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Surgeon General: Avian Flu Could 'Possibly' Hit Territory

March 23, 2006 – "We're all in a race against a virus that can cause significant levels of death and disability," U.S. Surgeon General Richard H. Carmona said to a group of about 100 local residents, health care providers, and government officials at a pandemic influenza summit held Thursday at the Marriott Frenchman's Reef Hotel on St. Thomas.
Carmona said that the U.S. government is particularly concerned about the H5N1 strain of avian flu, which has primarily been infecting birds in Asia. He said the virus has not yet mutated into a disease which can spread from human to human, but has killed 103 three individuals in countries such as Cambodia, China, Indonesia and Iraq.
"We do expect it to hit the U.S. and possibly the Virgin Islands," Carmona added. "And while we do hope that it stays within birds, we all have to be prepared in the event that the virus spreads to the human population."
Unfortunately, Carmona explained that the virus is constantly changing, making it hard for a specific vaccine targeting the strain to be developed. "We are working on a day-to-day basis to understand the characteristics of the virus, and everyday we learn a little more about it," he said. "However, every day there's a risk that the virus can mutate, so prevention is really the number-one cure."
National efforts to combat the virus, or at least keep it at bay for as long as possible, are centered around prevention, he said, adding that U.S. plans also include measures to respond to, mitigate, and recover from the disease once it reaches the mainland.
Carmona outlined such strategies as using bio-surveillance systems set up around the world to monitor emerging diseases, looking at past pandemic outbreaks and stockpiling vaccinations and other medical supplies.
Carmona said the U.S. currently has enough vaccines – primarily Tamiflu, a seasonal flu medication that can help mitigate the effects of the H5N1 strain – to distribute to about one-fourth of the mainland's population. However, while more supplies have been ordered, vaccine production has decreased in the United States over the past year. "What we now have to do is incentivize the private sector to come back into the business," he said. "These vaccines take about six to eight months to make, so we need as many people as we can get to come in and work with us, so we can delay the virus from coming as long as possible."
With such limited supplies and a high demand for the vaccine, local governments would have to look at its most vulnerable populations to determine who receives the flu shots, Carmona said in response to a question from the audience. "However, you have to remember that the most important thing is the continuity of government – first responders, for example, would have to get the vaccine because they're out there dealing with the community, so you might have to create a bit of a hierarchical system."
Al Martinez Fonts, special assistant to the private sector for the U.S. Department of Homeland Security, said it is also important for governments to protect critical infrastructure such as telecommunications, water and electricity, waste systems, and food distribution for community members.
Carmona further stated that Congress recently allocated $3.3 billion to the U.S. Department of Health and Human Services for the states and territories to better prepare for an outbreak. While the Virgin Islands has only received about $126,000 of those funds to date, Carmona said the territory would be eligible for more federal money once a local pandemic response plan is in place.
When asked after the summit, Health Commissioner Darlene A. Carty estimated the territory would need "upwards of $6 million to $7 million" to develop a full-fledged emergency response system, which includes providing enough hospital beds and medical supplies for a significant portion of the territory's residents and the millions of visitors who come to the Virgin Islands each year.
While Carty said during her presentation that the V.I. government is working on a pandemic influenza plan that "treats the greatest possible number of patients," she also outlined various possible effects associated with a global outbreak, including a shortage of medical workers, an overflow of bodies in morgues and a strain on medical supplies.
"There might also be a disruption in transportation, utility service, and communication," she said. "Businesses may also experience high levels of absenteeism, a change in the productivity of operations and a significant psychological impact on some their employees."
However, Carty said the territorial plan, which is still in the drafting stages, seeks to mitigate these effects by establishing guidelines to minimize social disruptions, establish a bio-surveillance system and open lines of communication between the government and the public.
"It's better to be prepared as a community, and we will need your expertise and as much help as possible," she said to members of the audience. "A threat anywhere is a threat everywhere – join us as the V.I. prepares."
Representatives from Planning and Natural Resources said they also had plans in place to control the virus if it hits local bird populations. "This disease is not new," William Coles, chief of environmental education at DPNR's Division of Fish and Wildlife, said, further explaining that the department has been developing measures to combat the disease for the past few years.
"The only real problem we have is with migrating birds who come in during certain seasons. We don't exactly know what our real threat is in terms of what birds are carrying the disease, but we are fortunate because the Virgin Islands is not a stop in the migratory path of carrier birds like ducks and geese."
Coles added that Fish and Wildlife has already required that any animals being imported into the territory be issued a health certificate and permit.
Bethany Bradford, a veterinarian with the Department of Agriculture said that local poultry farms are also being identified and monitored, since the virus is spread through contact with the infected feces, respiratory fluid and blood of poultry.
Bradford also said the department has developed various response scenarios for pandemic situations, is finalizing its emergency plan, and is enforcing local rules for the importing and exporting of animals to and from the territory.
Giving further assurance to residents, Gov. Charles W. Turnbull — who organized the summit in conjunction with the Health Department and various local businesses — said the territory has a Memorandum of Understanding with the British Virgin Islands to "help each other when there's an emergency."
During the meeting, he and Carmona also signed a resolution that outlined the federal government's commitment to providing funds and technical assistance to the territory in the event of pandemic influenza.
"I think we [the Virgin Islands] are way ahead of the curve on planning for this," Turnbull said during a brief press conference after the meeting. "And for once we can say with confidence that we're making sure we're doing everything possible to protect ourselves."
For more information on pandemic flu, visit http://pandemicflu.gov. Residents can also view a draft of the territory's Pandemic Emergency Plan at www.governorturnbull.net.
One notable aside to the meeting, which captured the audience's attention, was an announcement made by Carmona that he and Mel Vanterpool, director of the local Homeland Security office, served in the same Special Forces unit during the Vietnam War. Carmona said the two had "lost touch over the years," but were able to cat
ch up during a meeting Wednesday evening.
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