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Fears of Global Bird Flu Outbreak Increase

Human Pandemic Would Kill Many Millions, But Crucial Facts Still Missing

Public Health Response Slow continued...

Fortunately, there's hope that a worldwide pandemic could be contained. Ira Longini, PhD, professor of biostatistics at Rollins School of Public Health at Emory University in Atlanta, is part of an international team that's developing mathematical models of flu outbreaks. The models, nearing completion, predict exactly how far a flu outbreak will spread under different circumstances.

The models are sobering. For example, Longini's earlier work shows that if a flu outbreak were like the relatively mild 1957 Asian flu virus, it would infect 93 million Americans and cause 164,000 U.S. deaths.

Would a bird flu outbreak be worse? Probably. But Longini says it's highly unlikely that a bird flu would be as deadly as some people fear.

"Based on past experience, we don't have to panic," Longini tells WebMD. "It's clear that pandemic flu is inevitable. It is going to happen, and it could be a fairly pathogenic strain and could be a real problem. Right now, H5N1 bird influenza looks like it is fatal in 70% of cases. But this 70% figure is totally absurd. It has never been true of any human flu strain. I have never seen any evidence that human influenza is anywhere near that virulent. Case fatality of even highly virulent strains are a couple of deaths per 10,000 people infected."

It's also likely that human-to-human bird flu infections would spread slowly, at least at first. That would buy time. And since the bird flu bug is sensitive to Tamiflu, an oral flu drug, public health officials could buy even more time by giving the drug to all contacts of infected people.

"With good surveillance, with antivirals, and easy-to-implement public health methods -- strategies such as closing schools and public places and limiting movement -- we should be able to contain the pandemic at the source, wherever that may be," Longini says. "That would buy time to make vaccine to deal with it if it should spread. Emphasis should be on good surveillance everywhere, especially in Southeast Asia, and quick response with targeted use of antivirals."


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