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Influenza: preparing for pandemic

As bird flu continues to make headlines across the world, GlaxoSmithKline is getting ready for a possible flu pandemic.

Most people know the symptoms all too well - the fever, aching muscles, runny nose, sore throat, headache and feeling of extreme tiredness. These are clear signs of seasonal influenza, a condition that lasts up to two weeks and hits the northern hemisphere every winter.

In fact, most of us self-diagnose flu incorrectly when we suffer from nothing more than the common cold that lasts no more than two or three days.

Seasonal flu is a much more serious condition than the common cold and can be a killer of people who are susceptible or weakened by other illnesses or old age. In the UK alone, the seasonal flu outbreak of 1999-2000 killed almost 20,000 people.

Each year vaccine manufacturers create a vaccine that helps to protect against the most likely strains of seasonal flu and this is usually given to people at risk about a month before the annual flu season starts. For many, this takes away the worry of catching seasonal flu, but what has made the headlines for the last few months is a very different type of flu.

Bird flu

Also known as avian flu, this is a strain of flu that affects migrating fowl and domestic birds. The strain that is currently in the news is called H5N1 and was first discovered in Hong Kong in 1997.

It is now thought that up to 200 million birds, mainly in south-east Asia, could be infected with this deadly strain of the virus.

Since the discovery of H5N1 in south-east Asia, the virus has spread west with cases reported in birds in at least half of the European Union's countries including France, Germany, Italy, Greece and the UK.

The main concern is that migrating birds will spread this form of flu to the rest of the world and create conditions that make it easy for the virus to pass to humans.

It’s reassuring to know that there is no evidence that bird flu can be caught from eating well-cooked bird meat or eggs. The main risk to humans is amongst those who care for or live with poultry or those involved in the slaughter, defeathering, butchering, and preparation of poultry for cooking.

By 12 November 2007, cases of H5N1 bird flu in humans were reported by the World Health Organization in Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Laos, Nigeria, Thailand, Turkey and Vietnam - 335 people, mainly in south-east Asia, have caught bird flu and 206 have died.

A possible flu pandemic?

The fact that bird flu has already transferred to humans is of great concern to scientists because it is a new strain of flu against which we have no immunity.

So far it seems that bird flu does not easily pass to humans but the greatest risk would be if the H5N1 bird flu virus could be passed from human to human, a condition that would create a pandemic infecting up to 25% of the world’s population. This could happen if the virus mutated or combined with a strain of flu that already passes between humans through coughing and sneezing.

Although these conditions have not yet been met, there remains a great concern about the possible spread of bird flu to humans, especially when we remember that a previous pandemic of bird flu in 1918 killed 40 million people worldwide.

Preparing for pandemic

The most immediate action against bird flu has been the culling and vaccination of millions of birds and changes to farming practices in Asia to stop the spread of the disease between birds and to reduce the risk of its transmission to humans.

If a flu pandemic breaks out, treatment may include vaccination of the population to prevent people from catching flu. In this case, the World Health Organization would alert governments on how to tackle the outbreak. This is why governments are planning to stockpile specific vaccines once the strain of flu that will cause a pandemic has been identified.

To meet this demand, pharmaceutical companies such as GSK are planning to increase the production of suitable flu vaccines and antiviral medicines and governments are planning for the logistic and economic impact of a pandemic.

The US government has estimated that a flu pandemic could kill up to 2 million Americans and cost the country over $500 billion.

GSK is planning for a potential flu pandemic by investing in the development of two vaccines for the H5N1 strain of flu and the increased production of Relenza through its own manufacturing facilities and through partnerships with other companies.

GSK is investing heavily in increasing capacity to help governments and other organisations to prepare for a global influenza pandemic. That includes investing $2 billion to conduct research and expand production capacity for both Relenza and a pandemic vaccine. The company has added several manufacturing lines to meet current demand for Relenza, and as a result, has already supplied significant quantities of Relenza to meet stockpile orders, with sufficient capacity to fulfill additional orders for antiviral stockpile and seasonal flu.

GSK’s two H5N1 flu vaccines went into clinical trials in Germany in March 2006 and will help the company to develop a vaccine against a pandemic-causing flu strain more quickly. Preliminary results from these clinical trials were released in July 2006.

What you can do

There are several things that you can do to reduce the risk of catching seasonal (and other forms of) flu:

• Ask your doctor about a flu vaccine if you are at risk: the elderly, asthmatics and infants are most at risk
• Stay healthy – a good diet, plenty of exercise and a healthy lifestyle will help the body to avoid and fight infection
• Avoid crowds during the flu season – if you cannot, wash your hands frequently and avoid touching your eyes and nose as this will reduce the chances of a flu virus infecting you
• If you travel to areas infected by H5N1 bird flu, avoid live animal markets, poultry farms and any free-ranging or caged poultry

The latest information on bird flu can be found on the World Health Organization’s website.

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