An Epidemic Waiting In The Wings

The New Republic: Bird Flu Not Gone, But Almost Forgotten

(The New Republic)  This column was written by Joshua Kurlantzick.

---

Only a year ago, coverage of Southeast Asia, a region largely ignored by the American press, focused on one terrifying issue: avian flu. As the disease spread into Vietnam, Indonesia, and other parts of Asia, it seemed destined to cross the globe. Soon enough, the untreatable scourge arrived in Eastern Europe and the Middle East. Hundreds of millions of birds were killed in a panic, and some nations began stockpiling anti-bird flu drugs. American publications competed in scare tactics. "The Bird Flu: The Race to Prevent a Global Epidemic," screamed Newsweek in the fall of 2005. "A Deadly Virus is Brewing in Asia. Could This Be the Next Global Pandemic?" asked U.S. News & World Report.

Yet by this winter, bird flu seemed largely forgotten. No Newsweek cover stories these days on the next epidemic. Even news this week of an exercise by the Centers for Disease Control and Prevention (CDC) on combating bird flu, which the CDC found could rapidly overwhelm hospitals, received only back-page coverage in U.S. papers like The New York Times.

The story of bird flu, then, offers an example of the short attention span of most of the American press, which seems to sprint from one potential terror to another, keeping people in a constant state of fear. But just because the news magazines have forgotten about avian flu, and the disease has not yet swept through America, does not mean it has gone away. Across Indonesia and other bird flu hot spots in Asia, people continue to die from the disease. In January alone, Indonesia reported four avian flu deaths, and the isolation wards at the Jakarta hospital tasked to deal with the disease have become overwhelmed by patients. At roughly the same time, Thailand reported a new bird flu outbreak, and Vietnam reports that the disease continues to spread quickly. Many of my Thai friends refuse to visit farms in the countryside or even eat chicken, though there is no evidence of transmission from well-cooked birds. Recently, suspected new cases even were reported in countries from Nigeria to Egypt to Japan to Hungary.

Under the radar, in fact, the disease may have become more dangerous. Overall, the number of bird flu cases in humans has grown since 2004, when the press onslaught began, and nearly half the people killed by bird flu died last year, even as coverage of the disease waned. In 2006 the virus killed a higher percentage of people it infected than it had in 2005.

Most of those people infected had been in contact with infected birds, but scientists still have no way to tell whether the disease will mutate into a form that could spread from human to human, triggering a global pandemic. And though governments have made strides in coordinating a bird flu response and developing tests to find bird flu, they have no effective treatment, and the longer the disease continues, the more likely farmers and other people handling birds, tired of restrictions, will return to their old unsanitary ways. A 2005 study in The New England Journal of Medicine found that Tamiflu, the most common drug used to fight the disease, might not be able to combat mutations of the virus. Last fall, China seemed to confirm this fear, revealing that one strain of bird flu had mutated into a drug-resistant form. Yet most countries remain heavily dependent on Tamiflu, one reason why British scientists have advised the United Kingdom to buy other drugs that might work.

Worse, the flu could still come here. Despite the CDC drill, America's poorly coordinated national health system would not be able to stop avian flu, as a study last April by a group of prominent scientists showed. A report last summer by the Agriculture Department inspector general further revealed that the White House had no idea how much commercial poultry was being tested for bird flu and no plan to find out.

The global disease hunters understand what is at risk. "As long as the virus continues to circulate in birds, the threat of a pandemic will persist. The world is years away from control," World Health Organization (WHO) Director-General Margaret Chan said in January. Several months earlier, the United Nations' coordinator for bird flu, Dr. David Nabarro, admitted that despite a major donor conference in early 2006 to raise money for avian flu, the world still needed at least $980 million more to combat the disease. (Very little of the total money spent on bird flu goes to poor countries fighting the disease, like Indonesia.) The WHO went farther, suggesting governments should raise another $10 billion to prepare for potential pandemic flu outbreaks. Worldwide, in fact, some studies still suggest an avian flu pandemic could kill over 300 million people. Maybe the American press should pay attention again.

[mgpm-2009]

This scares the hairy heck out of me, no kidding. I hope this holds off 'til after the next election and hope that the next administration gets some plan in place that works.

[bluestardad]

This entire pandemic thing is a bunch of birdshit it is made up to make people be scared. More people die drinking water than with some bushit bird flu! go flock yourself!

[fascistusa]

The Elite want to eliminate Millions of the Population.

It makes us easier to control.

I say go for it. We don't need you.

[fascistusa]

Influenza. My teacher said it was made in WW2 in the trenches.

Believable? No way. Viruses do not work that way.

Influenza was made at Ft. Riley Kansas by the US Miliary. Biological Weapondry. It worked.

AIDS was made by scientists. Monkeys? Come on.

[bradjergens]

Good story. IF you want to stay up tp date on the bird flu and Panflu preparedness, there is an online message board where people are discussing this whole thing. It's at HTTP://WWW.AVIANFLUTALK.COM

Hope this helps!

[medclinician]

Excellent articles. Keep on breaking Avian flu and Pandemic news at http://wwww.pandemic-worldnews.com

[oleander8]

Bird-flu, West-Nile virus, SARS, the media goes for instant ratings - and it's like the little boy who cried wolf...people are tired of listening to it and don't believe it.

[ns1_pfiforum]

We are discussing the current US, UK, Indonesian and Egyptian Influenza strains that are circulating on the Pandemic Flu Information Forum - http://pfiforum.com .

Currently many eyes are on Egypt where the H5N1 Case Fatality Rate is 100% (6 confirmed infections / 6 deaths) in this Influenza season. More compelling is the fact the 3 of the deaths are from the same family group suggesting potential human to human transmission (H2H).

We have recently receieved a NAMRU-3 release of H5N1 viral isolate genetic sequences from 2 of the Egypt deaths. Cytokinic Dysregulation is indicated in the clinical presentation. These topics, including in-depth analysis on the Indonesian and other worldwide human clusters, are being discussed.

Dr. Henry Niman, who predicted the S227N polymorphism in H5N1, is also discussing the Receptor Binding Domain-related recombinations (V223I and M230I) in the current isolates and their implications on human transmissibility.

Gharbiya Cluster Egypt- http://www.pfiforum.com/viewtopic.php?t=186 .

At this moment, a significant area of identity (5-aa %u2018GSGRI%u2019) within the critical Hemagglutinin Receptor Binding Domain (RBD) exists between the Egypt strains and the current circulating Influenza B seasonal strain. The current Influenza B seasonal strain is highly transmissible between humans.

Feel free to join us for a deeper background into the science behind the development of PF51 or to learn practical ideas on preparing for a pandemic.

[ns1_pfiforum]

Of contemporary interest is the finding of a genetic acquisition (N294S) in the Egypt strains that confers Tamiflu resistance. We are tracking that genetic material to determine if it is, in fact, in open circulation and traveling in migratory birds. A second group of anti-viral resistance mechanisms that sometimes expresses during treatment, H274Y in the Neuramindase gene segment and S31N on the M2 gene segment, is being explored as well at PFIforum.com.

[bradjergens]

WOW!! I JUST READ ABOUT THIS ON THE BIRD FLU MESSAGE BOARD LOCATED AT HTTP://WWW.AVIANFLUTALK.COM