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Wednesday 26th October 2016

H5N1 reappraisal

12th May 2006

01052006_birdflu1.jpgLast week, over 500 experts in avian influenza and other emerging infectious diseases met in Singapore for The Lancet's first Asia Forum. They represented 55 countries, including those nations that have suffered the greatest effect of the H5N1 virus; Vietnam (93 cases), Indonesia (32 cases), Thailand (22 cases), and China (18 cases). The report of the latest case in China took the total number of human infections to 205, with 113 deaths.

Influenza viruses, while commonly known, are strangely neglected, sometimes even misunderstood says an Editorial in The Lancet. We are forced to admit our ignorance about the biology and pathology of the H5N1 virus. Global surveillance systems are weak and detailed response plans to an emerging pandemic are absent, it continues.

Experts at the Asia Forum agreed that there are few truly effective and, most importantly, no coordinated global, regional, or national preparedness plans. Politicians and policymakers have become over-confident about how they might defeat a highly transmissible and pathogenic virus, following on from SARS.

There is complacency in suggesting that H5N1 poses “challenges�, and astonishingly even offers us “opportunities�; and dangerous rhetoric in talking of strategies and protocols, stockpiles and fire blankets.

The idea that within a week or two of a pandemic's initiation we could quench it by saturating a ring of at-risk population with oseltamivir, achieving 90% coverage and high compliance, and at the same time impose movement restrictions and social distancing 'is simply fanciful', says The Lancet.

The Lancet wrote after the 1918 influenza pandemic, if only we had acted earlier with a “collective health conscience�, many millions of lives could have been saved. We are repeating the same mistakes of a century ago. Avian influenza is not a challenge, concludes The Lancet, 'it is a predicament of extraordinary proportions'.

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