(College Station)—The global flu pandemic of 1918 was the worst infectious disease outbreak in recorded history. By the time it ended, as many as 100 million people—mostly the young and healthy—were dead, many in just a few hours.
If the same outbreak were to occur today, it would kill about 1.5 million Americans, more than die each year from the 10 top causes of death combined, including cancer, heart disease and car wrecks. Recent reports state that in a worst-case scenario, as many as 142 million people could die worldwide, and global economic losses could run to $4.4 trillion.
But while health care practices and technology are far more advanced than their 1918 counterparts, modern air and highway travel mean that the virus could spread around the world in mere hours, overwhelming hospitals and impeding the distribution and delivery of critical items such as groceries and electrical power.
A&M System administrators and researchers are doing their best to stay ahead of the threat of avian flu, which as of mid-February is not contagious among people and has not been found in North America.
Experts have grown increasingly concerned in recent years that an avian, or bird, virus called H5N1 may mutate into a genetic “kissing cousin” of the deadly 1918 strain. Many flu viruses originate in birds, and until last June, outbreaks of H5N1 were contained in flocks in southern Asia.
Since then, however, the virus has swept through flocks across Asia and into the Mediterranean, the Middle East, India and sub-Saharan Africa. In the last week, the virus also has been found in dead birds in six European Union countries. More than 200 million birds have been killed or culled since mid-2003.
Although H5N1 does not usually infect people, the World Health Organization has reported more than 165 human cases resulting in 80 deaths in Asia since 2003, mostly in people who had direct contact with infected poultry.
Because influenza viruses change continually, researchers are concerned that avian flu someday might be easily spread from one person to another. Furthermore, recent research on the 1918 virus suggests that it jumped directly from birds to people. Since birds migrate from continent to continent, disease could be spread almost simultaneously across the globe.
No one can predict exactly what will happen. Flu strains mutate randomly, and until or unless H5N1 develops the ability to easily latch onto human cell membranes, it will remain a difficult virus for humans to catch. On the other hand, since July 2005, the virus has made eight of the 10 mutations required for human-to-human transmission.
The H5N1 virus may never become a threat, but the A&M System is prepared nonetheless. Kevin McGinnis, director of risk management for the A&M System and a member of the board of the national University Risk Management and Insurance Association, said that the avian flu will be a topic at the association’s annual conference in May. As a board member, he is helping prepare a white paper on avian flu for the association’s members.
“As with most risks that may appear ‘distant’ to many, getting the proper attention on them ahead of time is the real challenge,” McGinnis said. “The A&M System has protocols for dealing with many different kinds of emergencies, including natural disasters and disease outbreaks.”
The A&M System’s Texas Veterinary Medical Diagnostic Laboratory http://tvmdlweb.tamu.edu/ is at the forefront for identifying and helping prevent the spread of animal diseases, including avian flu. TVMDL scientists at labs in College Station and Amarillo, and at poultry labs in Center and Gonzales, handle more than 180,000 requests for disease diagnosis per year.
As one of five hubs in the U.S. Department of Agriculture’s National Animal Health Laboratory Network (NAHLN) established after the terrorist attacks of September 2001, the TVMDL has upgraded its facilities, trained more people and purchased state-of-the-art robotic equipment. In addition, the College Station facility added Bio-Safety Level 3 capability veterinary diagnostic lab in 2004.
“If avian flu or an outbreak of any other disease happens, we could be brought to full capacity in two hours,” said Lelve Gayle, TVMDL executive director.
Gayle also is working to identify 100 or so additional trained technicians from across the A&M System who could be brought to College Station and work in rotating teams with TVMDL staff during a major outbreak.
“Eventually, a serious infectious disease will emerge,” Gayle said. “It might not be the avian flu, and it might not happen for years, but it definitely will happen. Our job is to safeguard the state’s physical and economic well-being when it does. We’ll be ready.”
The National Center for Foreign Animal and Zoonotic Disease Defense, a Department of Homeland Security center based at Texas A&M in partnership with three other institutions, is working with the U.S. Department of Agriculture on avian flu surveillance.
“Our scientists are developing new approaches for rapid detection and diagnosis of avian influenza in bird species that carry the virus,” said Neville Clarke, FAZD Center director. “This is important given concern that wild birds carry the H5N1 strain, which poses a threat to human health.”
The FAZD Center is focusing on the zoonotic element of the disease, or how the disease interacts with birds, the environment and humans. “We want to take short-term actions that can make a difference in preventing or protecting the United States against this imminent threat as we continue our longer-term research.”
The FAZD Center is cooperating with the University of Texas Medical Branch and the University of Texas School of Public Health to develop a proposal to establish a broad influenza surveillance program for both humans and wild birds in Texas.
John
Quarles
Texas A&M Health Science Center College of Medicine faculty member John Quarles has worked for the last two and a half years with DelSite Biotechnologies, Inc. and colleagues in Texas A&M’s College of Veterinary Medicine and Biomedical Sciences to develop a nasal powder influenza vaccine. The group received a $6 million grant from the National Institute of Allergy and Infectious Diseases in the fall of 2004 to continue preclinical work on the project, which will include a vaccine against avian flu.
DelSite has developed a vaccine delivery system called GelVac™, a powder based on an extract of aloe vera that will be combined with inactivated vaccine antigens. Administered intranasally, the powder creates a thin film of gel over the mucous membranes, allowing the vaccine to be taken up more slowly by the body. This slower uptake of antigens from the mucous membranes is expected to produce a better immune response than that of the currently licensed inactivated influenza vaccine, which is injected into the muscle.
“The pre-clinical phase of development first shows the vaccine works in animals. Then we start planning to conduct human trials. Bringing a new vaccine or drug to the market can take years, but we are making significant strides. The National Institutes of Health has been pushing for academic entities and private companies to form partnerships, and that’s exactly what we’ve done here,” Quarles said.
Approximately $600,000 of the three-year, $6 million grant will be used by Quarles and his research colleagues to continue conducting preclinical tests to study protection against the flu in animals. The remainder of the grant will be utilized by DelSite for product development and toxicology testing.
Although several companies are developing investigational vaccines for the avian flu, it is unlikely that enough vaccine could be made and distributed quickly enough to prevent a major outbreak. Avoiding sick people and maintaining good hygiene are still the best ways to prevent contracting any strain of flu.
The Centers for Disease Control also recommends the following: