Pandemic flu: what you should know | vec | the children's hospital of philadelphia

&A Pandemic Flu: What you should know Vaccine Education Center atThe Children’s Hospital of Philadelphia Reports in the media have sounded the alarm that a strain of bird flu
currently circulating among flocks of birds in Southeast Asia could signal
the start of the next influenza pandemic. Some reports have claimed that
as many as 50 million to 100 million people might die as a consequence.
Q. What is a pandemic?
Q. What is the “bird flu” that everyone’s
talking about?
A. A pandemic is a worldwide epidemic. Every year in the United
States and throughout the world, influenza viruses cause epidemics.
A. Bird flu is a strain of influenza that is killing large numbers of
However, because many people have some immunity, yearly epidemics poultry in Southeast Asia. In 1997, public-health officials detected
a strain of influenza in Southeast Asia that was lethal for poultry suchas chickens, ducks, turkeys and quail; the virus killed hundreds of The strains of influenza virus that cause pandemics are different than millions of birds. People are concerned about bird flu because before those that cause epidemics. Virtually no one in the world is immune 1997, it had never killed people. Because virtually no one in the to pandemic viruses. For this reason, pandemic strains of influenza world is immune to this virus, it has the potential to cause an influenza sweep across the world unchecked. Typically, many more people become ill and die during pandemics than during yearly epidemics.
Q. How often do influenza pandemics occur?
Q. What is the likelihood that bird flu will cause
the next influenza pandemic?
A. On average, influenza pandemics occur about three times every
century. During the past 120 years, influenza pandemics occurred
A. Some features of the bird flu are concerning and others are
five times: in 1889, 1900, 1918, 1957 and 1968. Some pandemics reassuring. The bird flu currently circulating in Southeast Asia is very
are more damaging than others. The pandemics of 1957 and 1968 contagious to birds; hundreds of millions of birds have been infected.
killed 4 million and 6 million people, respectively. But the pandemic And there is now evidence that birds infected with bird flu are of 1918 was even more devastating — a virus known as Spanish flu showing up in areas outside of Southeast Asia, such as Greece and killed between 20 million and 50 million people.
Turkey. Also, the virus has spread to mammals such as pigs, tigers and cats. Finally, bird flu has also spread to people — at least 200 people have been infected since 1997. Worse, when the virus infectspeople, it often kills them. About 50 percent of people infected with On the other hand, it is still uncommon for humans to contract bird flu; hundreds of millions of birds have been infected, but only about200 people have been infected with bird flu. And, the yearly incidence of people infected with bird flu since 1997 does not appear to be increasing. Further, people have caught bird flu from infectedbirds, not from other people. A pandemic will not occur until peopleinfected with the virus are highly contagious to other people. This hasn’t happened yet and it may not happen.
For the latest information on allvaccines, visit our Web site at vaccine.chop.edu
Q. If the bird flu doesn’t cause a pandemic, can I
Q. If I can’t get a vaccine, can I be protected by
feel reassured that the threat of a pandemic is over?
medicine like Tamiflu?
A. No. There will be another pandemic of influenza. If it isn’t the
A. Yes. Tamiflu is not a vaccine; it is an antiviral. An antiviral is
bird flu, it will be another strain of influenza virus. Historically, an antibiotic that works on viruses. It is possible that Tamiflu pandemics have occurred about three times every century; given early after infection could save lives. But there are several there is no reason to believe that this century will be spared.
problems. First, if Tamiflu is used indiscriminately, influenza viruswill become resistant to it. Second, Tamiflu is likely to be effective only if started within Q. What can I do to protect myself during a
48 hours of the beginning of the infection. Third, the drug isn’t pandemic?
perfect; several people in Southeast Asia infected with bird flu took Tamiflu early in their disease but still died from the infection.
A. The best way to be protected against influenza is to get an
So, prevention by vaccine is still the best option.
influenza vaccine. To prevent the next influenza pandemic, the
influenza vaccine will have to contain the strain of influenza virus
Q. Other than vaccines and medicines, is there
that is causing the pandemic. This means an effective vaccine anything else I can do to protect myself during
can’t be made until a pandemic begins.
an influenza pandemic?
Events that occurred during the 1957 pandemic are instructive. A. Yes, several simple strategies are effective. Careful handwashing,
In April 1957, a strain of influenza (later called Asian flu) infected covering your mouth when sneezing and staying home when ill 250,000 people in Hong Kong. A researcher in the United States all help to reduce the spread of influenza virus during a pandemic named Maurice Hilleman predicted that the Hong Kong outbreak signaled the start of the next pandemic. During the next fivemonths, he persuaded six U.S.-based pharmaceutical companies to make 40 million doses of influenza vaccine against the strain of virus circulating in Hong Kong. As predicted, Asian flu enteredthe United States in September 1957; 20 million people were infected and 70,000 died. But the vaccine likely prevented influenza in many Americans. The experience in 1957 taught us that if enough vaccine is made in advance of a pandemic, Today, although four companies make influenza vaccine (sanofi pasteur, GlaxoSmithKline, Chiron and MedImmune),the infrastructure to produce large quantities of influenza vaccinehas deteriorated. As it stands, we could not possibly make enough vaccine for all of our citizens in advance of a pandemic. For thisreason, the influenza vaccine would have to be rationed. TheDepartment of Health and Human Services is developing a pandemic influenza plan. Details can be found at www.pandemicflu.gov/plan.
This information is provided by the Vaccine Education Center at The Children’s Hospital of Philadelphia. The Center is an educational resource for parents and The Children’s Hospital of Philadelphia healthcare professionals and is composed of scientists, physicians, mothers andfathers who are devoted to the study and prevention of infectious diseases. TheVaccine Education Center is funded by endowed chairs at The Children’s Hospitalof Philadelphia and Kohl’s Department Stores. The Vaccine Education Center doesnot receive support from pharmaceutical companies.
vaccine.chop.edu
Some of this material was excerpted from the book, Vaccines: What You Should Know,co-authored by Paul A. Offit, M.D., and Louis M. Bell, M.D.
The Children’s Hospital of Philadelphia, the nation’s first pediatric hospital, is a world leader in patient care, pioneering research, education and advocacy.

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