Avian Flu Online Chat - transcript

May 30, 2006

William Christoffel, John Latimer - Washington County Director of Emergency Services, and John G. Newby, MD., F.C.A.P., are our Live Chat guests today starting at 7:30 am and ending at 8:30 am. Questions or comments can be submitted by clicking here before and during the chat. Or send an email to:

Moeller: 1. Does the state and the county have up to date plans prepared for a

pandemic avian flu?

Christoffel: At the present time both the state and the county are in the process of developing a plan for responding to the pandemic flu. Some of the components of the plan have been under development for some time, while others need to be started. Some of these include developing a county-wide immunization plan and public information/education strategy to enable the public to protect themselves during a potential pandemic flu outbreak.

Moderator: Every year we hear the announcements that it's time for flu shots and that it would be prudent for those at greatest risk to get them. Why is the avian flu more dangerous than the usual strain?


Newby: The usual form of seasonal influenza is of danger to certain populations, especially the very old and the very young. Those individuals for whom annual immunizations is recommended includes those over the age of 55, and those suffering from respiratory, cardiovascular diseases as well as individuals with chronic diseases such diabetes. Annually there are approximately 36,000 deaths attributable to the usual form of influenza. This is out of approximately a million cases annually. Avian influenza (H5N1) has a more significant level of lethality with greater than 50% of those infected dying from the disease.

Moderator: So what is the importance of a seasonal influenza immunization?

Newby: At this time, there is no vaccine for H5N1 influenza. Both the seasonal and Avian influenzas have similar symptoms. By innoculating a large proportion of the population against seasonal influenza, the presence of Avian influenza will become apparent earlier if it occurs.

Question: I am wondering if an influenza pandemic were to occur, how possible would it be to keep ones family safe. If you were to voluntarily quarantine yoruself and your family and only go out when you absolutely had to, would that be enough to protect you from the virus. Basically, what can the average person do to protect themselves? Also, are there masks that are better than N95 to protect against the virus?

Newby: Should an epidemic occur, the population may be asked to limit outside contacts and practice "social separation." This would occur only if a major epidemic was in progress. The need for such extreme measures prior to any epidemic is unnecessary. This social separation is, in fact, part of the overall plan for containing a potential pandemic.

Moderator: On Friday, The Washington Post reported that a family in Sumatra in Indonesia was apparently infected with no evidence of contact with infected birds. Is this the start of the pandemic?

Newby: First, while direct evidence of bird contact is not known in this case, it would not be unusual in the cultural context where this case occurred in northern Sumatra. The index (or first) case was a woman who died and was already buried prior to the investigation of what turned out to be seven cases within the same family. It is highly probable that bird exposure was involved, and that the human-human transmission that occured was an unusual event since the secondary cases were in the same small closed room with the woman who died first.

Christoffel: This case is important because it points out what the United States is doing to protect our citizens. Once the index case was identified in Sumatra, the Center for Disease Control dispatched several epidemiologists to Sumatra. The US strategy is to try to contain any outbreaks where they occur. The purpose for sending the CDC staff to Sumatra is to get additional information on the virus and to provide antivirals to other family members, reducing the potential for spreading the disease. Their studies confirm that the virus (H5N1) has not changed from its previous form.

Moderator: What's the status of a vaccine for H5N1?

Christoffel: One of the advantages of sending the CDC staff to Indonesia was the ability to obtain a copy of the H5N1 virus. This will enable the medical community in the US the opportunity to further their research in developing a vaccine that would protect against severe infection by H5N1.

Moeller: Assuming that an effective vaccine is produced, what are the priorities for vaccinating county residents--is it the Health Department employees first, the politicians second, the rich folks third, ... and the poor folks last?

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