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The Centers for Disease Control says it will deliberately combine the deadly bird flu virus that's circulating in Asia with human influenza viruses to understand whether and how it might cause a pandemic. This ScienCentral News video has more.
Flu Experiments
The Centers for Disease Control has announced that it will mate the Avian Influenza A (H5N1) virus (also known as "bird flu") and human flu viruses to monitor the resulting viruses' severity, and ability to infect and be transmitted. The process is called "reassortment." Flu experts say the lab experiments are crucial to find out what may already be happening naturally in Asia; they fear the lethal bird flu circulating there will swap genes with a human strain to create a killer strain that could easily spread from person to person.
Experts believe the bird flu virus isn't changing rapidly enough to spark a global outbreak, or pandemic, this year, but say it's impossible to predict beyond that.
Adel Mahmoud, president of Merck vaccines, welcomes the research. Mahmoud, who chaired an Institute of Medicine (IOM) workshop that called for urgent preparations for the next pandemic, says evidence that the bird flu has already transmitted between people is credible. "If that is going on today at a very low level, that is just a very, very serious warning sign that viruses are recombining…and then being transmitted within the human population," he says.
But Mahmoud says the gene-swapping research is just one of many needed preparedness initiatives highlighted by the IOM workshop. He says in this era of global travel a new pandemic could dwarf the one in 1918 that took tens of millions of lives.
"There is no other alternative but to prepare ourselves to be able to make vaccines against these strains and to deploy them in a very, very fast way," Mahmoud says, adding that he hopes the U.S. flu vaccine problems of 2003 through 2005 will serve as a wake-up call to the world: "The possibility that we'll just sit and watch it, cannot cross my mind."
Flu Shot Surplus?
The IOM workshop report, released in November 2004, also urged a campaign to increase demand for flu shots this season, pointing out that "demand remains too weak for manufacturers to make investment in preparations for a rapid ramp-up of pandemic vaccine production." Ironically, officials now worry that the mild flu season so far, combined with the early shortage of flu vaccine, has resulted in not enough high-risk people being vaccinated.
As health officials expand the criteria for eligibility for a flu shot, the possibility of wasted doses frustrates Mahmoud, because he says that even with the heightened awareness this season of the need for a flu shot, the level of response has been far less than appropriate. "Today, one third to one half of people who desperately should get the vaccine have not gotten it," Mahmoud says. "This exacerbates the cycle of disconnect between need and utilization" that's led to the fragile environment for production and deployment of influenza vaccines, he says.
Mahmoud says the possibility that manufacturers could end up "eating" unused doses this season highlights the need for government policies to encourage rather than discourage private sector investment in much-needed vaccine production capabilities. "In this country there used to be, in the mid-80s, approximately 25 to 30 vaccine manufacturers," he says. "Today there are only five. In the mid-80s there were five or six manufacturers of flu vaccines. Today we have two."
Mahmoud points out that to be truly effective, vaccines need to reach enough of the population to achieve what's called "herd immunity," which is the level of immunity needed to limit transmission of the virus. "That is a community responsibility," he says.
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