Dangers of 'bird flu'

POSTED 12 FEB 2004

1. On the verge of disaster?

2. Mixing and matching genes

3. Responding to infection

4. Science fights flu

Women pray during a mass cull of chickens on the Indonesian island of Bali. The Balinese Hindu "ngaben" cremation ceremony, usually reserved for humans, was performed to demonstrate the island's determination to stop the spread of bird flu among poultry. AP Photo

This 15-month-old girl died of avian influenza in Hanoi, Vietnam, in mid-January. The H5N1 virus has killed at least 13 people in Vietnam during the current outbreak.
AP Photo

"If  the 1997 virus had attained the ability to spread from person to person, the pandemic might have taken along the lines of a third of the human population."

"Many epidemiologists believe that a rerun of the 1918 epidemic will happen again. This time it will be worse."

In Vietnam, avian flu killed 13 of 18 confirmed cases.

Women in colorful dress pray over heap of dead chickens.Bird flu
That's not a typo. It's a disease that is spreading through Asia and now Europe, alarming doctors and public-health types who look back in horror at the flu epidemic at the end of World War I. The nasty 1918 virus -- which also originated in birds -- claimed "at least 20 to 40 million lives," according to Robert Webster, a flu expert at St. Jude Children's Research Hospital in Memphis, Tenn. (See "Influenza" in the bibliography.)

Even without the benefit of the 747, the virus still managed to leave a wake of death from Europe, through the Americas, all the way to Alaska, where entire native villages were consumed. The "Spanish flu" killed more than twice as many as the conventional weapons, poison gas and trench mouth of World War I. Combined.

Shifty, infectious and deadly, flu kills an average of 36,000 Americans in the average year. But avian flu could be far more deadly -- if it ever becomes able to spread from one person to another.

Sick infant in hospital bed, face covered with bandages.

A pandemic -- a global epidemic -- could mean global catastrophe, according to Webster, who has been sounding the alarm for years. He maintains that a 1997 outbreak of avian flu in Hong Kong was a close call: "If this particular virus had attained the ability to spread from person to person, the pandemic might have taken along the lines of a third of the human population."

Looking back at 1918, wrote Webster, "Many epidemiologists believe that a similar scenario will happen again. But this time it will be worse." Those words were written just before the latest outbreak was announced in Asia.

So here's the question: Will this time be the time?

Fluky flu?
The new flu virus, now scourging poultry in eight Asian countries, has already caused the death of dozens of millions of domestic birds. Many were killed directly by the virus. Others were killed to keep the virus from spreading.

Although avian influenzas usually don't infect people, this one has already killed 13 in Vietnam, and a smaller number in Thailand.

The new virus is called H5N1 for the structure of proteins on its surface. Already, says World Health Organization (WHO), "The outbreaks of H5N1 avian influenza in poultry, currently reported in eight Asian countries, are historically unprecedented in their scale, geographical spread, and economic consequences for the agricultural sector."

An influenza ward in Aix-Les-Bains, France during the 1918 epidemic.
An influenza ward in Aix-Les-Bains, France during the 1918 epidemic. You don't see these wards during "normal" flu outbreaks because the virus is a familiar one. The H5N1 now running rampant in Asia is not familiar ... Courtesy National Museum of Health and Medicine, Armed Forces Institute of Pathology, Washington, D.C.

Only a matter of time
To most who are not elderly or suffering immune deficiencies, flu can be a serious, but survivable, infection. But flu-obsessed scientists and doctors take a much darker view of unfamiliar flu viruses. "Experts agree that another influenza pandemic is inevitable and possibly imminent, cautions the WHO. Even before the current outbreak, Webster was warning, "We've seen enough incidents over the last three or four years to make us very alarmed" about the transfer of deadly flu viruses from pigs and birds to people.

As the world's public-health experts gear up, we Why-Filers are wondering:

What is so scary about bird flu?

The Why Files (home)

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Terry Devitt, editor; Sarah Goforth, project assistant; S.V. Medaris, designer/illustrator; David Tenenbaum, feature writer; Amy Toburen, content development executive

©2004, University of Wisconsin, Board of Regents.