Flu pandemic will strain resourcesBy Jill Coley (Contact)
The Post and Courier
Saturday, October 4, 2008
Additional storiesFlu vaccine available, effective, published 10/4/08 State, other providers to begin shots; Children, elderly and patients with medical problems most vulnerable, published 09/28/08 (this also has a links box with the web sites that are below.) Scientists from around the world meet every February to study the hundreds of influenza strains percolating around the globe. They predict the top three for each hemisphere and kick-start the six-month vaccine manufacturing process. They are usually right, but not always. Last year, three out of five seasonal flu cases reported were caused by strains not included in 2007-08 vaccine. This year's seasonal flu will bring its fair share of illness and an estimated 500 deaths statewide. But what if an entirely new virus hits, one never seen before? Dr. Robert Ball, an epidemiologist with the S.C. Department of Health and Environmental Control, said, "That's why this virus scares me. It has the ability to mutate in the blink of an eye." A worst-case scenario could kill up to 25,000 South Carolinians. The sick would overwhelm hospitals, absenteeism would close businesses and food supplies would slow. Ball is among those mobilizing the South Carolina Pandemic Influenza Task Force that will meet Tuesday in Columbia to answer some tough questions. Who will get the last ventilator? Who will get the first vaccines? Bio-ethicists at Johns Hopkins released a report Wednesday on who should be considered "essential" during a pandemic flu outbreak. Doctors, nurses and firefighters obviously made the list, but, surprisingly, so did truck drivers, communications personnel and utility workers. Study leader Nancy Kass, deputy director of Public Health for the Johns Hopkins Berman Institute of Bioethics, said that if the public has limited access to food, water, sewage systems, fuel and communications, "the secondary consequences may cause greater sickness and death and social breakdown than the virus itself." The report outlines a transparent response, stressing that the middle class and wealthy be self-sufficient in order to free up supplies for the poor and vulnerable. Historically, the interval between pandemics ranges between 10 to 49 years, with an average of 24 years, according to an article by Dr. G.T. Fabian in The Journal of The South Carolina Medical Association. The association's June issue was dedicated to pandemic influenza. The most deadly pandemic in the past century was the Spanish flu of 1918-19, which was responsible for more than 50 million deaths worldwide. The virus killed at least 675,000 Americans and as many as 10,000 South Carolinians, Fabian reported. Scientists do not ask "if" an influenza pandemic will occur but "when," Ball said. Attention is trained on the Asian virus called H5N1 that is already responsible for 241 human deaths in 10 countries. The so-called "bird flu" is only two mutations away from being transferred easily from person to person. This virus is so virulent, its 86 percent death rate is higher than Ebola hemorrhagic fever, Ball said. "Hospitals can't absorb this. There's a lot of planning going on," he said. Experts agree that hospitals need resource protocols in place before the next pandemic strikes. A state pharmaceutical stockpile was established in 2007. Combined with federal matches and allotments from national stockpiles, there should be enough antiviral medicine to treat 25 percent of the state's population, according to a report led by Max Learner in the June journal. "History teaches us there is a pandemic clock and that it is ticking. Complacency is always the enemy," Fabian wrote. Flu vaccine effective, readily available The rapidly mutating influenza virus is to blame for the spike in flu last year. The 2007-08 flu season brought 30,607 cases to Berkeley, Charleston and Dorchester counties, nearly twice the 15,922 cases reported the year before, according to the state Department of Health and Environmental Control. For more, see Page 6A. On the Web: To find a DHEC flu vaccine clinic visit scdhec.gov/flu/clinics.asp. Cost is $25. For information call 1-800-277-4687. To search for other clinics, visit www2.thecarolinascenter.org/ccme/ or flucliniclocator.org. Prices vary. Reach Jill Coley at 937-5719 or jcoley@postandcourier.com. |
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Comments
This article has 13 comment(s)
Posted by Kobie on October 4, 2008 at 8:34 a.m. (Suggest removal)
Tuesday should be interesting!!
BTW - ventilator triage has been worked out. It is not pretty but serves to guide health care workes and families. Also ventilators do not really help with bird flu. The H5N1 virs, like ebola or HIV virus, does more damage per unit time than the body can repair.
From the World health organization: 63% death rate from H5N1 with medical intervention (Source: http://www.who.int/csr/disease/avian_inf...) Like 1918, the virus kills those ten to thirty years of age most (source: http://www.wpro.who.int/NR/rdonlyres/FD4...)
The best thing is not to get sick.
Yes you can do something. If you feel you can change global warming or save the children then know you can also protect yourself and help your community.
Diaries of those from 1918, program to "Take the Lead" and webcasts from many US departments like transportation, educatin, HHS, are here: http://www.pandemicflu.gov/
Do contact your local public health and school to see what their plans are and how they will affect you.
Thre are also lots of citizen groups and news listings where you can get information. Avian flu talk, Flu wiki, Prepared Citizen, ReadyMoms.org. Each one is free and offers information.
As always go with the most credible source - pandemicflu.gov or your state and local leaders.
Kobie
http://www.newfluwiki2.com/frontPage.do - H5N1 info
"A country boy can survive, country folk can get by." - Hank Williams jr.
Posted by abitskeptical on October 4, 2008 at 9:05 a.m. (Suggest removal)
Deciding who, after the people/professions mentioned, should be next in line for the vaccines will be a very tough call for various reasons.
The vulnerable, in regard to the flu viruses fall into a # of categories, one of which will surprise most people:
The healthy young-middle age person. Their strong immune systems actually can work against them by contributing or causing a phenomenon called "cytokine storm". This immunologic reaction usually causes this group to die very early in the progression of the infection(simple reason-lungs become infused & overwhelmed by white blood cells).
The very old & very young usually do not mount a cytokine storm response, but are likely to die from the virus destruction of the lungs & other organs.
Ironically, measures taken to boost our immune systems might increase the likelihood of a cytokine storm.
Pretty depressing stuff. We all might be pretty much screwed if there is a 1918-like pandemic scenario.
Posted by oldglory on October 4, 2008 at 9:11 a.m. (Suggest removal)
P&C - This link appears to be broken (at least for me).
On the Web: To find a DHEC flu vaccine clinic visit scdhec.gov/flu/clinics.asp.
Posted by LutherVanderhorst on October 4, 2008 at 10:05 a.m. (Suggest removal)
A flu pandemic would strain resources. It is a public service to inform people of the threat, but the wording of the headline is alarmist.
Posted by iceman1978 on October 4, 2008 at 10:41 a.m. (Suggest removal)
Read about the Spanish Flu pandemic of 1918. Depending on whose statistics you look at, it claimed anywhere from 25 to as many as 50 million lives in less than nine months. Taking into account the population at the time, it would be the equivalent of 75 to 150 million deaths today. The only difference is that it would spread much more rapidly.
Posted by oldglory on October 4, 2008 at 10:41 a.m. (Suggest removal)
Kobie - thanks for the links, diaries quite interesting because my mother was a toddler in 1918.
Posted by abitskeptical on October 4, 2008 at 11 a.m. (Suggest removal)
Luther-the wording of the headline actually is the truth & perhaps even understated at that.
I understand that the public is tired of the alarmist news grabbing headlines over so many things.
However, in this instance, the seriousness of the issue can hardly be overstated.
People in the know have been carefully releasing information about this very serious threat, for a number of years now, in an effort to minimize alarm.
The medical community has been concerned about this grave threat for far longer than the public realizes--certainly for far longer than the topic has been hitting the general news community.
Posted by UrGatorbait on October 4, 2008 at 3:55 p.m. (Suggest removal)
I saw a report on that we had enough vaccine, but hey, keep the scare tactics up. More hysteria for the uniformed masses to enjoy.
Posted by abitskeptical on October 4, 2008 at 6:11 p.m. (Suggest removal)
Its not a "tactic" if it is the truth.
Don't know what report you saw, gatorbait. There rarely is enough of the proper vaccine & it usually is the epidemiologists' best guess as to what viruses are going to predominant in a given year.
Many of these viruses mutate rapidly making it more difficult & less likely to fully keep up vaccine-wise.
The H5N1 thankfully has stayed at the present mutated state (2 mutations away from easy person to person transmission) for a while now giving manufacturers time to produce more vaccine, but the production process is not a quick one & there have been troubles along various stages of production.
Further if & when H5N1 becomes easily passed from person to person, it is likely to start mutating at a more rapid rate.
There are new technological/medical methods of vaccine production on the horizon & we all should hope & pray they prove successful.
Posted by LadyTarHeel on October 4, 2008 at 9:32 p.m. (Suggest removal)
abit: H5N1 is already passed from person to person. I think you are speaking of Avian Flu that is 2 mutations away from easy person-to-person transmission.
Posted by abitskeptical on October 5, 2008 at 7:52 a.m. (Suggest removal)
LTH-h5n1 IS an Avian flu virus, & it was the one to which Dr. Ball was referring relative to mutation status.
It does appear it has had person-to-person transmission, but that is limited. The risk of pandemic comes when there is EASY transmission.
For more info see:
http://www.who.int/csr/disease/avian_inf...
"...instances of limited human-to-human transmission of H5N1 and other avian influenza viruses...have occurred in association with outbreaks in poultry...In no instance has the virus spread beyond a first generation of close contacts or caused illness in the general community. Data...suggest that transmission requires very close contact with an ill person...There have been a number of instances of avian influenza infection occurring among close family members. It is often impossible to determine if human-to-human transmission has occurred since the family members are exposed to the same animal and environmental sources as well as to one another."
Posted by starlight on October 5, 2008 at 2:49 p.m. (Suggest removal)
We don’t have any vaccine for the pandemic virus. Each vaccine is custom produced for a specific virus. A vaccine can’t be produced for the pandemic strain until the virus finishes mutating and the pandemic begins.
It will take at least 6 months after a pandemic begins to have vaccine for the pandemic strain.
They are making what they are calling "prepandemic vaccines" from the strains of H5N1 virus in 2004, 2005, etc.
I do not think it is likely that they will work once the virus mutates to cause a pandemic. Seasonal flu vaccines don't work when the seasonal flu virus mutates unexpectedly, and we only have approximately 13 million doses of prepandemic vaccine.
Posted by abitskeptical on October 5, 2008 at 5:56 p.m. (Suggest removal)
While we do not have a vaccine for the "pandemic" virus, whatever that might be, the vaccines that have been produced may offer partial immunity until the vaccine specific to the mutation is developed.
http://www.fda.gov/bbs/topics/NEWS/2007/...
"...a vaccine for humans against the H5N1 influenza virus, commonly known as avian or bird flu...could be used in the event the current H5N1 avian virus were to develop the capability to efficiently spread from human to human, resulting in the rapid spread of the disease...Should...an influenza pandemic emerge, the vaccine may provide early limited protection in the months before a vaccine tailored to the pandemic strain...could be developed and produced."
The following also is interesting reading:
http://www-als.lbl.gov/als/science/sci_a...