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S.C. prepares itself should bird flu strike

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  • S.C. prepares itself should bird flu strike

    S.C. prepares itself should bird flu strike

    Hurricane preparedness skills, iPods and even good old-fashioned hand washing would all play a role in protecting South Carolina if a pandemic flu finds its way here.

    Scientists believe birds infected with the avian flu, the deadly H5N1 virus, will wing their way to Canada and Alaska this summer, and migrate south sometime within the next year. Though the virus has not yet found a way to spread between humans, more than half of those who've been infected from contact with diseased birds have died - at least 104 people in the past two years.

    The federal government is ratcheting up its plans for dealing with bird flu, and Palmetto State officials are readying the health-care community and service industries with a plan similar to the one built to respond to a potential bioterror attack. They're also relying on Lowcountry residents to put their hurricane survival know-how to work.

    Because avian flu is not yet - and, perhaps, may never be - a threat to humans who don't handle birds and poultry, health officials say few people are at risk. But they say it's still wise to think about how to handle an outbreak if it happens.

    Putting aside food, water, medications and activities to keep kids occupied are all a good start.

    "Have enough supplies in your house that you could exist for an extended period of time," said Dr. John Simkovich, medical director for the South Carolina Department of Health and Environmental Control's Region 7. "If you can do that, that means you don't have to go outside and expose yourself to get this."

    And, he said, don't underestimate the simple stuff: Washing your hands with soap often could be just as helpful at staying safe from a new flu strain as it is at keeping away pesky seasonal cold and flu bugs.

    But with no vaccine and a too-small stockpile of antiviral medications, federal officials admit the United States isn't fully prepared to battle a pandemic flu. The S.C. legislature is considering a request from the governor and state health officials to buy $45 million worth of Tamiflu, the drug considered the best bet at staving off the worst consequences of the bird flu.

    But even that proposal remains a gamble. First, that supply of Tamiflu doesn't yet exist, and other states are hoping for their own arsenal of it, too.

    "We're basically begging Roche (the drug's manufacturer) to make it," said Michael Schmidt, a microbiologist at the Medical University of South Carolina and MUSC's representative to the state's bioterrorism task force.

    Even if they can get huge amounts of the drug to market in time, no one knows for sure if Tamiflu will work. Questions include when it should be given to have the maximum effect and how it would be doled out and to whom. Using the drug too long after exposure may be, as Schmidt noted, a case of closing the barn door after the horse has left.

    There are also concerns about how to get enough respirators for health-care workers to protect themselves while caring for the sick. Good ones are expensive, and to work best, must be fit-tested on each person, said Tim West, chief of infection control for Roper-St. Francis Healthcare.

    A true pandemic could affect more than 30 percent of the area's workforce, so local industries - from garbage collection companies to grocery stores - are being asked to figure out how to operate with decimated staffing levels.

    It's likely that services in other areas would be equally hard-hit, so businesses can't count on help from the outside, Simkovich said.
    Still, those involved in planning for the worst say there's plenty of good news.

    Because Charleston's airport isn't a major hub, local officials said they don't think fever-detecting technology or health questionnaires - like those used in Canada during 2003's SARS outbreak - would be necessary. And the city's port isn't expected to provide a gateway for human-to-human transmission of bird flu.

    The avian flu has an incubation period of two days, so infected shipping workers exposed elsewhere would only be contagious while on the boat en route to Charleston, Schmidt said. The Coast Guard or DHEC would likely take over once the boat docked.

    If the 1918 Spanish influenza pandemic is any guide, an avian flu outbreak among humans wouldn't hit the population the same way the annual seasonal flu does. Rather than pouncing on small children, the elderly and those who already suffer from chronic health problems, it would take hold across the entire community.

    "People will have no prior exposure to it, so everyone will be susceptible," Simkovich said.

    What 2006 has that 1918 didn't, however, is drugs. And in this case, Schmidt said, some of the simplest over-the-counter ones might help. A mega-dose of an anti-inflammatory drug like Motrin plus an antihistamine like Benadryl could give patients a better shot at recovering.

    The Lowcountry's vast suburban sprawl also could act as something of a built-in quarantine, Schmidt said.

    With master-planned communities - housing neighborhoods, day-cares, grocery stores and even doctor's offices - stretching from North Charleston to Mount Pleasant to West Ashley, those residents might be able to remain self-sufficient for days or weeks. By not leaving the area or letting others in, people who live there might be protected even if the flu were spreading elsewhere.

    "That's how the great city states of Italy protected themselves from the Black Death," Schmidt said. "Venice protected itself for 100 years because they wouldn't let anyone in."

    Among the plans:

    --Preparing hospitals to deal with a sea of highly contagious patients, and findings ways to distribute drugs and information so some patients could be cared for at home. Officials are also shoring up plans to use large assembly areas like schools to house sick patients if needed.
    --Developing podcasts to educate the public about how to stay safe. It's a cheap and easy way to disseminate information to lots of people, said Michael Schmidt, a microbiologist at the Medical University of South Carolina who is MUSC's representative to the state's bioterrorism task force.
    --Setting up ways to educate the Lowcountry's children if schools shut down, including the Internet and public television.