Bush Planning for Avian Flu Pandemic

By Kristina Herrndobler and Judy Holland Hearst Newspapers

WASHINGTON — President Bush said Tuesday that he is working on plans to deal with a possible outbreak of avian flu, including use of the military to quarantine regions of the country that may become infected.

“I’m not predicting an outbreak,” Bush said during a news Conference in the Rose Garden of the White House. “I’m just suggesting to you that we better be thinking about it. And we are. And we’re more than thinking about it; we’re trying to put plans in place.”

Bird flu has killed at least 60 people in Asia, and authorities in Asia and Europe have slaughtered millions of possibly infected birds.

So far, all known instances of human death from avian flu resulted from direct infection from birds. Scientists and government officials alike worry about what would happen if the flu mutates into a form that could jump the species barrier and spread from person to person.

Dr. David Nabarro, the new U.N. coordinator for avian and human influenza, said in a phone interview that governments and health agencies around the world are predicting that if the bird flu mutates, between five million and 150 million people could become infected and die.

At the news conference, Bush told reporters that “the policy decisions for a president in dealing with an avian flu outbreak are difficult.”

The best way to deal with a pandemic is “isolate it and keep it isolated in the region in which it begins,” Bush said.

Bush himself pinpointed some possible problems with quarantine, including how it would be enforced and who would enforce it.

“One option is the use of a military that’s able to plan and move, so that’s why I put it on the table.”

Health and Human Services Secretary Mike Leavitt acknowledged in an interview that the United States was not prepared for a pandemic flu outbreak. He plans to spend next week touring Thailand, Vietnam, Laos and Cambodia, the countries most likely to be the source of an avian flu outbreak, and talking with health ministers there about a coordinated surveillance of outbreaks.

“No one in the world is ready for it,” Leavitt said. “But we’re more ready today than we were yesterday. And we’ll be more prepared tomorrow than we are today.”

Bush said he is reading up on avian flu, including John Barry’s book “The Great Influenza: The Epic Story of the Deadliest Plague in History,” about the 1918 outbreak of “Spanish Flu” that killed an estimated 40 million people worldwide. Bush also said it is important for Congress to debate the issue.

As part of its defense spending bill, the U.S. Senate voted last week to provide almost $4 billion to the Centers for Disease Control and Prevention for bird flu preparedness. The House does not include such a measure in its version of the bill.

As President Bush spoke, Senate Majority Leader Bill Frist, R- Tenn., the Senate’s only physician, was meeting with Health and Human Services Secretary Mike Leavitt and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, to come up with a comprehensive plan for preparing for a possible outbreak of avian flu, said Frist’s spokeswoman Amy Call.

Call said Frist “wants to use bird flu as a case study to make sure we’re prepared for all pandemics.”

Such a plan would include setting up better tracking systems for the flu, increasing the capacity for vaccines in our country and setting up a distribution system, Call said.

Bush said that during meetings at the United Nations, he encouraged world leaders to rapidly report bird flu outbreaks to the World Health Organization.

Bush also said the development of a vaccine would “enable us to feel comfortable here at home.”

The United States has enough doses of the antiviral drug Tamiflu to treat 2.3 million people, which Frist criticized as being too few in a Senate floor statement last week.

Antiviral medicines and vaccines that might protect against avian flu are on the market, and some countries are stockpiling them heavily.

The government of Finland, for example, is asking its parliament to finance enough doses of a vaccine to protect its entire population.

Nabarro said there is no way to ensure that any vaccine will prevent the avian flu until scientists can study it in its mutated form.

“There are many, many unknowns we have to factor into our preparation,” Nabarro said. “We do know when the pandemic comes, it will cause some loss of life, a lot of sickness and it will affect trade, travel and the way in which our societies work.”

Nabarro said predicting when it will hit is tricky, but said the world is due for a flu pandemic, which historically hits in intervals of 35 years and generally originates in animals.

Nabarro, 56, said he is preparing for a flu pandemic in his lifetime.

Bush said the United States is monitoring outbreaks and is in communication with other nations.

“The people of the country ought to rest assured that we’re doing everything we can,” Bush said.

Symptoms of bird flu in humans often are typical of other forms of flu: fever, cough, sore throat and muscle aches, but can also include eye infections, pneumonia, and severe respiratory ailments.

In birds, the flu spreads in saliva, nasal secretions and feces, and most infections in humans result from contact with infected poultry or contaminated surfaces, according to the Centers for Disease Control and Prevention.

The CDC reports that its preparations include:

–Helping states with their pandemic planning efforts.

–Performing laboratory testing on the versions of the bird flu viruses.

–Investing in influenza surveillance in Asia.

–Working with the Department of Defense and the Department of Veterans Affairs on antiviral stockpile issues.

Contributing: New York Times News Service.