Vietnam takes steps to head off flu pandemic
(NPR)
Updated: 2005-11-04 09:14

Binh would also like to have a stock of Tamiflu, a drug that can save lives if given early and sometimes prevent the spread of flu. His hospital has enough Tamiflu to treat only two patients.

The government of Holland did give the hospital a respirator recently to treat patients with failing lungs. "But it doesn't work yet, because we still need oxygen before it works," Binh says.

Those kinds of problems make Binh skeptical that a pandemic could be stopped. "If the scientists prove that H5N1 [has been] transmitted human to human, then it would be a disaster. And once it is a disaster, it is really out of our control," he says.

A few miles from the hospital, in an office at the Thai Binh Provincial Health Department, Dr. Nguyen Van Thom unlocks two suitcases. "These are cases of the medicine, ready for when the epidemic occurs here," he says. Inside the suitcases are precious boxes of Tamiflu. He thinks a pandemic can be stopped, and says he's ready to try.

"This is like for quick reaction," he explains. "So even the most distant places we are able to bring this medicine in 45 minutes time. We have Tamiflu here, 1,000 tablets and also antibiotics and some other medicine needed in case."

If H5N1 breaks outs, it's going to take a lot more than 1,000 doses of Tamiflu to stop it. That's because experts think everybody within a few kilometers of the first cases will have to get the drug to stop the spread of the new virus. And they'll need to keep taking it until no more new cases appear.

Studies say that would take several million doses of Tamiflu. Right now Vietnam has a tiny fraction of that, and it's scattered around the country. The WHO has enough Tamiflu for 3 million people. It's sitting in a warehouse a few hours away by jet.

Once experts decide a pandemic strain is really circulating, the WHO would rush its stockpile to the outbreak. But that assumes the killer virus pops up in a single place. And "it may not happen that way at all," says the WHO's Peter Horby. "We may start to see multiple small fires bursting out over a wider area."

In that case, the supply of Tamiflu could run out fast.

And besides blanketing the area with Tamiflu, authorities will have to do other things: isolate flu patients, protect health care workers, and seal off the affected area so people don't flee, spreading virus as they go. Officials would also have to close schools and ban public gatherings.

In short, a lot has to go very right in a very short span of time. And flu planners hope the first outbreak doesn't happen in or near a city -- where the virus would spread too fast to contain it.

It's a tall order. But the WHO's Horby says it's necessary to give containment a try -- or forever regret it. "I think everybody realizes that it's probably a long shot, but it could be one of the most important public health shots ever. It may be unsuccessful but if it was successful you'd have a huge impact."

Back in Ha Tay Province, technicians on motorbikes go house to house, making sure every chicken is vaccinated. And a set of loudspeakers broadcasts messages about chicken flu to the residents of Huong Son Commune. "Make sure your poultry gets vaccinated," says the voice. "Report all suspicious cases of bird flu."