Facing Off a Flu Pandemic with IT

Opinion: IT can help with both prevention and cure, but if major bird flu outbreak hits, an Internet connection may be the best bet.

All in the first week of May, weve been told that most big companies havent got a clue how to keep business going if an avian influenza virus, or bird flu, pandemic hits. The federal government reckons the pandemic could cost $600 billion. And confronted with the Presidents latest plan for dealing with a pandemic flu outbreak, state and local governments applauded the effort, then said the plan lacked details and funds.

Crises by definition are difficult to manage, but if a form of bird flu capable of launching a pandemic evolves, IT will be essential to finding and treating infections early.

IT is already part of drug distribution infrastructure. Computer models are standard tools for studying pandemic preparedness, and most eyes peeled for warning signs are looking at computer screens.

But the Internets biggest contribution may simply be letting more people work from home, staying productive without getting exposed to or spreading the virus.

Before I start writing about gloom and doom, I should probably say that H5N1 does not keep me awake at night. Fears of bird flu didnt keep me from going to rural Cambodia last year. Fewer than 200 people have died from bird flu worldwide; there are over 20,000 flu-associated deaths each year in the United States.

Nonetheless, the World Health Organization has called avian flu a greater challenge than AIDS. Since the current form of avian influenza is not passed easily from person to person, it cannot cause a pandemic. Robert G. Webster, a virologist at the St. Jude Childrens Research Hospital in Memphis, estimates that the current form would need another 10 or so mutations to reach that state.

However, the flu virus mutates rapidly, and an easily transmissible form would be much more disruptive, and deadly, than seasonal influenza.

Though no one knows what good theyll be, electronic surveillance systems are already on the case. For the most part, that means search technology.

Both SARS and bird flu were identified by what is essentially a specialized Web crawler that sniffs out suspicious patterns of disease reported by doctors; and the head of Googles philanthropic arm wants to extend the Web crawlers reach much further.

At the end of last year, Health and Human Services Secretary Michael Leavitt called for a nationwide biosurveillance system that would stream emergency room data from local, state and federal authorities, and update it several times a day.

Toward this end, Beth Israel Deaconess Medical Center started transmitting clinical information to databases at the Centers for Disease Control every 15 minutes, starting February 2005. The hospital is one of 10 facilities that the CDC has approached for a biosurveillance program.

/zimages/3/28571.gifClick here to read more about efforts to fight avian influenza with IT.

When it comes to treating infections, options are more limited.

A recent study found that the drug Tamiflu could prevent deaths from bird flu, at least for infected ferrets that received treatment in the early course of the disease. In April, Tamiflus manufacturer Roche began allowing distributors like FFF Enterprises to start processing pandemic-preparedness stockpiling orders, said Luke Noll, who leads marketing of biologic products for Roche. But theres no way to tell how it will affect humans under real-world conditions. And the supply of the drug is limited.

FFF Enterprises is a big distributor for flu vaccine. Since no one knows exactly when or how much flu vaccine will be released each year, the company has a sophisticated information infrastructure to monitor supply and demand in real time.

"Through the tools, we can monitor current demand, what weve shipped, if were underbooked, overbooked," and respond accordingly, said Chris Ground, senior vice president of national accounts for FFF.

But such sophistication will be of limited use for bird flu, Noll said. "Its going to be pretty much handled by the CDC," he said. In public health emergencies, the CDCs Strategic National Stockpile is supposed to get medicines where they need to be quickly, but it is set up for local emergencies like earthquakes.

And the federal government has already said that local governments and private companies need to have their own plans in place.

Rather than asking physician friends for Tamiflu prescriptions, people should make sure their connections to the Internet are fast and reliable.

Just in case.

M.L. Baker is health IT and biotechnology editor for Ziff Davis Internets Enterprise Edit group. She can be reached at baker@ziffdavis.com.

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