December 14, 2004,
As if vaccine shortages, wars, terrorism, and Vioxx weren't scary enough, some folks who should know better are making predictions of worldwide contagion without cure. Officials from the World Health Organization (WHO) have sounded the alarm about a "bird flu" pandemic. Spokesmen warned of "billions" falling sick and "millions" of deaths. Millions in Southeast Asia have indeed died but so far almost all of them (except for 32 humans) have been feathered.
Secretary of Health and Human Services Tommy Thompson, in the course of his resignation remarks, morphed from his previously calm demeanor into hysteria. His bizarre farewell speech contained words of advice for terrorists about our country's weakest links and more bird-flu warnings. Thompson said, referring to the flu, that "there is a really huge bomb out there that could adversely impact on the health care of the world." Uh-oh.
Maybe Thompson can be excused for his end-of-the-world predictions he has no science background but we expect the WHO to be able to distinguish real health threats from theoretical ones. Instead, they seem to be acting in a needlessly alarmist way.
One WHO official said a bird-flu pandemic could kill up to 100 million people if the virus mutated into an uncontrollable form of human influenza. Another such expert advised public-health officials to start planning for overwhelmed hospitals, the construction of isolation wards, and widespread absenteeism if the pandemic occurs. Still another opined that there is "no doubt" that there will be another pandemic (global outbreaks have occurred every few decades, the last two being in 1957 and 1968). He continued, "...We are closer to the next pandemic than we have ever been before."
Of course, we will eventually have another pandemic sometime in the future. We are, therefore, getting closer all the time. And we won't have any vaccine to prevent this wholesale carnage for about two years. (One of the companies trying to make such a vaccine is Chiron, whose recent efforts to produce uncontaminated flu vaccine for the U.S. came to naught only two months ago.)
The new strain of bird flu, technically termed Influenza A(H5N1), has indeed ravaged Asian avians, as noted above. But the virus is genetically distinct from the flu bugs that infect humans every winter, and bird (as well as other animal) flu strains generally do not have the ability to make people sick. While it is cause for concern that 44 humans have contracted the virus from birds or fowl, and that 32 of them have died a worrisome mortality rate of over 70 percent, compared with a mortality rate of well under 1 percent for the common flu and 5 percent for the devastating 1918-1919 pandemic there are no documented cases of human-to-human transmission and only two cases suspected, one in Thailand and one in Vietnam. A major requirement for a viral epidemic is person-to-person spread (communicability).
So, should we head for the hills? No. There is no evidence of human-to-human transmission, despite many millions of sick and dead birds. And it is obviously extremely difficult to transmit infection to humans from birds again, the numbers tell the tale.
It's a good idea to be prepared, as the recent scarcity of flu vaccine has demonstrated. But the dire warnings about billions sick and millions dead from an onrushing bird-flu pandemic seem overblown, to say the least. We should keep doing the right things to avoid infection: hand washing and covering your nose and mouth when coughing or sneezing. Public health officials should make sure to stockpile anti-flu medications, which would probably work against the avian strain, if what is now theoretical becomes real. And we should use the methods of prevention we have including the vaccine against pneumonia, which is greatly underutilized even though it protects against the proximate cause of death in elderly people suffering from severe influenza.
Also, stay home from work, seek medical attention if you're sick, and get plenty of rest. Just don't stay awake worrying about bird flu it's bad for your health.
Gilbert Ross is executive and medical director of the American Council on Science and Health.