Spread of bird flu to the United States is a "time bomb waiting to go off"

Sep 12 2005

One of the government's top scientists said Monday that the spread of bird flu to the United States is a "time bomb waiting to go off" but that federal and industry efforts to produce a vaccine are progressing.

"Although the threat of pandemic flu is there, it is impossible to predict in a number" what the odds are of it striking the United States, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told reporters. "But I can say it is much much greater than a few years ago."

"We do know that sooner or later there will be a pandemic flu" in the United States, Fauci said, and "we, the government, are working very hard to get a vaccine capability in shape …You know something likely will occur, but you don’t know when."

He said the aim is to have 100 million doses ready if bird flu is detected in the United States. Even if the strain is different than what is now found in Southeast Asia, the scientific infrastructure is in place to quickly shift to "massive production" of a new vaccine. The goal in the next few years is 150 million to 180 million doses.

Last year, contamination of flu vaccine in a British facility curtailed the distribution of about 48 million doses to the United States, half of what was planned.

"Pandemic flu" is defined as a strain never before seen in humans and that spreads across the globe. There were three such pandemics in the 20th century, in 1918, 1957 and 1968 — the latter two much milder than the first, which killed between 20 million and 40 million people worldwide, and infected one in four Americans, killing 675,000.

The flu infecting fowl in Southeast Asia can spread to people, although not very efficiently, Fauci said, and spreading it from one person to another is even less efficient. There have been only 112 cases reported so far of human-to-human infection. As a result, he said, there is no reason to vaccinate everyone in the United States against bird flu.

But it will eventually spread, he predicted. "It’s an epidemiological time bomb waiting to go off," Fauci said, although he cautioned it would not occur suddenly and massively and would give officials time to produce a vaccine.

"It’s unlikely that if the H5N1 (flu strain) we see now in Asia develops the capability of efficiently spreading from human to human, which we don’t see now, it is unlikely to happen overnight. It is likely to develop over a period of months. It is not going to happen between Tuesday and Thursday. It is going to happen between February and April," he said, using the time frame as an example rather than a prediction.

He said federal spending on pandemic flu increased by a factor of 10 in the past four years and that scientists are moving from using eggs to incubate a vaccine to using cell-based cultures, which would avoid the problem of a chicken infection killing an egg and would allow faster production in an emergency.

If there is enough vaccine available in the future, Fauci said it may be recommended that shots be given not only to infants and the elderly, who are most vulnerable to flu, but to healthy children as well. Vaccinating children, he said, would protect the larger population from disease spread. Children get the mild form of flu "and they sneeze on grandpa and grandma," putting them at high risk.