YESTERDAY’S paper is today’s fish and chip wrapping, so the news it contained is soon forgotten. This may be just as well for those who figure in the gossip columns or in the Sunday papers, but it is a dangerous principle when medical news stories are involved.

In spring this year there was a scare, a thoroughly justified one about the spread of avian flu, better known to most people as bird flu. For a time people worried about their Far Eastern holidays, and wondered whether they should cancel their bookings and brave Benidorm instead. The scare was soon superseded by other worries, and the holidaymakers who were so concerned in February and March will now be sunning themselves at a newly refashioned Thai beach complex, just as they did last year.

So thoroughly had the hazard that avian flu presented to the world been relegated to the margins of the news that a warning by the World Health Organisation last month was largely overlooked. Their experts advised that the strain of avian flu that caused such alarm earlier in the year has now shown changes in the H5N1 influenza virus, which is likely to make it more infectious to humans. They also reported that there had been more outbreaks of avian flu, and that these outbreaks were lasting longer than had previously been noted. Furthermore, blood tests on the people who have been in contact with avian flu showed that there was an increasing number who demonstrated a response indicating that they had suffered a sub-clinical infection.

The good news, or comparatively good news, from WHO was that the death rate among those infected with avian flu recently was not quite as high as it had been previously. The age range of people who had more recently caught flu from their hens, ducks, or migrating water birds was also much greater. The earlier outbreaks had attacked mainly young active workers rather than the elderly, infirm and children who usually suffer in any epidemic. As long as the virus is spread only from chicken to chicken, or even chicken to human, and not human to human, chicken-house workers would be at greater risk than those such as the elderly or the under-fives, who have a poor immune system. It was noteworthy that this pattern was changing.

There is as yet no firm evidence that the dreaded human-to-human transmision of avian flu is anything other than an extreme rarity. However, since the publication of the WHO report, there has been news of the spread of avian flu in Indonesia, where three cases have been reported. The WHO researchers said that, although it couldn’t be proved that human-to- human transmission was occurring, there were some signs during the spring outbreaks that it was possible that some of these cases could have been spread in a way that suggested this was happening.

There is a possibility, some doctors think even a probability, that, once the H5N1 strain has mutated so that it is able to spread from person to person, it will not be as lethal as the infection when caught from a chicken or duck. They predict that the death rate from it might then fall to about 30 per cent. This is considerably lower than the current mortality rate, but is not a statistic that is likely to be reassuring to the general public.

Although the only publication to give the WHO warning much coverage was GP magazine, the Government has now issued a statement about its plans for the introduction of a vaccine against avian flu. Only enough doses will be stockpiled for essential medical and other services. Doubt has been expressed that this vaccine will be able to trigger a sufficiently strong antibody response to prevent an attack of the flu in most people.

The vaccination may therefore be of little help to the community, for, if doctors and nurses were only partially protected, it may well be that the mild flu they would suffer would be worse than them having a normal attack. It would be a great advantage for those who had the vaccine in that presumably they would have a better opportunity of recovering but if their illness was so mild that they were able to continue working while suffering a modified attack they might spread the flu even faster, and to people whose resistance was already at a low ebb by reason of their age or other diseases.

The only way that a pandemic as widespread, but much more deadly, than the Spanish flu of 1918-19 can be avoided or nullified is either to produce a stockpile of enough of the present vaccine for everyone, or preferably to manufacture a more effective one so that total protection will be afforded by it. In the meantime, the Government should be stockpiling vast amounts of Tamiflu so that if the worst happens, and experts think that this is inevitable, there will be enough of the anti-viral agent to treat the 30 per cent of the population who are predicted to catch flu if there is an epidemic.