Q&A: Is This the 'Mother of All Bird Flu Clusters'?
By AMY MALICK
May 25, 2006 ? ABC News Medical Unit producer Amy Malick spoke with bird flu expert Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center.
Q: Could these new cases in Indonesia signal the start of a pandemic?
A: That was the question that obviously the World Health Organization and the Indonesian public health people had, but the initial investigation would appear reassuring. And that's because WHO, very quickly, caught the virus, sent it to the laboratory and did a genetic analysis. The virus seems to be, fortunately, quite similar to the conventional bird flu ? the poultry viruses that have been seen in Indonesia. So it does not look, at the moment, as though the virus has changed. It's not readily transmittable person to person, as far as we know at this time. So our anxiety level can diminish a little bit, but the investigation continues.
Q: Is this the easily transmissible type of avian flu that experts have been fearing?
A: Probably not. This does not appear to be the easily transmissible virus. This looks like a poultry virus, a bird flu virus, that happened to get into a person. And then because the extended family had such close contact with that person, all that coughing, etc., resulted in exposure of the other family members, and they got sick. Similar to what happened about two years ago to a family in Thailand, where a mother and daughter had similar exposures.
Q: How are these cases in Indonesia different from the ones we have seen before?
There are two things. The first is, at the moment, the source of the virus is a puzzlement. People are not sure how the first case acquired her infection. And so that always raises the question: Could it have come from a person rather than a bird? Of course, sadly, in this extended family of seven people, six have now succumbed, so we can't get a history. So neighbors and other people will have to be asked about that. So the source is a mystery.
And the other, frankly, is this is a large cluster: Seven people ill, even though they are in one family. That's also provocative. So that does raise the question, could it have been human-to-human transmission of the sort we feared? So far, that's not the case. That's what sparked the investigation.
Q: How alarming is this cluster of cases?
A: It's not alarming. It's very noteworthy, but the rest of us can stand down, relax a little and watch the progress of the investigation. This is something for us, the pros, to get excited about. But the rest of us can just relax a little, for the moment. And stay tuned.
Q: Does this change at all what laypeople should be doing to prepare for a potential pandemic?
A: I think this does not change things, but it should be another stimulus. ? Colleges, businesses, even the average family should have a plan, and this is another stimulus to give it some thought.
Q: A WHO spokesperson has called these new bird flu cases the mother of all clusters. What is your reaction to that?
A: It's more excitable than if I were the official. I wouldn't say that. It's certainly a cluster. This is a large group of people who were exposed and have become obviously seriously ill, and we still don't know the source. So that's the sort of thing that needs an investigation.
By AMY MALICK
May 25, 2006 ? ABC News Medical Unit producer Amy Malick spoke with bird flu expert Dr. William Schaffner, chairman of preventive medicine at Vanderbilt University Medical Center.
Q: Could these new cases in Indonesia signal the start of a pandemic?
A: That was the question that obviously the World Health Organization and the Indonesian public health people had, but the initial investigation would appear reassuring. And that's because WHO, very quickly, caught the virus, sent it to the laboratory and did a genetic analysis. The virus seems to be, fortunately, quite similar to the conventional bird flu ? the poultry viruses that have been seen in Indonesia. So it does not look, at the moment, as though the virus has changed. It's not readily transmittable person to person, as far as we know at this time. So our anxiety level can diminish a little bit, but the investigation continues.
Q: Is this the easily transmissible type of avian flu that experts have been fearing?
A: Probably not. This does not appear to be the easily transmissible virus. This looks like a poultry virus, a bird flu virus, that happened to get into a person. And then because the extended family had such close contact with that person, all that coughing, etc., resulted in exposure of the other family members, and they got sick. Similar to what happened about two years ago to a family in Thailand, where a mother and daughter had similar exposures.
Q: How are these cases in Indonesia different from the ones we have seen before?
There are two things. The first is, at the moment, the source of the virus is a puzzlement. People are not sure how the first case acquired her infection. And so that always raises the question: Could it have come from a person rather than a bird? Of course, sadly, in this extended family of seven people, six have now succumbed, so we can't get a history. So neighbors and other people will have to be asked about that. So the source is a mystery.
And the other, frankly, is this is a large cluster: Seven people ill, even though they are in one family. That's also provocative. So that does raise the question, could it have been human-to-human transmission of the sort we feared? So far, that's not the case. That's what sparked the investigation.
Q: How alarming is this cluster of cases?
A: It's not alarming. It's very noteworthy, but the rest of us can stand down, relax a little and watch the progress of the investigation. This is something for us, the pros, to get excited about. But the rest of us can just relax a little, for the moment. And stay tuned.
Q: Does this change at all what laypeople should be doing to prepare for a potential pandemic?
A: I think this does not change things, but it should be another stimulus. ? Colleges, businesses, even the average family should have a plan, and this is another stimulus to give it some thought.
Q: A WHO spokesperson has called these new bird flu cases the mother of all clusters. What is your reaction to that?
A: It's more excitable than if I were the official. I wouldn't say that. It's certainly a cluster. This is a large group of people who were exposed and have become obviously seriously ill, and we still don't know the source. So that's the sort of thing that needs an investigation.