Preparing for the worst

Preparing for the worst
May 7th 2009 | NEW YORK
From The Economist print edition


Vaccine makers are ill-prepared for an influenza pandemic





MEXICO CITY sprang back to life this week after two weeks of fear and inactivity. Officials shut down most of the economy to halt the spread of a previously unknown strain of the mongrel H1N1 virus, which is comprised of avian, swine and human influenza viruses. The hope is that the outbreak has now peaked.
If so, that will come as a relief to many, as the virus has spread rapidly around the world. On May 6th the World Health Organisation (WHO) reported 822 confirmed cases in Mexico, including 29 deaths. Altogether, 403 cases have been detected in the United States, including at least one death. Dozens of non-lethal cases have been found in 22 other countries. If a cluster of self-sustaining cases in a region outside the Americas is confirmed, the WHO will raise its concern from level five to the top of its six-level scale for global pandemics.
Richard Besser, the acting director of America’s Centres for Disease Control (CDC), said the virus “so far is not looking more severe than a strain that we would see in seasonal flu.” That is not as reassuring as it sounds. An influenza outbreak in 1918 began in a mild way, but returned in a lethal form months later and killed millions. Margaret Chan, the WHO’s boss, cautioned: “it may come back…the world should prepare for it.”
One of the best ways to do so is vaccination. Surveillance systems and antiviral treatments will help contain a disease, but they cannot halt it the way a vaccine could. Such a treatment would have to come from the makers of vaccines for the more ordinary, seasonal strains of flu. Yet despite all the advances in biological science, this industry still relies on capital-intensive, inflexible and old-fashioned technologies, such as producing vaccines from millions of chicken eggs.