U.S. Bird Flu Threat May Be Overstated, Experts Say

But that's no reason to relax preparedness efforts, they add

FRIDAY, April 21, 2006 (HealthDay News) -- As the Bush administration puts the final touches on a massive response plan for a potential avian flu pandemic, experts -- including top-level administration officials -- are predicting that if and when the avian flu reaches American shores, it's not likely to be the disaster most once feared.

"It is impossible to predict whether we're going to have an H5N1 [the current strain of avian flu] pandemic and, if so, how severe it's going to be," Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told HealthDay.

Fauci had earlier told the Associated Press that he thought it "very unlikely that there is going to be the type of situation [here that] we see everywhere, from Nigeria to Indonesia."

That sentiment was echoed by Dr. Julie Gerberding, head of the U.S. Centers for Disease Control and Prevention. Speaking to attendees at a recent meeting in Tacoma, Wash., she said "there is no evidence it [bird flu] will be the next pandemic."

For Fauci, however, planning for a worst-case scenario remains a necessity, even if, realistically, it is highly unlikely to transpire.

"We, the public health people, in order to make sure that we don't tragically undershoot our preparedness, must assume that the worst-case scenario will occur even though the fact is there really is no guarantee that it will occur," Fauci said. "The American people should not be worried. They should execute some degree of reasonably intelligent, non-panicky, non-hysterical preparedness, which really means 'have a plan for your family.'"

Another expert believes panic over a possible pandemic is unwarranted.

Dr. Marc Siegel, author of False Alarm: The Truth About the Epidemic of Fear and a clinical associate professor of medicine at New York University School of Medicine in New York City, said, "There's a complete psychosis here."

"The whole problem with the topic is the blurring of the distinction between birds and people. I'd be worried if I was a bird -- maybe. But not even all birds should be worried," Siegel said.

The current H5N1 virus has generated more fear than normal because of its virulence and ease of transmission among flocks of domestic birds, said Dr. Alan I. Hartstein, professor of clinical medicine at the University of Miami Miller School of Medicine.

So far, bird flu has killed 110 people in nine countries, the lion's share in Vietnam, Indonesia and other parts of Asia. More than 200 million domestic fowl have been killed worldwide to help stem the spread of the illness.

Human casualties remain largely confined to Asia and to people who have had close and prolonged contact with infected birds, such as poultry farm workers. But one-third of Americans polled said they personally feared becoming infected with the bird flu.

That fear may be intensified with the looming threat that migrating birds may soon bring the virus to American shores. The U.S. Fish and Wildlife Service and Alaska's Fish and Game Department are setting up more than 50 camps to screen birds for the virus, the AP reported.

There's no question that this is a very serious infection -- for birds. "This is a pretty bad one, probably the worst one we've seen in birds, but that doesn't correlate to what's going to happen to humans," Siegel said.

But the fact remains that what people are seeing is still the bird flu, he said.

"The threat to people is minimal," Siegel said. "In Asia, people have gotten sick because they had such close contact with birds. In Europe, we haven't seen a single case in humans. There's no reason to believe that there's an imminent threat to human beings."

So far, the virus has shown no ability to jump from human to human. To gain that ability, it would need to undergo genetic mutations.

"Any influenza virus that can cause a pandemic must gain the ability to be easily transmitted from person to person," said Hartstein. "Thus far, the H5N1 viruses do not have this capability and cannot cause a pandemic."

There may not even be much of a threat to poultry, as long as U.S. farmers keep their birds separate from wild species. As reported by the AP Wednesday, federal officials said any commercial poultry flock even suspected of being infected with H5N1 would be killed off immediately, before test results confirming infection came in.

Said Fauci, "Would I be surprised if sometime in the future a migratory bird somewhere within the borders of the U.S. was found to be infected H5N1? No. Is it inevitably going to happen? I have no idea. If it did happen, would there be infection of chicken flocks? There is a chance. Do I think there will be massive contamination of domestic flocks? That would be unlikely because we're much more analogous to Europe than we are to developing nations."

So, is the U.S. government's preparedness plan an overreaction?

Not at all, Hartstein said.

There were three flu pandemics last century. "The threat of a new influenza pandemic is real and thought to be inevitable at some point in time," Hartstein said. "People can only guess when this will occur."

One question is whether the plan will include the elements many experts deem crucial.

"When I think of human preparedness, I think of long-term preparedness," Siegel said. "We need to improve how we make vaccines using 21st century technology so that, instead of reacting, we could anticipate a threat." Wetlands also need to be preserved, he added, so that migratory birds have a place to go that is geographically removed from poultry.

"We're better off now than we were six months ago, and it's extremely likely that six months or a year from now we'll be even better prepared," Fauci said. "Is anybody in the world optimally prepared for the worst-case scenario? The answer is an unqualified no."

More information

For more on bird flu, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Anthony Fauci, M.D., director, National Institute of Allergy and Infectious Diseases; Marc Siegel, M.D., author, False Alarm: The Truth About the Epidemic of Fear, clinical associate professor, medicine, New York University School of Medicine, New York City; Alan I. Hartstein, M.D., professor, clinical medicine, division of infectious diseases, University of Miami School of Medicine; Associated Press; News Tribune
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