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The Honolulu Advertiser

Posted on: Monday, November 29, 2004

Hawai'i must prepare now for flu pandemic

We usually think of a case of "the flu" as a nasty bug resulting in a week off from work. And we're well aware that for those chronically ill and most at risk for serious complications, influenza can be a life-threatening event.

But for the most part, the advent of flu vaccines has kept this disease reasonably manageable — at least in the affluent countries that can afford them. A well-publicized shortage of vaccines this year produced serious concerns, but emergency measures coupled with a fortuitously late flu season seem to have headed off the worst-case scenarios.

But now, there's a new danger on the horizon.

The World Health Organization has just issued a dramatic warning that bird flu could trigger an international pandemic that could kill up to 7 million people worldwide.

Flu pandemics occur when a virulent new strain of flu, for which there's no vaccine and no human resistance, appears suddenly. A strain of flu from birds killed 32 people in Thailand and Vietnam earlier this year, leading to the slaughter of millions of poultry birds across the region.

Experts say a pandemic will emerge from an animal, most probably a pig, that can harbor both flu viruses that affect humans and the avian flu variety. The two would mate and produce a virus to which people have no immunity, they say.

"There is no doubt there will be another pandemic," Klaus Stohr of the WHO Global Influenza Program told CNN in Bangkok, Thailand. Even with the most optimistic scenario, he said, "the pandemic will cause a public health emergency with estimates which will put the number of deaths in the range of 2 million to 7 million."

It's expected that a human vaccine may be ready as soon as next March — but that probably will be too late, Stohr said, since the disease is already spreading. And scientists might not be able to develop the vaccine until 2007, some officials say.

That means public health officials will have to resort to containment measures. The ramifications are staggering, because between "25 percent and 30 percent will fall ill," according to Stohr.

There have been three global flu pandemics in the 20th century. The worst occurred in 1918-19, killing as many as 50 million — half of them young, healthy adults. Asian flu in 1957 and Hong Kong flu in 1968 each killed about 1 million worldwide.

Because the virus will originate in Asia, it follows that Hawai'i may be among the first American lines of defense. Hawai'i's government and public health officials should waste no time in preparing for this looming threat.