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Bird Flu, Your Questions Answered

Panorama brings together experts and concerned viewers to discuss what should be done if the Bird Flu pandemic should strike the UK.

Sir Liam Donaldson is the Chief Medical Officer for the Department of Health and is responsible for the UK’s Avian Flu Contingency Plan. He receives the first question from Zozi Gallus, a mother of three young children.

She asks "As a mother of three children who are all at primary school, I’m wondering, when the first confirmed reports come through of some pandemic type flu, wouldn’t the safest thing for me, as a parent, be to take my children out of school and look after them at home until the pandemic has passed?" Sir Liam considers this and replies "There may be circumstances in which it might benefit our control, of this pandemic, to close schools for a while or ask children not to come to school. But the problem with a pandemic is that it will be around for a long time. It’s not like a hurricane that hits our shores and then goes away. It will probably come in several waves and, one way or another, we would expect a quarter of the population to be affected".

The next question comes from Jason Milner who studied science at university and has been taking a keen interest in the pandemic plan the department of health has put on their web site. He asks "The Intensive Care Society published a report back in September saying that the NHS probably didn’t have enough acute care beds if a pandemic was to hit the UK. What have you been doing to address this situation?" Sir Liam responds "We will have a lot of pressure so we’ll be working very hard to try and ensure that community services are strong so that when people feel very ill but aren’t at the stage of having their lives threatened or getting serious complications like pneumonia that they’re able to be cared for in the community and don’t necessarily put the burden on the health service because we need to keep as much capacity as we can for the people that really need it."

Next, we move to Scotland to meet Professor Hugh Pennington, a microbiologist from Aberdeen University who is acting as a government advisor.

A number of email questions focus on the perceived risks from eating poultry or from being in close contact with birds. Some were concerned about being able to get their Christmas turkey. Concerns about the food chain are common with people asking if ingesting the virus would be a way to catch it.

The first question is an email question asking "Is it safe to buy and eat chickens from the supermarket?" Professor Pennington explains "There is no bird flu in the poultry industry in the UK so British poultry, from the bird flu point of view, is completely safe to eat. I’m not aware of any well-described circumstance where anybody has caught flu from eating a sick bird and there are several reasons for this. You don’t normally eat the flesh raw, it’s cooked and cooking will kill the virus. The acid in your stomach would kill the virus anyway, so even if you did eat it raw the virus would still be killed. It doesn’t grow in our intestines, the virus grows in the lungs or upper respiratory tract".

Terry and Giles have questions about food and the knock-on effect of Avian Influenza in the food chain. Giles Garton asks "Professor, I just want to ask about the safety of eating eggs if the egg yolk is still liquid." Professor Pennington reiterates "Eating eggs, even from a bird with bird flu, is not going to infect you, the stomach acid will kill-off any virus that’s there. Birds that are sick with bird flu won’t be laying anyway."

Terry Murphy then asks "How easy is it to transmit the virus if somebody who is infected coughs on food and you then eat the food, will you be able to catch the virus this way?" The professor’s answer is "It’s very unlikely, there wouldn’t be very much virus on the food. It’s theoretically possible, but I’m not aware of it ever having happened. Normally what happens is that you have to inhale the virus."

There are no scientifically confirmed cases of the virus transmitting from person to person, but if the virus mutates and becomes able to transfer, easily, between humans then it could spark a flu pandemic. This concerns the GCSE science pupils at Lady Margaret School, so they are given the opportunity to put their questions to Dr. Alan Hay, Director of the World Influenza Centre.

Olivia Gamp-Haill is the first to pose her question "How can the disease be passed? Can it pass from human to human and, if so, is it highly contagious? Can it be passed from coughing and sneezing?" Dr. Hay responds "A normal pandemic virus would become highly contagious and that’s the feature of influenza, it passes very readily from one person to another. We would find it very difficult to contain a pandemic caused by influenza. But, the H5N1 virus that people are focusing on at the moment, does not readily pass from one person to another and the majority of infections have been the result of direct exposure to infected poultry."

Imogen Long is next and she asks "If bird flu was to come over here, what would the symptoms be?" Her answer is "Many of the cases that have been studied to date, have been people who have been hospitalised with very severe illness, these people have a high fever , they generally have an infection of the lower respiratory tract which leads to pneumonia as well as many other symptoms. In nearly half of these case it has led, ultimately, to death."

Finally, Louise Wellby enquires "With all the media hype, the public is hearing things like, if bird flu were to grip Britain, then 50,000 people could, potentially, die." Dr. Hay acknowledges "We have to take an influenza pandemic very seriously and the number you are quoting is actually the lower end of the scale that people are concerned about. Other estimates have been closer to 750,000 deaths in this country."

Perhaps more significant concerns are held by those individuals involved in health care. How is an already overstretched NHS going to cope with an influenza outbreak on this scale?

Dr. Jonathan Van Tam, an Epidemiologist from the Health Protection Agency seeks to address these issues.

Dr. Paul Caldwell, a general practitioner from Humberside says "My concern is that there’s going to be a waiting room full of people who may be in the pre-symptomatic stage of pandemic flu, yet are infectious. Our waiting room could be one of the most infectious places in the community." Dr. Van Tam concurs "I completely agree with you that the pandemic will definitely not be ‘business as usual’ and we can expect an additional burden for everybody, and of course general practitioners are among the people who will feel that. We need to start thinking about how we deliver that now."

Derek Smith, a retired microbiologist from Lincolnshire tells Dr. Van Tam about his ideas to train his local community to use a paper filter as a face mask and asks "What is your feeling about the government taking the initiative and saying to everybody, particularly through schools, that this is a good first line of defence?" Dr. Van Tam replies "First of all, if you’ve got pandemic flu the place you belong is at home and I think there’s a real element of shared community protection if we stick to that message. We have examined the literature where surgical masks were worn in community settings, particularly in SARS, and, I have to say, the evidence they provided any benefit is pretty weak."

Pippa Harrison a nurse practitioner explains that she advocates the vaccinations for seasonal flu to the over 65’s and asks "Do you think we should be targeting a wider audience?" Dr. Van Tan counters "We don’t expect the seasonal flu vaccine to offer any protection. The virus that might cause a pandemic is completely different to the viruses that circulate at the moment."