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The Honolulu Advertiser
Posted on: Sunday, October 23, 2005

State finalizing bird-flu strategy

By Mike Gordon
Advertiser Staff Writer

State health officials have nearly completed a plan to deal with pandemic viruses that would include, but are not limited to, a potentially deadly bird flu outbreak.

The plan is due in January and incorporates several programs currently in place, including a network of doctors who report suspicious flu cases to the state lab, a database of hospital cases that can be updated daily, and distribution procedures for vaccines and medications already used for seasonal flu outbreaks, said Dr. Linda Rosen, the state Department of Health's deputy director of health resources.

Also part of the plan is a screening station for sick passengers arriving at Honolulu International Airport, set to begin operation Oct. 31, she said.

"We actually have an array of activities that we are doing," Rosen said. "The airport is just one of the places we are checking. If we get early warnings, the steps we may take may not be dramatic, but effective."

Health officials worldwide are worried about the spread of bird flu, which has killed 60 people in Asia.

Bird flu, which spreads to people from bird excretions, is most prevalent in Southeast Asia. Scientists are not sure if it will mutate to allow it to spread easily from person to person.

People infected with the virus get quite sick, and if one of them was diagnosed in the community, Rosen said, the response would be straightforward: the patient would be hospitalized.

"If it is avian flu, the way you keep it from spreading is you isolate the person," she said. "If they are ill, they can spread it to other people. How you isolate them and where you isolate them depends on the nature of the disease and how ill the person is."

The virus has not reached a stage comparable to seasonal flu outbreaks, where people are sick, but not so sick that they cannot move among their friends and neighbors, infecting them, she said.

Rosen likened a response to bird flu to that of seasonal outbreaks: Keep people at home, have them wear surgical masks, encourage frequent hand-washing.

"Those are very simple measures but those are the ways you would keep it from spreading through the population," she said.

Quarantines may not be applicable, especially if the virus is discovered after a large number of cases are confirmed, she said.

"If you don't find out until you have 5,000 cases all over the island, there is no opportunity for quarantine," Rosen said. "We don't want to talk that much about using it because scenarios for using it are limited."

Health officials want to have their "early warning systems" in place to prevent a spread like that.

Doctors across the state — part of the Sentinel Physicians Network overseen by the Centers for Disease Control and Prevention — routinely send samples to the state for testing when they are unsure about a patient's respiratory illness.

Hospital emergency rooms are also set up to report cases to an electronic database of current illnesses they are seeing, Rosen said. It isn't used until the state feels a problem is looming in the community, but does not take long to initiate, she said.

Every suspected case, however, has to be confirmed with officials at the CDC, she said.

"Rest assured that everything is well thought out," Rosen said. "You want to operate on good data, but you don't want to wait forever."

Reach Mike Gordon at mgordon@honoluluadvertiser.com.