Detection | Vaccines | Prevention | Preparation | Recommendations

A 'Pandemic'

Wikipedia defines a pandemic as an outbreak of an infectious disease that affects people or animals over an extensive geographical area – precisely the threat that H5N1 currently poses and the situation it would produce if the virus spread easily from person to person.

Pandemic Alert Phases

As part of its Global Influenza Preparedness Plan, the World Health Organisation has specifically established a system for assessing the level of severity in a potential pandemic situation. There are 6 different phases incorporated into this evaluation system, with phase 1 marking the first signs of this possibility, where a human influenza subtype begins to infect a non-human species. This has in fact, always been the case with pigs contracting human influenza viruses, but the risks posed have always been quite low.

Currently however, the situation of human bird flu infection is ranked at phase 3 on the scale, whereby a new strain of virus (from H5N1 in Asia) has emerged, but human-to-human transmission of the disease is not yet evident. The situation would further develop through phases 4 and 5 if the virus mutates and becomes more infectious among humans, allowing virus transmission between persons. Phase 6 of the scale indicates a full-size pandemic that satisfies the three essential conditions (see H5N1) and would cause countless mortalities as well as devastating economical loss.

Government and Organizational Initiatives

Many countries are well into the process of preparation against the worst-case scenario - a global pandemic. Various governments have already allocated vast amounts of national budget toward both the prevention and possible battle-to-be against avian influenza.

Most notably, the US government announced a weighty US$7.1 billion budget to fight bird flu at the start of November 2005. Vaccine research/production tops the expenditure list, with a massive US$2.8 billion allocated to vaccine development strategies aimed at optimizing the efficiency of current production methods. The purchase of anti-viral drugs (both Tamiflu® and Relenza®) as well as vaccinations against current H5N1 strains fall into second place on the US agenda, totaling a hefty US$2.2 billion expense. The remaining US$2.1 billion targets preparatory measures including rapid virus detection methods and medication distribution within states.

In September 2006, Indonesia, bearing the highest death toll from H5N1, announced a 2007 target of US$100 million to be set aside in the battle against avian influenza. Increased levels of public awareness are expected to be the key focus with the government launching an awareness campaign at the beginning of September. However, whether sufficient funds can be achieved will depend on Indonesian arrangements with the World Bank and various pledges of funds from other countries.

A number of other funds have also been pooled toward the fight against H5N1 in Southeast Asia, hoping to contain the virus within the region.

• Australia promised an AU$100 million package toward preparatory measures in Asia in mid November 2005.
• The CDC (Centers for Disease Control and Prevention US) allocated US$5.5 million toward the improvement of influenza surveillance systems in 2004.
• The Indonesian government has assigned US$20 million in funds for 2006 to go toward the control of H5N1 within the country.
• CARE International commenced an awareness campaign in Vietnam during mid October 2005 to distribute tens of thousands of leaflets aimed at enhancing bird flu awareness.
• Thailand set aside US$7.5 million in 2004 for the construction of a vaccine research laboratory.
• The EU has allocated €884 000 toward extending bird flu testing programs in Europe to include wild birds in an initiative to stop the spread of H5N1 from Southeast Asia.

Many other initiatives have been launched around the globe and even more expected to be announced over the next few years in the fight against avian influenza.

Pandemic Response Plans

The WHO, the EU and numerous other countries have each drafted pandemic response plans for implementation during an actual pandemic. Any preexisting outbreak management systems were in fact only refreshed recently in many nations following the SARS outbreak of 2003 and similar measures will be undertaken in the case of a bird flu pandemic. The key difference between SARS and avian influenza however, is that the latter has proven to be even more infectious than the former, with a greater potential to spread disease. Some key points mentioned throughout various response plans include:

• The order of priority for vaccinations (essential personnel, hospital staff, high risk groups etc. in first priority)
• Border control measures (increased screening, quarantine measures)
• Efficient public communications (media updates, free call hotlines, public broadcasting of advice/information etc.)
• Social interaction issues (possibly closing down schools or preventing gatherings in high-risk areas)
• The activation/establishment of pandemic emergency committees.

The Australian government also initiated a series of simulation exercises in 2005, designed to prepare a number of federal departments as well as major organizations against a pandemic.

Companies around the globe have already been encouraged to draft response plans of their own, highlighting points such as vaccinations for traveling employees, improving staff awareness of bird flu and temporary accommodation for staff if transport home is discouraged. A pandemic would inevitably be a significant impact on international economy and preparing businesses against one is an important measure.