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WASHINGTON — The Pentagon’s top health officials have devised a multilayered plan of attack for the avian flu which mirrors President Bush’s plan for the nation announced Tuesday.

Dr. William Winkenwerder, assistant secretary of defense for health affairs, and Dr. John Grabenstein, director of the Military Vaccine Agency, spoke at length with Stars and Stripes recently to clear up misconceptions about the plan.

On Oct. 13, Stripes published a story that said the Department of Defense was experimenting with a vaccine and that the Pentagon did not need Food and Drug Administration approval to go ahead with inoculations, and wrongly attributed the information to Marianne Coates, Winkenwerder’s director of communications.

A vaccine to combat the H5N1 bird flu virus is in fact being developed at the National Institutes of Health, not the DOD, and the Pentagon has ordered 2.7 million doses, which it expects to get first shipments of in February.

That vaccine will not be licensed by the FDA at that time, and the DOD will not use it without what is called an Emergency Use Authorization, Grabenstein said. That must come from the Department of Health and Human Services, which is spearheading the national plan outlined by President Bush.

The DOD expects the product to be licensed by the end of 2006.

In addition, the DOD is buying 2.5 million treatment courses — two pills a day for five days — of the anti-viral medication called Tamiflu. These medications are not a preventative — they are given with the onset of symptoms, “almost like an antibiotic,” Winkenwerder said.

“We’re exploring the acquisition of other anti-viral medications, specifically Relenza … an inhaled product,” he said.

The Pentagon also is pushing for its personnel to get their seasonal flu shot, purchasing 3.5 million doses of Fluzone and the inhalable FluMist.

But stockpiling vaccines and medications is just one aspect of the DOD plan.

The Pentagon also is educating leaders and the population about what avian flu is and what it isn’t, and thus what people should and shouldn’t do in the event of an outbreak, and monitoring potential outbreaks worldwide.

“We have been … working on our preparedness and ability to respond for about 18 months,” Winkenwerder said. “Our first priority is to protect the health and safety of our troops, anywhere, anytime around the world.”

Winkenwerder said the DOD is updating policies for both preparedness and action in the event of an outbreak.

Defense Department-run laboratories around the world have been testing samples of the H5N1 virus, deadly in bird-to-bird transmissions, and thought to be equally deadly if it mutates into a human-to-human transmittable form.

“The most recent outbreak … reported two or three weeks ago, involving a child and a parent, was picked up through [a DOD laboratory] in Jakarta,” Indonesia, Winkenwerder said.

In the event of an outbreak, the DOD would pursue a “ring containment” policy, Winkenwerder said.

That effort “involves getting an accurate report of individuals that might have been affected, identifying people that have come into contact with those individuals, tracing their contacts and so forth,” he said.

Personnel nearby would be vaccinated, as would others in “priority groups.”

“And among those priority groups would surely be our troops who are deployed, because they’re performing mission-critical functions, health-care workers, because they’d be in a position to care for people,” Winkenwerder said.

Since 2003, at least 62 people in Southeast Asia have died from H5N1; most regularly handled poultry. Strains of the virus have been seen in foul in several European countries, and a strain was found in migratory birds in Canada, it was reported Monday.

Officials stress importance of getting flu shot

DOD health officials are stressing that despite the focus on avian flu this year, servicemembers, families, and especially retirees need to get their seasonal flu shot.

Each year in the United States, 36,000 people die from seasonal flu.

There is no shortage of seasonal flu vaccine.

“All the doses aren’t everywhere yet, said Dr. (Col.) John Grabenstein, director of the Military Vaccine Agency. “It’s still coming off the assembly line. But, within about two or three weeks, all of our doses should be everywhere, and then it’s just a matter of having them come into the clinic. But every clinic has a starter supply to begin their local process.”

That includes troops downrange, who were sent the first batches of FluMist, an inhalable vaccine, and the injectable shot, Fluzone.

Those in Iraq and Afghanistan were “first on the list, Korea was second, and then we refocused back on the States — the elderly, retirees — because they’re the ones at risk of dying, and now we’re filling in the gaps everywhere else,” he said.

— Patrick Dickson

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