Peninsula mayors plan for possible pandemic

Posted: Wednesday, May 03, 2006

As bird flu kills tens of millions of birds worldwide, disease experts worry that if the flu strain mutates to a human form, the world could face a pandemic that might kill millions of people.

At an April 28 meeting of the Kenai Peninsula Conference of Mayors in Homer, the municipal officials discussed ways to join forces in preparing for, and if necessary responding to, a pandemic outbreak of bird flu among humans.

Efforts to develop a coordinated response program are already underway at the staff level, and a flu summit is scheduled for May 23 and 24 at the Kenai Senior Citizens Center in Kenai. That meeting is expected to draw municipal government, healthcare and emergency response officials, and possibly representatives of business and industry.

So far, the world has been lucky to avoid a pandemic, primarily because transmission to humans is extremely rare. Since 1997, the virus strain, otherwise known as H5N1, has infected fewer that 200 people worldwide, mostly individuals in extensive contact with infected birds. Human-to-human transmissions have typically stopped after one transmission.

The H5N1 strain, however, is far worse than the run-of-the-mill seasonal flu. Viral pneumonia and multi-organ failure are common results, and about half of those infected have died, according to the World Health Organization.

What has experts worried is that viruses can mutate rapidly, and a form might develop that would spread easily between people.

As a result, the H5N1 virus is considered today to be the world’s major pandemic threat.

Migrating flocks have already spread the flu strain to birds in many parts of Asia, Africa, the Near East and Europe, and it is believed that migrations will eventually bring it here to Alaska.

The peninsula mayors agree they should prepare to meet the challenges of a pandemic.

Kenai Peninsula Borough Mayor John Williams said the borough is part of statewide discussions regarding creation of a pandemic education program.

“The biggest concerns are how soon we will see definite evidence that there is a jump between birds and humans with regards to transmission of disease, and the time element being looked at is this fall because of the returning migration of birds coming across our flyways,” Williams said.

Williams’ aide Bill Popp noted the recent conference held in Anchorage included review of a federal model for a flu response program. Anchorage is “taking a leadership role” in preparing for an outbreak, he said.

Impacts of a pandemic would go far beyond the immediate need to care for the sick, Popp noted.

“Pandemic flu, when it strikes, is not just the issue of dealing with those individuals who come down with the flu in terms of medical care; it could potentially have catastrophic effects on our economy,” Popp said. “Picture in your minds if 40 percent of your work force of your government, your business, your school system doesn’t come to work one day.”

Forty percent, he added, might be a conservative number. Not only would the sick not come to work, healthy people might stay home to care for family members.

The impact on public health and on the economy could be dramatic. It’s happened before. Three flu pandemics occurred in the 20th Century, with devastating results.

According to the National Institute of Allergy and Infectious Diseases, as many as 50 million may have died worldwide in 1918, including at least 500,000 Americans, as a result of a strain commonly called the “Spanish flu.” In 1957, the “Asian flu” accounted for 70,000 U.S. deaths among an estimated 1 million to 2 million across the globe. The 1968 “Hong Kong flu” pandemic killed an estimated 700,000 people including 34,000 in the U.S.

The chances that a virulent strain of influenza could reach pandemic proportions depends much on its opportunity to spread. While the planet’s medical agencies are much better at identifying flu strains and initiating responses than they were in 1918 or 1968, modern transportation systems make global dispersion almost inevitable.

The United States Department of Health and Human Services advises that preparedness activities should assume the entire world’s population would be susceptible.

In Anchorage, Mayor Mark Begich formed a Pandemic Flu Cabinet earlier this year. At its first meeting in March, the group discussed a list of possible responses to a flu outbreak, including such things as ordering public facilities closed; ensuring essential government, utility and business services had appropriate staffing policies; identifying “key services” and “non-essential” services and deciding when non-essential services might be discontinued; identifying when school closures might be warranted; building mutual aid support programs among businesses and working with local media.

One of the assumptions that group made was that vaccines would not be a key component of Anchorage’s initial response. The cabinet members determined that there were too many unknowns regarding how fast a flu vaccine could be developed, produced and distributed to count on it as a first-line response.

Although a name brand drug called Tamiflu has been shown to be “marginally effective” in treating people infected with the H5N1 strain, it is prohibitively expensive (stockpiling enough for Anchorage would cost $15.6 million) and there is no guarantee it would work in a pandemic, cabinet members said.

At the Homer meeting, Soldotna Mayor Dave Carey suggested municipalities and businesses should be prepared to tell some employees that they should stay home and work from home computers if possible, to better avoid chances of flu transmission.

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