Bird flu Q&A

What is bird flu and why are people afraid of it?

It’s a strain of influenza, known officially as avian flu or H5N1. According to the World Health Organization, it typically affects birds and sometimes pigs. Health experts fear its potential spread to humans.

People get the flu all the time – what’s the big deal?

Avian flu is nasty in a human host. According to WHO research, it’s more likely to cause severe symptoms, and the fatality rate is higher than that of other strains of flu. More than half of the people diagnosed with the disease have died.

How many people have died?

Latest numbers from the WHO say 200 in 12 countries between 2003 and Sept. 10 of this year. The bulk of those deaths – 85 – occurred in Indonesia. Most of the other deaths occurred in Asian countries, including China (16), Thailand (15), and Vietnam (46). Deaths have also been reported in Egypt (15) and Turkey (four). No deaths have been reported in the United States or the Western Hemisphere.

That’s a small number in the global sense – why worry?

Health experts say the danger is adaptation. In its current form, the virus rarely passes from birds to humans. Experts fear that could change, making the virus more infectious – the first stage of a pandemic. They cite a recent uptick in the number of migratory birds afflicted with the virus as another cause for concern.

To date, there is no evidence that the virus has adapted. During an April 2006 speech in Tacoma, Dr. Julie Gerberding, head of the Centers for Disease Control and Prevention in Atlanta, downplayed avian flu fears.

“There is no evidence it will be the next pandemic,” she said. “There is no evidence it is evolving in a direction that is becoming more transmissible to people.”

How do people contract the virus?

Through direct contact with birds – poultry – or bird feces. This manner of transmission is one of the reasons skeptics say concerns about bird flu are overblown. So far, the documented cases have occurred in rural areas where people live with birds – in other words, families living with flocks of chickens that roam through the household and living areas where children play.

Does this mean we can’t eat chicken?

No. It means you have to cook it. Same goes for eggs. Here’s the bottom line from the WHO: “Avian influenza is not transmitted through cooked food. To date, no evidence indicates that anyone has become infected following the consumption of properly cooked poultry or poultry products, even when these foods were contaminated with the H5N1 virus.”

What’s the best treatment for bird flu?

There are drugs promoted as effective counters – Tacoma-Pierce County Department of Health Director Federico Cruz-Uribe tried to buy generic versions of both products from sources in India. The first is Tamiflu, manufactured by Roche, a Swiss pharmaceutical company that holds the patent. Tamiflu comes in capsule form. The second product is Relenza, an inhalant marketed by Glaxo-SmithKline, a British pharmaceutical company.

How well these products work is a matter of debate, filtered through layers of continuing research and drug company spin. According to FDA labeling, Tamiflu can shorten the length of flu symptoms by a day or so, if taken within about 48 hours of symptoms first appearing. Clinical trials conducted by Roche indicate Tamiflu can prevent the flu in some people. Drug companies want their products to sell, so they fund studies and promote data that skeptics question. What’s clear so far is that governments looking for a stockpile of bird flu medication tend to choose Tamiflu.

What have local governments done to combat a bird flu pandemic?

In fall 2006, the Tacoma-Pierce County Health Department voted to buy 15,000 doses (10 capsules per dose) of Tamiflu for $293,000, which included federal matching funds. Those doses are aimed at first responders – emergency service workers – who would theoretically help the public fight a potential outbreak.

In October 2006, King County ordered 190,000 does of Tamiflu for $2.7 million, federal matching funds included.

Why does the federal government restrict purchases of imported or generic medication?

This depends on your appetite for conspiracy theories. Either the Food and Drug Administration is trying to make sure imported drugs are safe, or it’s protecting the interests of wealthy pharmaceutical companies. The FDA restricts purchases from sources that haven’t met its standards. Skeptics argue that the federal government is more interested in protecting the financial interests of drug companies that hold the patents for such drugs.

To counter this argument, the FDA cites examples of illegal medications that have been diluted, altered or counterfeited. In one case, FDA officials and U.S. Customs inspectors say they halted a shipment of drugs labeled generic Tamiflu, which turned out to be a mixture of vitamin C and other substances.

Sean Robinson: 253-597-8486

sean.robinson@thenewstribune.com