Should You Be Scared about Bird Flu?

"We do not know what the virus is that will cause pandemic 'flu. What we do know is that Mother Nature has the recipe book and its just a matter of time before she starts cooking." Sir Liam Donaldson speaking at the launch of his 2005 Annual Report, at the Royal College of Pathologists, Carlton Terrace, London, 21 July 2006. (See Quotes)

THINGS YOU DON'T NEED TO BE SCARED ABOUT

Hopefully the summary on previous pages like "3 Different Types of Bird Flu" should put your mind at rest that there isn't currently any immediate public health scare that you need to lose sleep about.

The type of Bird Flu that is spreading around the world infecting birds is a great concern to farmers, like any other disease that affects our livestock. Many wild birds and a lot of domestic poultry will be made ill by the virus, and many will die. Many more birds will die as they are killed in any attempts to slow the spread of the disease. But however badly the virus affects birds, that does not mean that there is any danger to people. Yet.

The type of Bird Flu that occasionally jumps from a sick bird to a person is still quite rare. Around the world, less than 200 people have died from such an H5N1 infection in recent years. The only people to be infected have been agricultural workers in close contact with sick birds, or those involved in the culling of sick birds. The small numbers of infected people that have died have mostly been in poor countries, and/or poor rural communities, where they have not received the best of modern medical care.
And most important, few people infected with H5N1 have ever been shown to have infected another person. Even where several members of a family or community have become infected, it seems they usually caught the infection from the birds, and seldom passed it between themselves.

For this reason, we can be confident that a strain of H5N1 that could pass between people and cause an epidemic has not yet evolved. It may happen in the future, but it hasn't happened yet. That is why the current scare stories in the media are irresponsible – because they are talking of the current infection in birds as though it is something that represents a present threat to people – and it doesn't.

THINGS YOU DO NEED TO BE SCARED ABOUT

The one great worry amongst health officials is that a new strain of H5N1 will evolve that can easily pass between people. That would cause an epidemic.
Because we already know that none of us has any significant immunity to H5N1, we know that if it gains the ability to spread between us any epidemic would be a bad one.

Every 10 or 20 years a flu epidemic affects us, and every time is different.
Each strain is different in the speed with which it spreads, and how badly it affects us.
But in recent years we have become a little blasé about flu!
As we have all become better fed and fitter and healthier, we have come to regard flu as a nuisance that might need a few days off work, but which has a serious effect only on those who already sick from other causes, or those who are very young or very old.
This time it could be different…

Because H5N1 hasn't done the rounds for so long, none of us has any natural immunity – so it could affect us all very badly. How badly? Well, it could be very badly indeed…

WHEN WILL THIS HAPPEN?

Honest answer – we don't know.
Will it definitely happen? Yes, probably. Almost certainly.

You see, what we have to worry about is that just one of all the countless H5N1 viruses that are currently infecting birds will make a change that makes it easy for it to infect a person – and that a person then gets infected and passes it on.
We can't be certain if and when that will happen.
However, because of the enormous numbers of viruses infecting millions and millions of birds, and because of their capacity to vary themselves so quickly, we have to assume that it will definitely happen sometime…

A recent addition: in the course of re-writing this text in October 2006, I have had to update some of the information on this page as I first wrote it in 2005.
Originally I had written that "no person infected with H5N1 has ever been shown to have infected another person. Even where several members of a family or community have become infected, it seems they caught the infection from the birds, and never passed it between themselves".
And yet, in the text above I have had to write "few people have infected another person" and "seldom passed it between themselves"...
The changes are happening, you see. Bit by bit the virus mutates to exploit new ways of getting around.
The Chief Medical Officer to the UK Government, Sir Liam Donaldson, has now said on many occasions that an epidemic of H5N1 passing person-to-person is "now inevitable". He says "It isn't a matter of if, it is a matter of when".

WHERE WILL THIS HAPPEN?

An epidemic would have to start because a suitable virus had passed from an infected bird to a person, and that the newly infected person had incubated the new strain, developed an illness, then passed it on to other people.
For this reason, it is most likely that it will happen in countries where poor people traditionally live in close contact with poultry. This means Asia or Africa.
Statistically it could happen anywhere – but it is unlikely to happen in Western countries where people now live separately from their livestock.

Even with workers involved in culling unhealthy birds, their good initial health, use of protective clothing and disinfectants, and modern healthcare, should reduce the chances that any suitable virus survives to start a chain of infection in people.
In Third World countries, the proximity of poultry and people, and their lack of protection and healthcare, means that it is the place where transmission of new varieties of H5N1 will occur between birds and people.

So it is only if (or when) you hear news reports of a new flu epidemic passing H5N1 from person to person that you need to worry…

HOW BAD WILL IT BE?

Again, we just don't know.
Flu viruses constantly change themselves in several different ways in order to get under our guard and avoid our immune system.
Until the mutation occurs that allows an H5N1 virus to become infectious between people, we won't know what other specific characteristics it has…
Will it pass slowly between people by touch, or will it be able to pass between us in the air – just one sneeze infecting a roomful of other people?
How badly will it affect us – just a few days of high temperature and feeling bad, or will it kill a lot of people really quickly?

We can't know these things in advance.
We have to wait for them to happen…
What we do know, is that the last time that a strain of H5N1 appeared for which the population of the world had little immunity was in 1918 – and what was then called “Spanish Flu” was devastating.

That epidemic was famous because of some unusual characteristics:

One true story that illustrates how terrible that epidemic was comes from the US.
Four ladies met up one evening to play cards. All four felt well. They felt well when they said goodnight. But three of them didn't wake up in the morning…

That epidemic is estimated to have infected 98% of the world's population, and 28% of them fell ill. And 3% of them died. That means over 40 million people died – more than 1% of the population of the planet at that time.

There is absolutely no reason to assume that it will be better this time!

WHAT?

That's right, it could be horrific.

We have forgotten how bad flu can be, because recent epidemics haven't affected us too badly in the West…
However, flu is a very successful virus. Every year most of us are exposed to it because it gets around so easily. Every year it kills millions of people. Mostly it kills off the poor and the sick, so people in the West who are well-fed and healthy survive it and develop a level of immunity.

Even recent pandemics have been strains to which we had some immunity – such as Hong Kong flu of 1968 or the Asian flu of 1957 – so they weren't too bad for us.
But if the next pandemic is caused by H5N1 we are least likely to have any immunity and the result could be carnage. This is not scare mongering, this is just basic science.

If the next people-to-people strain has the same lethality as the 1918 strain, then the World could suffer 60 million deaths. But this time they could be here in the West and not in some distant place on the news…
And we are not used to it…

A lethality of 1% would mean over half a million deaths in the UK.
Over 3 million in the USA.

We are not used to that level of misery and suffering and loss in these countries…
Even worse, some communities would suffer disproportionately, with some having casualty rates of 25% or more… Like in the US in 1919, everyone in those places would have lost someone.

Neither are we used to such a high level of social disruption.
In the US in 1918, bodies went unburied because they couldn't make coffins fast enough.

We live in a tightly integrated consumer society where we expect fresh food to move from farm to supermarket shelf in hours. We expect the lights to go on when we need them. We expect radio and TV to keep us updated.
But if there was 25% of the population at home in bed – all fearing that they might be one of the 500,000 scheduled to die – how many would go to work?
Would you?

What Can We Do About Bird Flu?

What Is Our Government Doing To Help Us Survive Bird Flu?

What Is Our Government Not Doing To Help Us Survive Bird Flu?

What Can I Do For Myself To Protect Against Bird Flu?

Being Positive About Bird Flu

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