Amid growing concern about whether the United States is prepared for a large-scale medical emergency, medical experts say a worldwide avian flu pandemic is inevitable.
"Pandemics are like hurricanes, tsunamis and earthquakes," Michael Osterholm, director of the Center for Disease Research and Policy explained on "Good Morning America" today. "We had 10 of them in the last 300 years, and we're due for another one sometime soon."
The World Health Organization said today that between 2 million and 7.4 million people could die from a global flu pandemic. WHO spokesman Dick Thompson told reporters in Geneva that countries have been warned to be ready to deal with up to 7.4 million deaths, but conceded there was no way to determine the deadliness of the avian flu "until the pandemic begins."
The estimate was a stark contrast to the range given Thursday by Dr. David Nabarro, the U.N. coordinator for global readiness against an outbreak. He said that the world response to warnings would determine whether an avian flu virus ends up killing 5 million or as many as 150 million.
The avian flu virus is spread by chickens, ducks and other birds and has been a problem in Southeast Asia for years. Since late 2003, it has killed at least 65 people in four Asian countries and has been found in birds in Russia and Europe.
With strains of the virus turning up in humans, there is growing concern among U.S. officials about the possibility of a pandemic and whether the United States is prepared to handle such a widespread medical crisis. The draft report of the federal government's emergency plan predicts that as many as 200 million Americans could be infected and 200,000 could die within a few months if the avian flu came to the United States. Right now, there is no vaccine to stop the flu.
While experts cannot pinpoint when a pandemic would strike, many say conditions are ripe.
"We believe the avian situation we currently have in Southeast Asia is a perfect setup for this virus to mutate into a human-to-human transmitted agent, which is a big problem and could lead this to be the next pandemic," said Osterholm. "We also have to keep an eye on other viruses."
Osterholm said the world needs to take the avian flu threat seriously because of the large human and bird population in Southeast Asia, the lack of a vaccine and the easy transmission of the disease.
"The flu is one of the most infectious agents to humans, so readily transmitted person-to-person," he said. "In the case of our population today, we have no immunity throughout the world to this particular strain of virus in Southeast Asia and because of the large bird population and human population now together over there, this virus has an opportunity to continue to be transmitted among birds, occasionally hitting humans, and each one might become a human agent."
"It's the perfect setup," Osterholm said. "Then you put air travel in and it could be around the world overnight."
Osterholm noted that no one is particularly immune from avian flu and that it has killed young, healthy people with strong immune systems. He said there are important lessons in the influenza virus pandemic that killed some 20 million people worldwide in 1918.
"You have to take a look at the 1918 experience and realize if 50 [million] to 100 million people died and those numbers come from a recent study from a group of historians that went country by country to determine that number," said Osterholm. "Today we have three times the number in the world -- those numbers are roughly at 180 [million] to 360 million could die. The bottom line is the way these people die. Our medical care delivery system in the modern world isn't any better prepared than in 1918."
A concern about avian flu has prompted the Senate to approve $4 billion for bird flu readiness. On Thursday, U.N. Secretary-General Kofi Annan announced Nabarro's appointment to lead a coordinated global response to a possible pandemic. Nabarro has helped outline WHO's plans for several potential crisis situations, including malaria, environmental health and food safety.
"The appointment is critical as the world is fast recognizing the risk of an imminent human influenza pandemic and is taking steps to reduce the risk and to get prepared," WHO said in a statement.
WHO said several countries already have joined forces to coordinate preparation. Agriculture ministers from the Association of Southeast Asian Nations are meeting in the Philippines to discuss measures to curb the avian flu virus in birds. In addition, the United States announced a new International Partnership on Avian and Pandemic Influenza at last month's World Summit in New York. Several countries are joining the effort, with a planning meeting slated Oct. 7-8 in Washington. WHO also is hosting a meeting of all partners on Nov. 7-8 to coordinate the funding needed.