World will have to act fast to prevent bird flu pandemic: WHO

[Guest guest]

World will have to act fast to prevent bird flu pandemic: WHO

MANILA : No one knows exactly when an influenza pandemic will hit,

but when it does ground zero will almost certainly be in Asia,

according to one of the world's leading influenza specialists.

" Will we be able to catch it in time to prevent a global catastrophe?

I just don't know ... no one does, " said Dr Hitoshi Oshitani,

Regional Adviser on Communicable Disease Surveillance and Response

with the World Health Organization's (WHO) Western Pacific office in

Manila.

" The window we have to prevent a pandemic is two to three weeks from

when the outbreak is first detected. "

In a wide ranging interview with AFP, the man who was on the

frontline in the WHO's fight against severe acute respiratory

syndrome (SARS) two years ago, says the threat of a pandemic is real.

" Yes, some countries are better prepared than others, " he said from

his cramped office in Manila.

" Obviously when the pandemic hits the impact will be greatest in the

developing countries, especially here in Asia.

" Healthcare systems will be overwhelmed with patients, hospitals will

run out of beds and there will be no drugs to fight the virus.

" It is almost certain healthcare workers will be affected as the

public health systems of many countries break down.

" Many countries in this part of the world are hard pressed meeting

their own healthcare budgets as it is. A pandemic would be

catastrophic. "

Oshitani said the developed world would suffer too but probably not

to the same extent.

" When the pandemic hits, rich countries will be too busy looking

after their own problems to help the poorer countries. That is why

WHO is developing support mechanisms now to help the poorer

countries. It won't be perfect but it will be better than not having

anything at all. "

Will the next pandemic be like the Spanish flu pandemic in 1918-19

which killed an estimated 50 million people? Or will it be like the

1957-58 and 1968-69 outbreaks that still killed millions of people

but was not as severe?

" No one knows, " Oshitani admitted. " The world has advanced a great

deal since 1918 in terms of science, public health infrastructure and

surveillance. But even with all this knowledge we only have a slim

chance at the most of stopping the pandemic. "

Oshitani said the H5N1 virus had become particularly virulent in

humans.

According to the latest WHO data there have been 118 cases of avian

flu among humans and 61 deaths including the latest in Thailand this

week.

But the scientists are still not certain whether the current virus in

Asia will trigger the pandemic.

Since the re-emergence of the virus in 2003 some 150 million chickens

and ducks have been killed throughout Asia but deaths among wild

birds, believed to be carriers of the H5N1 virus have

been " relatively minor " .

" What we do know is that wild birds carry the virus but their genetic

make-up makes them not susceptible to severe avian flu, " Oshitani

said.

" The challenge we all face today is being able to detect the first

outbreak of avian flu among humans ... not one or two isolated cases

but a cluster of 10 to 20 people in the same area and being able to

quarantine the area.

" While we don't know where the pandemic will start it is almost

certain to be somewhere here in Asia. And that's the hard part.

People are more mobile today than they were say 30 years ago and I

don't think it is possible to fully restrict the movement of large

numbers of people, " he said.

Since the first outbreak of avian flu in 1997 the WHO has been at

pains to warn governments of the potential threat of a pandemic. But

with no further outbreaks the threat seemed to slip from the health

radar screens of most countries.

The alarm bells started ringing again in 2003 and have been growing

louder ever since.

Oshitani said the SARS outbreak - which affected 29 countries and

caused 774 deaths, most of them in Hong Kong and China - was much

easier to control and contain once the virus had been isolated and

method of transmission determined.

" Once that was done you could work out a strategy of containment and

isolation of those infected. Even if you had SARS you were not

infectious until you developed severe pneumonia. But with influenza

people could be infectious even before they have symptoms like

fever, " Oshitani said.

But there are still some unanswered questions with SARS and one is:

how could some people carry the virus but not show any of the

symptoms? The WHO is still trying to find the answer to that

question.

Is the WHO overreacting to the threat of an avian flu pandemic?

" No. The danger is there. The current outbreak of avian flu is

historically unprecedented in the number of domestic chickens and

ducks infected and the geographical distribution of the virus ... 14

countries if you include Romania and Turkey, " Oshitani insisted.

" It is also significant in terms of the number of human cases ... 61

deaths in four countries (Vietnam, Thailand, Cambodia and Indonesia) -

over 50 percent of the total number of humans infected. "

" All these are very significant and probably understates the actual

numbers in that most of these cases were recorded in hospitals

anyway. There might have been many milder cases that we simply did

not know about because they were not hospitalised.

" I know there is a lot of anxiety out there and yes, we are still

trying to find answers but it would be morally wrong for us to

underplay the threat of a pandemic, " Oshitani said.

" There is so much about this virus that we simply do not know and

time is not on our side. " - AFP/de

http://www.channelnewsasia.com/stories/afp_asiapacific/view/174563/1/.

html