[Ip-health] Global flu pandemic would probably kill 62m, study says; Poorest countries will be the most affected

[Ira Glazer]

[In an accompanying editorial in the Lancet, infectious diseases expert
Neil Ferguson wrote, '"So long as resistance does not become a major
issue, prompt use of antiviral drugs . . . should substantially reduce
mortality." ""However, large stocks of antibiotics or antivirals are
unlikely to be available in most resource-poor countries during a
pandemic . . . a rather damning indictment of global equity in health
care." ]

http://www.guardian.co.uk/print/0,,329669302-110418,00.html

Sarah Boseley, health editor
Friday December 22, 2006

Guardian

Around 62 million people in the world are likely to die if there is a
flu pandemic and more than 70,000 of those deaths will be in the UK,
according to a statistical analysis published today.

Previous estimates of the likely death toll have ranged from two million
to one billion.

But the authors of the latest study in the Lancet medical journal argue
that those estimates were largely based on historical documents and
witness accounts of the devastation caused by the 1918-20 Spanish flu
pandemic, which had by far the highest mortality, rather than
high-quality data from death registries.

Christopher Murray, from Harvard University, and colleagues looked at
death registrations between 1915 and 1923 in places around the world
where the data was believed to be at least 80% complete. By looking at
deaths before and after the pandemic and comparing them with the rate
during the pandemic, they were able to calculate the increased mortality
caused by the disease.

Extrapolating that death rate to 2004, the authors calculate that
between 51 million and 81 million individuals will die around the world
if a similar virus causes a flu pandemic now. They say the deaths would
be concentrated in the 0 to 14, 15 to 19, and 30- to 44-year-old age
groups. They add that there is no logical or biological reason why
mortality should not be higher than in the Spanish flu pandemic, severe
though that was.

Death rates varied as much as 30% across countries, which could be
explained by income variation, they say. The poorest are far more likely
to die than the richest. They predict that 96% of deaths in a pandemic
today would be in the developing world.

In wealthier parts of the world, where people are generally healthier
and better nourished, such as the UK, rapid treatment of those with flu
symptoms, use of antiviral drugs such as Tamiflu, which is being
stockpiled by many governments, vaccination, and antibiotics for
bacterial pneumonia, which those with severe flu can develop, would be
likely to reduce the effects of a pandemic.

"By contrast, the countries and regions that can least afford to prepare
for a pandemic will be affected the most," they write.

"The potential risk to populations of sub-Saharan Africa, south Asia and
other developing regions presents a policy dilemma.

"When resources to tackle the health problems already present in the
community - including HIV, tuberculosis, malaria, cardiovascular
diseases and road accidents - are already scarce, how much can these
populations afford to spend on preparing for a potentially very harmful
but also very uncertain threat?"