If ever a global outbreak of avian influenza occurs, health officials say millions of Americans could become ill and at least two million could die. Every facet of society would be affected. Schools would close, public transportation could stop, and hospitals and morgues would have no room for the sick and dead.

We are far from prepared to respond to such a crisis. Right now, bird flu is not easily passed from person to person, but if the virus mutates into an easily transmissible form, a pandemic would occur. If that happens, people will need vaccinations and medication. Most are unlikely to receive either.

Vaccines are needed

When most people think about preparing for a pandemic, they immediately ask, “Why can’t we just get vaccinated against it?” The problem is that it takes several months at a minimum to develop a vaccine after a flu strain is identified.

In the case of a pandemic, several months would be too late to prevent the virus from affecting many people. Right now, the WHO is working with the United States and other nations to monitor avian influenza and to develop a vaccine. Still, nearly every health expert agrees that a vaccine would not be created in time to stop the flu from spreading.

Currently, there is no vaccine for the H5N1 strain of avian influenza. It takes months for a vaccine to be developed once a flu strain is identified, so a vaccine would not be available at the beginning of a pandemic.

Most likely, millions would die before a vaccine became available. Even after a vaccine was introduced to the public, producing enough to protect a large portion of the population could take years.

The United States Department of Health and Human Services (HHS) says it would attempt to buy 20 million doses of any vaccine that could protect against a pandemic. However, some experts say in order to adequately protect the nation, we would need 100 million doses.

America has a population of about 300 million. Arguing over how many doses we need may be a moot point. Even getting 20 million doses would take time, considering the current speed of vaccine production.

Scientists worldwide are working to develop a vaccine for H5N1. One is already in clinical trial. Researchers isolated the virus from a person in Vietnam who contracted H5N1 from an infected chicken.

Antiviral drugs and the Tamiflu controversy

Antiviral drugs cannot entirely prevent you from getting the flu, but they can prevent the onset of severe symptoms. Unfortunately, WHO has stated that there are not enough antiviral drugs available to stop a pandemic from occurring.

Two medicines, TamiFlu and Relezna, may be useful treatments for people who contract avian flu. WHO is stockpiling millions of doses of these antiviral drugs. About 30 countries, including the United States, have ordered large quantities of the medications, but it could take a long time for manufacturers to make enough to fill all of the orders.

TamiFlu reduces the symptoms caused by H5N1. The drug is produced by a Swiss pharmaceutical company, Roche Laboratories, Inc. Roche stepped up production once researchers discovered that Tamiflu can treat avian influenza. Many countries, however, have placed large orders for Tamiflu, and Roche can’t keep up.

The company has decided to fill orders on a “first come, first served” basis, which is not good news for the United States. America placed its order after other countries and is now far down on the wait list. WHO has two million courses of TamiFlu in stock and three million more have been ordered.

With WHO's five million courses of antiviral drugs, it may be possible to effectively treat hundreds of thousand people and contain the pandemic flu if it is noticed soon enough.

Roche under pressure

Roche is now coming under international pressure to license Tamiflu to other manufactures in order to speed up production. While they consider that move, it might still take years to produce an adequate supply.

America has set a goal of having 20 million courses of TamiFlu by the end of 2006. Again, critics say even that would not do much to protect most of the population.

Meanwhile, Roche is warning people not to buy Tamiflu over the Internet. Some consumers, worried that their government will not be able to protect them, have started to seek their own supply.

There is fear that dishonest individuals are selling counterfeit drugs in an effort to make a fast buck. Tamiflu is a prescription medication and should only be purchased from reputable pharmacies.

See also

• Government preparations
• How the virus mutates
• The latest news
• What you need to know