lesser quantity.

Q: How close are we to a possible pandemic?

A: Nobody knows. But many scientists say we are due because flu pandemics seem to occur in 25-year cycles and the last one hit in 1968. Fears have grown lately because the bird flu virus has been shown to infect mammals, including leopards and tigers. A recent lab experiment revealed that the avian flu virus could also jump between cats. In addition, the virus has infected ducks without the birds getting sick or showing any symptoms -- thereby increasing the risk to poultry farmers. "Nobody believed this could happen. The storm clouds are gathering," says Klaus Stohr, head of the World Health Organization's flu program.

Q: What are the symptoms of avian flu in people?

A: It starts off with a mild fever, headaches and aching joints. The fever may subside for a day or so before spiking sharply. The patient finds it hard to breathe and develops a cough. As oxygen is increasingly cut off from the brain, coma and death can follow.

Q: Is there any treatment?

A: Because the symptoms of avian flu appear to be so similar to those of regular flu, the danger is that doctors may not differentiate between them. But if an avian flu infection is identified within 48 hours and the patient is given flu medicine -- such as the antiviral Tamiflu -- the person usually makes a full recovery.

Q: What are government authorities doing to stop it?

A: Millions of chickens and ducks have been slaughtered in affected Asian countries, to reduce the risk to uninfected flocks as well as people. Surveillance in susceptible areas, such as poultry farms, has been increased. Doctors have been asked to watch for avian flu symptoms in their patients. But the WHO says that, if a pandemic were to break out, no country is adequately prepared, either in terms of having enough antiviral drugs or a workable vaccine.

Q: Can you catch avian flu by eating chicken or duck?

A: No, provided the chicken or duck is cooked.

Q: What progress is being made toward a vaccine against a pandemic flu?

A: Scientists are in the very early stages of testing an experimental vaccine against the H5N1 strain of avian flu, which is circulating in Asia. If a pandemic based on H5N1 strikes in the next year or so, millions of people in Europe and the U.S. -- and billions more elsewhere -- are unlikely to have access to a vaccine. Individual governments will decide who gets priority for the vaccine, depending on whether they want to reduce possible deaths, minimize social disruption or reduce the economic toll of a pandemic.

Q: How does this compare with other deadly flus the world has faced?

A: Three pandemics occurred in the last century, and each was triggered by genes originally found in bird viruses. Between one million and four million people died in each of the relatively mild flu pandemics of 1957 and 1968; about 40 million died in the 1918 pandemic.

Q: Is there a big international effort under way to combat these bugs? How are countries working together?

A: In November, the WHO made a strong plea to governments, asking them to expedite the manufacture and stockpiling of vaccines. The U.S. appears to be ahead of Europe in this respect, although countries such as France and Italy have hatched plans to build vaccine stockpiles. Roughly 10 companies in the developed world are working on vaccines related to pandemic viruses, and many are expected to start clinical trials this year.
Q: How does the threat posed by this flu compare with the SARS epidemic? What happened to SARS?

A: SARS was caused by an entirely new virus that jumped to humans from an as-yet-unidentified animal host. Swift action by the WHO, governments and a team of international scientists helped to contain SARS before it became a bigger threat. The WHO believes that if it emerges again it could be quickly identified and subdued. The avian flu virus, however, is always circulating, and so poses a greater threat.
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