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    Bird Flu Threat Rises

    WHO Expert Panel: World 1 Step Closer to Killer Flu

    Killer Flu Pandemic: What Could Happen? continued...

    Osterholm notes that with current technology, it would take at least six months to start producing a vaccine -- and two doses would be needed for protection. And as Stöhr notes, the virus would reach the U.S. within three months.

    If the bird flu started a pandemic now, Osterholm wrote:

    "We would be facing a 1918-like scenario. ... We would have no surge capacity for health care, food supplies, and many other products and services. ... We have no detailed plans for staffing the temporary hospitals that would have to be set up in high-school gymnasiums and community centers -- and that might need to remain in operation for one to two years. ... We have no way of urgently increasing production of critical items such as antiviral drugs, masks for respiratory protection, or antibiotics for the treatment of secondary bacterial infections. ... Nor do we have detailed plans for handling the massive number of dead bodies that would soon exceed our ability to cope with them."

    The WHO expert panel underscores this concern. They note that the H5N1 virus already has resulted in the death -- or culling -- of 100 million chickens and ducks. To date there have been 97 confirmed human cases and 53 deaths in Vietnam, Thailand, and Cambodia. Many more cases undoubtedly have gone unreported.

    "H5N1 viruses have the potential to cause far greater harm if they evolve and gain the ability to easily infect and transmit among people," the panel's report notes. "An H5N1 virus with this ability could lead to a global pandemic and many millions of deaths worldwide."

    Action Needed

    The WHO panel recommends rapid action, including:

    • Improving cooperation and information sharing among all human and animal health agencies.
    • Improved surveillance of all clusters of human infections.
    • Regular meetings of a WHO task force.
    • An international stockpile of antiviral drugs.
    • Nations should rehearse their rapid response plans to contain early flu outbreaks.
    • WHO should explore ways to make human H5N1 vaccine available to affected Asian countries before the start of a pandemic.

    Osterholm calls for a huge U.S. effort.

    "Planning for a pandemic must be on the agenda of every public health agency, school board, manufacturing plant, investment firm, mortuary, state legislature, and food distributor," he writes.

    If a pandemic were 10 years off, Osterholm says a "worldwide influenza Manhattan Project" to develop and distribute a vaccine "just might make a real difference."

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