Posted on 11/30/2004 12:54:30 PM PST by neverdem
HONG KONG, Nov. 29 - A pandemic of human influenza could kill up to 100 million people around the world, a World Health Organization official said today, significantly raising the agency's earlier estimates of the number of deaths in such a catastrophe.
W.H.O., a United Nations agency based in Geneva, has been warning about the potential for the A(H5N1) strain of avian influenza virus (known popularly as bird flu), which has spread widely through Southeast Asia to mutate and cause the next pandemic.
Governments should be prepared to close schools, office buildings and factories to slow the rate of new infections if a pandemic strikes, and should work out emergency staffing arrangements to prevent a breakdown in basic public services like electricity and transportation, W.H.O.'s regional director for Asia and the Pacific, Dr. Shigeru Omi, said.
Such arrangements may be needed if the disease infects 25 to 30 percent of the world's population, Dr. Omi said in a speech and news conference. That is the W.H.O.'s current estimate for what could happen if the disease - currently found mainly in chickens, ducks and other birds - develops the ability to spread easily from person to person.
The death toll associated with the rapid spread of a new form of human influenza would be high, Dr. Omi said. While W.H.O. has previously said that the death toll would be 2 million to 7 million people, Dr. Omi said the toll "may be more - 20 million or 50 million, or in the worst case, 100" million.
And Dr. Omi said that in his opinion a global pandemic of influenza was "very, very likely" now.
Reached later, W.H.O. officials in Geneva said they had not received an advance copy of Dr. Omi's remarks and did not know the basis for his estimates and why he believed a pandemic was imminent.
W.H.O. has expressed concern that the avian strain has become a more dangerous threat as it has jumped species. But Dr. Omi's estimates are not based on any new scientific information about the virus's ability to cause human disease or ways to assess the odds that the virus will become readily transmissible among people.
In sounding the alarm about avian influenza, "W.H.O. is trying to raise concern because we're concerned, but W.H.O. is not trying to scare the planet," a spokesman for the agency, Dick Thompson, said in a telephone interview.
"No one knows how many are likely to die in the next human influenza pandemic", even when it will occur, Dr. Klaus Stöhr, W.H.O.'s top influenza expert, said. "The numbers are all over the place."
W.H.O. is using different historical, mathematical and demographic models to better estimate the number of people who might become ill and die in the next pandemic, Dr. Stöhr said. Such reports are expected to be available by next week.
Dr. Malik Peiris, a top influenza researcher at Hong Kong University, said that Dr. Omi's range of possible death tolls was realistic and consistent with current research into the A(H5N1) avian influenza virus. The biggest questions, Dr. Peiris said, are whether the disease will develop the ability to spread easily from person to person and, if it does so, whether it will retain its current deadliness.
"H5N1 in its present form has a pretty lethal effect on humans," he said.
A few analysts have suggested that the death toll could be considerably higher. Henry L. Niman, a medical researcher in Pittsburgh, who tends toward gloomy predictions and is a strong critic of W.H.O. for being too conservative, said that with more than 70 percent of the human victims of the disease dying so far, the death toll could in theory exceed a billion people if the disease were to spread rapidly among people with little if any reduction in current mortality rates.
"That estimate is unscientific unjustified, and an inaccurate extrapolation from the current situation," Dr. Stöhr, the W.H.O. expert, said.
W.H.O. has reported 44 confirmed human cases of A(H5N1), all in Thailand and Vietnam, and 32 of the patients, or 72.7 percent, have died. W.H.O. has identified only one case of probable human-to-human transmission, a Thai mother who cradled her dying daughter all night, while the rest of the cases appear to have been acquired directly from animals.
Dr. Stöhr, Dr. Omi and Dr. Peiris each said that the high death rate recorded for human A(H5N1) infection so far might be overstated, because people with less severe cases of the disease might not be diagnosed as having it at all.
Virologists have been struggling to determine how and whether the disease might develop the ability to spread easily from person to person through the air the same way human influenza viruses do. Dr. Omi said that for several reasons, it was becoming more and more likely that the virus would develop the ability to spread among people.
The virus has proved highly versatile in mixing genetic material with other viruses, he said. The disease has recently evolved the ability to survive in domesticated ducks and be excreted in large quantities without making the ducks sick, making it hard for farmers and veterinarians to know which birds to cull. And the world has gone an unusually long time since the last influenza pandemic, the relatively mild Hong Kong flu pandemic in 1968.
No significant quantities of vaccine for disease caused by A(H5N1) are likely to be available until five or six months after the virus becomes a pandemic, Dr. Omi said. The virus is constantly evolving, and vaccine manufacturers will not want to commit themselves to large-scale production now of a vaccine that may prove worthless if the virus evolves further before starting a pandemic, he said.
Even when a vaccine does go into mass production, pharmaceutical companies have the capacity to make enough vaccine only for a small percentage of the world's population. "Some people say if we develop a vaccine, that can avert a pandemic - that is not the case at all," Dr. Omi said.
"W.H.O. has never said that a vaccine would avert an influenza pandemic," Mr. Thompson said. But, he added, "it would be irresponsible not to try to develop a vaccine against a pandemic strain of human influenza virus" because such a vaccine would reduce the severity of illness and "hopefully save lives and perhaps slow any pandemic."
At W.H.O.'s urging, a small but growing number of governments are starting to make contingency plans for a pandemic. The United States unveiled its plan earlier this autumn, but that plan said that further study would be needed on how to address difficult questions like how to allocate scarce medical supplies during any crisis.
The secretary of health, welfare and food in Hong Kong, Dr. York Chow, said in a radio interview there this morning, before Dr. Omi spoke at lunchtime, that in December the Hong Kong government would announce its plans for preventing the spread of avian influenza in local poultry and to respond to any possible outbreak among people.
ping
Tens of millions Pleeze where do these idiots get their numbers at this rate the world should be wiped out in a few years.
I'd like to see the demographic information on the people who have died.
The thing that made the Spanish Flu so deadly was that it hit mainly young adults who were healthy. Children and the over 50 crowd were very lightly affected.
I also wonder about the transmission rates. Weren't most of the victims involved with poultry? What's the human-to-human infection rate?
Did you read the whole story? In the pandemic of Spanish flu just around the end of World War I, tens of millions died around the world. IIRC, it probably started in USA.
That's the trouble,THEY SEE TOO MUCH!!
FReepmail me if you want on or off my health and science ping list.
ping thanks.
Remember when all the talk was about ways to control global over population. Whats wrong with natures way of reducing the excess.....just a long as it's not me.
http://www.cviog.uga.edu/Projects/gainfo/1918flu.htm
Chronology of the 1918 Spanish Influenza Epidemic in Georgia
The most deadly epidemic to ever strike the United States occurred in 1918. As America prepared for war, a soldier at an Army fort in Kansas reported to the base hospital with flu-like symptoms. There, he was diagnosed as having a strain of flu that was called Spanish Influenza (since it was erroneously believed the strain had originated in Spain). Before the year was out, 675,000 Americans would die from the flu -- more than the total of all Americans to die in all wars in the 20th century. The 1918 strain of flu created not just an epidemic -- but a global pandemic causing 25,000,000 deaths. In the U.S., the epidemic's worst month October, when almost 200,000 Americans died from the virus. October 1918 was also the month the flu epidemic hit Georgia, as detailed by the following chronology:
October 1 Augusta's Camp Hancock experienced an outbreak of the Spanish influenza then sweeping the nation. On the previous day only two soldiers had been in the infirmary. On this day, 716 showed up with flu-like symptoms--and it would get worse.
October 2 The Spanish influenza epidemic of 1918-19 had now hit Georgia. At Camp Gordon near Atlanta, the second day of the outbreak finds 138 soldiers with the deadly flu, ten of which had already died of pneumonia.
October 5 Four days after the initial breakout of two cases of Spanish influenza, Augusta's Camp Hancock reported 3000 cases of flu. Already, 52 soldiers had died of the disease. Furthermore, the epidemic had now spread off base with 47 cases reported in the Augusta area.
October 7 Acting upon a recommendation from the U.S. Public Health Service, the Atlanta City Council declared all public gathering places closed for two months as a precautionary measure against the epidemic of Spanish influenza sweeping the nation. This ban included schools, libraries, churches, and theaters. Street cars were directed to keep all windows open -- except in rain. In a precautionary move, the University of Georgia announced it was indefinitely suspending classes. Back in Augusta, where the epidemic was most active, military officials on this day ordered soldiers to sleep under the stars, and by now everyone was wearing gauze masks during the day. No one was allowed on base except close relatives, and soldiers were restricted from going to Atlanta without a special pass.
October 8 W.H. White, Jr., president of the Atlanta Chamber of Commerce, urged landlords not to evict those infected with Spanish influenza, saying they had no authority to do so and added that any such evictions be reported to his office. That same day all Fulton County school children reported to class, got their books and some final instructions, then were sent home for the duration of the public gathering ban announced the previous day.
October 9 Precautionary measures against the spread of Spanish influenza in Atlanta seemed to be working as few new cases were reported. Meanwhile, the flu epidemic continued to spread through the country.
October 10 Atlanta remained relatively healthy as only 105 new cases of Spanish influenza were reported, with only eight deaths in the past week. These numbers were far fewer than those in other East Coast cities of similar size.
October 11 Spanish influenza cases remained relatively low in Atlanta, while the University of Georgia announced classes would resume October 21. Classes had been suspended October 7 as a precaution against the Spanish flu epidemic.
October 12 As fears of Spanish influenza abated and victory neared for allied forces in World War I, a Liberty Loan parade was held. It was a solemn affair, paying tribute to the many who had died in the war effort. At the same time the Atlanta Constitution reported much of the rest of the nation was not so lucky with the flu epidemic claiming significantly more lives than German bullets in Europe.
October 13 Atlanta city health officer Dr. J.P. Kennedy announced the public gathering ban would last at least one more week. It had originally been instituted for two months, but the Spanish influenza epidemic was not hitting Atlanta as severely as the rest of the country. With "only" 750 deaths, Atlanta would get off light from a worldwide epidemic that would kill 675,000 Americans--more deaths than resulted from World Wars I and II, the Korean War, and the Vietnam War combined. Globally, 40 million people died in just 18 months.
October 15 The Spanish influenza epidemic sweeping the nation hit Macon, with 250 new cases reported in the previous 48 hours. A new preventative measure also appeared on the streets of Macon -- "flu masks", which basically were cloth masks with small eye, nose, and mouth holes. Fort Gordon, near Atlanta, ended its military quarantine, which had been in place for several weeks due to the flu epidemic. But the scare was not over -- Maj. Joel B. Mallett, selective service officer for Georgia, instructed all local boards of health to cease physical exams for new military registrants until further notice - - effectively stemming the draft (albeit temporarily). While this was ordered as a preventative measure against the flu, it also was possible because Allied armies were on the brink of defeating Germany at the time.
October 16 The Atlanta Constitution reported that the Red Cross was calling for local volunteers to construct 40,000 'flu masks' for patrons at the Southeastern Fair Association, then being held in Atlanta. Patrons were required to wear the masks to attend the fair, under a regulation adopted by the State Board of Health. The Red Cross also announced it was immediately opening a school of nursing in Atlanta, to teach elementary hygiene and home nursing to people to help with home emergencies brought on by the flu epidemic. Meanwhile Governor Hugh Dorsey called for a meeting of the State Board of Health to discuss statewide preventative measures. Still Atlanta had not been hit by the epidemic as badly as most cities its size; only 500 new cases had been reported in the previous week, most of them mild.
October 17 Medical authorities reported 209 new cases of Spanish influenza in Atlanta, still far less than most comparable cities. By now the flu had appeared in every state but was deadliest along the eastern seaboard.
October 18 The State Board of Health met and recognized the seriousness of the Spanish influenza epidemic. Along with federal health authorities present a resolution was passed allowing an executive committee of the State Board to take whatever actions necessary to control the disease wherever it might appear in Georgia. A report on new cases in the previous 24 hours was given -- statewide there had been 2,749 new cases, with 48 deaths. Hardest hit was Cartersville, with almost 1000 new cases the previous day.
October 20 There was a slight decrease in the number of new cases of Spanish influenza reported statewide.
November 4 - The few remaining quarantines at Camp Gordon were lifted as fears of the Spanish influenza epidemic waned. Concern with flu was not slowing the war effort, as 1,000 Atlanta women met at the Capital City Club to begin a new United War Work campaign, as Germany's last ally --Austria-Hungary -- had surrendered, and Germany itself was reeling.
November 5 Fulton County public schools were re-opened after having been closed to help prevent the spread of Spanish influenza.
For more information, see:
PBS's The American Experience: Influenza 1918 website
Influenza Pandemic of 1918
In Search of An Enigma: :The Spanish Lady"
Seeking the 1918 Spanish Influenza Virus
Should we not treat any influenza outbreak in a manner similiar to the AIDs outbreak? Closure of schools, businesses, etc would result in discrimiantion against those that have the flu. Don't we have laws against taking those kinds of actions? Wouldn't wearing a mask to help prevent the spread be seen a disrimination against those that have the flu?
Professional athletes that catch the flu would be deemed heros for coming out of the closet.
Sesitivity traing would be required for anyone who tried to prevent the spread of the flu.
It would be part of professional licensing to understand the impact of the flu on the individual that has the desease.
As the flu spreads throughout the world, we can all protest that the United States is not doing enough for finding a cure.
Exactly ! The WHO "expert" is using some pretty far-out estimates............to justify an increase in budget ??
The H5N-1 strain has been zoonotic in certain conditions,but person-to-person transmission has been pretty rare-if the regular reports from ProMed are to be believed.
Interestingly,about the ONLY country in the world actually working on a human vaccine is the USA. They are said to be making excellent progress-something WHO prefers to ignore.
We have also been working on the 1918 strain,and some cautious indications of success have been reported.
Some moron just got zotted for posting this nonsense.
Be sure to check out the nonsense in comment# 11.
The flu goes around every year and they keep getting worse as they become drug resistant. There is nothing anyone can do about it. Wash your hands a lot, take vitamin C and make sure you eat right.
You're missing my point. The article is about the new avian flu, and comment# 11 is about the Spanish Flu of 1918, which caused internal hemorrhage within the lungs. I'm not trying to draw attention to the usual, annual flu epidemic.
I remember the swine flu scare. Most Americans treated it as a joke..
I new a guy in the Army whose mother got Guillian-Barre Syndrome after being vaccinated for the swine flu.
I wouldn't worry about avian flu any more than I worry about al Qaeda nuking NYC. Sh@t happens.
Concur..the biggest health problem that Americans face is that because of incessant over-prescribing of antibiotics...many common strains of infections have developed a strong resistance.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.