A century of pandemics?

Date: 06/04/06

The threat of an influenza pandemic now hangs over the world. H5N1, a virulent strain of bird flu, has killed thousands of birds and about 100 people working closely with the infected birds.

The fear is that if the virus mutates into a disease that can easily be transmitted from human to human then mortality rates will soar.

Optimists point out that Europe has now been free of flu pandemics for 38 years, that the three 20th century pandemics saw progressively lower mortality rates and, most importantly, that healthcare, hygiene standards and observation capacities have all improved immeasurably over the past century.

They add that much has changed since the infamous Spanish flu pandemic of 1918-19, which killed between 40-50 million Europeans, and that mortality rates were exacerbated then because Europe was still struggling with the effects of a world war. Another view is that, regardless of the improved quality of life in Europe, influenza is still spread the same way that it always has been: by inhaling the virus.

We also, as yet, have no vaccine for H5N1 or any other potential mutant virus and today's greater international travel by planes and trains could make it easier for the disease to spread.

The European Commission recently carried out a pandemic simulation test across the 25 member states, to test the EU's ability to cope if a killer virus does emerge.

The Commission assumed that in the event of an influenza pandemic 25% of EU citizens would fall ill. Of these, 1.5% would die.

The assumed mortality rate means that out of every 800 Europeans, three would be killed by the pandemic - about 1.7 million of the EU's 450m citizens would not survive.

EU governments, alongside the Commission and its nine-month-old European Centre for Disease Prevention and Control are set to spend much of the coming year preparing to fight off a theoretical deadly virus.

Markos Kyprianou, the European commissioner for health, reported to his colleagues last week that the Commission had identified some weaknesses in preparedness, among them insufficient attention to the problems of maintaining public order, to the disruption of economic activity and to various international aspects, including border control and international transport, particularly airports.

An influenza epidemic will only add to the substantial challenges for the EU posed by already-existing epidemics: HIV/AIDS, malaria and tuberculosis. If the international community is to make advances in the fight against these pandemics then European vaccine manufacturers will have to play a substantial part and the governments of the EU must expect to make a sizeable contribution to the bill.

Introductory article to a six-page European Voice Special Report on 'Pandemics'.