Bird Flu: Major Threat or Chicken Little?/For Dan's website
- From: hoofprints <equsphotogophr@xxxxxxxxxxx>
- Date: Tue, 29 Aug 2006 17:08:06 -0700
From Medscape Public Health & Prevention
Public Health Perspective
Bird Flu: Major Threat or Chicken Little?
Posted 08/09/2006
Howard Markel, MD, PhD
Want some free medical advice? Don't start swallowing Tamiflu tablets
right away. When it comes to avian influenza, the sky isn't falling.
Yet. Since 2003, over 200 people have been stricken by bird flu; more
than 100 have died as a result. Most of these unfortunate people
contracted the disease from chickens they butchered or were living with
in close proximity. No cases have yet been detected in North America --
among birds or human beings. If you live in the United States or western
Europe, you have a much better chance of being struck by lightning than
contracting this potentially devastating scourge. But, at least for
birds, it does remain a threat in places like Vietnam, Indonesia, China,
and Africa, even though relatively few new cases of bird flu have been
reported this year.
So can we take a deep breath and relax? The best medical answer is a
qualified "maybe."
Flu viruses reassort or mutate, readily jump species, and can easily
spread among humans in the simple acts of sneezing, coughing, and even
breathing. The viral variants that are new to our collective immune
systems are especially infamous for wreaking contagious havoc. That's
precisely what happened in 1918, when an influenza strain containing
genetic components of avian flu stalked the world with a vengeance,
claiming over 40 million lives. Most public health experts
understandably worry that we are way overdue for a new pandemic.
The current wave of bird flu first emerged over 2 years ago in
Indonesia, a nation that boasts Southeast Asia's largest populations of
people and poultry. Many of the poorest people there raise their own
chickens and live very close to these birds. Indonesia also suffers from
one of the most understaffed healthcare systems in the world. All these
factors could conspire to fan and spread the flames of a pandemic.
Indonesian officials knew about the avian influenza problem among
domestic chicken flocks since mid-2003. Succumbing to intense lobbying
by its local poultry industry, at best the Indonesian government's
public health polices can only be described as ostrich-like. It was not
until July 2005, that Indonesian president Susilo Bambang Yudhoyono
exhorted his fellow citizens to come clean on bird flu, and finally
requested help from the World Health Organization (WHO).
Sadly, recent reports from the region suggest that avian flu is all too
common among the many backyard flocks of chickens that make up a major
food source for those living there and is killing more and more birds
each month.
When a similar outbreak was discovered in Hong Kong in 1997, the orders
were clear, transparent, and immediate: All domestic chicken flocks were
quickly destroyed -- no ifs, ands, or buts. Disaster was temporarily
averted. We may not be so lucky this time because of Indonesia's
concealment and delay.
In other parts of Asia, there is encouraging news that Vietnam and China
are making great strides in the culling of diseased poultry and
surveillance of migratory birds in 2006. But no one should assume that
the problem has simply flown the coop -- especially when it comes to the
rather decentralized governmental structure of Indonesia and the
inability of health officials to get provincial governors to take
serious steps toward eradication.
More effective than sneezes in spreading germs is the chaos that results
when a particular nation conceals early but clear signs of impending
contagious crisis for financial, political, or any other reason. Think
only as far back to the SARS scare of 2003. China's failure to act
definitively or openly in cases appearing in the Guangdong province in
late 2002 led to an epidemic that threatened to spread globally and cost
the world economy billions of dollars.
If bird flu were to become a true pandemic today, the costs in lost
revenue, healthcare, reduced productivity, and markets would amount to
hundreds, if not thousands, of billions of dollars. The global death
toll could exceed tens of millions or more.
But even if we are lucky enough to come through next year -- or the year
after -- unscathed, despite our disorganization and poor planning, this
problem will not go away. And if bird flu does not become a human
problem, rest assured that another virulent form of influenza or some
other emerging infectious disease will inevitably take its place as the
threat du jour.
Last summer, the WHO sent every nation's public health ministry or
department a detailed plan for responding to an avian flu pandemic. The
plan includes recommendations for veterinary and/or agricultural means
of detecting and handing domestic bird outbreaks, human surveillance,
transparent international communications that feature reliable early
warning systems, quarantine plans, and vaccine or antiviral development
and distribution. So far, relatively few countries have instituted their
own preparedness plans. Even among those that have plans, most are not
quite ready to be reality checked.
Maybe that's why so many medical experts are screaming that the sky
really is falling. When it comes to epidemics, we can never let our
guard down or -- when they do not appear in a given year -- assume that
the problem has resolved. It hasn't and it won't. That's why we need to
plan -- and replan -- for the worst case scenario, far in advance.
Howard Markel, MD, PhD, George E. Wantz Professor of the History of
Medicine, Professor of Pediatrics and Communicable Diseases, and
Director of the Center for the History of Medicine at the University of
Michigan; author of When Germs Travel: Six Major Epidemics and the Fears
They Have Unleashed (Pantheon Books)
Disclosure: Howard Markel, MD, PhD, has disclosed no relevant financial
relationships.
Medscape Public Health & Prevention. 2006;4(2) ©2006 Medscape
--
Hoof
"With friends, like these, who needs enemies!" Y.G. Ph.D. Psychology. ©
1988.
{ Disclaimer: Non Existent words contained within this poast
were created in response to the Paperwork Reduction Act.}
{If you have a problem with that,
take it to the Environmentalists Complaint Dept.}
A Free Thinker. © 2003
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