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Britain unveils flu pandemic preparedness plan, buys 14m courses of treatment drug

Tuesday, March 1, 2005

The government of the United Kingdom has unveiled their strategy to deal with any future influenza pandemic in their Pandemic Influenza Contingency Plan.

The document, based on the World Health Organization's framework for responses, explains how the UK would respond to a major outbreak of flu.

Any flu pandemic would differ from the seasonal outbreaks of flu observed worldwide every year. While seasonal flu kills 12,000 Britons annually, a pandemic would affect far more people and could result in the deaths of up to 50,000 people in the UK if there were no medical intervention.

The government will have the power to cancel events where large numbers of people gather, such as football (soccer) matches. It could also advise travel restrictions to and from areas of high infection, but would not be able to enforce any such measures.

Schools might be closed in the event of a flu pandemic, and infected people would be asked to remain at home, although again no quarantine measures could be imposed by the government.

Further plans include education of the public to recognize symptoms of the flu and how to avoid infection.

Measures will be made to maintain basic services in the event of a pandemic despite staff absences through illness.

A major cornerstone of the plan is the prescription of oseltamivir, an oral neuraminidase inhibitor drug that combats influenza. The drug is currently marketed by Hoffman La Roche under the trade name Tamiflu®.

The UK Department of Health intends to stockpile 14.6m courses of the drug over the next two financial years, giving enough to treat one in four of the population - the ratio recommended by the WHO.

Canada and Australia have also bought the equivalent amounts of anti-viral drugs. The U.S. has also bought large amounts of similar drugs.

The total cost of the acquisition was not published by the government, but the BBC estimated the cost to be £180 million.

Unlike a vaccine, oseltamivir can be used to treat any strain of the influenza virus. Many new variants of the influenza virus are seen every year, and combined with the long lead times associated with the development of vaccinces, mass vaccination is frequently impractical.

Some parts of the newly-revealed plan already exist. The UK government recently gave £500,000 to the WHO for survellience of so-called 'bird flu' in South East Asia, a possible source for any future pandemic. The Department of Health will also continue to monitor flu-like cases seen by doctors and hospitals.

Background on Influenza, from Wikipedia

Influenza is an extremely variable disease; similar viruses are found in pigs and domestic fowl. In areas where there are high concentrations of humans, pigs and birds in close proximity, such as parts of Asia, simultaneous infections across species enable genetic material to be exchanged between the various strains of flu. This appears to be the principal method by which new infectious strains arise.

It is believed that sooner or later, a recombination may occur to produce a strain as lethal as the 1918 virus. In late 1997, a new strain of avian influenza (also known as bird flu) originating from chickens infected 18 people in Hong Kong, of whom 6 died. This strain did not appear to be readily transmissible from human to human, but such a high mortality rate, and the possibility of a further recombination to make it more infectious, meant that the risk was considered so great that all domestic poultry in Hong Kong was slaughtered. Avian influenza transmissible to humans resurfaced in January 2004 in Cambodia, Vietnam, and Thailand.

There were several serious outbreaks of influenza in the 20th century. The most famous (and the most lethal) was the Spanish Flu pandemic (type A influenza, H1N1 strain), which lasted from 1918 to 1919 and is believed to have killed more people in total than World War I. Lesser flu pandemics included the 1957 Asian Flu (type A, H2N2 strain) and the 1968 Hong Kong Flu (type A, H3N2 strain).

Although there were scares in New Jersey in 1976 (the Swine Flu), worldwide in 1977 (the Russian Flu), and in Hong Kong in 1997 (Avian influenza), there have been no major pandemics subsequent to the 1968 infection. Increased immunity from antibodies and the development of flu vaccines have limited the spread of the virus and so far prevented any further pandemics.

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