TUESDAY, Nov. 1, 2005 (HealthDay News) -- To better prepare the United States for a possible worldwide outbreak of avian flu, President Bush on Tuesday outlined a $7.1 billion strategy that would include $1.2 billion for enough vaccine to protect 20 million Americans against the current strain of bird flu.
The president also called for better liability protection for drug companies to encourage more firms to produce lifesaving inoculations, the Associated Press reported.
The avian flu strain, which first surfaced among poultry in Asian nations several years ago, has yet to show the ability to infect large numbers of people. But health officials are worried the strain could mutate, and possibly adapt with a more common flu strain, making it far easier for person-to-person transmission, raising the specter of tens of millions of deaths worldwide.
With that prospect as a backdrop, Bush, in a speech at the National Institutes of Health, said no one knows when or where a deadly strain of flu will strike but "at some point we are likely to face another pandemic."
To prepare for a pandemic, which scientists say is long overdue, Bush said the United States must be ready to detect outbreaks anywhere in the world, stockpile vaccines and anti-viral drugs and be ready to respond at the federal, state and local levels if a pandemic reaches the United States, the AP reported.
Bush outlined a strategy, the AP said, that would cost an estimated $7.1 billion:
- $1.2 billion for the federal government to buy enough doses of the vaccine against the current strain of bird flu to protect 20 million Americans;
- $1 billion to stockpile more anti-viral drugs that lessen the severity of the flu symptoms;
- $2.8 billion to speed the development of vaccines as new strains emerge, a process that now takes months;
- $583 million for states and local governments to prepare emergency plans to respond to an outbreak.
Worldwide, health officials have confirmed 77 humans cases of avian flu infection, including an estimated 60 deaths. All cases have been confined to Southeast Asia.
A draft of a federal report obtained by The New York Times in early October predicted a worst-case avian flu scenario in the United States that could lead to the deaths of 1.9 million Americans and the hospitalization of 8.5 million more people with costs exceeding $450 billion.
Early outbreaks of avian flu occurred among poultry in eight Asia countries -- Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam during late 2003 and early 2004. In response, officials ordered the slaughter of more than 100 million birds in the affected countries in an effort to control the outbreak. By March 2004, the outbreak seemed under control.
But beginning in late June 2004, new outbreaks of avian flu among poultry were reported in such Asian countries as Cambodia, China, Indonesia, Kazakhastan, Malaysia, Mongolia, Thailand and Vietnam, according to the U.S. Centers for Disease Control and Prevention.
Recently, avian flu has continued its westward push, with cases identified among poultry in Turkey and Romania.
The last great pandemic, the Spanish flu outbreak of 1918-19, killed an estimated 20 million to 40 million people worldwide. An estimated 675,000 Americans died of influenza during the pandemic.
Even in a normal year, an average of 36,000 Americans die from seasonal flu. Most of those deaths occur among people with weak immune systems, such as infants, the elderly and people with AIDS.
Bush unveiled his plan a day after scientists reported a potentially better and faster method of producing flu vaccines both for the regular seasonal flu and, more immediately, for the much-discussed avian flu.
The technique, called reverse genetics, uses cultured kidney cells from monkeys to cultivate the proteins needed for the vaccine. The old system, which the study authors described as "cumbersome," grows the flu virus in eggs.
A report on the new technique appears in this week's issue of the Proceedings of the National Academy of Sciences.
The senior author of the study was Dr. Yoshihiro Kawaoka, a professor of virology at the University of Wisconsin-Madison School of Veterinary Medicine.
Many people believe the existing system for making flu vaccine is antiquated. That system grows the flu virus in fertilized chicken eggs. Technicians then take the virus from the eggs and make it inactive. The inactivated virus forms the basis of the flu shots millions of people receive each year.
Antigens destined for inclusion in the vaccine are selected around January and the vaccine is not ready until about August, in time for each approaching flu season.
Because the circulating regular flu virus changes every year, a new vaccine needs to be made every year. "Sometimes we get a very good match and the vaccine is very good, and sometimes it's a less-than-ideal match," said Dr. Donald J. Kennedy, professor of internal medicine and infectious diseases at St. Louis University, who was not involved with the research.
With the new reverse genetics method, the necessary proteins or antigens from the flu virus can be produced in tissue cell cultures.
"It's much more rapid, much more efficient," Kennedy said. "Instead of the old cumbersome way with a low yield and more expense, this technology can generate large amounts of these proteins much easier."
He likened the advance to one that took place with the hepatitis B vaccine. When that vaccine first came out in the mid 1970s, researchers had to find infected individuals, collect their blood, purify it and then make the vaccine.
In the 1980s, scientists discovered a way to insert the genetic material for the hepatitis B proteins into yeast cells and grow it as if they were making beer.
The new method for flu vaccine represents a similar quantum leap, Kennedy said.
And, the new technique might help head off a possible pandemic, Kennedy said. "Based on this technology, when somebody decides what flu antigen we need in a vaccine, it would be able to be produced much more rapidly and in higher quantities," he said.
More information
The U.S. Centers for Disease Control and Prevention has more on avian flu.
