Asian Flu: the Outlook

Asian influenza will hit the U.S. this fall before mass immunization can be effective, and the nation faces an epidemic which may strike 15 million to 30 million people. The disease is relatively mild (in no way comparable to the killing "Spanish flu" of 1918-19), and is likely to cause only a small number of deaths among the feeble young and enfeebled old. But it may compel 10% to 20% of the population in affected areas to take to their beds at the same time, thus cripple essential services.

Who Gets It & When. These disquieting facts emerged last week from a conference on flu and vaccination prospects sponsored by the U.S. Public Health Service. Nub of the problem: the U.S. population has no immunity against this new mutant strain (TIME, June 24), can gain immunity only from contracting the disease itself or from preventive inoculation with a new vaccine prepared especially to combat it. Despite the best efforts of medical men and vaccine manufacturers around the world, there will not be time enough to immunize more than a fraction of the U.S. population before the disease strikes in force.

With these facts in mind, PHS's Surgeon General Leroy E. Burney has asked six manufacturers* to churn out vaccine as fast as possible, and in response they are putting their virus laboratories on two or three shifts, seven days a week. But there is only so much vaccine available for seeding; it will grow only at its naturally appointed speed (in fertilized eggs). So, even with their crash program, the manufacturers can promise only 8,000,000 shots of vaccine by mid-September. After that, cooler weather is expected to send the flu rate soaring.

The first 4,000,000 doses (1 cc. each) are already earmarked for the armed forces and their dependents overseas. For the next 4,000,000, Surgeon General Burney suggested, doctors, nurses, hospital attendants and practical nurses (totaling about 3,000,000) should have top priority. Next, he thought, should come essential workers in the transportation, communications and utilities industries. Since these add up to another 9,000,000 or so, on this basis there would be no vaccine for the general public until late October. Still, the PHS (in spite of its experience with polio-vaccine shortages) is proposing no nationwide system of priorities in allocating the vaccine, relying instead on manufacturers to work out distribution with state and local health officers as best they can.

How Many Shots? For those who can get it, the vaccine will probably cost $1 (in bulk military orders it costs only 20-c- to 40-c-), plus doctor's fees. One shot should trigger the production of protective antibodies in ten to 14 days. Because single shots of flu vaccines are usually effective in only 70% of cases, the armed forces like to give a second shot. In this case, because of short supply, their second shots will probably have to wait. The six manufacturers aim to produce 60 million cc. in all by Feb. 1.

With thousands of scattered cases already reported across the U.S., most areas have been exposed to the virus by now. If epidemics develop as expected with the onset of cooler weather, they could spread from San Francisco to Boston within a month.

*Eli Lilly & Co. and Pitman-Moore Co. of Indianapolis; Lederle Laboratories of Pearl River, N.Y.; National Drug Co. and Merck Sharp & Dohme, Inc. of Philadelphia; Parke, Davis & Co. of Detroit.

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