How Nebraska prepares

Avian Flu Preparations
Human outbreak called likely

Nebraska health officials continue to gear up for what many experts say is inevitable -- a human outbreak of avian flu.

Pandemic Preparedness

Dr. Taronna Maines, a microbiologist with the CDC, conducts an experiment with an H5N1 avian influenza virus.

Nebraska, which has received national recognition for its pandemic planning, has been aggressively preparing for bird flu for the past two years. The government's most recent efforts include implementing a statewide surveillance system, talking with communities about the effects of an outbreak and testing wild birds for signs of the disease.

"We have been working very diligently on this for a long time," said Dr. Joann Schaefer, the state's chief medical officer. "There's always room for improvement. There's always room for more planning.

"I would be hesitant to say we would ever be fully prepared," she said.

Schaefer highlighted Nebraska's new surveillance system as a unique tool in pandemic preparedness. It could be used as a prototype for other states.

The computer model monitors factors such as absenteeism at schools and businesses, weather patterns and animal behavior, alerting health officials to anomalies.

For example, dead birds found in the same area where a large number of students are ill may indicate an avian flu outbreak.

Most human cases of the virus have been linked to close contact with sick birds or their droppings carrying the H5N1 strain. Experts fear the virus could mutate into a form that spreads easily from person to person, causing a worldwide pandemic.

The human strain of bird flu will be "a brand new virus that we've never seen before," said Sharon Medcalf, the associate director of the state's Center for Biopreparedness Education. "It happens to be a very lethal one."

The U.S. Department of Health estimates 209,000 to 1.9 million Americans could die in a pandemic situation. In Nebraska, that figure is projected to be 1,181 to 10,832.

Until the human strain emerges, researchers cannot create a vaccine specifically for it. Two anti-viral medications, Tamiflu and Relenza, are believed to be effective in treating bird flu.

The federal government has allotted Nebraska 258,923 doses of vaccine, according to Leah Bucco-White, a spokeswoman with the state Health Department.

The state Legislature, she said, will be asked to authorize the purchase of 45,600 more.

Lt. Gov. Rick Sheehy, who handles the state's homeland security efforts, said Nebraska has a universal plan in place to respond to emergencies as varied as terrorist attacks and pandemics.

"We have a great plan in place," he said, adding that the government needs to continue to educate emergency responders and the public about how to respond to a pandemic.

When that pandemic could emerge is anyone's guess.

Michael T. Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said a human outbreak could surface tomorrow or four to five years down the road.

It's "not a matter of if, just when and where," he said.

The H5N1 virus, he said, is developing the same way the Spanish flu did in 1918. That virus moved from birds to other animal species and then to humans.

Fifty million to 100 million people are believed to have died worldwide from the Spanish flu. An estimated 1,500 died in Nebraska.

Medcalf said the United States should be on alert for avian flu this winter as birds travel south from Alaska. Those birds, she said, have been mingling with birds from southeast Asia and could carry bird flu.

The Nebraska Game and Parks Commission is already on the lookout for infected birds.

Since June, more than 2,000 samples have been taken from Canada geese, mallard ducks and other migratory birds in Nebraska, according to the commission.

All of the samples have tested negative for H5N1, said Mark Vritska, manager of the commission's waterfowl program.

Nonetheless, Nebraskans are being told to prepare.

Bucco-White said the Health and Human Services System is stressing "personal preparedness."