As the staffs at Maryland hospitals and public health officials make local contingency plans for a possible avian flu pandemic, it is far from certain that the current strain of flu contracted by humans in Asia and the Middle East will cause the next pandemic in the U.S., a Hopkins epidemiologist told the GBC Healthcare Committee at its May 9 meeting.
The reason? The H5N1 avian flu, which first emerged in Hong Kong in 1997 and re-emerged in Asia’s poultry population in 2003, has not yet proven to be easily transmittable from one human to another, according to Dr. Lisa Maragakis.
Since 2003, slightly more than 200 cases of H5N1 flu have been confirmed among humans in nine countries. In all but a very few cases, the virus was contracted through direct contact with poultry. The only cases where it was passed on from human to human have been among family members with very close contact to the patient. For instance, in one case a mother and an aunt of a patient contracted the strain while they were caring for the patient and in close contact with her. No one else in the hospital, including health care professionals who treated the patient, contracted the flu.
Nevertheless, the H5N1 strain is the first avian flu to be passed from birds to humans, said Maragakis. It has a high mortality rate – approximately 51 percent – and could spread very quickly if the strain evolves and develops the ability to be easily transmitted from one human to another. That’s why it has galvanized the public health community to begin planning for a pandemic, should it occur, she said.
If a pandemic materializes, it could spread around the world in a matter of weeks or days and “the impact on our health system could be significant,” Maragakis said. In Maryland, more than 20,000 could be hospitalized with H5N1, according to estimates.
Meanwhile, federal government resources would be limited. “We need to be ready to depend on local resources. We can’t expect to depend on the federal government’s support, especially early,” Maragakis said. Health officials are seeking to establish a network of communication among Maryland hospitals to facilitate a better response to an avian flu outbreak, she said.