| Bird flu is a disease caused by a specific type of | | | | occur. The central question is, when will it exchange |
| avian (bird) influenza virus, the so-called H5N1 virus. | | | | enough genetic material with the usual seasonal |
| This virus was first discovered in birds in China in | | | | human influenza-viruses to become more like a |
| 1997 and since then has infected 125 people in | | | | human-influenza virus—and thus become easily |
| Vietnam, Cambodia, Thailand, and Indonesia, killing 64 | | | | transmissible between people? |
| of them. It is spread by infected migratory birds | | | | Many people believe that the virus will continue to |
| (including wild ducks and geese) to domestic poultry | | | | spread around the world until it is present in most or |
| (primarily chickens, ducks, and turkeys), and then to | | | | all countries—before it will “go |
| humans. | | | | human” (become easily transmissible between |
| Since 1997, and especially since the beginning of | | | | people). And that may be the case. The pandemic of |
| 2004, approximately 150 million birds have either died | | | | 1918-19 is thought to have started in Kansas (of all |
| from the disease or been killed to prevent further | | | | places). So it is certainly possible that the coming |
| spread. Nevertheless, this very infectious and deadly | | | | pandemic could start somewhere else than in |
| virus has spread relentlessly to China, Thailand, | | | | Asia—although most experts believe it will, in |
| Cambodia, Vietnam, South Korea, Japan, Taiwan, | | | | fact, start there. It could start in a country which has |
| Laos, Russia, Indonesia, Mongolia, Kazakhstan, | | | | not yet been host to the virus. |
| Malaysia, Turkey, Romania, England, Croatia, | | | | However, it is most certainly not necessary for the |
| Macedonia, and other countries. This ongoing | | | | virus to march all the way around the world before a |
| geographic extension of the virus is of great concern | | | | pandemic can begin. The fact that the virus already |
| around the world. It is feared that it will continue to | | | | has spread to more than 15 countries, and to many |
| spread to all continents, including the Western | | | | different bird and animal species, provides the |
| Hemisphere—and it no doubt will. | | | | opportunity for it to commingle with a |
| Normally, different types of viruses infect just one, | | | | human-influenza virus and create the dreaded human |
| or a limited number, of species specific to the | | | | contagion. There is no known reason why this could |
| particular virus type. The bird-flu virus, however, has | | | | not happen tomorrow. While it is true that the |
| infected a large number of birds and animals, including | | | | probability of the switch increases with time, the |
| ducks, chickens, turkeys, tree sparrows, peregrine | | | | probability of its happening tomorrow is far from |
| falcons, great black-headed gulls, brown-headed gulls, | | | | zero. |
| gray herons, Canada geese, bar-headed geese, little | | | | The flip side to the possibility that the crossover |
| egrets, pigs, clouded leopards, white tigers, mice, | | | | could happen at any time is the fact that the virus |
| domestic cats, crows, magpies, peacocks, blue | | | | has been around at least since 1997 and, as a matter |
| pheasants, rare eagles, turtledoves, swans, terns, and | | | | of record, has not yet switched to a deadly |
| others. This is another sign of the virulence or | | | | human-to-human form. At least a few scientists |
| destructiveness of the virus. | | | | believe that the virus can’t and won’t |
| Researchers, historians, and infectious-disease | | | | make the switch to a deadly form, possibly ever. |
| experts have determined that influenza pandemics | | | | And so we are left with these two very different |
| (global epidemics) occur approximately once every 30 | | | | possibilities—at any time, and as soon as |
| years. The most deadly pandemic ever recorded | | | | tomorrow, the virus could mutate into a deadly form, |
| occurred in 1918-19, killing more than 100 million people | | | | readily transmissible between people—or it might |
| across the globe in less than two years. Two other | | | | never transform itself into such a form. There |
| much less severe pandemics occurred, one in 1957, | | | | appears to be much more evidence for the former |
| when approximately two million people died, and one | | | | and, presumably, that is why the vast majority of |
| in 1968, when about one million people died. Because | | | | scientists and governments are scrambling to prepare |
| we have already had three pandemics in less than | | | | for the worst. |
| 100 years, we are “overdue” for | | | | This situation is analogous to living on the Gulf Coast |
| another one. | | | | during the beginning of hurricane season. Residents |
| And so this disease-causing virus continues to infect | | | | there have been through it before, but most of the |
| more and more species in more and more countries. | | | | time the storms are not too severe and the people |
| In laboratory experiments, it has been shown to be | | | | can get by without too much hassle. However, there |
| one of the most lethal influenza viruses ever known. | | | | have been rare severe storms that have been |
| In addition, just recently and after 10 years of work, | | | | devastating. Some day another hurricane is coming, |
| researchers determined that the H5N1 bird-flu virus is | | | | and it appears that it might well be a Category IV or |
| genetically more similar to the deadly 1918-19 | | | | even V by the time it strikes land. However, |
| influenza pandemic virus than to the viruses which | | | | that’s not certain—no one can say for |
| caused the much less severe pandemics of 1957-58 | | | | sure, and no one knows exactly when it will strike |
| and 1968-69. | | | | land. So what should the residents do? What should |
| To summarize the important points so far: The | | | | the residents have done before hurricane Katrina? |
| bird-flu virus is a very deadly strain of avian influenza | | | | The coming bird-flu pandemic might be mild and it |
| called H5N1 that has killed millions of birds; 2) the virus | | | | might not come for years. On the other hand, it |
| is spreading relentlessly around the world; 3) the virus | | | | might be severe and it might start tomorrow. The |
| has infected many species, which is uncharacteristic | | | | U.S. Government Accountability Office (GAO) has |
| of most viruses; 4) the virus has been shown to be | | | | said, “While the severity of the next pandemic |
| similar to the most deadly virus ever known, which | | | | cannot be predicted, modeling studies suggest that |
| caused the 1918-19 pandemic; 5) the virus has been | | | | its effect in the United States could be |
| shown to be much more deadly in laboratory | | | | severe.” We should also be mindful that the |
| experiments than regular influenza viruses; and 6) the | | | | pandemic could come at any time, even before the |
| virus is known to have infected at least 125 humans | | | | virus methodically marches around the globe. No |
| and killed 64 of them so far, yielding a fatality rate of | | | | matter how advanced science has become, we still |
| approximately 50 percent. | | | | can not predict when the switch will occur; it is |
| The virus continues to kill humans, but at a slow | | | | currently unknowable—and that does not mean |
| rate—it has not yet acquired the capacity to be | | | | it will come later, in a predictable fashion. As Miguel de |
| easily transmissible between humans; humans | | | | Cervantes admonished, “Forewarned, |
| become infected primarily from sick birds. Because | | | | forearmed.” |
| humans alive today have no natural immunity to the | | | | Bradford Frank, M.D., M.P.H., M.B.A. |
| H5N1 virus, once it becomes easily transmissible | | | | The Frank Group |
| between humans a pandemic or global epidemic will | | | | P.O. |