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Expert: Window exists to prepare for pandemic

Dr. Anne Moscona


A flu pandemic is a global outbreak caused when a new form of the influenza A virus emerges that can spread easily between humans, or an older form re-emerges after a long time. The pandemic can cause widespread illness and death because people's immune systems offer little protection against the new virus. The 1918 "Spanish flu" pandemic killed more than 500,000 people in the United States and up to 50 million worldwide.

Source: CDC


Are authorities worldwide doing enough to prevent the spread of bird flu?
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CNN Access
Flu Season
George W. Bush
Daryn Kagan

ATLANTA, Georgia (CNN) -- President Bush on Tuesday outlined his plan to prepare the country for a possible pandemic of avian flu. Though he noted that no pandemic in people exists anywhere in the world, "there is reason to be concerned."

After Bush's speech, CNN's Daryn Kagan spoke with Dr. Anne Moscona, an expert on influenza, about the risks of a pandemic. Moscona also answered questions sent by e-mail to CNN.

KAGAN: We're thinking about something that, in a lot of ways, doesn't exist yet. All of this effort, all of this attention, billions of dollars, for something that only 62 people in the whole world have [died from]. What is it about this particular disease that has people so frightened?

MOSCONA: Well, you're exactly right. And I was glad to hear President Bush actually focus on the fact that we do not have a pandemic flu yet. However we have the warning signs. We have an influenza that, as the president mentioned, ... has shown the ability to infect humans and cause lethal disease.

So we are preparing for the possibility that either this or a different strain of influenza will be able to be transmitted from person to person, and then we will have a pandemic. However, he and you are correctly focusing on the fact that while we don't have a pandemic strain yet, we have a warning, giving us time, we hope, to prepare adequately for a virtually certain occurrence.

KAGAN: And also looking at exactly what the situation is right here in the U.S., no sign of bird flu. Not even in any poultry or the poultry industry. Certainly and not any people who would have it. Doctor?

MOSCONA: Yes, that's right. The point to understand though is that once, if and when this virus or another similar virus does acquire the ability to transmit itself from human to human, then global spread would be rapid unless it's stopped. So that during this period of time when, you're correct, the virus has only been spread really from birds to humans, this is the time window that we have in which to prepare for when it could begin to be able to go from human to human.

We don't want to wait for that moment to begin to prepare, because with the global situation the way it is, with travel, international travel, so rapid, once we have a virus spreading between people, it's going to spread rapidly around the world.

KAGAN: As expected, viewers have a lot of questions at home about bird flu.

This one is from Anne in San Pedro, California.

She asks, "If one is inoculated for the current strain, then a flu shot becomes available for avian flu, is it safe for a person to be inoculated for both in the same season?" Or is there any danger in that? Or are we getting ahead of ourselves, because there is no shot for bird flu right now?

MOSCONA: Right. Of course, we are getting ahead of ourselves, but just to dispel any concerns about that, I'll say that it would be absolutely safe. These will be two different vaccines, and they should not interfere with each other if given the appropriate distance of time apart.

So in the, let's hope, unlikely event that that's going happen, it would not be a problem.

KAGAN: And would this be a time you'd want to make a push for something people can do right now, and that's protect themselves against the influenza that we currently face and get a flu shot for the upcoming season.

MOSCONA: Thank you very much for giving me that chance. Yes, right now we are dealing with the yearly seasonal flu, which still makes a lot of people very sick and kills quite a few people in this country. So get out there and get your flu shot and get your loved ones to get vaccinated. Absolutely.

KAGAN: We move on to Karen in Michigan. She asks, "Can you catch the bird flu by feeding the birds in your back yard?"

MOSCONA: There aren't birds in this country that have avian flu yet. If we detect birds carrying the avian flu, the H5N1 strain, then we'll need to make decisions about people staying away from birds. At this point, it's absolutely not a problem. There's no bird flu here, so you can go ahead and feed the birds in your yard.

KAGAN: Trudy in High Springs, Florida, asks, "I can't take the flu shot due to allergies, and I have cancer. So what does a person with this kind of problem do?"

MOSCONA: Well, I don't know the details about this person, but let me just say that there are two types of flu vaccinations. One is the shot, which is pretty much good for everyone unless you're allergic to eggs, and the other is an inhaled vaccine, which is useful up to and including age 49 under certain circumstances.

I would suggest for this person to talk to her physician, because there is likely an option she can use to protect herself against seasonal influenza.

KAGAN: You know, that brings up an interesting point. President Bush was talking about getting a vaccine that's not egg based but cell based. Why is that important?

MOSCONA: The egg-based system of making vaccines is very time-consuming and also requires huge numbers of eggs, and it's very cumbersome. Theoretically, a cell-based vaccine development could be much quicker and much more streamlined, be brought to the production situation much more rapidly and also be scaled up much more easily.

KAGAN: And another e-mail question for you, doctor. This is from Jennifer in North Branch, Minnesota. She says her grandmother contracted a severe case of the 1918 flu and survived. Is it possible her future offspring may have developed a genetic resistance to similar flu strains, including avian flu?

MOSCONA: That's a good question. Unfortunately, no. Unfortunately, we don't pass down that kind of immunity to our offspring. So each one of us has to face an influenza virus and mount an immune response, and hopefully a successful one, on our own.

KAGAN: This one is from Karen in Rochester, New Hampshire. Karen wants to know, she says, "I'm a flight attendant. Is my risk to contract this flu even greater?"

MOSCONA: Well, that's a good question. Remember, this flu is not out there. The flu is not spreading between people and between individuals, and so on a plane, what you're at risk for are infectious diseases that spread between individuals. In the event that we have an avian flu pandemic, I'm certain that travel will be somewhat curtailed, and that precautions will be taken for people like yourself, who are in constant contact with people.

KAGAN: This question is from Erin in Hawaii. She wants to know, "Should she stop eating poultry? Is there a threat of our supply being contaminated before we know it has been?"

MOSCONA: I want to reassure everybody that you can eat chicken, you can have your Thanksgiving turkey. This infection is not acquired from eating cooked meat. Cooked turkey, cooked chicken are completely fine. Just relax about that.

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