Bird Flu: "This thing just continues to march"

The CP interview: Dr. Michael Osterholm of the University of Minnesota's Center for Infectious Disease Research and Policy talks about the flu bug that could bring the world to its knees

CP: Your answer to this is partly implicit in all you've said, but let me ask you to sum up how you'd rate the U.S.'s and Minnesota's state of preparedness for a pandemic.

Osterholm: I think the U.S. right now is leading the way in terms of the overall issue of pandemic influenza preparedness. The problem is that, for much of the developing world, they don't have a lot to prepare for. They don't have sophisticated supply-chain issues. In some ways I think they're better off than we are, because they already live a very simple, hand-to-mouth existence. For us, with our complicated supply networks, we have a long, long way to go. And I think that's as much a private-sector issue as a government issue. I think Secretary Leavitt has been brutally honest in telling American communities, you're going to be on your own. And I think he's right. You know how you creep, then you walk, then you run? We're still on our knees.

CP: What kind of measures might we in the Twin Cities expect to see undertaken in the short term if an outbreak did reach the U.S.?

Osterholm: I can't say. I don't know. I know that the governor today, in his State of the State address, said that he's just committed $10 million to influenza preparedness. What that means, I can't say. We don't have the details yet.

When the virus gets to this continent as a bird virus, it's important that we not overreact and misinterpret it to mean that now the pandemic's here. This will be an important issue for poultry, but as I pointed out, I think most of the poultry in this country—aside from the free-range organic poultry—is going to be pretty well-protected.

It's about the birds and it's not about the birds. It's about the birds now, but when real pandemic influenza occurs, the birds become inconsequential. It's human-to-human transmission that matters then. That's where we're not any better prepared here than anyone else in the world.

CP: How would you rate the media's performance in covering this story—too salacious, too understated, just right?

Osterholm: It's like talking about the weather, I guess—depends on which day, and where. There have been some outstanding reporters on this issue. Helen Branswell, from Canadian Press, covered SARS and has become the primary person on this. She's done it as well as anybody. On the whole, it has been poorly covered in the sense of distinguishing H5N1 in the bird population from pandemic influenza. That part has not been covered in depth. The issue about covering preparedness—no one has really gone into depth and explored the supply-chain issues to say, okay, what does this all mean? Let's take a community and say, what would happen here? We're so fixated on the news cycle that it's too often about, "what new country has just been infected with bird virus?" and not really get into the issues. Ted Koppel at Nightline did an excellent series of stories and asked good, hard questions. But now he's gone and Nightline hasn't picked it up since he left. 

*Cytokines are a class of proteins produced by white blood cells whenever the body finds itself responding to an infection. They vary in function—some cytokines attack invading microbes directly, others relay chemical messages from cell to cell, still others bind with cells in the hypothalamus region of the brain to produce fevers. Cytokines are toxic not only to infectious agents in the body but to the body itself: Much of the pain and discomfort that accompany illnesses like the common flu, for example, are in effect hangover symptoms from the toxic effects of the body's own immune response. The term "cytokine storm" refers to the immune response that occurs when the body is confronted with an infectious agent that reproduces at great speed and in huge volume. This "viral storm" generates an equally huge immune response—the cytokine storm—that can take such a toll on lung tissue (the main battleground where the virus and the immune system face off) that it deprives vital organs of enough oxygen to function, and sets off cascading organ failure.

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