Better European coherence urged

European nations need to improve their coordination on public health measures to deal with the threat of a human influenza pandemic, a leading public health expert said yesterday.

Many countries have national plans in place but Dr Richard Coker of the London School of Hygiene and Tropical Medicine said although Europe is moderately well prepared, there are critically important gaps.

"Coherence about travel restrictions was a major problem," Dr Coker told a conference on preparedness for pandemic flu.

With 150 million people crossing international borders every day, some health experts believe air travel may help to spread the virus. But many national plans have not addressed the issue.

Cooperation with neighbouring nations was also rarely mentioned and the link between animal health surveillance may also be inadequate.

Dr Coker said coherence is needed on providing antiviral drugs and a vaccine and uncertainties also exist between countries over the use of non-pharmaceutical interventions such as the use of face masks.

Scientists believe a global influenza pandemic is already overdue. The Spanish Flu pandemic of 1918 killed up to 50 million people and one million died in later pandemics in 1957 and 1968.

Professor Lindsey Davies, the National Director of Pandemic Influenza Preparedness in England, told the meeting that a flu pandemic could kill between two million and 50 million people worldwide and that as many as 25 million could be hospitalised.

Up to 25 per cent of the workforce in Britain could take five to eight days off from work because of flu. But she added that the world is better prepared to deal with a pandemic than before.

"We have an opportunity to get ahead of this," she said. Dr Coker, who analysed pandemic flu plans of European member states as well as Bulgaria, Romania, Norway, Switzerland, Australia, Hong Kong, New Zealand, Thailand and Vietnam, said surveillance was reasonably well approached by most nations.

All had strategies for antiviral drugs which are expected to be a first line of defence in the event of a pandemic but struggled with the logistics of how to deliver them.

"Many plans failed to address who will get antivirals," he said.