Correction to This Article
A Jan. 4 Federal Page article incorrectly implied that Susan J. Blumenthal, a former assistant surgeon general, suggested a flu shot could protect against the avian flu. She was referring only to protection against seasonal flu.
Q& A: Susan J. Blumenthal, M.D.

Prevention Is Key to Avian or Seasonal Flu

Susan J. Blumenthal, an expert on infectious diseases, recently discussed what the government and individuals can do to reduce their risk.
Susan J. Blumenthal, an expert on infectious diseases, recently discussed what the government and individuals can do to reduce their risk. (By Lucian Perkins -- The Washington Post)
Wednesday, January 4, 2006

Avian flu has recently moved to the top of President Bush's health care agenda. But medical experts such as Susan J. Blumenthal have been warning for years that international travel, a weakened public health system and antiquated vaccines have made the prospect of an influenza pandemic a matter of when, not if.

Blumenthal, a former assistant surgeon general, in a recent speech in Washington warned that the H5N1 strain of the virus, now confined largely to birds, has the potential to develop into a deadly human virus. Already, the virus has "killed more birds than any in the history of the world," humans do not have immunity, it is striking younger victims and it has spread rapidly into at least 16 countries, she said.

A clinical professor of psychiatry at Georgetown and Tufts University schools of medicine, Blumenthal was the first deputy assistant secretary for women's health, from 1993 to 1997, and is an authority on global public health. She retired from the government last year.

In an interview, she talked about infectious diseases and chronic illnesses -- and what individuals and the government can do to reduce risk. She said one of the lessons of Hurricane Katrina is that the United States is not sufficiently prepared to deal with any number of crises, from a terrorist attack to a natural disaster to a pandemic.

-- Ceci Connolly

Q Why is a pandemic a matter of when, not if?

AEach generation has had a pandemic. The 1918 influenza pandemic killed 40 million people and infected 500 million. It was like a global blizzard over 18 months. With international trade and modern travel, the world is shrinking. . . . In 1969, the surgeon general announced the "war against infectious diseases is over." We thought we had conquered the microbe. But we've had 30 new diseases since 1972, including SARS [severe acute respiratory syndrome], monkey pox and Lyme disease.

How real is the threat of an avian flu pandemic?

On the question of are we more vulnerable, there is the group of people I call the ostriches and the Chicken Little. The ostriches point out that we have better science and public health than ever before, that we have not seen the H5N1 virus here. The Chicken Little say we do not have enough antiviral [medications]; we don't have a vaccine. The threat is probably somewhere in between.

How is the virus spread?

It begins in aquatic birds, moves to domestic poultry and then potentially to humans. . . . Asia is a hotbed [for H5N1] because people live in close proximity to poultry, and they lack a strong public health infrastructure. You can become infected through direct contact with poultry or contact with a surface that has poultry droppings or excretions. There have been about 135 human cases since 1997, which is relatively few.

Your speeches are alarming. Is that intentional?

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