Air Date: Week of February 23, 2007

Dr. Anothony Fauci is the Director of the National Institute of Allergy and Infectious Diseases at the NIH (Courtesy of NIH)

Host Steve Curwood gets an update on the bird flu threat from Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci says that recent outbreaks among poultry in Britain and humans in Southeast Asia show that bird flu continues to loom as a major threat, and that humans are still unprepared.

Transcript

CURWOOD: It’s Living on Earth. I’m Steve Curwood. With the exception of a recent culling of a turkey flock in the UK, the H5N1 bird flu has stayed mostly out of the news since a flurry of concern more than a year ago. About 200 people have died from the disease, mostly from direct contact with infected birds, but so far there has been no sign of the pandemic that is expected if the H5N1 flu were to mutate into a form that can be easily transmitted among humans.

For a check up on the bird flu, we turn now Dr. Anthony Fauci. He runs the national institutes of Allergies and Infectious diseases. Thanks for joining us.

FAUCI: Thank you it’s good to be here.

CURWOOD: So when we last checked in with you in March of 2005 there was quite a bit of activity and discussion about the avian bird flew migrating into humans. And then things have been pretty quiet. And then just recently there has been a bit more news. So where are we now on the threat of this possible pandemic?

FAUCI: Well, the threat really has remained about the same. It has not gotten worse nor better. There’s still this smoldering activity of not being able to eliminate the infection of H5N1 among bird flocks. And it continues to smolder in Indonesia and Southeast Asia and then most recently in the turkey farm in the UK. And as long as there are chickens that are infected and sick and dying there’s always the possibility of it, as we say jumping species from the chicken or the turkey to the human. That has not occurred in the UK but in other parts of the world like Southeast Asia there have been a steady trickling in of cases.

CURWOOD: Now when we last spoke you were in the midst of a vaccine project here in the United States. What’s currently happening with that?

FAUCI: Well, it was successful in many respects in that the H5N1 Vietnamese strain that was being tested has shown to be predictive of being protective. That was the good news. The sobering news is that the dose required to get to that level of immunity was prohibitively high and the protective immunity was only seen in about 50 percent of the people. Since that time and since we last spoke there’s been a considerable amount of work done on the use of vaccines together with adjuvants. And an adjuvant is a compound when given with the vaccine amplifies, expands, and heightens the immune response. We needed that because we needed to get away with a much lower dose to induce a protective response. So I think that’s going to be very helpful if and when we come to the point of needing to make large amounts of vaccine.

CURWOOD: Do we have one today?

FAUCI: Well, you know, we have it. We don’t have enough to have a meaningful impact if we are confronted with a real pandemic influenza among humans. But actually having a vaccine in hand is not anything major there. It’s getting enough doses that can be distributed in case we do in fact have a human pandemic.

CURWOOD: So where are we in the vaccine process?

FAUCI: Well in the vaccine process there are a number of things that are going on in parallel. The classic way that we traditionally get a vaccine for influenza is to grow it in eggs to get the product; either the whole virus that you then kill and use as a vaccine or you break up the virus and you use its components. There are a number of companies that are taking that approach. In parallel with that are a number of organizations, researchers, and companies, which are using the more modern vaccine techniques which we call recombinant DNA technology. In other words you don’t have to deal with the entire virus itself. You can use the molecular genetic capability of using just the components of the virus that are important for the vaccine. One such trial was actually just started in an early phase just a couple of weeks ago.

CURWOOD: We hear that Tamiflu isn’t particularly effective anymore against the bird flu. Um, how true is that?

FAUCI: Well, it depends on what you mean by particularly effective against the bird flu. If you’re talking about resistance of the virus to the Tamiflu effect that still most of the isolates that we get right now are actually sensitive to Tamiflu. However there’s a broader point with Tamiflu and other existing antivirals. And that is the original conditions for which it was approved by the FDA was that if given within the first 24 to 48 hours Tamiflu can diminish the duration of symptoms by about one and a half days. We have no idea how well Tamiflu will perform if given to people who are desperately ill with a pandemic flu.

CURWOOD: How worried are you now about an avian flu pandemic among humans?

FAUCI: Well, I think that pandemic is going to occur sometime in the future. We’ve had three of them of varying degrees of severity in the 20th century. It is highly likely that within a reasonable time in the 21st century we’ll have one. Whether that’s going to be the currently circling H5N1 we have no idea. We do know that pandemics do occur. So if there’s anything positive going on right now I think it’s focusing our attention, and a wake up call, that a pandemic is a possibility. It may not occur with this virus. It may not occur this year, next year, or the year after, but eventually we need to be prepared for a pandemic flu. You need to prepare for the worst.

CURWOOD: Anthony Fauci is director of the National Institute of Allergy and Infectious diseases. Thank you so much sir.

FAUCI: You’re quite welcome. Good to be here.

 

Links

National Institue of Allergy and Infectious Diseases

Centers for Disease Control and Prevention: Avian Influenza