Vietnam. Indonesia. Thailand. Turkey. The bird flu marched across Asia and toward Europe. By the start of spring, the virus had infected 184 people, killing more than 100. Doctors warned that the virus could mutate, allowing widespread human-to-human transmission and causing a pandemic.
Thousands of miles away, Cornelia Dekker and her team are working to stop that from happening. Dekker, an associate professor of pediatrics and director of the Stanford-Lucile Packard Children’s Hospital Vaccine Program, is testing a vaccine to protect people against the disease.
At present, people who haven’t had contact with infected birds are extremely unlikely to contract the worrisome strain of avian flu, technically the H5N1 variant of influenza A. Human-to-human transmission is rare and does not continue beyond one person. But if that changes, a worldwide outbreak is anticipated. “We know there is going to be another pandemic,” Dekker says. “The big question is when and how bad.”
This is not the first time Dekker’s vaccine efforts have been closely linked with major world events. After 9-11, her group tested a revamped smallpox vaccine aimed at protecting people from terrorists who might use the once-vanished disease as a biological weapon.
Dekker’s group is testing the bird flu vaccine under contract with the National Institutes of Health. The vaccine was developed by Emeryville, Calif.-based Chiron Corp., using a blood sample taken from a patient infected with bird flu in Vietnam.
The Stanford team selected 82 participants from more than 300 volunteers and gave them two injections apiece in March. There has been no sign of significant side effects. Each patient will have their blood tested to see whether they have developed antibodies against the disease.
The researchers caution that participation in the trial provides no guarantee of protection against avian flu. Some of those poked got a placebo. Others got a dose that may be too low to be effective, even if it does produce some antibodies.
Even if the vaccine proves effective, don’t expect to be able to get it at your doctor’s office anytime soon. This trial, which involved only healthy adults, was just the first step in a U.S. vaccine-approval process that typically takes years. The next step is to try the vaccine on children and the elderly.
But if avian flu were to start spreading fast through the human population, normal approval procedures might be set aside. “I think in an emergency all bets are off,” Dekker says. “If we are unlucky enough to have a pandemic coming up, I think there would be good thinking about whether they should immunize the population here.”
