Bush offers plan to fight possible avian flu crisis

He says military should play big role


WASHINGTON -- President Bush expressed concern yesterday about the threat of a global flu epidemic, and said Congress should consider letting the U.S. military play a broader role in enforcing quarantines and other emergency measures.

Bush said the possibility of a virulent new strain of avian influenza spreading rapidly around the world raised difficult questions about a president's ability to direct an effective domestic response effort and the federal government's authority to carry it out.

Flu pandemics have tended to occur about three times a century, after the emergence of a new influenza virus to which humans have developed no immunity.

The last such outbreak was in 1968. The deadliest was the 1918 pandemic that killed as many as 50 million people worldwide, and an estimated 675,000 in the United States.

"I'm not predicting an outbreak," Bush said. "I'm just suggesting to you that we'd better be thinking about it. And we are. ... We're trying to put some plans in place."

World health authorities have become increasingly alarmed about the pandemic potential of a lethal strain of avian influenza called H5N1, which has killed millions of birds, and about 60 people who came into contact with them, since it was first detected in Asia in 1997.

Scientists have cited initial signs the virus might be mutating into a form that could spread rapidly from human to human, and possibly trigger a pandemic.

Bush said his concern was heightened when he recently read The Great Influenza, a book by John M. Barry, who described the devastation of the 1918 pandemic and mistakes made by federal, state and local authorities in this country that worsened its impact.

Asked about avian flu during a White House news conference, Bush said the potential risk of an outbreak was great enough to justify a more aggressive preparedness campaign.

Part of the planning process should focus on the federal government's legal authority to take any steps needed to contain a flu contagion, including local or regional quarantines, Bush said.

Bush said one option would be to deploy the U.S. military to provide the kind of rapid command and control measures needed during a pandemic. He asked Congress to consider the need for legislation to expand the federal role.

Doing so would require changing laws that restrict the role of active-duty troops in domestic emergencies, a possibility raised in response to the government's problematic response to Hurricanes Katrina and Rita.

Some military officials have expressed skepticism about assuming more responsibility in such situations, and some lawmakers have voiced concern about the diminished authority of state officials and the National Guard units they control.

Health and Human Services Secretary Michael O. Leavitt, who is directing the administration's preparedness efforts, said HHS was about to release the final version of the government's first comprehensive pandemic response plan.

It is not certain at this point whether the H5N1 virus will trigger a worldwide contagion, Leavitt said in an interview.

But there is little question that at some time, some kind of global influenza outbreak will occur, he said.

"There will be another pandemic," Leavitt said. "I view it to be the most important health preparedness issue we are dealing with currently."

The HHS plan outlines steps that officials would take to detect an outbreak, administer antiviral medicines to reduce its severity, and then develop, manufacture and distribute a pandemic-specific vaccine that could eventually stop it in its tracks.

One factor limiting the U.S. government's response capability is the lack of domestic vaccine manufacturing capacity, a problem underscored by last year's shortage of ordinary flu vaccine.

"What we're dealing with here is the need to rekindle an entire industry," Leavitt said.

Last week, the Senate voted to appropriate $3.9 billion to finance an expanded pandemic preparedness initiative. HHS is expected to submit a detailed funding request when it releases its action plan.

Warren Vieth writes for the Los Angeles Times.

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