Dark Bilious Vapors

Slate's "Medical Examiner" column has me worrying:

Avian flu and the risk of worldwide epidemic.

The news on the avian flu front ranges from very bad to moderately bad to slightly good.

The worst first: As this animated map shows, avian flu is marching inexorably westward across Russia toward Europe, wreaking havoc among poultry and occasionally infecting humans. Just to remind you, H5N1 influenza virus is highly virulent for chickens and for humans (infected chickens or humans have a substantial chance of dying), highly infectious for chickens (exposed birds usually become ill), but, so far, poorly infectious for humans (exposed people generally do not acquire the disease). However, if this strain of flu behaves like other strains—and there is no reason to expect otherwise—sooner or later it will acquire the ability to easily infect people; and if that happens, we may be at risk for the same fate as those tens of thousands of dead chickens in the poultry houses of Asia and Russia. The risk of the disease as it is carried west by migrating waterfowl is being taken so seriously in Europe that the Dutch government has ordered farmers to move all poultry indoors, and German farmers will likely shortly be similarly instructed.

The middling bad news: While H5N1 may be preventable by a vaccine, we don't have one yet that has been fully tested and shown to work. We have a candidate vaccine, and the federal government has contracted for 2 million doses of it (because if things get bad we might need to use it, fully tested or not). The federal agency sponsoring the vaccine's development, the National Institute of Allergy and Infectious Disease, trumpets it as strong and effective and anticipates that the only problem is whether we can produce enough. Others looking at the same data, however, are not sure the vaccine will work.

Sensing opportunity, some small startup American firms are aggressively trying to develop alternative vaccines based on totally different approaches that have ever been used before. There is no telling what people will do if widespread desperation sets in, but it seems to me very unlikely that any of these products can possibly be ready in time.

The minimally good news: The world is starting to take H5N1 seriously. For example, the British government just circulated a fine booklet about the virus. Probably more important, the Swiss drug maker Roche has donated 3,000,000 doses of the one remaining effective anti-viral drug (oseltamivir, sold as Tamiflu) to the World Health Organization's rapid-response stockpile, to be used in poor countries where the disease might emerge. I understand the U.S. government's need not to fan panic, but I hope it is privately addressing this problem in a more serious way than is readily apparent. If not, we are in big trouble.

Len on 09.06.05 @ 07:45 AM CST