Friday, February 02, 2007

CDC issues guidelines emphasizing closings in case of pandemic avian flu

The Centers for Disease Control in Atlanta issued guidelines as to how a pandemic of avian influenza could be controlled, on Feb 1, 2007. The main link at the CDC seems to be this: This is the parent site, and it does offer RSS syndicated feeds of news releases.

Two of the major news stories are by Donald G. McNeil of The New York Times, 2/1/2007, p. A12, “Closings and Cancellations Top Advice on Flu Outbreak”, and David Brown of The Washington Post, “CDC Issues Guidelines For Battling Flu Pandemic: School Closings Likely, But Restricting Travel Not Suggested”, p. A3 on the same date. The Post also has a correlated story by Mr. Brown, “Tiny Mutations Can Limit Influenza Spread, Study Finds; Re-Created Spanish Flu Virus Less Contagious After Changes”.

The CDC organized its recommendations into Categories resembling those of hurricanes. The 1957 and 1968 pandemics would have been category 2. I had the 1957 flu in October of 1958, when I was a sophomore in high school, and missed one week. It caused extreme congestion. I did not have another absence of comparable length in my whole high school experience. Most years I have been vaccinated. It appears that adults exposed to these strains in youth may have more resistance to most outbreaks today in middle age.

Avian influenza reached humans in Egypt and Nigeria, and killed over 50% of people known to be infected. As a practical matter, if it became transmissible human-to-human readily, it would probably adapt to the human host and become much less lethal. Still, the 1918 Spanish influenza had a 2% mortality rate in the U.S. and 20% in some parts of the world. The likely extreme variability in individual susceptibility raises profound moral and ethical questions in control. Some persons (probably older adults in middle age) will not be susceptible at all and will resent the economic harm caused by closings.

States have the authority to close schools and gatherings, but will look to the CDC for guidance. More severe categories would lead to closings not only of schools, but also sports events, theater, movies, and the like, and could do extreme permanent economic damage to these industries; although the Internet might provide some creative ways to adapt. The Post article describes “Pandemic America” as one in which people will not have a choice about restricting their social and commercial loyalties to family and community. This has a profound relevance to our social debate on such matters as individualism, blood loyalty, family values, gay rights, and individual sovereignty and personal autonomy, even private property rights as we have come to enjoy them.

The NY Times article mentioned evidence that the 1918 epidemics in St. Louis and Cincinnati may have been milder because of a pre-spring epidemic in those cities conferred resistance.

On 2/2/2007 Britain reported an H5N1 outbreak on a turkey farm (Reuters story by Luke MacGregor).

Representative Jim Moran 's (D Va 8th District) letter to me on June 1, 2006 on this topic is available here. It is certainly disturbing.

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