November 24-December 1, 2005
slant
Defense DepartmentWhy we're losing the war against avian flu.
A recent Inquirer headline proclaimed, "Bush: Troops Could Fight Flu." My first thought was that the president was going to redirect our enormous military resources to help generate vaccines against the avian flu. My second thought was, "Nah, that would be far too logical."
Unfortunately, I was right. He was thinking of using troops to impose a quarantine, the same tactic used by frightened kings against the bubonic plague.
The enemy here is neither soldier nor insurgent: It's that the influenza A virus can jump from animal to human. And a vaccine against one probably won't work against another. The 1918 "Spanish flu" pandemic that killed 40 to 50 million people was caused by the H1N1 variant virus. Today's chief enemy is H5N1. But in China, the swine flu is only a mutation away from joining the headlines. Here at home, we're taking this one step further, by seeking to transplant pig organs into the hundreds of thousands of people waiting for transplants that might give animal viruses a free ride into our bodies. In other words, we're under attack from both white meats.
Like Iraq, we can fight this "over there," at the source. These infections arise from people being in close proximity to animals carrying disease. Horrendously overcrowded, Southeast Asian chicken and pig farms are ripe for spreading virus. The U.S. Centers for Disease Control and Prevention (CDC) is launching a $5.5 million initiative to improve influenza surveillance in Asia, an effort akin to draining a swimming pool with a teaspoon. The only way to fight effectively is to bring more modern, sanitary conditions with up-to-date veterinary medicine to much of the underdeveloped world. Unfortunately, the Bush administration, lobbied by poultry interests, has consistently failed to adequately aid the U.N. Food and Agriculture Organization.
Sooner or later, we'll have to fight the enemy here, at home. A quarantine? The military would be called upon to supply provisions without spreading the infection among themselves. Then there's the small matter of Americans watching other Americans dying on camera 24 hours a day.
So, we're left with immunizing ourselves. According to the British journal Nature, if the entire U.S. production system was devoted entirely to making pandemic vaccine, it could make enough for 15 million people. Problem is, there's 290 million of us.
Current vaccine production is based on growing viral strains in millions of fertilized chicken eggs, and then killing the viruses for use in vaccines. Cutting-edge technologyfor the 1950s. Sometimes, egg batches go wrong. What's needed are faster, more flexible methods for producing flu vaccines, including cell culture, reverse genetics, and using different harmless viruses as carriers for a vaccine. All while we prepare an ever-growing "library" of potential viruses (with vaccines) that can be put into rapid production.
Why hasn't Big Pharma modernized? There are two reasons: economics (there is little demand until it's too late) and liability fears (lawsuits stemming from potential adverse reactions). I hate to say it, but tax incentives, subsidies and liability limitations might help. A better way would be a comprehensive coordination of research and production activities by the National Institute of Allergy and Infectious Diseases (NIAID) with pharmaceutical and biotech companies, possibly in conjunction with other governmental resources.
What about stockpiling anti-viral drugs? Well, of the two that may be usefulTamiflu and Relenzaneither has been proven effective against this threat. Neither gives immunity. Both must be taken within two days after appearance of symptoms, which is questionable at best at slowing down an epidemic. A piece of the Pandemic Influenza Preparedness and Response Plan is available online, but the full 381-page report has yet to be released.
The threat from the enemies lurking in our favorite white meats shows no signs of backing down anytime soon.
Nelson Erlick is the author of the just-released The Xeno Solution (Forge Books). If you would like to respond to this Slant or submit one of your own (750 words), e-mail duane@citypaper.net.
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