Posted on 12/13/2003 1:01:22 PM PST by CathyRyan
For all the public concern over the rapid spread of the new Fujian strain of influenza, health officials and doctors say there is still no way to know whether this year's flu season is particularly severe or just off to an early start. And for all the clamor for dwindling supplies of vaccine, no one knows how effective the current vaccine will be against the Fujian strain.
But the flu season has already thrown some realities about the public health system into sharp relief, these experts say. It suggests that the country needs to be far better prepared to deal with influenza — either the conventional strains that cause serious illness each year, or a horrendous strain like the one that caused the 1918-19 pandemic, which killed at least 30 million people worldwide.
Influenza is arguably the most unpredictable of viruses, and protecting the public against it is a tricky balancing act. It involves a number of factors: inadequate scientific knowledge of the virus; educated guesswork in choosing what strains of influenza to include in each year's vaccine; time-consuming, old-fashioned manufacturing techniques; and skills in communicating with a skeptical public.
Such protection also depends on a strong public health system. But years of underfinancing have weakened the system. And confidence in it was scarred by the flawed emergency swine flu immunization program in 1976, which was halted after a relatively few of the 45 million people who had been vaccinated became temporarily paralyzed from Guillain-Barré syndrome.
More recently, gaffes and miscommunication about events like the anthrax attacks of fall 2001 left Americans unsure what to think about public pronouncements, and insecure about the nation's capacity to deal with a severe epidemic of SARS or a new strain of influenza.
Communication has improved since then. Still, the government had little to say about influenza this fall, while the health and human services secretary, Tommy G. Thompson, and his top aides visited African countries torn by AIDS. Only after their return did news conferences about influenza resume.
Government health officials have repeatedly warned about the inevitability of another influenza pandemic. Yet the government has yet to approve final plans to counter such a disaster.
No one knows why influenza has hit the western United States in particular, or why it happened so early this season. No evidence exists to suggest that the Fujian strain is more virulent than other strains that have caused past epidemics or that this season's influenza is worse than those of the past. Although the Fujian strain also struck early in Europe, the World Health Organization said it was not aware of unusually severe influenza this season outside the United States.
Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, put it bluntly: "No way will the Fujian strain cause a pandemic."
Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention, says the vast majority of influenza cases are an annoyance, causing only a mild respiratory illness. But Dr. Gerberding also noted that influenza is lethal for 36,000 Americans on average each year.
The deaths are among the reasons health officials have been urging Americans to take influenza vaccine. An estimated 185 million Americans are eligible for it, but manufacturers produced enough vaccine for only 83 million Americans.
Each February and March, the World Health Organization and the United States government invite experts to meet independently to choose the three influenza strains they believe are most likely to cause outbreaks the following season.
The three strains are turned into the following season's vaccine, and W.H.O. provides the seed viruses free to all vaccine manufacturers.
The Fujian strain was detected too late to be included in this season's vaccine. Officials have said that the vaccine should still afford "some protection" against the Fujian strain but do not know how much.
Because the manufacture of influenza vaccine is entirely in the private sector in the United States, market forces determine the amount produced.
One reason for the gap between supply and demand this season is the perennial lack of response to pleas from health officials for most Americans to get flu shots. That consumer response forced manufacturers to discard 12 million of the 95 million doses produced last season at a loss of millions of dollars. So manufacturers produced 83 million doses for this season.
The time when the three strains are chosen is critical to vaccine production. One reason is that it takes tens of millions of chicken eggs to produce each season's vaccine, and they must be bought months in advance. Once production is complete, additional doses cannot be made without reducing the amount that could be produced for the next influenza season, Dr. Gerberding said.
Because the process is complex and even the best influenza vaccines are about 70 to 90 percent effective, a notch below the standard childhood immunizations, health officials have long urged researchers and industry to find new ways to produce influenza vaccine. Scientists have come up with promising new methods. But major problems, including those involving technology and intellectual property rights, are unresolved.
Dr. Barry R. Bloom, dean of the Harvard School of Public Health, said that because of industry's limited capacity to make vaccine, "we would be in terrible shape" if there was a pandemic of a virulent strain. "That is unlikely to change without government intervention," he said.
Soon after the swine flu episode in 1976, the government began drafting a plan for its response to a real pandemic. Then in 1993, it created a panel to come up with the plan. Many drafts have been prepared as the science has changed, but there is no final one, said Dr. Bruce G. Gellin, the director of the government's National Vaccine Program Office.
Critics say an official plan is needed. But even a draft, Dr. Gellin said, has been useful as a blueprint for preparing against a bioterrorism attack and in dealing with SARS.
"We need to diversify our manufacturing base and develop new techniques to improve our chances of success," Dr. Gellin said. "Ideally, that would produce a vaccine that would be given once and protect against all influenza viruses."
People are always complaining about "the system" or "the government". My biggest beef is "the people", the ones who exhibit symptoms and refuse to stay home, or who have kids who are sick and refuse to leave them home. Instead, you find them in almost every line at the grocery store or Wal-Mart or in school, spreading disease willy-nilly to every innocent in sight. Rather than stay home and let the disease run it's course, they are out and about or flock to doctors' offices and ERs to infect everybody else just because they don't feel good.
The flu can be deadly to some. But, instead of common sense self-quarantine - which is adequate for most cases - people blithely go out spreading it like it is no problem they infect others. It is the height of selfishness and inconsideration. It borders on criminal negligence, IMHO.
I really get annoyed at this, and so should everybody else.
Well, Kobe, Lacy, and OJ are being replaced with the latest sensationalism called, "The FLU."
1/4 of the H3N2 isolates are Panama and 3/4 are Fujian even though Panama has been in every vaccine batch since 2000. Thus, some people have had Panama 4 years in a row, but it still causes 1/4 of the H3N2 infections this season in the US (and at this time, almost all of the flu cases are H3N2).
I've got a cookie for anyone who gets that literary reference.
Witch
No kidding. SOMEBODY is making a lot of money off this, and that's about it.
My wife just came home, and told me about a friend of hers who is whining that her daughter is sick, and that she is afraid that she might have the flu. In the next breath, she invites me wife to go to the mall with her for a little shopping. My wife, who isn't a dumb*ss, politely declined.
So after 17 years of failure to come up with a plan, government farms it out to 'a panel' and 10 years later there is still nothing....(Shaking head)......
I used to live near the author in Bangor...what kind of cookies? :-)
I think there are five things behind the agenda:
1. Slam George Bush and his Adminstration for failing to take action "soon enough" or "aggressively enough" and indirectly pin the deaths and suffering on GWB and the GOP (next year is an Election, right?), and
2. Use this "crisis" to push for a new law requiring the Federal Government to take over the annual buying and distribution of vaccine for flu. In other words, it's another government medical program, leading incrementally toward government medicine in toto, and
3. Shift the blame from the clinton maladministration for nearly destroying our vaccine manufacturing industry (it all now becomes "Bush's fault"), and
4. Give the Trial Lawyers a banner year. They need more money to adequately fund their favorite Democrats, and
5. The Media, being chronically lazy, find it easier pontificating on this manufactured crisis which is blazing with emotion, rather than doing any real and difficult reporting on actual news - such as the recent Court decision on Campaign Finance Law or our succcesses in Iraq.
Stay Safe !
Nor I!
I was just shaking my head at the utter waste.
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