Bird flu pandemic?

Inspired by this article:

I went browsing several other sites (some of which seemed to have ulterior motives, like being REALLY pressimistic so they could hawk their nutrition supplements to fight the flu…or are they?)

seems to have links to reputable sites, but also seems to have links to the nutrition-esque sites.

I’m not sure if this would be better in Great Debates, or IMHO, but for now I think there can be factual answers.

My question, is the doom-and-gloom that is being mentioned (millions killed, very high mortality rate) legit? I mean, I can understand the figures, especially in some of the less-industrialized areas of the world, but how would a pandemic like this affect the U.S/Europe for example? Would it just be a lot of people sick, with more deaths than normal, or something I can’t comprehend?

Also, I seem to be fascinated by some of the science that I’ve read about it, the virus mutations, strains, etc…are there any really good websites with more scientific info about this?

Thanks in advance!

Remember, it’s the worst-case scenario that sells newspapers.

That said - yes, a global pandemic caused by a new and deadly strain of flu could easily kill millions. It happened in 1918, it could happen again.

What we can do against viral diseases is very limited. We have very few drugs effective against viruses, and we don’t have them in mass quantity. We have flu vaccine, but it must be customized for each strain of flu and that would likely take longer than any such epidemic would last. Making vaccine is particularly problematic for the avian flu, because we normally culture flu vaccine in chicken embryos and the avian flu tends to kill them off before any vaccine can be made. For all of these reasons, those of us in the industrialized world have few, if any, advantage over those in more medically primative areas.

As far as boosting one’s immune system – there is now evidence that one reason the 1918 flu killed something like 25 million around the world in just a few months was that it was capable of turning the body’s immune system against itself, which would account for why the young and healthy died at higher rates than the young and elderly, the opposite of the normal pattern seen. Then again, the crowding of young soldiers in barracks and ships no doubt contributed as well.

Yes, it would be a lot of people sick and more deaths than usual - on a scale most of us can’t imagine.

I’m watching this very closely, but not panicking.

There is no immediate crisis.

That being said, we must remember that Indonesia’s health care system is destroyed or swamped with tsunami victims right now. The chaos has weakened the power of the central government in the remote provinces, leaving effective action a challenge.

Points to recall:[ul]
[li]Pigs are displaying symptoms. Many scientists studying the horrifying 1918 Spanish Influenza belive that the virus started in birds, adapted to mammals in pigs, & jumped to Humans.[/li][li]Cats, including Tigers, have been infected. This shows the virus is very adaptable, & learning new tricks. Is your Kitty a potential animal vector?[/li][li]The most recent victims in Vietnam had non-repiratory organs infected with the virus. This is very strange, but similar to 1918 Spanish. It also means that undiagnosed cases are out there.[/li][li]The longer the disease exists in Man, the better adapted it is to us. And it’s been around a few years.[/li][/ul]

I agree with what’s been said already: this is potentially a very serious problem, though as of yet it is just potential.

However, I can’t resist linking to the recent Onion article:

Nation’s Leading Alarmists Excited About Bird Flu

I’d be very skeptical of the “72% mortality rate” cited in the CNN article.

Note that this stat is for “identified cases.” For all we know there may be many more cases of bird flu out there which took a milder course, and from which the stricken individual recovered easily without ever seeking treament. I would expect that only people who became seriously ill sought treatment and were thus “identified.” The true mortality rate may be much lower.

Many epidemiologists have been warning of a flu pandemic originating from Asia (esp. China) for years due to agricultural practices there that place pigs, ducks, and chickens in close proximity. Having those three animals that close gives the flu a wide variety of genetic material to mutate itself with. It really is only a matter of time.

One thing to remember is that the 1918 situation was very different from what the case is today.

  1. The situation was not taken seriously at the beginning. One possible epicenter was U.S. troops being assembled to go to war. Had the initial victims been immediately quarantined and treated, it might not have spread as far. Instead, the initial attitude was “Oh, it’s just the flu.” Trainloads of young men carrying the virus were transported around the country, packed into ships and sent overseas.

  2. Many of the victims succumbed to opportunistic bacterial infections. Antibiotics were not available.

  3. In many locations there was no public health service to speak of.

If I’m remembering correctly, the concern is that we humans are less adapted to an avian mutant flu than the normal run of the mill flu. It’s because the surface proteins are different from the usual stuff that we get during flu season. Since we’d have no natural immunity, we could go down hard and fast.

MLS is right though. It’s a different environment than it was back in 1918. It’d take a bit for it to spread like it did then.

A few other reasons it’s different now than it was in 1918:

  1. We now know much more about what influenza is and how it spreads. In 1918, they weren’t even entirely sure it was a virus. Knowing what exactly causes the disease would help people avoid getting it, rather than resorting to ineffective countermeasures like gauze masks.

  2. We have better supportive measures than in 1918. For example, if this flu causes pulmonary edema, a collection of fluid in the lungs, there are ways of stopping this from killing the patient before they recover that were not available in 1918.

  3. We have general antiviral drugs that provide some benefit, as well as the possibility of producing a vaccine.

The last two apply more in developed countries than in less developed ones. For these reasons, the reasons already mentioned, and others, this won’t be a repeat of 1918 on a far more massive scale, although of course some people seem to want it to be. Besides the scary 70% figure, CNN also reports a ONE HUNDRED PERCENT MORTALITY RATE in serious cases, which could mean the entire population of the earth could be destroyed in a science-fiction style plague!!! (If everyone is infected, and everyone gets a ‘serious case’. )

Viruses aren’t capable of learning, and their mutations are not somehow directed towards some goal or strategy (first we’ll go from birds to mammals by infecting the pigs, then we’ll hop over to cats, then we’ll kill all the humans in a particularly insidious B-movie fashion through their own pets). They reproduce quickly, and thus undergo a relatively large number of mutations in a short period of time. Strains that are more dangerous than others occasionally arise, but not strains that are orders of magnitude more dangerous than others. As others have said, there were probably reasons for the seriousness of the 1918 pandemic besides the virus itself.

There are a number of good books on the subject of the 1918 flu epidemic. One that I found to be quite interesting was The Great Influenza: The Epic Story of the Deadliest Plague In History by John M. Barry.

From Publishers Weekly, as quoted by

As I understand it, the strain of bird flu causing the concern does have a 100% mortality rate so far. There has even been human to human transmission: a mother caring for her sick infant caught the disease and died.

As I said, this is simply a strain of flu that is entirely different from what we are used to. All of the flus that bound around are different in some ways but alike in others, so we have at least a partial immunity. The avian flu strain could turn into something completely different which is where the high mortality rate comes from. Our immune system would be completely unprepared.

I’ll dig up the Discover magazine that I read about this in in the morning to get some quotes.

I’m not doubting the lethality of the bug if it does go Capt. Tripps. I just think we’ll have a better grasp on the spread than in 1918.

The total number of pigs & domestic fowl in Asia is way up, due to recent economic gains there. Thus effective increasing the opportunities for Flus to get started.

And when estimating risk, please recall the existance of modern air travel, which could spread a bird influenza globally in a matter of days.

Roches and Harborwolf, we’re going to need a cite for the ultra-scary, run-for-the-hills 100% mortality rate figure.

The CNN article linked in the OP cites a 72% mortality rate in identified cases. And as I pointed out in my previous post, the actual mortality rate may be much lower, because there may be many milder unreported cases which never get “identified.”

The US is preparing to test a bird flu vaccine, and apparently already has 2 million doses of the vaccine at the ready. Cite. (Of course, some quick cipherin’ will tell you that 2 million doses ain’t enough to protect the US, but it’s a start.)

Here, , here, and here are a few scientific links. It find more google <H5 influenza> (leave off the carats

The February 28 issue of <i>The New Yorker</i> contains an article on the avian flu, plus some interesting information about how groups like the CDC go about investigating potential epidemics, and the problems of trying to research health crises in other countries that may not have more advanced methods of tracking infected people and their causes of death.

You’re right. In 2004 it was 32 out of 44. That’s according to Discover magazine. I’d link to the article but it requires registration. I do recall somewhere reding 100%, but that was likely a while ago when the bug first broke.

Here is a site that give you the science behind this, down where it says "antigenic shift, you’ll see what the problem is with avian flu.

All true flu viruses are orthomyxoviruses. Birds have their own flu virus-strain, as do most animals. Generally the viruses aren’t contagious to other species. So if your dog gets the flu you can’t catch it. However, both birds and humans (and pigs) have eight discrete “packets” of genetic material and one of these packets can “jump” into another virus causing dramatic genetic changes. These changes can make the virus far more virulent than either of its “parents”.

Usually the “jump” occurs when humans live in very close quarters with their livestock. This puts both the human and avian virus in close contact allowing them to swap genes. This is why so may flu pandemics originate in Asia, where a high portion of their populace lives with their animals.

If flu like this were to get out, I believe it would be less devastating in the developed world that the underdeveloped for several reasons though not the one I suspect you would expect.

  1. Less dense population. Since disease is spread by direct contact, it is rather obvious that if you have less contact, you have less disease. It’s the same reason schools are often hardest hit.

  2. Better reporting. Since all hospitals are required to report to the CDC any disease of unknown origin, new disease are usually detected and quarantined rather rapidly.

  3. Better over-all health and healthcare. Since westerners are generally well fed and medicated, and thus less immunocompromised, disease is much easier to fight. In addition the hospitals are better equipped to handle communicable disease

  4. Better communication. Basically, this just means that, we have alerts in place, where we can alert the public quickly after discovery, and give instructions.

  5. More Government transparency. One of the big reasons that many developing countries have trouble with immerging disease is because the government won’t acknowledge the problem in the first place. I have no idea why this is, but we se it repeatedly: China with SARS, South Africa and AIDS etc…

One thing won’t be speedy; vaccine production. It isn’t easy to make a vaccine. Although bird flu will be much easier than the common flu, it could be years before a vaccine was produced in any numbers to help the population.