150million predicted, page-4

penny to drop for imugene soon September 28, 2005

Waiting for the egg to drop



It has happened before. The Spanish flu virus, in 1918, killed over 40 million people, the Asian flu, in 1957, claimed 100,000, and 700,000 died in the 1968 Hong Kong pandemic. It is threatening to happen again: the H5N1 strain of bird flu or avian influenza has killed six people in Indonesia in the last two months raising the death toll in Asia to 65 since 2003. One hundred million birds have been killed or sacrificed to date to harness the disease. The World Health Organization (WHO) fears that if the virus can spread from man to man, the result would be a full-blown pandemic that could kill up to 50 million people and sicken more.
H5N1 is an intimidating virus because it can mutate rapidly and has been found to exchange genes with other viruses. Acquiring genes from the human influenza virus could make it highly infectious and lethal. Lab studies have shown that this virus can be highly pathogenic to humans. What starts with flu-like symptoms can lead to sore eyes, pneumonia, respiratory distress and life-threatening conditions.
The 1997 introduction of the virus in Hong Kong has already spread to 14 Asian nations including Russia. While the spread is primarily through transport of poultry products, ducks, migratory birds and illegally imported birds are thought to harbor the virus as well. Birds can spread the virus through their saliva, nasal secretions and feces. Most human cases arise from exposure to infected poultry or contaminated surfaces.
If the Indonesian outbreak is not controlled, it has the potential to trot the globe in a matter of months. A bird flu pandemic would demand mass production and rapid delivery of drugs and vaccines. At this point, there is not even a licensed vaccine. The best combat would be antiviral drugs such as Tamiflu and Relenza, which may help restrict an outbreak; but there are caveats. Tamiflu is not licensed to treat infants, a particularly vulnerable group. H5N1 is already resistant to some of the current drugs and more could become ineffective as the virus mutates.
The ideal scenario would be to vaccinate people, but this is not easy. Protocols involved in vaccine preparation are patented and companies that can mass-produce the vaccines are reluctant to pay royalties to the patent holders. Besides, they do not find flu shots lucrative because they can make much more money producing more phenomenal drugs. In addition, vaccines carry a risk factor and a predisposition to lawsuits and bad publicity. Politicians are also hesitant to spend on a commodity that may never be touched in their tenure. Still, U.S. and Canadian governments are coaxing drug companies by promoting the use of seasonal flu shots which are bought from them. Australian firm CSL Ltd. hopes to have 40 million doses of a flu vaccine ready by August 2006. Needless to say, poorer countries cannot afford these magic bullets.
The United States is far from safe. This country has so far invested $350 million in producing a vaccine and has stockpiled 2 million doses. Early clinical trials show encouraging results, but the vaccines need to be tested with children and the elderly before FDA approval. The United States has also promised to provide $5.5 million in aid, scientists and medical workers to Asian countries to help nip the outbreaks in the bud.
Of the $250 million the WHO seeks to contain the outbreaks, only about $16 million has been obtained. The developed countries are in a rush to stock up antivirals, vaccines and masks in an engagement to protect themselves. Money is needed to establish surveillance, track the spread of the virus, analyze virus samples in outbreaks, vaccinate the birds and to enhance production of vaccines and antiviral drugs for humans worldwide. Money is needed in the poorer countries where these epidemics are spawned. Rather than raise money for disaster victims, the difficult task of procuring prophylactic money should be pursued.
Indonesia is tackling a potential epidemic. The United Nations has urged Indonesia to slaughter poultry in afflicted areas and invest on fighting the virus. Australia has promised 50,000 courses of antiviral drugs to Indonesia. The one thing remaining between a global pandemic and us is time. We are technologically more advanced than in 1918, but also more populated, more itinerant and more prone to panic, thanks to the incredible media. It would be a pity to watch the world fall helplessly to another pandemic. The only hope is to kill the epidemics before they pan out a pandemic.