The bird flu news isn't encouraging, the head of the CDC said today.

The comments by CDC Director Julie M. Gerberding, MD, MPH, came at the opening of the 2006 National Influenza Vaccine Summit meeting of public health officials and vaccine manufacturers.

Preparation for a flu pandemic is only a small part of the meeting. But in her opening remarks, Gerberding stressed how seriously the CDC is taking the threat of a bird flu pandemic.

"This is not media hype. This is a real situation," Gerberding said. "And at CDC we are very focused on the possibility of pandemic with this virus or some unexpected virus."

An Evolving Virus

Bird flu — the virus known technically as H5N1 avian influenza — is evolving. Whether it will necessarily evolve into a pandemic flu virus depends on whether it gains the power to spread easily from person to person.

But only one thing is certain: Flu viruses are notoriously unpredictable.

"The strategic national stockpile does not contain a crystal ball," Gerberding said. "What we are hearing is not encouraging. We know the virus is on the move. It has moved on from the Vietnam clade [virus group] we made vaccine against."

Front Lines of the Flu Battle

The CDC director promised that if bird flu does start spreading among humans — anywhere on earth — the U.S. will not sit on its heels.

"If pandemic influenza is a threat anywhere in the world, it is a threat here," Gerberding said. "If anywhere in the world there appears to be person-to-person transmission, we will do everything we can do to quench the initial outbreaks. We will engage on the front lines."

Could the CDC and its international partners really succeed? Gerberding is cautiously optimistic.

"We believe if the virus is found in a small rural area, we would have a chance to quench it," she said. "But of course if it happened in a city, the chance of quenching it is pretty small."

If a Pandemic Strikes

If a bird flu pandemic breaks out, all is not lost. Gerberding says the initial plan would be to screen travelers and to quarantine those found to be infected.

"We are practicing this in airports around the country," she said.

There would, of course, be a race to produce a vaccine. But with current technology, that would take the better part of a year at least.

"Many of you would be working to slow illness and death while we work to get a vaccine," Gerberding told the audience of public health officials. "So we would be using our antiviral supply to treat those who can be isolated. Pubic health measures will be essential, especially distancing. There would be no meetings like this. And be prepared for early closing of schools. We will all be working from home."

Accurate information, Gerberding said, will be a key issue. Family doctors will be key players.

"We have learned from previous public health emergencies that the most important information providers are doctors," Gerberding said. "People want information from their own doctors. So we must get information from the source to these providers."

The Power of Seasonal Flu

Since 2003, bird flu has killed 82 people. Every year, seasonal flu kills 250,000 to 500,000 people worldwide.

About 36,000 Americans die of flu every year, noted J. Edward Hill, MD, president of the American Medical Association, who shared the podium with Gerberding.

"That is twelve 9/11s or 65 jumbo jets crashing each and every year," Hill said. "Those are incredibly high numbers that we can and must lower."

It's pretty unusual for the AMA, which represents fiercely independent U.S. doctors, to join forces with a government agency. But Hill said that it's time for private doctors to accept responsibility for public health.

"Physicians do public health one patient at a time," Hill said. "Every doctor's second specialty should be public health."

Increasing Public Knowledge

Hill called the flu vaccine one of the basic tools doctors use in their day-to-day work. He pledged the AMA's support in fixing the U.S. flu vaccine production and distribution system — and in increasing the number of people vaccinated each year.

"We have to do a better job of educating doctors and the public," Hill said. "In my private practice, I still see people every year suffering under the myth they will get flu if they get the flu vaccine. It is ridiculous, but not a small problem. Convincing them otherwise is hard."

Hard though it may be, Hill was more willing than Gerberding to predict that flu vaccination will go more smoothly next year than it did this year. But Gerberding said the CDC is committed to resolving all of the troublesome issues surrounding flu vaccination.

"The problems that we didn't solve this year, we want to take steps to solve in the future," she said. "It is frustrating to have year after year go by and still feel we are not meeting the public's expectations."

Gerberding said that the federal funds being spent on preparing for a possible bird flu pandemic won't be wasted if bird flu doesn't appear.

"Everything we are doing for pandemic flu will pay off for seasonal flu," she said.

By Daniel J. DeNoon, reviewed by Louise Chang, MD

SOURCES: 2006 National Influenza Vaccine Summit, Atlanta, Jan. 24-25, 2006. Julie M. Gerberding, MD, MPH, director, CDC. J. Edward Hill, MD, president, American Medical Association.