2006-04-19-EU must co-operate on bird fluUnderstanding Avian Influenza
2006-04-19-EU must co-operate on bird flu
European countries need to work more closely together in planning for a future flu pandemic, a study suggests.
Although Europe's preparations for dealing with an outbreak are broadly good, important gaps remain, a study of 21 countries' plans in the Lancet says.
The maintenance of essential services and the way vaccines and other medical supplies are distributed need to be better planned, the UK team said.
There should be better surveillance of those working with animals, it added.
Avian flu has been found in birds in Italy, Greece, Bulgaria, Germany, Austria, France, Slovenia and Britain, but so far no humans have become infected in the European Union.
Although several human cases of the particularly lethal strain of bird flu, H5N1, have been discovered in Turkey.
Worldwide around 200 people have become infected, half of whom have died, most in South East Asia.
But experts believe a human flu pandemic, most probably linked to a mutant form of the H5N1 virus, is inevitable.
The report said: "With the spread of avian influenza H5N1 to Europe in 2005, countries should consider the possibility that the pandemic could originate in Europe.
"Surveillance of animals and of people working with them should be closely aligned, with effective cooperation and coordination between systems."
But it found that there were no joint standard procedures for health and veterinary authorities in dealing with the disease.
In 2004, the World Health Organisation urged nation states to draw up plans to protect their populations from a flu pandemic.
It provided a checklist of actions which would reduce the spread of infection, the number of cases and deaths from the disease.
The team, led by Dr Richard Coker of the London School of Hygiene and Tropical Medicine, evaluated the plans of 25 EU countries and four other non-EU European nations against the WHO guidance.
Most countries predicted death rates of between 2.3% and 4.65% in the event of a flu pandemic and estimated that between 15% and 50% of the population would become infected.
Although the team found preparations were generally good with national planning committees set up on in 18 of the countries surveyed, all countries envisaged outbreaks via humans coming from abroad.
Plans rarely stated the need for collaboration of other members states, including direct neighbours, despite a call for this from the European Commission.
The report said the EU should play its part in ensuring the consistency of plans.
Nearly all, 20 countries, had developed an drug strategy using antiviral medicines.
But only five, the Netherlands, the UK, France, Latvia and Romania set out clear priorities for treatment.
Dr Coker said that on vaccines and treatments the major challenge would be timing.
This is because work to provide full protection from a mutated form of H5N1 which might pass easily from human to human could only begin once that strain emerged.
He said: "Then the manufacturing capacity will have to be addressed and then there will be the issue about who gets the first lot of vaccines.
"There are internal domestic issues around planning for scarce resources whether its vaccines or face masks."
He added: "Europe is pretty well-prepared and has a lot of resources and effort going into the plan.
"But the question is are there lessons different regions can learn from each other. I am sure there are."
Commenting on the study, avian flu expert Kennedy F Shortridge said it was not surprising that governmental commitment was high and preparedness was broadly good.
But he said: "Although most countries have an immunisation strategy for a pandemic H5N1 vaccine, the hard reality is that plans have been drawn up without a commercially available vaccine."
He added that there was also concern that antiviral treatments may not necessarily be the "magic medicine" to stop human to human transmission.