Australian Broadcasting Corporation


LOCATION: http://www.abc.net.au/7.30/content/2005/s1324215.htm

Broadcast: 15/03/2005

WHO warns of bird flu danger

Reporter: Tom Iggulden

TOM IGGULDEN: Another planeload of travel-weary passengers arrives at Sydney airport. It's one of hundreds of flights that arrive from Asia every week, carrying thousands of passengers. Any one of them could be infected with what the World Health Organisation calls the greatest disease threat facing the world today.

PROFESSOR GRAEME LAVER, MOLECULAR BIOLOGIST: It'd be explosive. I mean it's a highly transmissible virus, it'd just explode in the community. There's no way of stopping it.

TOM IGGULDEN: Two outbreaks of Asian bird flu have killed at least 47 people in Thailand and Vietnam over the past 18 months. Most have caught the disease after coming into contact with infected poultry. Millions of chickens have been destroyed in an effort to check the spread of the disease.

DR ALAN HAMPSON, WORLD HEALTH ORGANISATION: I think that the outbreaks that we're seeing in South East Asia of the H5 virus, which has been spreading and has now become established, I believe, in domestic ducks and probably a number of wild bird species in a very potent and dangerous form, poses a very significant risk.

TOM IGGULDEN: Health officials are worried the virus could mutate, allowing the disease to be passed from person to person.

PROFESSOR JOHN HORVATH, AUSTRALIAN CHIEF MEDICAL OFFICER: What we're really frightened of is when it becomes efficient, when one person can spread it to 15 or 20 people, and that means the virus has changed into a human form of flu.

TOM IGGULDEN: That change would set the scene for what the WHO says is an inevitable pandemic with the potential to kill millions, and it's happened before. In 1919, soldiers returning from the First World War spread a strain of influenza that killed 40 million - five times the death toll of the war. Since then, there's been a global flu epidemic about every 30 years, each with a death toll in the millions. Experts believe we're already overdue for the next one.

DR ALAN HAMPSON: I think it's a matter of when rather than if, and I guess I'd like to have as much chance of winning the lottery as there is of a pandemic occurring.

TOM IGGULDEN: The symptoms of bird flu are similar to normal human influenza. High fever, a cough, sore throat, aching muscles and weeping eyes. But as the virus takes hold, things get much worse. Most of its victims die from pneumonia, or other breathing problems. Peter Molloy is the chief executive of Biota, which researches anti-viral drugs to fight influenza. He says an outbreak of bird flu could eclipse previous flu pandemics.

PETER MOLLOY, CHIEF EXECUTIVE, BIOTA: In the outbreaks in Vietnam and Thailand in 03/04, between late 2003 and mid-2004, the mortality rate was about 70 per cent, which is astronomical when you compare it with the Spanish flu back in 1918.

TOM IGGULDEN: Australia's chief medical officer, Professor John Horvath says he is prepared to quarantine travellers from any overseas city or region where a pandemic breaks out.

PROFESSOR JOHN HORVATH: You can't give a 100 per cent guarantee, but most of our early-intervention plans are around minimising that risk. I think we have a very high chance.

TOM IGGULDEN: But Professor Laver argues it will be impossible to prevent a pandemic from spreading here.

PROFESSOR GRAEME LAVER: Somebody could be infected at Bangkok airport, he wouldn't have any symptoms. He'd be shedding the virus on the plane and after about six hours, the rest of the plane would catch it and they wouldn't show any symptoms, they'd arrive in Sydney, it'd come into Australia undetected and spread out to the community. That's almost certainly what would happen.

TOM IGGULDEN: So if a highly contagious and potentially fatal flu does enter Australia, what can the Government do to stop it spreading?

PROFESSOR JOHN HORVATH: The anti-virals are there, the personal protective equipment, surveillance within the country to know where it is, and sensible usage of the quarantine laws.

TOM IGGULDEN: While vaccine is available to inoculate against human influenza there's no vaccine for bird flu. The last line of defence against a bird flu pandemic would be drugs called anti-virals, designed to save lives by minimising the symptoms. Last year, the Australian Government began stockpiling an anti-viral called Tamiflu. While the Government won't specify the size of the stockpile, it's understood to be enough for around 200,000 people.

PROFESSOR JOHN HORVATH: The principles are, those people who would be dealing with potentially or actually infected people would be the ones who would be given these anti-viral drugs and that's the sort of sensible, normal thing.

PROFESSOR GRAEME LAVER: The emergency departments at hospitals at the moment can hardly cope with patients. Imagine if there were thousands of flu victims seeking intensive care desperately. There's nothing you can do about it. So really, there has been no preparation for a pandemic.

TOM IGGULDEN: Professor Laver argues there could be widespread panic unless Australia follows the example of other countries which are preparing much larger stockpiles of anti-viral drugs.

PROFESSOR GRAEME LAVER: How will the rest of the population react when they know that somebody has the drug and we haven't got it and my child is sick? What are we going to do about it? They haven't thought of that. The British Government have made a good enough decision. They've stockpiled enough drugs for one quarter of the population.

TOM IGGULDEN: Others are pushing an even more radical strategy, that the best defence against a pandemic in Australia is to contain it at the source, by sending our anti-viral drugs overseas. In bird flu hot spots such as Thailand, Vietnam and China, stockpiles are virtually non-existent.

PETER MOLLOY: I think it's every country's natural inclination to want to protect their own citizens first and a number of countries have gone ahead with that, but clearly, there's a need beyond the individual country's shores here.

PROFESSOR JOHN HORVATH: If 20 million people suddenly get avian flu in South-East Asia, there's not much the developed world can do about it at this stage.

TOM IGGULDEN: Is there something they could do before that happens in terms of stockpiles?

PROFESSOR JOHN HORVATH: This is a discussion that will occur at WHO in May.

TOM IGGULDEN: But even with all the precautions in the world, Professor Horvath maintains that containing a pandemic here could come down to sheer chance. Even critics of the official bird flu strategy concede he's facing a tough job, preparing for a disaster they believe is only a matter of time.

PROFESSOR JOHN HORVATH: It's impossible to put figures on it because we don't know its transmissibility. All you can do is plan for a worst-case scenario and make your plans accordingly and hope you never have to use them.

TOM IGGULDEN: So you don't have a figure in mind of how many Australian lives could be at risk in that worst case scenario?


TOM IGGULDEN: A few serious questions for consideration there.