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From NPR News this is ALL THINGS CONSIDERED. I'm Robert Siegel.

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And I'm Melissa Block.

When the next flu pandemic strikes, doctors won't have many tools to fight it. An effective vaccine will take months. Tamaflu pills almost certainly will be in short supply. Now some researchers are pointing to a treatment devised during the great flu pandemic of 1918.

NPR's Richard Knox has the story.

RICHARD KNOX reporting:

As soldiers and sailors were dying in 1918, a couple of U.S. Navy doctors in Boston got an idea. Maybe they could rescue flu victims by injecting them with the blood of flu survivors. That had sometimes worked against ordinary pneumonia when doctors exposed horses to the pneumonia germ and then extracted their blood serum.

It seemed to work against the flu, too. Military doctors from North Carolina to California began using it. But modern day Navy doctor Tom Luke says back in 1918 almost no civilians got the treatment.

Dr. TOM LUKE (U.S. Navy): It wasn't applicable to where most people got their care in that time which was a primary care physician in the home setting. It just wasn't applicable to that situation.

KNOX: It was a complicated procedure. Doctors had to draw flu survivors' blood, allow it to clot then drain off the straw colored serum. Years later, doctors found out why it worked. The clear part of blood contains antibodies that attack the flu virus. Luke and his colleagues dug out old studies describing what happened when the treatment was used on 1,700 soldiers and sailors. The report appears today on the online version of the Annals of Internal Medicine.

Dr. LUKE: For those that had pneumonia but were not treated, the death rate was almost 60%.

KNOX: But not for those who got the antibody treatment. The difference was especially striking among those who got treated within four days after severe symptoms began.

Dr. LUKE: For those that were treated early, the overall death rate was 19% and the range of the fact was 26 to 50% reduction in death, which is very, very significant.

KNOX: Luke says not to make too much of the 88-year-old studies. They weren't up to today's scientific standards. But he says the antibody treatment still should be investigated. To study it in bird flu victims, researchers would have to first persuade governments to allow it to be used and then share the data.

Dr. LUKE: Egypt, Iraq, Indonesia, Thailand, Vietnam, Laos, China, you know, we want to bring in as many colleagues as we can so that they can attempt to study this in the context of a standardized trial.

KNOX: Researchers will have to get bird flu survivors to donate blood plasma. These days that's fairly simple using a device called a plasma apheresis machine. Once they have enough antibody rich plasma they'll have to get it to the latest bird flu outbreak fast.

Dr. Stephen Hoffman is another author of the study. He's with a company called Protein Potential. Hoffman says the study will need lots of patients to detect a real difference between those who get treated and those who don't.

Dr. STEPHEN HOFFMAN (Protein Potential): To be able to show a difference you need 65 patients in each group.

KNOX: That's 130 widely scattered bird flu victims. Cases have been popping up at a rate of 12 a month so it will take a while to get enough. But bird flu expert John Trainer of the University of Rochester thinks it's doable.

Mr. JOHN TRAINER (University of Rochester): I think we can. I think we can do these studies. I think we should do them and I really do think we must do them or face the consequences of not knowing how to handle it when the pandemic starts.

KNOX: Nobody knows when that will be of course but everybody agrees there's no time to lose.

Richard Knox, NPR News, Washington.

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