Avian Influenza Virus H5N1
Nations Face Quandary Over Avian H5N1 Virus
Because of the many questions unanswered regarding the current avian influenza and the risk it poses, nations are faced with a predicament: How can these governments commit their limited community health services financial resources to a latent yet possibly disastrous occurrence. Research clinicians testing a chicken’s blood at a renowned contagion control hospital in China warn of a highly contagious bird flu virus with the wherewithal to claim millions of lives in a global pandemic.
The risk would be calculated but how do you respond when there is no way to forecast when it will get severe and yet the cost of doing nothing could be ominous. It is an impossibility to know in advance when a bird flu pandemic will happen and so forecasting a crisis is difficult and the possibilities are vast. What is certain is that the next great pandemic is nearing its due date if not having surpassed it.
The twentieth century bore witness to three deadly pandemics. The Spanish influenza in 1918 -1919 in which some estimates claim nearly fifty million people perished. The Asian influenza of 1957 -1958 with approximately one million fatalities and the 1968 – 1969 Hong Kong influenza took anywhere from one million to four million lives. Estimates vary widely as a testament to the lack of record keeping and resources during a major worldwide health crisis.
All three of these outbreaks are believed to have had their origins in avian species. There are fifteen known bird flu virus sub variations and H5N1 is specifically anxiety producing. This strain of avian flu has slammed domestic bird sectors in eight nations, of these three of them, Cambodia, Thailand and Vietnam, have reportedly had altogether seventy nine human infections and more than fifty percent of these illnesses were deadly.
Never has there been such destructive fallout to so many nations by the H5N1 bird influenza virus at once causing anxiety to populations and economies to suffer so greatly in both farms and residences as well as industrialized poultry producers. The H5N1 Bird flu strain has displayed two frightening characteristics thus far, the ability to spread infection quickly and to cause harsh disease in humans. What it has not yet shown is the capability to spread human to human. If and when this third indicator appears it would be considered the beginning of a pandemic and would certainly prompt an international reaction from The World Health Organization and the initiation of emergency preparedness plans for an influenza pandemic.
The worry right now is that this H5N1 bird flu virus could mutate, it has a history of doing just that, developing the means to spread more easily from person to person contact. Experts wonder if this mutation or change could occur from adjusting to the infected masses or via an inherent modification with a known human influenza virus. Currently the infection is spread through direct human exposure with contagious domestic poultry.
The WHO has stated that there is no confirmed link of any continued person to person diffusion instead there were limited infection sequences that remain quite typical in bird flu virus not yet tailored to people. It is understood by authorities that each specific cluster of infected persons could be an indicator of an oncoming pandemic, meaning each case needs to be examined promptly.
Expert clinicians concur the unparalleled scope and transmission of H5N1 bird flu has increased the chances of a serious influenza pandemic reoccurring, their human mortality approximations are anywhere from two million to fifty million globally. Because of international travel being so common and the massive amount of trade between countries there is little that can be done to inhibit the spread of the virus worldwide.
When SARS [severe acute respiratory syndrome] was a problem a few years ago, infected persons were able to be identified and quarantine measures taken at airports. H5N1 Infected persons during a pandemic are going to be able to infect anyone they come in contact with before symptoms even start to present. This is a real concern for the medical and health services since infected travelers won’t be caught at the airports this time.
The WHO is asking all of its member nations to urgently review and revise their influenza pandemic emergency response plans. It is mainly industrialized, more affluent nations that have done these revisions while many others are scrambling to do so. These preparedness plans are based on suggestions made by the WHO to utilize a phased reaction in order to decrease the feared force of any influenza pandemic.
The plan is to produce a vaccine quickly and warehouse antiviral medications such as generic tamiflu or Oseltamivir, which has displayed an effectual response to the H5N1 bird flu virus. Generic Tamiflu will probably be as effective against any upcoming flu strains in the future as well. The WHO has also recommended thirty other pandemic guidelines not related to medical intercession that should prove valuable if we are facing a pandemic.
If we make the assumption that the H5N1 has its roots in the Far East Asian nations we must also assume that we will not be able to stop it from reaching the industrialized western nations of North America and Europe. When it lands here it will hit with a ferocity racking up illnesses and causing havoc with our daily lives. Preplanning for this event horizon will go a long way to decreasing the effect overall on the national communities affected.
The United Kingdom has decided to acquire nearly fifteen million therapeutic courses of anti viral medication Oseltamivir or Generic Tamiflu. This means treatment can be given to one in four Britons who could potentially be infected, this number estimated by the WHO for antiviral stocks on hand. Great Britain is only one of a number of countries that are stockpiling Tamiflu and other antiviral medications. They are also taking part in the research to quickly ramp up production of a vaccine against any future H5N1 pandemic flu outbreak.
Current influenza vaccines won’t give any defense against a future pandemic flu virus. But knowing that a potential mutation will initiate from H5N1 and have little difference genetically, The WHO is urging its members that preventative warehousing of current vaccine may be an option of some protection for wealthier countries to consider. At least it would be available immediately and it may offer a certain amount of help from the human exposed pandemic virus. There is the hope that this could also bring about investment from companies to begin pandemic vaccine development. Vaccine has an expiry date of a couple years so it could in the end just be thrown away but it would be considered cheap insurance in the event of a full blown pandemic health crisis.
Countries like China, France, Canada, Japan, the UK and the United States have made arrangements with manufacturers to produce a sample H5N1 vaccine, but if any new flu strain is drastically modified from the H5N1 virus the vaccine will be deemed ineffective. This on the back of a report from the WHO stating that a vaccine offering protection against the H5N1 as it is now could be nearly as effective against a new variation. Error on the side of caution according to the richer nations.
For the first time many countries are affected outright by the disease and the economic losses alone are overwhelming for farmers, industrial poultry producers and common households in these countries.
Currently the vaccine production is taking place in Australia, North America, Europe and Japan but during a pandemic the need will stretch around the world. There are concerns that less affluent countries seem to get hit the hardest by the influenza pandemic because their people tend to be less fit and undernourished. Poor countries have fewer health service staff and weaker health organizations overall that can’t stand up to the load of a pandemic virus and are lacking an emergency preparedness plan of any significance.
Because of a lack of resources most emergent nations are concentrating on surveillance of the H5N1 disease rather than warehousing antiviral tamiflu and vaccine production. If a pandemic hits these areas they will be extremely susceptible to illness in overwhelming numbers and not have the medicinal resources to anything about it.
The danger faced by humans from H5N1 flu has been second guessed lately. Medical personnel initially approximated the mortality figures at about ninety percent but adjusted that number as additional cases became obvious so the number dropped down to sixty seven percent along with newer confirmation of a lack of symptoms shown in many people so there may well be more cases that go unnoticed making an accurate death toll difficult to predict and possibly much lower than originally considered. It should be mentioned that a lower death tally doesn’t necessarily mean a lesser menace to humans from the H5N1 virus.
With H5N1 it was always suspected that the illness cases to death ratio seemed strangely elevated and the range of illness more general than only severe cases that were being recorded. Still, with lower fatality numbers based on more cases of illness, easier spreading of the flu virus means more people will get infected and hence, more individuals will become fatally ill.
The WHO is still quite certain that a pandemic of H5N1 virus will hit us globally. Regardless of all the unanswered questions surrounding the bird flu virus and its shock to society, preplanning for a pandemic will have a positive effect on the outcome. Lives will be saved, some will be lost, and the economy will still take a beating along with societal structure in general but emergency response organization will be improved and that is at least something positive. Better to be prepared as much as possible regardless of a nations internal capabilities.