ORLANDO, Fla. - The world is teetering on the verge of a major influenza outbreak, and even wealthy nations such as the United States are unprepared for the next pandemic, according to a report released yesterday.
The report from the Institute of Medicine does not predict when an outbreak might occur, though it notes that the ingredients for a virulent new flu strain are brewing in Asia.
At least eight Asian nations are dealing with avian flu, which continues to spread among birds and, occasionally, to people. But the deadly virus might be only "a few mutations away" from turning into a form that can be passed easily from person to person, the report said.
This year's vaccine shortage in the United States, its authors note, underlined a key vulnerability: the serious lack of flu-shot production worldwide.
They estimate that as many as 8 million could die worldwide in the next pandemic, including 207,000 in the United States. The last century's worst flu outbreak occurred in 1918, when 500,000 Americans and an estimated 20 million people worldwide perished from the Spanish flu.
"Most infectious-disease experts believe the world stands on the verge of an influenza pandemic," the report states. "Yet despite the legacy of the 1918 Spanish flu ... the general public appears relatively unconcerned about the next `killer flu.'"
The report is based on presentations and discussions from a two-day workshop in June overseen by the Institute of Medicine, a private, nonprofit group that studies health issues. The institute is part of the National Academy of Sciences.
At that meeting, experts said the inadequate production system for influenza vaccines was a major obstacle to preparing for an outbreak.
Since then, the United States was thrown into an unexpected shortage of influenza vaccines this season after 48 million doses from one major U.S. supplier were seized because of bacterial contamination.
The shortage raises "questions about our ability to respond to an influenza crisis or pandemic if we cannot provide routine influenza vaccine in a typical influenza season," the report concludes.
Currently, the vast majority of flu shots are produced in nine countries: Australia, Canada, France, Germany, Italy, Japan, the Netherlands, the United Kingdom and the United States.
In the event of a flu outbreak, these nations would control the manufacture of a vaccine against the deadly strain - although scientists estimate it could take as long as six months to produce flu shots under the current system.
The report's authors conclude that those nations would not share their doses with others, leaving much of the world without the best defense against influenza. A pandemic could last for many months, coming in waves of increasing and subsiding severity.
"Equitable access [to vaccines] will not be possible so long as global manufacturing capacity remains inadequate," the report states. "Countries with manufacturing capacity can be expected to reserve scarce supplies for their own populations."
The Orlando Sentinel is a Tribune Publishing newspaper.
