Continue to prepare for possible flu pandemic

THE ISSUE Studies show that the bird flu is not likely to pass from human to human in its current makeup -- but that could change.

TWO recent studies concluding that the avian flu virus in its current form is not likely to be passed from one person to another should make people breathe a little easier. That does not mean efforts to prepare for a pandemic are vain. Virologists agree that a flu pandemic will occur sooner or later.

The state has assigned a medical team to test arrivals at Honolulu Airport for avian or other kinds of flu, and the state's medical network has stockpiled goggles, gloves, boots and other gear to protect its personnel in case of a pandemic. Those precautions continue to be worthwhile.

Research groups in Japan and Holland concluded in separate studies that cells favored by the avian flu virus are located in the lower lung. Human flu viruses commonly infect cells found toward the windpipe and are spread by coughs and sneezes.

The avian virus would have to make many genetic mutations before becoming a pandemic strain, according to Yoshihiro Kawaoka, a virologist who teaches at the University of Tokyo. The University of Wisconsin, where Kawaoka also is a professor, said in a news release that the agencies "may have more time to prepare for an eventual pandemic."

However, researchers at the Erasmus Medical Center in Rotterdam concluded that only a couple of mutations might be needed for the avian flu virus to become contagious among humans. That is similar, in its early stages, to the virus resulting in the 1918 Spanish flu epidemic, which killed 50 million people worldwide and 500,000 in the United States.

The studies' findings, published last week in the journals Nature and Science, are not surprising. Flu experts already knew that people who have contracted the current avian flu virus were infected in the lower lung. The studies confirmed the reason.

A third study, presented last week at a conference in Atlanta, concluded that the virus, which emerged in Hong Kong in 1997 and has spread to Europe and Africa, already has mutated at least once. Researchers from the Centers for Disease Control and Prevention found that a genetically distinct strain of the same virus began infecting humans in Indonesia last year.

Researcher Rebecca Garten, who presented the findings, said she expects the virus to become more genetically diverse. "Change is the only constant," she said. "Only time will tell whether the virus evolves or mutates in such a way that it can be transmitted from human to human efficiently."

While experts learn more about the virus, Hawaii should continue to prepare for a pandemic that could kill more than 1,000 people and hospitalize nearly 5,000 in the islands, according to model estimates.