Pandemic past & future...

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MSNBC.com

 

Past flu pandemic gives clues to protections

 

By Matthew Bigg

Reuters

Updated: 8:04 p.m. ET Dec 12, 2006

 

ATLANTA - If history is anything to go by, the key to surviving a flu pandemic is to act quickly and decisively, researchers told a conference Tuesday.

 

Measures to contain disease -- such as isolating the sick, quarantining those exposed to illness and closing churches and schools -- helped to protect communities from the most notorious pandemic, the "Spanish Flu" of 1918, said Howard Markel, a professor of the history of medicine at the University of Michigan.

 

Markel's historical survey, presented at a conference organized by the U.S. Centers for Disease Control and Prevention, supports a separate study published by the Institute of Medicine Monday which also found that any action to fight pandemic flu must be prompt and consistent.

 

In San Francisco, public health officials ordered the population to wear face masks, while in Philadelphia officials took little action until the flu epidemic was near its peak.

 

Philadelphia had the highest death rate in the country, with 250 deaths per 100,000 cases against 20 to 40 deaths per 100,000 in cities that took prompt action, Markel found.

 

Experts agree that another flu pandemic is inevitable at some point. They happen, on average, three times a century.

 

The biggest current threat is the H5N1 avian influenza virus, which has killed 154 people since 2003. Doctors fear it could evolve into a strain that passes easily from person to person, triggering a pandemic.

 

Between 40 million and 100 million people died in the 1918 pandemic -- more than the number killed in World War One. And H5N1 bears unsettling resemblances to the H1N1 virus of 1918, scientists say.

 

WORST CASE SCENARIO

 

"We can't predict when it will happen nor do we know which strain of flu virus it will be or how the human body will deal with it," Markel said.

 

"But all of us in medicine or public policy need to do some planning, not just for regular events but for the worst case scenario," he told Reuters.

 

Markel's study, to be published next year, will look at the experience of 45 cities affected by the 1918 pandemic, in which some 650,000 people died in the United States.

 

"What my preliminary data suggests is that (taking public health measures) will diminish the number of deaths, diminish the peak rate of death and diminish the number of cases," Markel said.

 

Taking prompt public health measures also would relieve the burden on hospitals in the period before a vaccine was found, even if the same number of people became sick overall, he said.

 

The Institute of Medicine report had similar findings, saying several models showed that early action may not reduce the total number of people infected, but might spread them out over time, relieving the strain on hospitals and buying time for the development and distribution of vaccines and drugs.

 

Options for controlling a pandemic could include closing schools and churches, canceling public events and putting affected individuals or families in isolation or quarantine.

 

The Institute of Medicine report also highlighted common-sense hygiene measures such as frequent hand washing, voluntary isolation of infected people and quick treatment of the ill.

 

Antiviral drugs are in short supply but they could also be used quickly and strategically to treat the ill and perhaps to protect those they have been in contact with, it said.

 

http://www.msnbc.msn.com/id/16177399/