Plan Now for Avian Influenza, Speaker Says

By Jane Stoever • Kansas City, Mo.
5/12/2006

Plan for avian influenza, and keep yourselves and your patients educated about the disease. This was the advice American Public Health Association Executive Director Georges Benjamin, M.D., gave to family physicians and AAFP chapter staff at the combined National Conference of Special Constituencies and Annual Leadership Forum here May 4.

Georges Benjamin, M.D., executive director of the American Public Health Association, advises family physicians, "Ask yourselves, 'How am I going to run my office when my nurse isn't there?'"

Benjamin, an internist, asked participants to make plans for avian influenza outbreaks under the following conditions:

having enough vaccine and antiviral agents to treat all infected individuals worldwide,
having some vaccine and antivirals in some places, and
having no vaccine or antivirals anywhere.

In any case, said Benjamin, many people would stay home from work to recuperate or to avoid infection.

"Many people can operate (a business) from home. I'm not sure most of you can do that," said Benjamin. "Ask yourself, 'How am I going to run my office when my nurse isn't there?'"

Benjamin encouraged participants to join in local planning for an avian flu pandemic, and then he advised, "We have not a clue whether the H5N1 virus (an avian influenza A virus) is going to be 'the one.' We should not be surprised if it turns out to be some other avian virus in 10 years" that causes a pandemic in this country. When the first H5N1-infected bird is detected in the United States, however, "that will be a public health event because every one of your patients is going to call you -- well, at least all the ones with colds or the sniffles."

Benjamin outlined some HHS assumptions concerning an avian flu pandemic, including

global susceptibility to the disease,
an incubation period of about two days,
a prevalence of infection in at least 30 percent of the population in affected areas,
a demand for outpatient care for 50 percent of those infected,
an active disease period of between six and eight weeks at a time and
the possibility that the disease may come in waves.

Benjamin gave his talk on the heels of a May 3 White House press conference on the Bush administration's release of the National Strategy for Pandemic Influenza: Implementation Plan (PDF file: 233 pages / 4 MB. More about PDFs.). That document gives implementation specifics for the national strategy document on pandemic influenza issued in November.

Benjamin suggested federal leaders and health professionals should take a broad view about diseases originating in Asia, where people are often in extremely close contact with their livestock -- sometimes even sharing their living quarters with potential disease hosts. Ameliorating impoverished conditions in this area of the world might go far in reducing the spread of communicable disease, he noted. "I'd like us to add an economic development perspective to our health diplomacy" in seeking ways to prevent the occurrence and spread of disease, he said.

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