• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

The Year In Review 2005: Britain: BIRD FLU: Apocalypse Postponed. But the Deadly Virus May Yet Be on Its Way

Posted on: Friday, 30 December 2005, 09:00 CST

By JEREMY LAURANCE

Armageddon didn't arrive in 2005 (at the time of writing), but it was a close-run thing. Wild birds carrying the highly pathogenic avian flu virus H5N1 got as far as the borders of Europe " Ukraine, Romania, Turkey " but have not, so far, advanced further.

In Britain, the toll was one dead parrot in a quarantine facility in Essex and a couple of dozen finches, presumed to have brought the infection with them from Taiwan. The virus did not spread beyond the facility, enabling the Government to claim that the quarantine system had worked.

Avian flu had, by early December, infected 133 people in the Far East since 2004, and 68 were known to have died. New cases were being reported weekly but the feared global pandemic of human flu, caused by mutation of the avian virus, had not yet materialised. The cynics moved in, claiming that it was a scare story invented by the media.

Sir Liam Donaldson disagreed. In his seven years as the Government's Chief Medical Officer, Sir Liam has earned a reputation for his cool head, sound judgement and refusal to bow to pressure from political masters. 'Dead-parrot jokes do not help us,' he told a conference of investment analysts. 'This [pandemic] will come, it will be real, and only if we plan can we reduce its impact.'

How bad will it be? He doesn't know and we don't know. It depends on the nature of the virus that emerges, almost certainly in the Far East, which will spread around the world because no one will have immunity to it. The flu virus is mutating all the time, so each year's outbreak is caused by a slightly different virus. But, once in a generation, it mutates more dramatically to create a wholly new virus. Its impact depends on how infectious, and how lethal, that virus is.

People old enough to remember the flu pandemics of 1957 and 1968 will recall that most victims recovered. There was no panic, cities did not empty, travel did not come to a halt, and economies weren't devastated " all scenarios that have been raised this time. Each of these pandemics killed fewer than 50,000 mainly elderly people in Britain, and about one million worldwide. The last serious flu outbreak in Britain, in 1996- 97, caused an estimated 35,000 excess deaths.

So, pandemics are nasty but they do not necessarily spell disaster. What has alarmed health experts and governments this time is the emergence of a flu virus in the Far East " H5N1 " that has shown itself capable of infecting humans and is highly lethal. H5N1 first emerged as a threat to humans in 1997 when an outbreak in Hong Kong's poultry markets infected 14 people, of whom six died. A million chickens were slaughtered and the outbreak " in birds " was contained. Outbreaks in birds followed in countries in the Far East " and further cases and deaths in humans. But it was not until late 2003 that the H5N1 virus was deemed to have spread so far through the poultry populations in the region that it was declared to be endemic.

From the start of 2004, the World Health Organisation stepped up surveillance to identify cases in humans as early as possible, track the virus's evolution, identify human-to-human spread (not yet confirmed) and provide maximum warning of a pandemic. The hope is that the onset of a pandemic could be slowed " or even halted, though this is less likely " to give time to prepare.

The current H5N1 death rate of over 50 per cent " 68 out of 133 humans so far infected " makes it a very serious infection. If a pandemic strain emerges, it is expected to lose much of its lethality as it gains in infectivity. But even a 2.5 per cent fatality rate, as occurred in the 1918 flu pandemic, could translate to millions of deaths.

Optimists point out that highly pathogenic avian flu viruses such as H5N1 have never previously caused a human pandemic. But pessimists say that as H5N1 has proved itself capable of infecting humans, it only needs a tweak to its genetic make-up to create a strain that could sweep the world. This might occur as a result of one big genetic shift or, more likely, of genetic drift " a series of smaller changes. In that case, we might see human spread start gradually and then accelerate, giving more time for preparations to be made.

Sceptics have argued that, as chance mutations drive the flu virus, there is no more reason for a pandemic to occur this year than any other. But this ignores changes in the Far East that hugely increase the chances of a pandemic virus emerging. Third World urbanisation and the intensive farming have created the ideal conditions in which a new virus could evolve. The number of humans living in close contact with chickens and ducks (880 million and 14 billion respectively in China alone) is larger than it has ever been, providing maximum opportunity for avian and human flu viruses to mix and mutate.

When the pandemic comes, we will have little to defend ourselves against it. Ordinary flu vaccine is ineffective, and pandemic flu vaccine takes six months to produce. The UK Government has put its faith in the antiviral drug Tamiflu, which it is stockpiling. But no one knows how effective it would be in a pandemic. Even when stocks are complete (in September), there will be enough for only a quarter of the population.

The best defence will be strict personal hygiene. Flu is transmitted via particles in the air, and it is hard to better the instructions printed by the News of the World on 3 November 1918: 'Wash inside nose with soap and water each night and morning; force yourself to sneeze night and morning, then breathe deeply. Do not wear a muffler; take sharp walks regularly and walk home from work; eat plenty of porridge.' Porridge is, of course, a known cure-all " and the rest of the advice holds as true today as it did then.

Source: Independent, The; London (UK)

More News in this Category