The threat of avian flu

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The avian flu virus is a pathogen invisible to the human eye which poses an immense potential threat to American civilization. In the past several months, it has become clear to me that we remain dangerously unprepared to defend ourselves against it.

At a glance, some may dismiss the avian flu virus: Only 59 people have died from it over the past two years and fewer than 120 have become infected. So far, humans infected with the avian flu have not transmitted it to other humans. Thus far all known human cases have happened far away.

But the avian flu may not remain trivial for long. The virus — known as H5N1 — changes very quickly. Humans have no natural immunity to it. And infected birds may be able to transit it before they show symptoms. Any virus with these characteristics could devastate the human population while causing massive economic and social chaos.

And, indeed, they have: Influenza viruses like avian flu have caused the greatest pandemics in world history. They mutate continually, making it almost impossible to wipe them out entirely. Even today in the United States, the flu kills over 30,000 people each year. But past epidemics have been much worse. Between 1918 and 1919, the Spanish Flu killed 40 million people around the world. Most were children and young adults. Given the world has nearly four times more people and far more efficient means of travel, another pandemic could spread more quickly and kill more people than before. If it were to become transmissible between humans, avian flu might kill 160 million to 200 million people.

Given our inadequate preparation, indeed, many deaths could happen in the United States. The effects, needless to say, could be catastrophic: massive declines in GDP, limitations on travel and enormous loss of life. Earlier this year, I called for a "Manhattan Project for the 21st Century" — an all-out effort to defend against the threat of human-made and naturally occurring infectious disease. On Tuesday, I wrote to Health and Human Services Secretary Michael Leavitt to ask him to improve our ability to respond to a potential avian flu crisis.

Right now, our national stockpiles of anti-viral drugs sit at dangerously low levels — about 2 percent of what we would need in a serious outbreak — and no existing vaccine can provide perfect protection against the avian flu virus. Vaccine and drug production in the United States, furthermore, couldn't make up this difference quickly enough were a serious outbreak to occur. While HHS has drafted a Pandemic Influenza Response and Preparedness Plan, it remains incomplete.

The situation in many other countries is even worse. Some poorer countries don't even have plans. And, particularly in the underdeveloped world, we might not even be able to detect and contain an outbreak before thousands die.

The United States needs to act immediately: We should stockpile enough anti-viral drugs to treat at least half of the U.S. population while simultaneously improving our ability to defend against an outbreak at home or abroad.

If a pandemic occurs soon, we will be in a race against time to build the appropriate defenses on the fly. We cannot afford inaction. Through the Project Bioshield legislation President Bush signed last year, we began the process of preparing for biological, chemical and nuclear threats. But Congress and the administration still need to do much more.

The avian flu poses a serious risk to our nation's health and security. Every medical worker, public health specialist, parent, and, indeed, every citizen, needs to think about how we can confront it. Right now, preparing to face a pandemic should rank very high among our nation's priorities. And, for the safety of its people, our nation needs to act now.

Senate Majority Leader Bill Frist, M.D., is a Republican from Tennessee.