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An Epidemic Waiting In The Wings

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.

By Joshua Kurlantzick
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