Tipsheet: Avian flu
A lesson not learned could lead to catastrophe. World Health Organization officials are worried that avian flu could become a dangerous pandemic unless they receive the information they need to track the deadly virus. Scientists need to collect many avian flu virus samples from humans and animals to monitor for genetic changes, and they need to correlate these changes with how the disease behaves in humans who get infected. Only then can they tell whether a killer pandemic strain is emerging. Affected countries don't have the equipment to do genetic analysis, and they've been reluctant to let virus samples out of the country. "The most-affected countries don't have the equipment for genetic testing, but it is readily available at the international level," said Professor Allen Anderson, a public health expert in the School of Public and Environmental Affairs. "Perhaps the lesson from SARS -- that playing a disease outbreak 'close to the vest' can be catastrophic -- has somehow been forgotten." Anderson's research and teaching are focused on public health, in particular HIV/AIDS control and prevention in the People's Republic of China and international health issues. Anderson can be reached at 812-855-0563 or allander@indiana.edu.
A pamphlet is now available to the public identifying the main threats from avian flu and other forms of influenza and explaining how people can best protect themselves and their families from these threats. The pamphlet, titled "Influenza and Its Growing Importance: An Investigative Compilation," can be viewed online at https://www.indiana.edu/~pirt/flu/flufull6.htm. It resulted from a class on public health at Indiana University Bloomington in which students examined the existing information about avian flu and similar diseases such as SARS. IU Professor James C. Riley supervised the students' work on the pamphlet. Avian flu is a viral disease spread among birds. In its current form, avian flu is unable to infect humans on a pandemic scale, but it may be only a few mutations away from human-to-human transmission. Many experts believe it is not a matter of whether such mutations will occur, but when. The goal of this pamphlet is to alert and inform people about influenza, including symptoms, prevention and treatment. The major factors contributing to the spread of the avian flu virus are poor hygienic practices. If public health systems in the United States and the rest of the world are adequately prepared, they can help prevent pandemics and control outbreaks. Riley can be reached at 812-855-6344 or rileyj@indiana.edu.
IU scientists have constructed a model that predicts how an emerging pandemic influenza might spread across the globe by airliners. Their model is said to be the world's largest-scale epidemic simulation of its kind. The investigators were Vittoria Colizza, Alessandro Vespignani and Marc Barthélemey of IU; Alain Barrat, Université Paris-Sud, France; and Alain-Jacques Valleron, Institut National de la Santé et de la Recherche Médicale, France. H5N1 avian influenza, commonly referred to as bird flu, has not yet resulted in a pandemic influenza because the virus lacks the ability to spread efficiently and sustainably among humans. However, public health officials are greatly concerned that a human flu strain could be triggered by the H5N1 virus, which is found in bird flocks around the world and has repeatedly crossed the species barrier and infected people. "The threat of a pandemic is pushing the international community to develop adequate preparedness plans," Colizza said. The researchers developed a mathematical model using massive passenger-flow databases from the International Air Transport Association, an organization of airlines comprising 99 percent of worldwide commercial air traffic. In a previous study, the same researchers showed how air-transportation-network properties are responsible for the worldwide pattern of diseases. The team was able in both studies to simulate how an influenza pandemic would spread, both over time and geographically, and to provide forecasted scenarios and confidence intervals. The researchers showed that strict travel restrictions would do little, if anything, to prevent the flu from spreading throughout the globe. But the model predicted that the use of antiviral drugs would significantly thwart a global flu outbreak if every country in the world had a drug stockpile sufficient to treat 5-10 percent of their populations. Next, the study focused on realistic scenarios in which antiviral resources are not equally distributed, with a higher concentration in wealthy countries. Different strategies are compared: a selfish strategy in which each country relies on its own supplies, as opposed to a cooperative approach in which prepared countries would donate part of their resources for global use. "Surprisingly," said Alessandro Vespignani, "the cooperative strategy is shown to be more effective in delaying the pandemic evolution and mitigating its impact on the population of both donor and recipient countries." To arrange an interview with Alessandro Vespignani or Vittoria Colizza, contact Joe Stuteville at 317-946-9930 or jstutevi@indiana.edu. The study can be viewed at https://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040013.
