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The Bird (to Human) Flu Epidemic—If or When?

It has been nearly 8 years since the first child in Hong Kong died of bird flu 1997, when an avian influenza strain became known to virologists as H5N1. Since then H5N1 has spread inexorably throughout Southeast Asia’s bird population and traveled west to Eastern Europe. It poses a big problem for the poultry industry. Yet, this is not a human flu outbreak, epidemic or pandemic; fewer than one hundred fifty people are believed to have caught H5N1 directly from birds (as of December 2005), and an unknown number of people are thought to have caught it from other people. The HRN1viruses have been known to infect birds, pigs, housecats, tigers, and leopards. The virus has killed millions of poultry and at least 57 people in outbreaks in Asia since late 2003. Direct human to human cases have yet to be confirmed with any certainty. Currently, this is not a problem for human health. Despite the situation, countless media reports, including experts on CNN proclaiming a 100% certainty of a pandemic claiming an unknown number of deaths, continue to challenge the world and worry many people. Shots for seasonal influenza have increased, and top policy officials suggest spending at record pace stockpiling a so-called treatment response with any potential efficacious medicine; many have even suggested breaking a patented product’s exclusivity and making a generic drug, despite the lack of evidence that such a treatment may be effective should an epidemic emerge. If history is any prediction of current responses, a global outbreak of influenza could mirror a pandemic as virulent as the 1918 infamous ‘‘Spanish flu’’ that killed between 25 and 50 million people. While many estimates of the potential death toll are wide-ranging and chilling, the current response may be more political than scientific since there were poor systems in place for the hurricane striking New Orleans despite warnings for years. This political response also is linked to the inability to cure SARS or flesh-eating bacteria that could also spread quickly and kill people. However, just as there are seasonal weather variations, influenza pandemics do occur periodically. There were three in the 20th century. Virologists suggest a pandemic influenza will be unlike the seasonal version, more severe and deadly—the result of a genetic mutation in the virus. The recent strain of avian influenza (H5N1; bird flu) that is currently endemic in Asia has just the characteristics to be the first pandemic of the 21st Century. The 2005 World Health Assembly recently underlined the importance of influenza pandemic preparedness and response by adopting a resolution calling on all 192 Member States to develop and implement national plans for pandemic-influenza