From Dr R. Busuttil

In her article “Of spin doctors and real doctors”, Marisa Micallef writes about what her brother, who runs a neonatal department of a children’s hospital somewhere in Europe, told her (TMIS, 28 January).

Accuracy and reliability should be the cardinal principles guiding professional columnists in their contributions. It is strange that we were not told the name of this children’s hospital somewhere in Europe to verify accreditation and facts.

Contrary to what is perceived by the world’s scientific bodies and the World Health Organisation as an imminent global threat, Ms Micallef argued that the whole world got it wrong. Her research told her that the influenza pandemic threat was a “very unlikely threat”.

On 22 January, the Federal Minister of Health Ulla Schmidt, at the Presentation of the German Presidency Programme to the European Parliament’s ENVI Committee, was reported to have said in section 8 on Pandemic Planning “The risk of an influenza pandemic persists unabated. Consequently, efforts continue to improve pandemic planning and, where necessary, to coordinate efforts at European and international level...”.

http://www.bmg.bund.de/cln_040/nn_616968/EN/

EU-Council-Presidency/Documents/ presentation-programme, param=.html__ nnn=true

And yet, we are told that this concept of pandemic planning, as instructed by the German Federal Minister of Health, has not reached this far away children’s hospital somewhere in Europe. And yet, is a doctor in the neonatal department in a children’s hospital involved in the influenza pandemic planning of any major hospital or of any country? So how can a columnist present the public with hearsay as a matter of fact?

Ms Micallef is being short-sighted in her judgement. Having more than a 55 per cent case fatality rate, an avian flu virus that has not developed a pandemic potential is very worrying to anyone who cares for the general public health. This gets worse when one realises that such a mutant virus would know no frontiers in its global spread.

While agreeing that the actual influenza pandemic virus still does not exist in the world, the current circulating H5NI Avian Flu Virus shows a pandemic potential, that is, a capacity to become increasingly transmissible from human to human. The longer it continues circulating globally, the greater this potential is. The fact that this virus is deeply embedded in countries and is very hard to eradicate is very worrying.

Regarding the effectiveness of the antivirals, the worldwide scientific body cannot be concretely sure, as yet, that the antivirals will work against any novel virus just because this virus does not exist so far. But when Tamiflu was used on human cases of H5N1 and under laboratory conditions, it was found effective against the said virus.

Unlike what is said to be done in this children’s hospital where Ms Micallef’s brother works, Tamiflu has been effectively used in the treatment of human cases of avian flu. It is worth pointing out that in many countries it is central government that has taken the responsibility for procuring stocks of antivirals, therefore it is no wonder that the hospital where Ms Micallef’s brother works has not bought any!

To counter doubts raised by Ms Micallef’s contribution, I refer Ms Micallef and your readers to personally consult these sites and reach their own conclusions on the subject.

* The United States Health and Human Services (http://www.hhs.gov/pandemicflu/plan/sup7.html)

* The European Centre for Disease Control and Prevention (http://www.ecdc.eu.int/ Health_topics/Pandemic_Influenza/QA.html)

* The Italian Ministry of Health Influenza Pandemic Plan (http://www.ccm.ministerosalute.it/imgs/C_17_pubblicazioni_511_allegato.pdf)

* The Government Plan for the Prevention and Control ‘ Influenza Pandemic’ in the Office of the French Prime Minister (http://www.grippeaviaire.gouv.fr/IMG/pdf/Plan_version_anglaise.pdf)

* World Health Organisation individual country Influenza Pandemic plan

(http://www.who.int/csr/disease/influenza/nationalpandemic/en)

* Antiviral Management of Seasonal and Pandemic Influenza by Hayden FG published in the Journal of Infectious Disease 2006 Nov 1:194 Suppl 2:S 119-26

* Influenza Pandemic: preparedness and planning in Germany, published in the Eurosurveillance monthly release – a peer reviewed European information on communicable disease surveillance and control (http://www.eurosurveillance.org/em/v07n01/0701-221.asp)

* The United Kingdom Health Protection Agency http://www.hpa.org.uk/infections/topics_az/influenza/avian/avianflufaq_vaccines.htm#five

* “Pandemic Influenza science to policy” by the Royal Society and the Academy of Medical Sciences – Policy document 36/06 Nov 2006 ISBN -13:978085403 635 6 available on www.royalsoc.ac.uk and www.acmedsci.ac.uk

* Entering the words “Influenza pandemic paediatric hospitals” on Google search gives a library’s worth of information on influenza pandemic planning, including those pertaining to paediatric sections.

Ray Busuttil

Director General (Health)