Wash Your Hands!
THE RECENT discovery that turkeys on a British farm were infected with the H5N1 "bird flu" virus was, as bad news goes, auspiciously timed. Just before the turkeys once again focused attention on the fast-moving virus, the U.S. Centers for Disease Control and Prevention released interim guidelines detailing what states and localities could do to cope with a pandemic of a dangerous form of influenza -- the sort of outbreak that a mutated form of H5N1 could spark.
The CDC's guidelines instruct American communities on how they might slow the spread of a bad flu in the absence of viable drugs or vaccines. Such rules are desperately needed. Last September, a group of international experts on pandemic preparedness concluded that it was likely that vaccines would prove ineffective against mutated forms of the virus. Tamiflu can lessen the severity of flu symptoms but does not eliminate the virus. Meanwhile, efforts to shorten the time required to formulate new vaccines when a virus mutates still face years of research. So if a pandemic strain arrived in the United States tomorrow, the country's best tools might turn out to be old-fashioned technologies and techniques of the sort listed in the CDC report, such as quarantines and public information campaigns promoting proper hygiene.
Not everyone in the public health world welcomed some of the more extreme guidelines. The CDC's proposal to shut down schools for three months in the case of a severe outbreak is generating resistance from scientists who claim that the tactic is not as effective as the CDC says it is. Others point out that the guidelines, which advise people to avoid crowded spaces such as train cars or offices, do not address the needs of poorer Americans (among others) who must take public transportation or who can't telecommute. As the CDC gathers comment and updates its interim guidelines, it must consider how state and local governments might deal with the potentially massive social costs of school closures and work stoppages.