Eilisha Joy Bryson

July 7, 2006

Biol 501~ Principles of Biological Science

Writing Assignment ~ Analysis of Avian Flu

Stockpiling Vaccines Against A(H5N1) Avian Flu Will Not Protect the US

Introduction

The avian flu A(H5N1) is at risk of being a pandemic. Countries are making plans to deal with this, but the question at hand is should the US stockpile vaccines against this flu strand. This paper will analyze this option along with other suggestions that have been recommended by scientist and health organizations.

What is the avian flu problem?

There are several problems that the world faces in dealing with the avian flu A(H5N1). The main problem that this avian flu is presenting is the fact that it is a new type, and it is not yet spreading amongst humans independently. At this point, humans are contracting this virus and its side effects from infested birds. Contact with a contaminated bird has killed close to 200 humans, but it has not begun to spread exclusively through humans without the ill bird contact first. Because of this scientist are stuck in a void.

Scientists are studying this and other viral samples to determine what could happen next, but it is really impossible for them to predict anything with certainty. What they know, and actually fear, is that A(H5N1) has shown some signs of mutating, and it is this that makes a pandemic a possibility. If the virus mutates, it could develop the ability to spread from human to human. Scientist cannot predict if this will happen, and cannot determine what part of the virus would mutate if it did indeed happen. Without this knowledge it is impossible to develop an effective vaccine. Scientists have to wait to see what the mutation will be and then manufacture the vaccine.

Why is this a problem? Because by the time all of this takes place, the virus will have spread and become a pandemic situation. This is the state of the world right now.

What are the Suggestions?

Scientists, government officials, and special health organizations such as WHO, World Health Organization, have made the following recommendations in expectations of the A(H5N1) virus mutating and thereby developing the ability to spread among humans. These recommendations are not perfect. A brief description of each, as well as their pros and cons are presented below.

1. Drug manufacturers have been advised to make anti-viral drugs, or neuraminidase (N) inhibitors.

Neuraminidase (the N in the H5N1) is the protein in the virus that directs the virus to spread to other cells. After much research and development, scientists have determined a way to block this protein from doing its job. The anti-viral drugs that are being produced are designed to inhibit the spread of the virus. This is definitely a positive development, but a negative side does exist as well. It is highly expensive to mass-produce this drug. In addition to this, the anti-viral medicine will not treat the symptoms of the flu. So although the flu will not spread to others, whoever has it will not be healed.

2. Drug manufacturers have been advised to make influenza vaccines.

The flu vaccines that are being made at this point in time are being produced for countries to use in case the virus mutates and becomes a human threat. The vaccines work by stimulating the body to produce immunities to the virus. This is good, but again, problems do exist. For one thing, the companies that manufacture the vaccine are also responsible for manufacturing the vaccines for the normal winter flu strains. They can only produce the A(H5N1) vaccine between normal productions. Ultimately, they cannot make the needed amount in enough time. Surpassing that is a greater problem that deals with the effectiveness of the vaccine. The vaccine cannot be designed to combat the mutated A(H5N1) because it has not mutated yet. Scientist do feel that the current vaccine will act to dampen the effects of the mutated A(H5N1), not warding off sickness, but possibly preventing death.

3. Governments have been advised to stockpile vaccines and develop a plan of action.

The US government and other countries around the world have signed contracts with manufacturers to create dosages of the flu vaccine for its citizens. They would be administered when an actual warning of a pandemic exists. In addition to this arrangement, the government had to develop a plan of what to do with the vaccines. Unfortunately, for reasons stated above, there will not be enough for every citizen, so the plan is to administer the drug to health care workers who would have to aid in the pandemic. Meanwhile, manufacturers would work on developing a more accurate vaccine. The problem here is interesting. There is not enough vaccine for everyone, so the question that begs to be asked is, is it worth it?

4. Social Distancing.

Another suggestion to help contain the spread of the avian flu is to restrict people from interacting with others. Specific suggestions include limiting travel, closing country borders, and closing schools and work places. Computer simulations show that this alone or even in conjunction with anti-viral medicines is not effective. What would aid in containing the virus includes an infected person being treated immediately after symptoms appear, then those in their household and those they work with being treated in combination with social distancing. This would require effective monitoring and a well-developed plan, in addition to vaccine availability, which is already in question.

Should the US stockpile vaccines?

Based on the research that has been presented, it seems that this question is incomplete. Stockpiling vaccines will by no means guarantee the safety of US citizens. Preparing for a pandemic would require so much more than just that. The pros and cons of this particular line of defense were presented above, along with the other preventative measures that could be put in play to prevent a pandemic. No one suggestion seems to cover all of the bases. This is definitely an example of varying degrees of certainty, where things are not always true or false.

Stockpiling for every citizen did not work well back in 1976 when a swine flu scare was at hand. The president then issued all citizens to be vaccinated, but the flu never developed to a human threat. However, many citizens still died because of adverse side effects to the vaccine. From this experience, the government and its citizens have learned to be more cautious about health recommendations.

Sources

Altman, 2006, “With every pandemic, tough choices”, New York Times.

Grady, 2006, “Doubt cast on stockpile of vaccine for bird flu”, New York Times.

Grady and Kolata, 2006, “How serious is the risk of bird flu?”, New York Times.

Laver and Garman, 2002, “Pandemic Influenza: its origin and control”, Microbes and Infection.

MacKenzie, 2006, “Only drugs and vaccines will deflect bird flu pandemic”, New Scientist.

MacKenzie, 2006, “Stockpile human bird flu now, says experts”, New Scientist.

MacKenzie, 2006, “ Today’s bird flu vaccines will do”, New Scientist.

Monto, 2006, “Vaccines and antiviral drugs in pandemic preparedness”, Emerging and Infectious Diseases.