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PRI's Environmental News Magazine

Flu Preparedness

Air Date: Week of October 14, 2005

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As the dangerous avian flu spreads from Asia into Eastern Europe the White House comes up with a readiness plan. We assess the preparations when host Steve Curwood talks with John Barry, author of "The Great Influenza: The Epic Story of the Deadliest Plague in History."

Transcript

CURWOOD: From the Jennifer and Ted Stanley Studios in Somerville, Massachusetts, this is Living on Earth. I'm Steve Curwood.

As the deadly H5N1 influenza virus continues to spread into poultry flocks in Asia and, more recently, into Turkey and Eastern Europe, President Bush has joined the mounting chorus of concern.

BUSH: I am concerned about avian flu. I’m concerned about what an avian flu outbreak could mean for the United States and the world.

CURWOOD: So far, the human-to-human transmission of the H5 bird flu has been limited to a handful of cases in Asia. But public health officials are making plans should the virus mutate into a more contagious form. President Bush says the military may have to enforce quarantines, and he urged all nations to make prompt and open reports if a virulent strain erupts in their populations. He says we have to be prepared.

BUSH: I have thought through the scenarios of what an avian flu outbreak could mean. I tried to get a better handle on what the decision making process would be by reading Mr. Barry’s book on the influenza outbreak in 1918. I would recommend it.

CURWOOD: Joining me is John Barry, the author of the book President Bush mentioned. It's called "The Great Influenza: The Epic Story of the Deadliest Plague in History." John, glad you could talk with me today.

BARRY: Well, thank you. Glad to be here.

CURWOOD: Health and Human Services Secretary Michael Leavitt has said recently that the likelihood of a flu pandemic in the future is very high, if not certain. So can you tell me a bit about the Bush administration’s plan to deal with such an outbreak?

BARRY: I think, in fairness to the administration, prior to the current hoopla, they had been trying to get a little ahead of the curve. But one of the things they’re going to do, and I think they’re all important, put more money into surveillance. Buy more anti-virals – I think they’re a little bit slow on that. Put more money into vaccine infrastructure development, which they have been doing. They are actually ahead of the rest of the world in developing a vaccine for the H5 virus.

Although, since the virus mutates so rapidly, that vaccine may not work if and when – hopefully, it won’t happen – but if and when this virus does jump to humans, and becomes a human virus. I think, generally speaking, with the possible exception of not enough money to basic research, I think they’re doing generally the right things right now

CURWOOD: Now, the president has said that he wants to use the military to effect a quarantine. What do you think of that idea?

BARRY: The first question, of course, is whether you do quarantine at all. If you are going to do one I don’t know how you would enforce it without the military. You know, most people have dumped all over the plan, and the reality is it’s not quite as ridiculous as it seems, and the reason is that I don’t think anybody believes they could actually contain influenza. The disease is simply too contagious and too explosive.

But if the 1918 virus is a pattern, then even slowing the transmission of the virus could make a big difference. And even over a period of two or three weeks from its peak virulence, the 1918 virus dropped precipitously in terms of the death toll. So, anything that slows the virus’s movement might make a difference in saving lives. You know, that doesn’t automatically mean that a quarantine would work, and I’m not sure that they’ve committed to it; it’s just something that you need to look at very hard.

I think the thing that’s gotten the least attention – the least amount of money – that may be the most important thing, ultimately, is basic research. Because the real answer to influenza is going to be a vaccine that works against all influenza viruses.

CURWOOD: Give me a breakdown of what the Bush administration plans to spend the money that it says it’s going to have towards flu preparedness.

BARRY: One thing they’re certainly going to want to do is buy a lot more of Tamiflu.

CURWOOD: Tell me what Tamiflu is.

BARRY: Tamiflu is an anti-viral drug and, unfortunately, it’s only made in one factory in the world, by Roche. And all the Western countries have already placed orders for it. The U.S., this is one thing you could fault the administration for, seemed to be last in line and placed its order late and did not have enough.

On the other hand, I don’t have a lot of confidence personally that the virus won’t develop resistance to Tamiflu. It hasn’t yet done so in the laboratory but, again, it’s one of the fastest mutating viruses in existence. I think chances are, you know, reasonably decent that it would. Plus, Tamiflu is by no means a cure-all. In fact, there are some studies that indicate that it doesn’t cut the mortality rate at all, which is a little bit counter-intuitive because it does seem to cut down the severity of an attack.

CURWOOD: How much Tamiflu would be available if we had a worldwide flu pandemic?

BARRY: Well, it depends on when the pandemic comes.

CURWOOD: Today?

BARRY: Today, there’s not much out there.

CURWOOD: John, do you have any Tamiflu yourself?

BARRY: Yes. (LAUGHS)

CURWOOD: Would you recommend other people get it?

BARRY: Well, you know, I guess by definition if I have it. By the same token, I don’t want to start a stampede or panic. It might do some good, it might not.

CURWOOD: What’s happening right now with this H5N1 influenza virus that everyone’s worried about? What similarities do you see to the Great Flu of 1918?

BARRY: Well, I mean, certainly there’s real reason to be concerned but like 1918, it seems to be targeting young adults. Some of the symptoms are similar. There’s no guarantee, thankfully, that this virus is going to jump. I know one of the leading scientists in the world on influenza, although he has a minority view, but I find reassuring, he doesn’t think it will jump because he thinks so many people have been exposed to it so far. There are actually several million people in China who have some antibodies to an H5 virus. He thinks it would have jumped by now if it were going to. But he recognizes it’s a minority view and that he could be wrong. Most people think this is fairly likely to jump.

CURWOOD: John Barry is author of the book "The Great Influenza: The Epic Story of the Deadliest Plague in History." John, I hope this was all speculation.

BARRY: Unfortunately, whether it’s H5 or not, there will be another pandemic. If it comes in the next couple years we’ll have a real problem, even if it’s a mild virus. However, if it comes in ten or 15 years, with the attention we are now giving to the problem, things will go a lot better.

CURWOOD: Thank you, John Barry.

BARRY: Thank you.

 

Links

"The Great Influenza" by John Barry

 

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