1 July 2003

Influenza: "enormous potential for bioterrorism"

Influenza has the potential to be a far worse bioterror risk than diseases like smallpox and anthrax, claim US experts in the July Journal of the Royal Society of Medicine. In a special article, Dr Mohammed Madjid and colleagues at the University of Texas Health Science Center explain the issues at stake and suggest seven key proposals governments should adopt to combat the threat.

Influenza four times more deadly than estimates show
Dr Madjid 's team pioneered research on the link between flu and fatal heart attacks. Their data suggested the usual estimates of flu-related deaths (20,000 people per year in the US) should be revised upwards to 90,000 once the effect on the heart is taken into account.

Flu as a bioweapon
Scientists have nearly finished sequencing the flu genome from the 1918 epidemic, which killed up to 40 million people. The possibility of using gene information to create more virulent strains of viruses is "moving from theory to practice", warn the authors. A terrorist could transmit a genetically engineered virus in a passenger plane or subway, by using an aerosol spray - a far more effective method of transmission than relying on personal contact.

Flu epidemic: "a considerable head start on public health authorities"
Many bioterror warnings have focused on diseases like smallpox, but flu has very different implications for public health. Influenza is far more easily available, and common enough that a cluster of cases would not cause alarm at first. Once an epidemic has begun, it is more difficult to immunize against, as the incubation period is short. The virus is very difficult to eradicate since birds, rats and pigs all carry flu.

Proposals for governments worldwide
The authors warn: "even a natural epidemic of influenza can devastate our healthcare system and render society vulnerable to terrorism attacks of any kind." With the added threat of 'weaponized flu', they suggest seven urgent proposals, including:

  • Better security for key laboratories, vaccine manufacturers and distributors
  • Stockpiling antiviral drugs and improving vaccine development programmes
  • Extended and improved flu immunization programmes
  • Expanding disease surveillance, perhaps offering incentives for doctors reporting cases of flu
  • Antiviral filters, biosensors and inactivation systems for ventilation systems

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Read the full article [PDF 43k]

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