work to prepare for bird flu
human pandemic of the dreaded H5N1 bird flu virus might not
happen, but pandemics at large are inevitable, scientists
say. And they usually arrive sooner than most people think.
"Each new human case gives the virus an opportunity to
evolve towards a fully transmissible pandemic strain," the
World Health Organization warned more than a year ago about
Since that WHO report was published, more than 140 new human
cases have been confirmed. Most have been traced to direct
contact with infected poultry, but a few people have gotten
the virus through close personal contact.
Nov. 28, a 35-year-old woman in Indonesia became the latest
Scientists have raised their eyebrows at H5N1's ability to
infect a variety of mammal species, including pigs, tigers,
leopards and domestic cats in addition to humans. The more
it adapts to different conditions, the more likely it is to
achieve rapid human-to-human transmission.
Jeffrey Greene, infectious disease specialist at New York
University Medical Center, points out in his new book, "The
Bird Flu Pandemic," that H5N1 has met three of the four
conditions necessary for a pandemic to begin:
has spread over a vast geographic area in animals.
a new strain to which humans have no immunity.
has the ability to infect humans, killing roughly half those
that remains is for the virus to pass easily from person to
how bad is the risk?
"Let's just say it's serious — not enough to make you want
to run off and buy a case of surgical masks and plan to live
off the land, but serious enough to stay informed and follow
developments as they unfold," Dr. Greene said.
serious enough for planning at the local level.
Last year's health and sanitation crisis after Hurricane
Katrina proved that communities can't rely on immediate
federal help, said Acushnet Fire and Rescue Chief Kevin A.
Gallagher. He and a handful of other local officials
started last spring planning for a pandemic.
seven towns, New Bedford and UMass Dartmouth (acting as a
voting member for its town-size population of 8,700)
continue to develop their coalition, called the Southcoast
Emergency Planning Partnership.
Mr. Gallagher is part
of the partnership's three-member steering committee and the
emotional leader of the movement, spurred in part by a
personal connection to the deadly flu pandemic of 1918. A
relative on his mother's side, Edward Dahill, was fire chief
in New Bedford when the pandemic hit, and he believes some
of his relatives died in the outbreak.\
Members of the
partnership are towns that consider St. Luke's their local
hospital — Acushnet, Fairhaven, Dartmouth, Freetown,
Mattapoisett, Marion, and Rochester, along with New Bedford
and the university.
and Wareham have not been invited to join because of their
proximity to other hospitals.
The group's "biggest
success to date," Mr. Gallagher said, is creating a unit of
the Medical Reserve Corps, part of a federal program
established after the terrorist attack of Sept. 11, 2001.
Its main role is to
pre-credential and train volunteers, both medical and
non-medical, to participate in emergency relief.
Louise Donaghy, New
Bedford public health nurse, is serving as the Medical
Reserve Corps coordinator on a volunteer basis.
If and when funding is
available, a handful of full-time positions could be created
to keep the training and credentialing up to date.
The corps has started
building a Web site through the U.S. Surgeon General's
Office at gnbmrc.com, and each community has a contact
person in the corps.
Among the contacts are
Mr. Gallagher and the two other members of the Southcoast
Emergency Planning Partnership steering committee: Dartmouth
Director of Public Health Wendy W. Henderson and Kathleen M.
Stefani, a representative of New Bedford Mayor Scott W.
"As we are still in
the infant stages," Ms. Donaghy said, "we have not yet
defined our infrastructure."
In addition to doctors, nurses, pharmacists and mental health
professionals, the corps needs many non-medical people — perhaps
as many as 10 times the number of medical volunteers, they say —
to serve in support roles doing language translation, child
care, driving, food preparation, data entry, custodial work, and
review of forms.
volunteers are not obligated to work a particular emergency.
The corps has applied for
a variety of grants and entered an agreement with the Community
Foundation of Southeastern Massachusetts to serve as its fiscal
Both of the new groups,
the Southcoast Emergency Planning Partnership and the Medical
Reserve Corps, are designed to help the public cope not only
with pandemics, but any mass medical emergency, such as a
natural disaster or bioterrorism attack.
The Medical Reserve Corps
will be modeled, in part, after its sister organization on Cape
The Cape Cod Medical
Reserve Corps, founded in 2002, provided health care for
Hurricane Katrina survivors who were flown to Otis Air National
Cheryll Bushnell, director
of the Cape Cod group, said the volunteers saved the state more
than $60,000 in Katrina relief funds.
"We have many battle
scars," she told an October gathering of about 45 SouthCoast
One of the challenges of
planning for emergencies, she said, is that volunteers flood the
phone lines only after an emergency begins. Two days before
Katrina, the corps had 89 volunteers. A month later, it had more
than 400, and not until September — a year after the hurricane —
did the group finish processing all the applications.
"That's why we do it
ahead, because it's a nightmare to credential people at the same
time as you deploy them," she said.
Independent of the Medical
Reserve Corps, local health authorities hope state funding will
be set aside for pandemic flu preparation.
They are working with
Southcoast Hospitals Group and the Greater New Bedford Community
Health Center to plan for rapid flu vaccination at existing
sites called Emergency Dispensing Sites throughout the region.
New Bedford alone has nine.
Those operations would be
activated only for a large-scale emergency, not for standard flu
Hospitals around the state
are also planning off-site infection care units that could be
opened in case of a pandemic.
executive director of the Massachusetts Public Health
Association, said a Dec. 31 deadline is looming for lawmakers to
agree on a pandemic plan in order to receive discounted Tamiflu,
a prescription medication that can lessen the duration of
influenza symptoms, through the federal government.
One Step Ahead
After Hurricane Katrina, Gov. Mitt Romney issued a $36.5 million
proposal to fund emergency preparedness. But the House and
Senate have their own plans. The Senate, for example, would
cover pandemic planners at the local level in a way the
governor's plan does not, Mr. Wilkinson said.
The House Ways and Means
Committee is looking at the Senate proposal, he said. The Senate
plan includes a rewrite of the Health Powers Act, which involves
things like quarantine and the taking of private property to
respond to an emergency.
"I think they will take
action, but perhaps on a stripped-down approach," Mr. Wilkinson
said. "The House may wait on a rewrite of Health Powers."
Massachusetts has made
progress on its bird flu preparedness, but still has a long way
to go, he said, especially with regard to so-called special
populations — children, elders, low-income people, and
"They really don't have
risk communications, even for the general population, nailed
down," he said.
Pandemic planners say they
may not be able to prevent an outbreak, but they can try to
minimize illness and social disruption.
"The flu is very
fast-moving," Mr. Wilkinson said. "We won't have much notice."
Stockpiling medication and
syringes is part of most pandemic strategies.
Dr. Marc Siegel, associate
professor at the New York University School of Medicine and
author of "Bird Flu: Everything You Need to Know About the Next
Pandemic," contends that while stockpiling will help in the
short term, a better long-term strategy would be to improve
vaccine technology so new vaccines can be developed faster in
response to new viral mutations.
requires three to six months for a new vaccine.
The world saw not one, but
three influenza pandemics in the 20th century. The "Spanish" flu
of 1918, by far the most virulent, is well known, but smaller
pandemics in 1957 and 1968 go largely unremembered outside
Human deaths from the
latest threat, H5N1, have increased each year since 2003. The
virus was first identified in China, and human cases have
appeared as far west as Turkey and Egypt. The total death count
is now at 154, with 76 this year alone.
Contact Jennette Barnes at
Back to Top