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Industry: Email Alert RSS FeedWhen flu flies the coop: a pandemic threatens
Science News, Sept 10, 2005 by Ben Harder
If the virus already is widespread but largely concealed in some wild birds, control measures such as culling overtly sick flocks will have little effectiveness.
PRACTICE PANDEMICS Draconian measures to contain and eliminate infected birds will become even less valuable if H5N1 changes into a strain that is easily communicable among people. At that stage, deflecting a pandemic might depend on how, when, and where governments deploy key medical tools and public health policies, such as travel lock downs and quarantines.
Nearly all the confirmed human infections since 2003 appear to have resulted from contact with infected birds. But a few people already appear to have been infected with H5N1 by relatives with whom they've had household contact.
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In the Jan. 27 New England Journal of Medicine, researchers in Thailand, along with two U.S. colleagues, reported a pair of probable human-to-human infections, both originating with the same infected person in a Thai home in 2004. Interpersonal transmission may also have caused two cases in Indonesia in July.
In past pandemics, a bird flu moved into people after the virus swapped genes with another flu virus, for instance, the agent causing a swine flu. But that won't necessarily be the case this time.
Any cluster of human cases with a strain that doesn't look like a standard winter-flu strain would be sufficient to indicate an imminent threat warranting a coordinated global response, according to biostatistician Ira M. Longini Jr. of Emory University in Atlanta.
Two research teams recently published studies analyzing how that response might unfold. Both groups used mathematical models to consider the relative importance of viral characteristics, antiviral drugs, and measures for preventing transmission in the early days of an outbreak, while the virus is still near its source.
"Neither one of the models shows that we can contain it at the source," stresses Emory biostatistician M. Elizabeth Halloran, who coauthored one of the studies with Longini and other researchers. "Both show that, with really concerted effort, there is a possibility that we could contain it."
"That should not lull anybody," Halloran says.
In the hypothetical scenario that Halloran and Longini considered, an outbreak begins in rural Southeast Asia. The researchers used data from a recent Thai census and other sources to estimate such factors as how densely populated the strain's birthplace might be and how many times each day typical residents interact closely enough that they might spread the infection. By using different values for the outbreak strain's ease of transmission, the investigators plotted several possible courses of the pandemic.
They also added flu-fighting countermeasures to the model, including the distribution of antiviral drugs such as oseltamivir (Tamiflu) and the use of a partially effective vaccine. They assumed that it would take at least a week from onset of the first human illness for health officials to recognize the outbreak and respond.
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