Pandemic Plan: Avain Influenza

PANDEMIC PLAN: AVIAN INFLUENZA -- (House of Representatives - October 25, 2005)

The SPEAKER pro tempore. Under a previous order of the House, the gentleman from Texas (Mr. Burgess) is recognized for 5 minutes.

Mr. BURGESS. Mr. Speaker, I just wanted to take a minute this evening to talk about something that has been in the news a lot lately, and something that this Congress is going to be dealing with more and more as the next several months go by, and that is a discussion about the avian flu, or the so-called bird flu. I wanted to use these remarks tonight to talk about what is the bird flu; perhaps some history that may be important; what is a pandemic, and what makes a pandemic a pandemic; and then, finally, what can be done to prepare ourselves and our country if indeed this pandemic is on the horizon.

It is important to remember, Mr. Speaker, that the influenza virus has been with us for a long time. It is constantly changing and undergoes a continuous process of evolution and changes. Generally, these are small changes referred to as genetic drift. It is why we have to get a flu shot every year. But occasionally, occasionally, the virus undergoes a major evolutionary change and undergoes a genetic shift, rather than just the drift that we see from year to year.

For the past several years, a flu type known as H3N2 has been the type against which we commonly receive our yearly flu shot. Because of genetic drift, a new vaccination is necessary every year. With the absence of a regular yearly update in the flu vaccination, we would all have some immunity that would carry over from year to year. But approximately every 30 years there is a major change in the flu virus worldwide. This type of major change took place in 1957, and 170,000 people in this country died from the Asiatic flu, and in 1968, when 35,000 died from the Hong Kong flu.

Mr. Speaker, the term ``pandemic'' applies when there is no underlying immunity within the community to the particular type of flu virus. A pandemic occurs with periodic evolution of the influenza virus.

Assumptions about prior pandemics become part of our planning for the avian flu, a particularly virulent strain of flu that could overwhelm all of the available responses and resources that we could have at our disposal in this country. Every hospital bed filled. Think in terms of nearly 2 million deaths in this country from a pandemic.

The virus under consideration, H5N1, actually has some similarities with the Spanish flu that caused the big pandemic in 1918. Both of these illnesses cause lower respiratory tract symptoms, high fever, myalgias, prostration and a postviral weakness that could last from 4 to 6 weeks.

The virus primarily replicates in bronchial tissue. It may cause a primary or secondary pneumonia. The pulmonary tree is unable to clear itself of secretions and debris. The vast majority of people could recover, but there is significant potential to kill, and it is related to the virulence of the virus.

Currently we talk about the 1918 Spanish flu. That was a pure avian or bird flu, which then adapted to humans with fulminant infections as a result. There is currently a widespread bird infection throughout Asia, Russia, several former Soviet republics and Southeast Asia, and recently we have seen it make an appearance in European Union countries.

The virus has jumped species. What began purely as a presence in avian populations is now present in canines and felines. Person-to-person transmission has occurred.

Because of the presence in birds, migratory flyways facilitate distribution of the illness, and, of course, modern worldwide travel imposes additional concerns, as we saw with the SARS epidemic 2 years ago.

The steps to a pandemic include: Number one, the virus in a widespread host such as birds; number 2, a wide geographic setting with involvement of other mammals; number 3, bird-to-human transmission; number 4, inefficient human-to-human transmission; and, number 5, efficient human-to-human transmission.

Steps 1 through 4 have already occurred since avian influenza first appeared in 1997. It is the last step, efficient human-to-human transmission, which to date has not occurred. This will require further genetic mutation of the virus, but if that event does occur, that is what will mark the commencement of a worldwide pandemic.

It is entirely possible that the mutation will not occur. It is also entirely possible that efficient human-to-human transmission will never be developed and the pandemic will not occur. The situation is very unpredictable, but because of the extremely wide geographic distribution of the avian flu, unlike any ever seen previously before, it is prudent to prepare for the outbreak in humans.

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