I'm reading reports that the migratory birds has started infecting Russia with the H5N1 virus and will soon spread to Europe.. My guess is that it's only a matter of time before this new virus becomes a pandemic strain.
Sorry, no cliff notes.
Prepare for disaster
08:17 PM CDT on Saturday, August 6, 2005
By LAURIE GARRETT
Scientists have long forecast the appearance of an influenza virus capable of infecting 40 percent of the world's human population and killing unimaginable numbers. Recently, a new strain, H5N1 avian influenza, has shown all the earmarks of becoming that disease.The havoc such a disease could wreak is commonly compared to the devastation of the 1918-19 Spanish flu, which killed 50 million people in 18 months. But avian flu is far more dangerous: As of May 1, about 109 people were known to have contracted it, and it killed 54 percent (this statistic does not include any milder cases that may have gone unreported).
In short, doom may loom. But note the "may." Nothing at all could happen. Scientists cannot predict with certainty what this H5N1 influenza will do.
An H5N1 avian influenza that is transmittable from human to human could be devastating: Assuming a mortality rate of 20 percent, the United States could be looking at 16 million deaths and unimaginable economic costs in a worst-case scenario. The entire world would experience similar levels of carnage, but the majority of the world's governments have no health infrastructure to handle the burdens of disease and panic.
In 1918, some 675,000 Americans ? about 6 percent of the population ? perished from the Spanish flu. It hit North America in the summer of 1918, killing 43,000 U.S. military personnel in about three months.
By late September 1918, so overwhelmed was the War Department by influenza that the military could not assist in controlling civic disorder at home, including riots caused by hysteria.
Influenza swept from populous U.S. cities to remote rural areas. Explorers discovered empty Inuit villages in what are now Alaska and the Yukon Territory, their entire populations having succumbed to the flu. Nearly 20 percent of the people of Western Samoa died. Many historians and biologists believe that nearly a third of all humans suffered from influenza in 1918-19 ? and that of these, 100 million died.
Victims suffered from acute cyanosis, a blue discoloration of the skin and mucous membranes. They vomited up blood; many young people suffered from encephalitis; and millions experienced acute respiratory distress syndrome, an immunological condition in which disease-fighting cells damage lung cells and the victims suffocate. Had antibiotics existed, they may not have been much help.
Understanding the risks requires understanding the nature of influenza. Influenza is normally carried by migratory aquatic birds, usually without harm to them. As the birds migrate, they can pass the viruses on to domesticated birds. Throughout history, this connection between birds and the flu has spawned epidemics in Asia, especially China.
As China's GDP grows, chicken farming is morphing into a major industry, with poultry plants rivaling those in Arkansas and Georgia in scale ? but lagging behind in hygienic standards. These factors favor rapid influenza evolution.
Influenza reproduces sloppily: Its genes readily fall apart, and it can absorb genetic material and get mixed up in a process called reassortment. When influenza successfully infects a new species, it may switch from being an avian virus to a mammalian one, resulting in a human epidemic. This explains why influenza is a seasonal disease. Vaccines made one year are generally useless the following.
Since the early 20th century, an H5N1 influenza has never spread among humans. According to the World Health Organization, "Population vulnerability to an H5N1-like pandemic virus would be universal."
Chinese scientists have been tracking the H5N1 virus since it first emerged in Hong Kong in 1997, killing six people and sickening 18 others. In January 2003, the "Z" virus emerged and spread to Vietnam and Thailand, where it became resistant to one of the two classes of anti-flu drugs.
In early 2004 it became supervirulent and capable of killing a range of species, including rodents and humans. That permutation was dubbed "Z+."
Although most of the 109 known human H5N1 infections have been ascribed to some type of contact with chickens, many cases remain unsolved.
The majority of the infected have been young adults and children. There has been one documented case of human-to-human transmission of a strain of the H5N1 virus, in late 2004, in Thailand.
The Z strain of the disease killed 68 percent of those known to have been infected. In H5N1 cases since December 2004, however, the mortality has been 36 percent. It is possible that H5N1 has begun adapting to its human hosts, becoming less deadly but easier to spread. Leading flu experts argue that this sort of phenomenon has in the past been a prelude to epidemics.
The medical histories of those who have died from H5N1 influenza are disturbingly similar to accounts of sufferers of the Spanish flu in 1918-19. Otherwise healthy people are overcome by the virus, developing: coughing, headache, muscle pain, nausea, dizziness, diarrhea, high fever; also, pneumonia, encephalitis, meningitis, acute respiratory distress and internal hemorrhaging.
According to test-tube studies, Z+ ought to be vulnerable to the anti-flu drug oseltamivir, which the Roche pharmaceuticals company markets under the brand name Tamiflu. It is difficult to tell whether the drug contributed to the survival of those who took it and lived. Lacking any better options, the WHO has recommended that countries stockpile Tamiflu.
In the current system, all influenza vaccines must be quickly made after a WHO meeting of flu experts held every February. At that gathering, scientists try to predict which strains are most likely to spread in the next six to nine months. Samples are delivered to pharmaceutical companies around the world for vaccine production, which are hopefully available to the public a few months after influenza typically strikes Asia, in the early summer.
Manufacturers have never made more than 300 million doses of vaccine in a single year. In the event of an H5N1 pandemic, millions would likely be infected well before vaccines could be distributed.
Resources are so scarce that it is doubtful that any nation would be able to meet the needs of its citizenry. Vaccine distribution schemes assume that only the very young, the elderly and those who are already fighting illness are at serious risk from the flu.
But in 1918 the young and the old fared relatively well, while those aged 20 to 35 suffered the most deaths from the Spanish flu. And so far, H5N1 influenza looks like it could have a similar effect.
Facing limited supplies, the U.S., European and Japanese governments might give priority to vaccinating heads of state around the world in hopes of limiting chaos. With death tolls rising, vaccines and drugs in short supply, governments would feel obliged to inhibit travel and worldwide trade. Most governments would likely resort to quarantines.
The economic consequences of quarantines and medical care would be outstripped by productivity losses. Entire workplaces would be shut down to limit human-to-human spread of the virus.
The potential for a pandemic comes at a time when the world's public health systems are severely taxed. This is true in both rich and poor countries.
The Bush administration recognized this weakness after the anthrax scare of 2001. The White House increased funding for the CDC's flu program, for the National Institutes of Health's flu-related research; for the Food and Drug Administration's licensing capacity for flu vaccines and drugs; and spent an additional $80 million to create new stockpiles of Tamiflu and other drugs.
On Aug. 4, 2004, the Department of Health and Human Services issued its pandemic flu plan, detailing further steps that would be taken by federal and state agencies.
Probably the greatest weakness that each nation must address is the inability of hospitals to cope with a sudden surge of new patients. Medical cost-cutting has resulted in a reduction in the numbers of staffed hospital beds in the wealthy world, especially in the United States.
National policy-makers would be wise to plan now for worst-case scenarios. Combating influenza will require multilateral and global mechanisms. The WHO, the United Nations' Food and Agriculture Organization and the World Organization for Animal Health have all published guidelines on how to respond to a pandemic.
The efforts of these agencies should be bolstered. The WHO, for example, has an annual core budget of just $400 million. An unpublished internal study estimates that the agency would require at least $600 million more were a pandemic to erupt. It must have adequate funding and personnel to serve as a clearinghouse of information about the disease, thereby preventing the spread of false rumors and global panic.
Whether or not this H5N1 influenza mutates into a human-to-human pandemic form, the scientific evidence points to the potential that such an event will take place, perhaps soon. Those responsible for foreign policy and national security, the world over, cannot afford to ignore the warning.
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