Preparedness key to averting pandemic

Federal officials believe that avian flu H5N1 will likely be found in a bird in the United States in the next few months. When it happens, it will not be an emergency — unless you're a bird. For birds, it's already a pandemic.

It could become an emergency for humans, though, if the avian flu changes in ways that allow simple human-to-human transmission, which no one can predict. Instead, officials are preparing "as if," because one thing is certain: There have been 10 documented pandemics (worldwide contagions) in the past 300 years. And it will happen again, according to U.S. Health and Human Services Secretary Mike Leavitt.

Leavitt, the former Utah governor, and officials from Homeland Security, the Centers for Disease Control and Prevention and the Environmental Protection Agency were in Layton Friday for "Utah Plans for Pandemic Influenza," the local version of a national series of governors' summits on preparedness designed to outline what's known, what's feared, what's uncertain and what's being done to get ready. Attendees included law enforcement, health, agriculture, education and other officials, representatives of local churches and others.

State and federal officials also signed a mutual planning agreement during the conference.

Although there have been human infections from the H5N1 avian flu, with 175 deaths, they have nearly all been caused by close contact with infected birds — contact such as playing with sick birds or sleeping in close quarters to them or swimming in canals contaminated by bird waste. Only one of the cases was confirmed person-to-person transmission. Officials say there is no danger from consuming properly cooked poultry.

The worry is that the H5N1 avian flu will undergo an antigenic shift, which is a change in the proteins on the surface of the virus through genetic reassortment, making it easy to pass among humans, who will have no protection from it.

When influenza raged in 1918, the most severe of recent pandemics, 20 million people died globally. Officials are watching this strain of avian influenza more closely in part because it is "genetically similar" to the virus responsible for that pandemic, which killed a half-million Americans.

"We're very concerned about this one," said Dr. Julie Gerberding, director of the CDC.

Given modern populations, a pandemic similar to 1918 would see 90 million infected, 45 million hospitalized and about 2 million dead in the United States. The estimate for Utah is 750,000 sick and 15,000 dead.