Government working on new bird flu vaccine

ATLANTA -- With new versions of bird flu emerging, U.S. health officials announced Monday that scientists must stir up a different vaccine recipe to try to protect people.

That's not unexpected because flu viruses - whether in birds or people - are constantly changing.

Federal health officials are merely trying "to keep right on the virus's tail and keep our vaccines as up to date as much as we can," said Dr. William Schaffner, a Vanderbilt University vaccine expert.

But despite its mutations, the continent-hopping bird flu virus seems content slaying wild birds and farm chickens, causing an estimated $10 billion in global agricultural losses.

The virus could continue to spread in its current forms, mostly sparing humans. It could mutate into a more harmless version, which isn't even dangerous to birds. Or it could become a deadly human flu that spreads easily around the globe with the potential to kill millions, he said.

"We cannot let our guard down, because a series of genetic changes could happen at any time that could allow this virus to pick up the capacity to move from person to person," Schaffner said.

That's the thinking that led to Monday's announcement by U.S. Health and Human Services Secretary Mike Leavitt. He authorized the National Institutes of Health and the federal Centers for Disease Control and Prevention to begin working on a second vaccine to protect people.

The government already has several million doses of a bird flu vaccine based on a sample of a virus taken in 2004 from Vietnam, where the first spate of cases in people began to show up.

But researchers have noted the emergence of a second version of bird flu. Under Leavitt's direction, U.S. researchers plan to create a new vaccine targeted at the second variety.

"In order to be prepared, we need to continue to develop new vaccines," Leavitt said at an immunization conference in Atlanta.

The second vaccine will be based on a virus sample taken from Indonesia last year, said Ruben Donis, leader of the molecular genetics team at the CDC's influenza branch.

The virus circulating in Indonesia is related to the Vietnamese virus, but it is not a descendant and it causes a different immune system response, he said.

The U.S. government is already spending $250 million for about 8 million doses against the Vietnamese version of bird flu, but has plans for enough vaccine to protect 20 million Americans.

Federal officials contracted with two companies - Chiron Corp. and Sanofi Pasteur - for those doses, and most already have been produced, said Bill Hall, a spokesman for Health and Human Services. Researchers are signing up volunteers to test the vaccine.

The second vaccine must be developed and tested, and health officials had no immediate estimate for the cost of that work or the time frame for producing a new vaccine.

The vaccine based on the Vietnamese virus would be protective for people in the Vietnam region, but less effective against viruses circulating elsewhere, health officials said.

For most parts of the world, Schaffner believes it would be "partially effective."

How effective? Scientists don't have enough data yet to make a good prediction, he said.

No matter how effective, work on the first vaccine - and now this second version - should benefit subsequent efforts, said Dr. Walt Orenstein, associate director of Emory University's Vaccine Center.

"It's not like this will get made and sit on the shelf and forget about it. Many things may be learned," Orenstein said.

Since 2003, the World Health Organization has reported at least 174 human cases of bird flu, including 94 deaths. Most, if not all, of the victims were in very close contact with infected birds, but health officials worry that as bird flu spreads, its chances of mutating into a form threatening to people increase.

Health officials probably don't know how many people have been infected, and it's possible that bird flu does not kill as many of its human victims as some data have suggested, said Dr. Andrew Pavia, an infectious disease specialist at the University of Utah.

Some scientists think that if it becomes more efficient at spreading among humans, it will lose some of its efficiency at killing. "But that's still speculative," Pavia said.

Dr. Margaret Chan, who is spearheading the WHO efforts against the virus, said it poses a greater challenge to the world than any previous infectious disease. Since February, the virus has spread to birds in 17 new countries in Africa, Asia, Europe and the Middle East, Chan said.

Poland on Monday confirmed its first outbreak of the disease, saying laboratory tests found that two wild swans died of the lethal strain.

In Austria, several cats tested positive for the deadly strain, officials in that country said Monday. Last week German officials reported a cat - infected from apparently eating a sick bird - and warned pet owners in some areas to keep their cats indoors and their dogs on a leash.

The WHO describes bird flu as unprecedented in its scope as an animal disease, saying it is costing the world's agriculture industry more than $10 billion and affecting the livelihoods of 300 million farmers.

Good post. I am starting to get scared again. Esp after reading this on this blog. http://www.yuppiesofzion.com/2006/03/a_fluttering_of_wings.php

A FLUTTERING OF WINGS
Saw an interesting bird flu related post on a message board today. It's from an epidemiology student in Georgia who volunteers for her region's Medical Reserves Corps, which is sort of like the Red Cross, but for trained health care workers rather than laymen. Depressing reading, as usual:

"Yes, I am a member of the NorthEAST Georgia Medical Reserve Corps (the thing you saw was for the Northwest). I joined because I wanted an "inside" view of what regional and state govs are doing to prepare people (both on staff and in the community) for BF.
Initially, our group of volunteers (56 people, mainly retired nurses) was talked to about smallpox as a bioweapon and how to set up and distribute vaccinations to the general public. Bird flu was mentioned in passing, always in terms of "we are being trainined to respond to threats like bioterrorism and pandemic influenza."

Finally, I asked our organizer (a regional public health official) the following question: "Listen, I'm not trying to be paranoid or anything, but why suddenly the big push to recruit volunteers? If this group was formed in response to 9/11, why the big flurry of activity (training, recruiting) now? Is it because you people have been told by the feds that we are really at risk of a pandemic and need to start taking action?" He replied that he had been told no such thing, but that he was capitalizing on increased awareness of biological threats and a corresponding rise in "political will" to form committees and deliver training. Of course, this rise in awareness has not meant a rise in money for the group. We have literally NO budget because all the federal money set aside for our (federally mandated) group was spent on Katrina.

So our last training event 2 weeks ago finally dealt with the BF. We had a fellow from the state emergency management agency speak to the group about the flu's past and its anticipated development, and let me tell you, I was IMPRESSED. It was as if he had been reading the flu clinic/old agonist boards every day. None of this crap about "no evidence of h2h transmission." He talked about family clusters in Indonesia, and Thailand, and said we could expect more soon. He said that many experts think we have been at stage 4 for a while now. No BS about "you can only get it by kissing chickens." He also admitted that there was no vaccine yet and that anti-virals were either unlikely to work or wouldn't be available. He was straight up about the personal and social ramifications of this event, and suggested that we begin preparing for quarantine (he did not say for how long). He scared the poo out of everyone there except for me (my poo was scared out of me years ago, when BF started spreading in Vietnam and Thailand).

He also said he would rely on our group to be first responders in the event that it goes pandemic. I raised my hand and said, "We've been training for months about how to set up vaccination stations and deliver vaccines to the population. Why have we been training for this? You just told us there is no vaccine. What are you going to expect us to DO in case of BF?"

He looked very upset and said, "Care for the sick in the tent hospitals we set up and dispose of the dead."

So I said, "But we won't have any immunity to the flu. We'll be just as likely to catch it as the people we're caring for."

He looked even more upset and said, "I know."

The entire crowd starting murmuring at this point. I heard "What? And bring it home to my family? No way!" and "I'm staying home," and various other comments.

I felt sorry for the man. But I also felt like the mask was off our group, so to speak. I really think the government folks in Georigia are starting to realize that this is going to happen unless we are very lucky. And I think they are trying to prepare a cadre of the population for the worst, so maybe we can start educating other people about what's likely to happen. I guarantee you everyone there went and told 5 other people about what they heard. And what they heard was THE REAL DEAL. I think that's the real purpose of this volunteer group. They know very well how few of us will show up to tent hospitals when our own families may be sick (or well). They are not training us for anything. They are using us to get the word out.

For the record, the spread of H5N1 in birds is becoming exponential; about twenty countries have confirmed their first cases of H5N1 in only the past three weeks. It is now found from Sweden to Nigeria, from Iraq to France, from Indonesia to India, from Algeria to Chechnya. It will be in American birds before we know it

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