Future flu pandemic toll could be "very scary": U.S

By Kamil Zaheer

NEW DELHI (Reuters) - The number of people who could die in a flu pandemic that matches the 1918 to 1920 outbreak will be "very scary" and far higher than the 62 million deaths forecast by a recent study, an adviser to the White House said on Monday.

"I think that number is a very optimistic number if we are talking about a 1918-wide pandemic today," Rajeev Venkayya, Special Assistant for Biodefense to President Bush, said.

The 1918-1920 "Spanish influenza" pandemic -- the worst in recorded history -- killed anywhere from 20 million to 100 million people. Half a million died in the United States alone.

Last month, a Harvard University study published in The Lancet medical journal said developing countries would bear the vast majority of the 62 million deaths in a similar pandemic.

Venkayya did not give a forecast of possible deaths in a pandemic -- which the World Health Organization and other experts say is inevitable and overdue through some disease -- but said the number of fatalities could be frightening.

"The bottom line is that they (U.S. government guesses about a toll) are all very high and all very scary," Venkayya told experts at a business chamber in New Delhi during a visit.

Washington estimates that if a 1918-type pandemic hits the United States today, nearly two million people would die and 30 percent of the country's 300-million people would be infected.

The Harvard study predicted 350,000 deaths in the United States in such a scenario, Venkayya said.

Health experts worry that the highly pathogenic H5N1 avian influenza virus which began in Asia and spread widely in 2006 to more than 50 countries could mutate to jump between humans, sparking a human flu pandemic.

The H5N1 virus has killed at least 154 people out of 258 human cases, besides ravaging poultry stocks.

"If a pandemic virus emerges, it is almost inevitable that the virus will sweep the globe," Venkayya said.

The U.S. government says countries need to sharply stepped up vaccine production capacity -- currently at around 350 million doses per year for a global population of over 6 billion people.

Venkayya also called for urgent efforts to try and utilize adjuvants -- substances that be delivered along with vaccines and that enhance the immune response to a vaccine dose.

"So for every individual you are immunizing, you can use a much smaller dose of vaccine than you would have without the adjuvant which means you can immunize many more people."

He said recent data from global drug firms like GlaxoSmithKline Plc, which were carrying out tests on adjuvants, suggested that if they proved to be safe, they would allow countries to immunize over 20 times more people from a single dose of vaccine.

"That is the single most promising thing on the vaccine side of the equation, I believe."