Health experts take issue with flu toll estimate

October 13, 2005|By LOS ANGELES TIMES

WASHINGTON -- Government projections that as many as 1.9 million Americans could die in a global flu epidemic amount to a guess that could prove to be highly inaccurate, several public health experts say.

"The problem with all the numbers is that nobody knows," said Dr. Arnold S. Monto, a University of Michigan epidemiologist who specializes in infectious diseases. "I try to avoid coming up with these numbers as much as possible. I know they are based on imperfect information, extrapolating from the past."

The figures in a draft of the government's pandemic preparedness plan have heightened public alarm about a highly virulent strain of bird flu from Asia that could undergo a genetic mutation, allowing it to become easily transmissible between humans.

While agreeing that preparation for a pandemic must be an urgent national priority, Monto and other experts say the death toll cannot be reliably estimated at this point.

"Usually, as a virus adapts to human-to-human transmission, it becomes less virulent," said Ira M. Longini Jr., a professor at Emory University. "A virus that kills the host cannot transmit itself as well. From the virus' point of view, it wants the host to live."

The worrisome strain of bird flu, known as H5N1, has spread rapidly among domestic and wild birds in Asia. More than 100 people have been infected with it, and about half have died. But in virtually all the cases, the human victims are thought to have caught the virus directly from birds.

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