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U.S. Unprepared for Pandemic Plague

By Ray Feliciano

The flu flavor of the year may be the Asian Bird Flu, but whether or not the next widespread outbreak of disease is this deadly bug, another yet to be found, or even man-made by terrorists, officials at all levels of government maintain that the United States remains woefully unprepared. The H5N1 strain of bird flu that is currently in the news has killed more than 60 people in South East Asia since 2003, which is just over a 50% fatality rate for those infected. Migrating birds carrying the disease have been confirmed now in Turkey, Greece, Romania, and Russia. The concern is that the virus will mutate into a version that easily passes from human to human, like the common flu. If it does and remains so deadly, many people will perish.

[clockwise from top left] 1. In the event of a pandemic, first responders will seek to minimize their exposure to potentially deadly disease by using hazardous materials suits, or ‘hazmat suits’, that protect the wearer from breathing or touching infectious microbes. As shown in the photo, after being exposed to a potentially infected area, responders will need to undergo a decontamination process to ensure they do not bring any of the disease back with them. 2. The internationally recognized symbol indicating a biological hazard, developed by Dow Chemical in 1966. 3. A face mask and gloves protect some of those testing potentially infected birds for the deadly Avian Flu. 4. A common plague prevention practice is to burn contaminated livestock, such as these chickens.

President Bush recently warned the public, “at some point we are likely to face another pandemic.” He revealed a $7.1 billion dollar plan to get the country prepared for such an outbreak, including having 20 million doses of bird flu vaccine ready. He also stressed the need to offer pharmaceutical companies liability protection for the drugs they produce so they are not dissuaded from making vaccines and other drugs.

Senator Hillary R. Clinton (D-NY) has introduced legislation with Sen. Pat Roberts (R-KS) to ensure there are adequate supplies of flu vaccine, to help prevent recurring shortages of vaccine and strengthen the vaccine delivery infrastructure to be able to respond to a crisis. The legislation, S.1828, would establish market guarantees, enabling the federal government to purchase, stockpile and buy back stores of vaccine, and increase research into vaccine development alternatives.

“Before we can be prepared to handle a response to a pandemic or avian flu outbreak, we need to make fundamental fixes to our flu vaccine infrastructure - and the clock is ticking,” she said. “We need to ensure an adequate and consistent vaccine supply by encouraging more vaccine manufacturers to enter and stay in the United State market.”

Besides the pandemics produced by nature, there is also the need to be vigilant against man made pestilence, such as from terrorists. To that end, New York State Senator Michael Balboni, Chairman of the Veterans, Homeland Security, and Military Affairs Committee has cited a need to increase our readiness to handle a biological attack for several years. “Unlike conventional weapons, agents of mass destruction including Smallpox, Anthrax, Sarin, Ricin, and Ebola are relatively easy to transport and deploy. In even the smallest amounts they can wreak incalculable havoc and death,” he says.

In a January 2004, the committee issued a report entitled “New York After September 11th- Shaken, but Not Stirred” which opened with the following major finding: “New York’s health care system, like the rest of the nation’s, is unprepared to respond and continue to provide services in the event of a large-scale bio-terrorism attack involving an infectious pathogen. Several important programs have been developed which have significantly enhanced detection, inter-hospital communication, mass inoculation and decontamination response plans by New York State, New York City, and some hospital systems. Though we are better prepared than almost every other state in the nation, response capabilities vary from hospital to hospital and critical programs such as surge capacity, hospital security, and long term mass care are still largely theoretical concepts.”

Senator Balboni returned our call to answer some questions regarding New York’s state of preparedness to handle a widespread outbreak. Asked what it would take for us to be ‘ready’, he answered, “Oh, a lot more than we've done today. There's a question as to can we can truly prepare a nation. We've taken steps. Information is absolutely crucial. ER's, doctor offices, schools, major transportation hubs... There are studies on how they transmit, not just person to person, but also from population to population. To understand that school absentee rates and sales at pharmacies give warning signs.... There is a fancy title, ‘syndromic surveillance’-watching the syndrome of the diseased state. A society-wide monitoring in attempt to determine when a disease state has taken a hold on a population.”

According to N.Y. State Wildlife Pathologist Dr. Ward Stone, if the bird flu migrates here, “We’re ready to identify it. If it does come to N. America, it’s going to be a big killer of birds.”

The World Health Organization said the spread of the virus to Europe’s fringes had increased the chances of human to human cases developing.

“It represents a call to arms on human health,” Mike Ryan, director of WHO’s alert and response operations, told Reuters. ”It’s not a time for panic, it is a time for action.”

Plague of Justinian (541 AD) - First recorded outbreak of bubonic plague, which was spread by fleas on rats. It is estimated that at it’s height, 10,000 people died per day. The Black Death (1300’s) - Killed over 20 million in six years, a quarter of Europe’s population at the time. Cholera (1816-1826) - Caused by ingesting bacteria from improperly sanitized water or fish. Killed millions, especially in Russia. Spanish Flu (1918-1919) - A especially lethal strain of influenza estimated to have killed over 20 million worldwide. Asian Flu (1957-1958) - Believed responsible for 70,000 deaths in the United States alone. Hong Kong Flu (1968-1969) - Believed to have killed 34,000 in the United States.

Ebola virus, Bolivian haemorrhagic fever, HIV, Marburg virus, Lassa fever, and Rift Valley fever

It is believe this children’s nursery rhyme is really about the bubonic plague, alluding to the rashes victims displayed, flowers used to hide the smell of the disease, and burning the bodies of the dead.