flu shot
© Heidi Heilbrunn/Special
As the U.S. begins its annual flu season, experts warn that the country is ill-prepared for a pandemic flu that could cause widespread disruption and death.

In a webinar Tuesday with the Association of Health Care Journalists, flu experts outlined potential problems that will occur if and when there is another flu pandemic. Those occur when there is a large mutation in the current circulating flu viruses that it is unlike previous strains or the emergence of a wholly new kind of strain, often from one that jumps from animals like chickens or pigs to humans, said Dr. Sonja Olsen, deputy chief of the Epidemiology and Prevention Branch in the Flu Division at the Centers for Disease Control and Prevention.

Since 2013, the CDC has been monitoring an avian influenza strain called H7N9 that has caused some human infections, increasing from 135 cases to 759 in the last season that ended in August. About 70 percent of those patients ended up in intensive care units and 40 percent died, she said. However, the virus has not shown yet it can pass very well from human to human, Olsen said.

In an analysis published in recent months, scientists looked carefully at the virus strain and tried to see if it could be made to create certain mutations that would make it more adaptable to humans, known as "gain of function" studies, she said. They noted that it already had some mutations similar to strains that caused pandemics in 1957 and 1968. And that with a few small changes, it could adapt to attack human cells that line the airway, Olsen said.

It "required only a small amount of change to potentially be more devastating in humans," she said.

The problem with preparing for a pandemic is not so much in the U.S. as it is with other countries whose infrastructure and public health may not be as robust. That is a problem because of the global nature of trade and in particular our reliance on other countries to supply essential drugs and supplies, said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

They looked at 30 essential drugs and found that they all are made outside the U.S. except for a couple made in Puerto Rico. Any kind of disruption from a pandemic elsewhere, particularly in India or China, would have a rapid impact on U.S. health care, he said. This is already happening with the devastation in Puerto Rico, which manufactures some drugs for the U.S. already in short supply now, he said. Nor is the U.S. government ready itself to deal with a pandemic, Osterholm said.

"This administration does not have a team in place to deal with that, in my estimation," he said, though in fairness neither did President Obama. "This is going to take a big team."

"There are lots of gaps globally," Olsen said.