American Scientist

To the Editors:

The article "Influenza" (March–April), by Robert G. Webster and Elizabeth Jane Walker, very effectively depicted the ongoing battle we face with emerging and resistant pathogens. The article was both poignant and well expressed. Dr. Webster did an important job of reminding us of the ever-present challenge we face with novel resistant strains and of the dynamics involved in the spread of globally communicable diseases. The burden of educating the lay audience of potential pandemics lies with the scientific community. It has become our responsibility to make the public more aware of biological threats, especially post-9/11 and now with the possibility of new global effects.

Research and prevention measures, such as widespread immunization programs and other preparedness, against emerging strains of influenza are tantamount to investigation of other biological threats we face, such as anthrax, smallpox and tuberculosis. The dissemination of knowledge concerning new virulent and resistant strains of global importance is timely. The spread of new infectious strains should widen our eyes even more, as it did when the Centers for Disease Control and Prevention first saw outbreaks of West Nile virus in New York City during the summer of 1999. The virus, much like the influenza virus, was transmitted through avian species, then into an intermediate reservoir and finally into humans. Continued support for surveillance, as well as research into novel approaches for vaccine design and delivery, will be our best defense.

Shawn Foti
Brown University TB/HIV
Research Laboratory
Providence, Rhode Island

To the Editors:

"Influenza" lays down three interrelated and significant elements for fighting influenza viruses: (1) educating people about this pandemic problem; (2) appreciating the role of scientists in identifying these viruses and ensuring that they don't escape immune examination; and (3) urging governments to pay for the cost of vaccines, including production and distribution. Thus, three targeted groups can be identified: the public, scientists and governments.

In order to win the global battle with influenza, these elements should be activated in parallel, and the goals should be communicated clearly to the targeted groups. Although the authors, in writing this article, are already implementing the first two elements, using only the "scenario" approach may not convince governments to contribute. Submitting a detailed study to the appropriate parties, at both the international and the national levels, would have a better chance of achieving the third task, and would constitute a valuable advance for years to come.

In addition to scenarios, I suggest that the authors prepare a study that contains detailed information on the costs (actual and expected) of the prevention of influenza, and publish it in this magazine. It would also be more persuasive if the authors made a study, for comparative purposes, on the cost of the treatment of influenza. I base this suggestion on the authors' own comment: "The scientific community has a responsibility to convince nations to stockpile NA [neuraminidase] inhibitors and promote vaccine production."

Nasma Barqawi
Ottawa, Ontario