Pandemic -- Are We Prepared?

What is a pandemic? Webster's Dictionary defines the word pandemic as an epidemic over a wide geographic area, affecting a large proportion of the populations. And our history shows there have been several pandemics that devastated millions of people throughout the world.

• 1918-19, "Spanish flu," [A (H1N1)], caused the highest number of known influenza deaths. More than 500,000 people died in the United States, and up to 50 million people may have died worldwide. This pandemic virus appears to have an avian origin.
• 1957-58, "Asian flu," [A (H2N2)], caused about 70,000 deaths in the United States. First identified in China in late February 1957, the Asian flu spread to the United States by June 1957.
• 1968-69, "Hong Kong flu," [A (H3N2)], caused about 34,000 deaths in the United States. This virus was first detected in Hong Kong in early 1968 and spread to the United States later that year. Influenza (H3N2) viruses still circulate today.

As posted on the U.S. Health and Human Services web site, "An influenza pandemic has the potential to cause more deaths and illness than any other public health threat.

"If a pandemic influenza with similar virulence to the 1918 strain emerged today, in the absence of intervention, it is estimated that 1.9 million Americans could die and almost 10 million could be hospitalized over the course of the pandemic, which may evolve over a year or more."

Pandemics occur when an influenza virus emerges that infects and can be efficiently transmitted between humans. This can start as an animal to animal virus that mutates to humans with or without the animal being the host. Avian viruses played a key part in the last three influenza pandemics.

Today, the biggest threat to the United States appears to be the Avian Flu (H5N1) which has killed over 62 people and infected over 150. It has mostly appeared in European and Asian countries, but transmission to the Americas is a real possibility. Millions of bird, duck and other foul have been slaughtered in attempts to control the spread of the flu. This virus does not jump easily from birds to humans or spread readily among humans. Should H5N1 evolve to a form as contagious as normal influenza, a major pandemic could begin that would have world wide consequences.

According the Washington Post, the deadly strain of bird flu that has devastated poultry and killed more than 60 people in Asia has been detected in a bird in Kuwait, the first known outbreak of the virus in the Gulf region. Tests showed a migrating flamingo found on a Kuwait beach had the lethal and virulent H5N1 strain. A second bird, a falcon quarantined at the airport, had the milder H5N2 strain.

This in itself does not mean the bird flu is going to mutate into the human type, but it demonstrates that it is not limited to one area, and can spread. If this flu mutates into the human-to-human form it could spread across the world in six to nine months, according to World Health Organization.

Chief Medical Officer Sir Liam Donaldson of the United Kingdom warned that a Europe-wide pandemic is "inevitable." He said 50,000 people would probably die in the UK in the winter of 2006-7 -- but a final figure of up to 750,000 was "not impossible."

A study published recently in the open access journal Respiratory Research reveals that, in human cells, the virus can trigger levels of inflammatory proteins more than 10 times higher than the common human flu virus H1N1. This might contribute to the unusual severity of the disease caused by H5N1 in humans, which can escalate into life-threatening pneumonia and acute respiratory distress.

The threat is also being taken very seriously by the Untied States. The federal government recently announced it is working on a National Strategy in the event of a pandemic. President Bush wrote, "A new strain of influenza virus has been found in birds in Asia, and has shown that it can infect humans. If this virus undergoes further change, it could very well result in the next human pandemic.