Professors say the avian flu virus is coming to Virginia: Don't panic
Perhaps it will be the millions of migrating
blackpoll warblers that will bring the avian flu virus to Williamsburg
when they arrive from Alaska this autumn. Perhaps it will be some other
species. Regardless, H5N1 will come to Virginia, where it will, if all
goes as several William and Mary professors predict, take up residence
indefinitely in local wild-bird populations. At that point, one of
those professors, Dan Cristol, associate professor of biology at the
College, will be among the first human beings locally to be at risk.
The reality makes him anxious—“not panicked, but very concerned,”
Cristol said. As an ornithologist, all of his research initiatives
involve birds. As a neighbor, his friends bring him birds—sick birds;
dead birds. In a recent column in the Virginia Gazette, Cristol placed
the threat in perspective, comparing it to what others face from the
mosquito-borne West Nile virus or from the rodent-borne Hanta virus,
each a non-indigenous strain that has found hosts here. Once
established, occasionally the avian flu strain, H5N1, will appear in
humans, just as it has first in China and now in several countries of
Europe and Africa. In more than 100 human cases, the virus has nearly a
50-percent mortality rate.
“Not this year, but eventually the virus will be here, and I could get it,” he said. “Worse, I could bring it home to my kids.”
At present, people who do not have prolonged contact with
wild birds need not be overly alarmed, Cristol said. Evidence suggests
that the current strain is not easily transferred to humans and has
been transmitted only in rare instances from one infected person to
another. At some point, however, an altered strain might develop that
easily can spread among humans. That prospect has given rise to the
specter of pandemic. Alarmists say H5N1 will make that jump sooner than
later. If that does happen, Cristol said, “All bets are off. There is
the real possibility for a worldwide epidemic.”
Among professors at William and Mary, the general advice offered
relative to avian flu is for concern and preparation. Sue Peterson,
professor of government, who studies the politics of epidemic diseases,
resents the climate of fear that some media reports have fostered.
“The media does tend to produce these kinds of scares,” she said, “but
that may just be the nature of the media. They’re looking for a hot
story. For a time they don’t say anything about it, then when they do
say something, it has the tone of ‘the sky is falling.’ That kind of
panic, those public-health alarms, tend to be counterproductive.”
The prospect that H5N1, or some similar bird virus, might mutate into a
form that can be spread easily from human to human has to be
recognized, she said. Avian viruses do mutate. In recent months, the
Spanish flu of 1918 was identified as an H1N1 strain. It killed at
least 25 million people as it circumnavigated the globe.
Peterson said that U.S. strategy, at this point, needs to include more
funding for institutions such as the World Health Organization to track
outbreaks of the disease and more efforts to cooperate with other
nations in order to respond. “We also need to consider using flu
vaccines in [developing countries] that take them away from stockpiles
in industrial countries,” she suggested. Such action might prevent the
virus from having the time to mutate. “That is a whole political
discussion we have not had,” she said.
“Our best defense against epidemic disease, most of which will
originate in the developing world, is a forward defense,” she said.
“Our goal should be to work with others to help nip any potential
pandemic in the bud.”
Beverly Sher agreed: “A lot of public-health officials have been
worried for years,” she said. “H5N1 is the first virus we’ve seen in a
while that has the potential to become a pandemic. The idea is that if
we are smart about this we can slow down or even stop a pandemic.”
Sher, visiting professor and health professions adviser in the
College’s department of biology, has been teaching a freshman seminar
on emerging diseases since 1997. During recent semeseters, avian flu
has been the hot topic. Her pre-med students want to know about the
basic biology of the virus. “Yes,” she tells them, “in theory it is
possible for someone to make a universal vaccine against influenza.”
Her international relations students want to know how countries can
cooperate. “Yes,” she says, “these viruses can be cooking away in
southern China, and the Chinese government might know, but the rest of
the world doesn’t.” All of her students want to know what can be done.
“We need to change the way we make vaccines,” Sher said. Instead of
growing them in embryonated hen’s eggs, vaccines should be made
utilizing tissue-culture methods, which would produce more volume
faster, she suggested. “We need to clean up questions about the patent
system, because it turns out that the reverse-genetics process that is
used to create the experimental H5N1 vaccine that is being tested now
is patent-protected,” she added. “We need to look at better drugs for
blocking the transmission of influenza.”
“What we basically need to be doing is putting political pressure on
the people who have the money to spend and to insist that they spend it
wisely so that we are prepared,” Sher said. She called recent efforts
by the Bush administration to earmark funds and to initiate dialogue
with potential global partners a first step. “We have a long way to
go,” she said.
As the avian flu virus continues its global spread,
pandemic scenarios are sure to proliferate. Many will invoke doomsday
rhetoric. Some will pin assertions in terms of national-security
concerns, a tie-in that Peterson will find troubling. AIDS has
established the current benchmark as to when a disease threatens
national security, she believes. A recently completed study with
colleague Stephen Shellman showed that AIDS indirectly affected
national security in many nations by lowering gross domestic product,
by devastating educational institutions and by eroding support for
political institutions.
“My take on this is that, whether you are talking about AIDS or the
avian flu, we have to be careful when we throw around words like
national security threat,” Peterson said. “National security
traditionally has been about the use of force, about the preservation
of our territorial integrity, of our national sovereignty and of our
political institutions.” Disease can rise to that level, she admitted,
but it would have to unleash a massive pandemic. By comparison, AIDS,
which has killed or infected 70 million people worldwide, does not
constitute a threat to U.S. security, she said. “AIDS is a humanitarian
crisis of epic proportion, and we need to respond to it as such. In
fact, American security is not directly challenged by AIDS.”
She suggested that, likewise, were avian flu to kill a few thousand
people in the United States, certainly it would be “a tragedy for the
individuals” and a “health problem for the nation,” but it would remain
far below the level of threatening the political or territorial
sanctity of the nation.
If the virus does adapt a form that enables it to be passed from human
to human in the next 12 months or so, Peterson is aware that severe
hardships would be created. “What’s scary is that the numbers will
actually swamp our emergency rooms, our ability to respond,” she said.
“That’s assuming everything goes well. Will public-health workers even
show up? That is assuming a lot.”
Said Sher, “We would be cooked. If it hit now, we wouldn’t have enough
drugs; we wouldn’t have a vaccine for six months to a year. Hospitals
would be overwhelmed. A lot of people would be on ventilators; we don’t
have enough ventilators in our country.”
Sher is encouraged by discussion among officials with the Centers for
Disease Control and Prevention (CDC) that reference employing a
floating corps of professionals to follow outbreaks though communities
and to call for “snow days,” essentially shutting down communities when
the virus flares. “Eliminating unnecessary gatherings and reducing
human-to-human contact in society would have an enormous economic
impact,” she said. Sher also believes that by cooperating with other
countries and planning wisely, there is a chance that pandemic can be
averted, perhaps for the first time in the history of the world.
In the meantime, she maintains no personal preventive strategy.
“I’m not taking any precautions,” Sher said. “People ask me if I got
Tamiflu for my family. I haven’t. If I knew avian flu was spreading
person-to-person in San Francisco, I would avoid crowds and keep my
hands clean. I might teach my seminar by computer for awhile.”
Cristol, however, is taking precautions. He and his students are
wearing gloves each time they handle wild birds; if they do so within
an enclosed space, they are wearing gloves and masks. When the flu
arrives, he said, respirators will be added to the required gear.
“Until it can move person-to-person with ease, you have to come into
contact with birds as a farmer or researcher—direct contact and
probably prolonged contact,” he said. “That may change any time, as we
all know. Meanwhile, people should be concerned about whether the
government is doing anything to prepare us for an epidemic and to
reduce the chance of an epidemic.”
Despite the rhetoric, Cristol said, he has seen little tangible evidence of that thus far.
