28 April 2006
International Talks on Pandemic Cooperation in Asia, Europe
More human cases of H5N1 reported; masks of dubious worth, study finds
By Charlene Porter
Washington File Staff Writer
Washington – High-level discussions to improve the global response to a potential influenza pandemic are under way on two continents this week.
Health ministers from the Group of Eight (G8) countries, meeting in Moscow April 28, discussed cooperative steps to jointly combat infectious diseases, including pandemic influenza, HIV-AIDS, tuberculosis and malaria. The outcome of their discussions will be forwarded to G8 leaders from Canada, France, Germany, Italy, Japan, the United Kingdom, the United States and Russia, for consideration at their July summit.
U.S. and Bangladeshi health officials signed an agreement April 27 to enhance South Asia’s ability to respond to pandemic. U.S. Assistant Secretary of Health and Human Services Stewart Simonson reached the accord with the International Center for Diarrheal Disease Research, Bangladesh (ICDDR-B).
“This memorandum of understanding will help better protect the world by strengthening Bangladesh’s disease surveillance infrastructure,” said Simonson in a statement released by Health and Human Services. The agreement will also boost pandemic preparedness activities in Bangladesh and surrounding countries.
While in Bangladesh, Simonson met with government officials from both animal and human health specialties to discuss collaboration on pandemic preparedness and response. The assistant secretary had similar meetings with officials in India.
THE SPREAD OF INFLUENZA
International cooperation on disease surveillance and prevention has been growing steadily in the past year in response to the continued spread of a highly pathogenic avian influenza virus that first appeared in East Asia and has now spread among birds in almost 50 countries across Asia, Europe, the Near East and Africa.
Some 200 million birds have died from the disease or have been destroyed in an effort to prevent its spread. The H5N1 virus has also infected just over 200 people in nine countries; of those, 113 have died.
The World Health Organization reported the latest human deaths April 21, confirming the findings of health officials in China and Egypt. Four deaths attributed to H5N1 have been confirmed in Egypt, with a total of 12 cases. Chinese health officials have reported 12 fatalities, with a total of 18 laboratory-confirmed cases.
The latest reports of human disease from this potentially lethal strain indicate that the infected had contact with ailing chickens. Mounting worldwide surveillance still has revealed no indication the virus can be easily passed between people through a cough, a sneeze or a handshake. That development could trigger pandemic disease, health officials warn.
THE MASK
Efforts to prepare for an influenza pandemic have focused attention on various strategies for limiting infection and preventing the spread of a disease that could cause tens of millions of deaths worldwide and widespread economic and social disruption.
The Institute of Medicine (IOM), part of the National Academies of Sciences, concluded April 27 that the use of inexpensive, disposable medical masks and respirators to prevent influenza infection is not substantiated by scientific evidence.
“Even the best respirator or surgical mask will do little to protect a person who uses it incorrectly, and we know relatively little about how effective these devices will be against flu even when they are used correctly,” said Donald S. Burke, professor of international health and epidemiology, Bloomberg School of Public Health at Johns Hopkins University and a member of the IOM panel that conducted the review. “Substantial research must be done to increase our understanding of how flu spreads, develop better masks and respirators and make it easier to decontaminate them.”
The IOM report comes in response to an HHS request for an evaluation on reuse of these masks in order to stretch what could be a limited supply in the event of a full-blown pandemic.
Disposable masks and respirators protect the wearer by trapping infectious particles inside fibrous material that covers the mouth and nose. Attempting to clean or disinfect the mask for multiple uses might damage the material rendering the device ineffective, the report found.
Various inexpensive masks and respirators being considered for widespread use in the event of pandemic have been certified to protect the wearer against certain test substances, but influenza viruses have not been among the agents used in the tests.
Whether users properly fit the mask around the face is critical to its effectiveness, and that could be an unpredictable variable when inexperienced people attempt to use a mask for protection.
Wearing masks and respirators was a common response to the 2003 SARS panic in Asia. The IOM panel said that experience provides some data on use of the devices by the inexperienced in the midst of a health crisis. However, the findings are limited and contradictory in some cases.
The IOM panel calls for more research on how influenza viruses are transmitted from person to person, predicting that knowledge will lead to better strategies for protection and prevention.
The report, Reusability of Facemasks During an Influenza Pandemic: Facing the Flu, is available on the National Academies Press Web site.
For additional information, see Bird Flu.
(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
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