Thursday, March 12, 2009

Is It Time to Panic about Bird Flu?


Friday, March 13, 2009
By Melissa Cullen
Associate Editor/Staff Writer

Don't eat eggs. Don't eat chicken. Keep away from birds. The advice against contracting avian flu is flying around the world in a flurry of emails, letters and phone calls.

In more developed countries, the public are aware of the potential danger but the World Health Organization (WHO) has advised that it is safe to consume the meat and eggs of an infected bird, "provided that these items are properly cooked and properly handled." The virus is susceptible to heat and one is highly unlikely to contract bird flu through the consumption of cooked produce.

For the average person, whilst the virus is in its current state and only able to pass from bird to human as opposed to from human to human, the risk of contracting avian flu is very slight.

However, the potential severity of the virus and the situation is frightening. The WHO has warned that "the emergence of a H5N1 that is readily transmitted among humans would mark the start of a pandemic." Scientists worldwide have all but said that it is only a matter of time before the avian strain mutates and can pass between humans. They say that a pandemic is imminent. This in itself is hardly surprising; scientists are far more likely to predict doom than to dismiss the possibility – they will always err on the side of caution, as it would endanger their careers more to reassure and be wrong. But governments worldwide are taking heed.

Many countries, such as Thailand, China and the USA, have established some sort of action plan to prepare ahead for the possibility of a global epidemic, including stockpiling anti-viral drugs such as Tamiflu.

But these drugs are not definitive vaccines against H5N1 in its current state, nor what it will be if it combines with a human flu virus. Experts fear that this will happen if a person is simultaneously infected with avian flu and human flu, allowing the pair to exchange genes and create a new virus.

(more) A vaccine cannot be created for a disease which does not yet exist. Furthermore, however quickly a vaccine is developed after the emergence of a combined flu, it would take months to produce a sufficient supply for the number forecasted to be infected.


If the H5N1 virus that threatens the world today does become passable between humans, it may well sweep the globe in a matter of days. With the ease and frequency of travel these days, it would take only one person to get on an airplane and fly halfway across the world to transfer the virus to another continent. It would be near impossible to stop all travel, and to stop any less than this would just delay the spread of the virus - not stop it.

Experts believe 20-30 percent of the world's population will become infected should the virus becomes passable between humans. The economic effects will be massive — a large number of the workforce will be ill or looking after the ill. There will be various knock-on effects that will ultimately, according to the most recent estimates by the World Bank, cost the world economy somewhere in the region of $800 billion.

Conversely, many benefit from scare-mongering. Drug companies are already taking mass orders, scientists receive extra funding for research, and newspapers sell. Cynical as it may be, there is always another side to the coin.

So just how serious is the threat of avian flu and from where did these endless and terrifying predictions arise?

The H5N1 strain of avian flu was first contracted by humans in Hong Kong in 1997, where six out of the 18 humans infected died. The high mortality rate and the fear of the virus combining with a human flu virus led to the slaughter of the city's entire chicken population.

The attempt to stem the spread of the virus seemed to have worked, and there were no further cases of this strain of avian flu in birds or humans until 2003, when it reappeared first in Thailand and then in chickens in central South Korea. Despite the culling of an enormous number of birds, the H5N1 strain quickly spread through a further six nations in south-east Asia. Until the summer of 2005, the spread was restricted to this area, but has since extended to Russia, Kazakhstan, Turkey, Romania, Croatia, Britain, and most recently, Kuwait.

It seems impossible to prevent its spread. If migratory birds take it from East Asia to beyond, there is nothing we can do to stop it. Furthermore, to stop it spreading within certain countries seems to be a losing battle. In poorer countries such as Indonesia, many people's livelihoods depend on the birds that they raise on small farms or in their back yards. The awareness of the danger is low and there is little incentive for people to report cases of bird flu. Instead, sick birds are quickly killed and either eaten or sold.



Close contact with infected birds or contaminated surfaces can easily result in the passing of the deadly virus from birds to humans, as the virus is carried in the bird's saliva, naval secretions, and feces. But the official figures for this seem reassuringly low. Just over a hundred cases of H5N1 bird flu in humans have been recorded since the outbreak in 1997, 63 of which have resulted in death.

However, it is said to be quite possible that there have been many more cases, since it was only recently discovered that it can affect other organs apart from the lungs; thus many deaths attributed to something else could actually have been bird flu. In addition, many cases may have gone unreported in poverty-stricken areas.

As yet, there have been no confirmed cases of the virus passing from human to human, although possible cases have been reported in Thailand, Vietnam, Hong Kong and Indonesia. The fear remains - if the avian flu mutates and joins with a human flu virus, the world could see a pandemic as deadly as the Spanish Influenza of 1918.

The Spanish Influenza emerged over 80 years ago, killing between 20 and 50 million of the world's population in a mere 10 months. Originally believed to be a combination of pig and human influenza, more recent research on the 80-year-old frozen body of an Alaskan woman has confirmed that it originated from an avian strain of flu, named H1N1. The most disturbing attribute of the virus was that it had an unusually high mortality rate among healthy young adults. But it struck at a time when the world was at war and thus focus was divided between two great killers. With the dramatic preparations governments are taking today, the world should be far better prepared to deal with such a pandemic.

There have been four flu pandemics in the past century and according to the WHO, we are "long overdue for another." The last two pandemics occurred in 1957 and 1968, but neither virus originated from an avian strain. They were human flu viruses that adopted some of the genetic elements of bird flu. Thus, they were lethal enough to take millions of lives but they were in no way as powerful as the Spanish Influenza.

It may be reassuring to some to remember the panic caused by the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003. This virus first appeared in China in 2002 and spread to about 30 other countries through international travelers. Incredibly, the disease did not turn out to be the huge killer that it could have been. Of the 8,000 people that became infected, only 775 died.

SARS seemed to be spread through respiratory droplets, therefore one would have to be in close contact with an infected person in order to catch it. However, the possibility of spread through airborne transmission or contact with contaminated objects or surfaces could not be excluded. If the world was able to prevent a deadly pandemic only two years ago, surely it will be able to do so now?

In essence, as it stands at the moment, bird flu is hardly a danger to most individuals. Unless one lives or works with infected birds, the chance of contracting the disease is extremely slim. There have been no reports of bird flu in Korea since 2003, but with the possibility that migratory birds could be spreading the virus, and the fact that it has spread through so many countries across the world, it seems wise to avoid contact with wild birds as well as observe recommendations for food preparation. A human flu inoculation may protect against bird flu, although studies have found that the flu virus often becomes resistant to drugs.

At this point, we can only fight what exists at the moment. It is unrealistic for the individual to prepare for a virus that has yet to emerge. To be aware of the potential danger is vital. But to panic is unreasonable. We have to come to the bridge before we can cross it.

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