Air Date: Week of March 18, 2005

Reports of a cluster of avian flu cases in Vietnam may signal a change in the virus' ability to spread; a change that world health officials worry could foretell a global pandemic. Host Steve Curwood talks with Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Disease, about the likelihood of a worldwide outbreak.

Transcript

CURWOOD: From the Jennifer and Ted Stanley Studios in Somerville, Massachusetts, this is Living on Earth. I'm Steve Curwood.

What health officials fear most about the bird flu may have already happened in Vietnam. In the city of Thai Binh, two nurses appear to have contracted the virus from the patients they were treating. Prior to this cluster of cases, 60 people in Southeast Asia came down with the bird virus called H5N1. But all of them caught it directly from poultry, with the exception of a single case. Most have died. These new cases could be a signal that the virus is morphing into forms that can more readily jump from human to human. Health workers warn that if the virus keeps evolving this way, a global pandemic may not be far behind.

Dr. Anthony Fauci joins me now. He's director of the National Institutes of Allergy and Infectious Disease in Bethesda, Maryland. Dr. Fauci, hello.

FAUCI: Hi, there.

CURWOOD: So, there's news that a cluster now of avian flu cases has developed in Vietnam. What do you know of the specifics of this case?

FAUCI: Some of the clusters that we're seeing are being investigated for the possibility that one or more of the infections could have actually been transmitted from person to person. There's one clearly documented case in Thailand months ago in which a mother was infected, not from a chicken but from her child who had been infected by a chicken. And, the mother was infected and actually died from the influenza. What it tells us is that it's rare and inefficient for this virus to go from human to human, although it's progressively getting better at jumping from bird to human. So, when you see a cluster like you're seeing in Vietnam, it puts a red flag up to make sure and investigated thoroughly that we're not dealing with a situation in which it's actually transmission from person to person.

CURWOOD: What kind of timeline are we looking at now in terms of how fast this virus could spread? I know this is a favorite question to you doctors, Doctor...

FAUCI: Well...

CURWOOD: How soon?

FAUCI: The answer, the favorite answer, there's no way of predicting. You just cannot predict because it's possible that it will do what it's doing now and then just hit a dead end and stop. That's unlikely that that would happen because the infection among bird flocks in Asia is really, in many respects, out of control. It's so pervasive among the chicken flocks that it becomes progressively more difficult to eliminate them all. Another important issue is that there are migratory birds that can easily fly from country to country which can then cross-contaminate even new flocks that are brought in. So, it's a very perplexing problem that, at least from the standpoint of the chicken flocks, is almost out of control.

CURWOOD: What's the reaction that you're seeing at the National Institutes of Health and, for that matter, in the U.S. public health sector at this recent news?

FAUCI: There are several things that are going on. The Department of Health and Human Services has a pandemic flu preparedness plan that involves greater surveillance and preparedness on the part of the Centers for Disease Control and Prevention, our CDC who have extensive monitoring in Asia and in this country. We are already starting clinical trials on an H5-N1 vaccine that has been contracted for by a couple of companies. The material is made and imminently the material will be going into humans for clinical trial, for safety and to determine what the correct dose is. And we've also contracted for two million doses of this vaccine to put into our strategic national stockpile.

CURWOOD: So, you're on the way to developing a vaccine and if you're satisfied, you'll ramp it up to a couple million doses.

FAUCI: It's already been ramped up. So we're assuming it's going to be okay. You cannot wait because otherwise you'll find yourself behind the eight ball in timing. The issue is is that if we do develop the beginning of a pandemic, you can ramp up those two million doses to be tens of millions of doses.

CURWOOD: Tell me, what could the scenario of a pandemic be? What would we be talking about?

FAUCI: Well, generally, in the United States on any given regular seasonal flu year, there are about 36,000 deaths from influenza. If you have a pandemic flu in which the population has no immunity essentially against it, that mortality can go up considerably. You can't predict what that mortality will be, but it certainly could increase by several fold above what we generally see in a regular influenza year.

CURWOOD: In terms of preparedness, compared to past year flu pandemics and the threat of pandemics, how do you think we rate today?

FAUCI: When you're dealing with a possible evolution of a pandemic, there's no amount of preparedness that's going to be absolutely safe guard everyone. Of course, that's not going to be the case. But already now, we're involved in things that are geared toward responding rapidly in the eventuality of there being a pandemic. So, I would say, that compared to other years, that the awareness of the resources that have been put into influenza, pandemic flu preparedness is certainly greater than what we've had in the past.

CURWOOD: So, news that there are now clusters of avian flu cases, no reason to panic?

FAUCI: Definitely, no reason to panic.

CURWOOD: Dr. Anthony Fauci directs the National Institutes of Allergy and Infectious Disease in Bethesda, Maryland. Dr. Fauci, thanks for taking this time with me today.

FAUCI: You're quite welcome.

[MUSIC: The Ventures "The Forth Dimension" The Ventures in Space (EMI) 1963]