THE FLU Experts: Practice hygiene

Basic precautions can make the difference, public health officials say.
KNIGHT RIDDER NEWSPAPERS
PHILADELPHIA -- If a flu pandemic erupts any time soon, survival could hinge on hygiene practices learned in childhood.
The medical marvels that many people think will protect them simply may not be obtainable, experts say.
The strongest defense -- vaccines -- would be in short supply, if available at all, said New Jersey state epidemiologist Dr. Eddy Bresnitz. Anti-viral drugs, which could prevent or treat the disease, also would be scarce and possibly ineffective, he said.
The best remaining option would require having people take such basic precautions as washing their hands and covering their mouths when they cough or sneeze, he said.
"Adhering to simple measures may mean the difference between life and death," said Bresnitz, a New Jersey deputy health commissioner, who would help lead the state's pandemic response.
Public health officials are watching anxiously a virulent flu strain that already has ravaged bird flocks in Asia and sickened more than 100 people, including at least 60 who died.
They fear the virus -- named H5N1 -- will mutate into a form easily spread by people and circle the world much like the devastating 1918 influenza pandemic that killed up to 50 million people.
'Response mode'
If a pandemic started soon, "vaccines and drugs would be a nonissue," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "We would be in a response mode. How do we get through the next week or month?"
Officials would be in a mad scramble to get enough food, protective masks and ventilators, among other items, he said.
Such a dire prospect has persuaded federal leaders to invest more in vaccine development and increase its anti-viral stockpile. President Bush met with vaccine makers last week to urge them to increase manufacturing capacity.
Bresnitz said such steps are prudent, but they don't guarantee supplies will be available in the near term to help most people.
For instance, the next generation of technology to improve vaccine manufacturing is not expected for about five years. And the government said last month it would spend $100 million for a vaccine targeted against the avian strain as part of plan to stockpile vaccine for 20 million people.
The two anti-viral drugs, which appear to be effective against the avian flu, would not be "the panacea" either, Bresnitz said. They are "an adjunct to managing the pandemic at best."
The supply also won't be adequate to give a daily dose to healthy people to prevent contagion, he said.
The current avian strain also could become resistant to the anti-virals, he said. And the drugs simply may not work against another potential pandemic strain.
"Nobody really knows," Bresnitz said.
Marla Gold, dean of Drexel University's School of Public Health in Philadelphia, said even if the anti-virals turn out to be a "Band-Aid," they will stop some of the bleeding.
"We are talking about buying time in case of a disaster," she said. Propelled by the avian fear, about 40 nations have placed orders for Tamiflu made by Roche, including 14.6 million treatments for Great Britain and 13 million treatments for France.
By year's end, the United States will have enough Tamiflu in its stockpile to treat about 5 million people, a company official said. Roche plans to add to that supply and start making the drug in the United States this year.
U.S. officials recently have announced a plan to purchase enough anti-virals to treat at least 20 million people. ."