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When Influenza Takes Flight
NY Times ^ | February 5, 2005 | HANS TROEDSSON and ANTON RYCHENER

Posted on 02/04/2005 10:24:58 PM PST by neverdem


Hanoi, Vietnam — IMAGINE this situation: A sudden outbreak of a little-understood disease in two European countries kills 41 of the 54 people it is known to have infected. In its wake it leaves 150 million chickens dead, some of them killed by the virus causing the outbreak, others slaughtered to stop its spread. At a zoo in one country, rare tigers suddenly begin dying from the disease. Reports from elsewhere in Europe say the virus, which is normally found only in chickens, is now also infecting pigs, cats and ducks.

Scientists sound the alarm. They say that while the disease is primarily attacking poultry, it is undergoing genetic changes that could make it much more dangerous to humans. The possible result, they say, is a pandemic that could have devastating social and economic consequences. They point out that pandemics of this nature normally occur every 30 years - and the last one was more than 35 years ago.

There's no doubt that the international reaction would be swift and efficient. Resources would be poured into controlling the outbreak, with money made available for research into its causes, the virus's transmission routes, associated risk factors and treatment. A vaccine would be a top priority.

Unfortunately, we don't need to imagine all this - it's happening right now in Asia. An outbreak of highly pathogenic avian influenza - commonly known as bird flu - has swept through Cambodia, China, Indonesia, Japan, Laos, Malaysia, South Korea, Thailand and Vietnam, killing humans, wiping out entire flocks of chickens and spreading fear.

The only difference between the fictional European situation and what is going on in Asia is the level of response. In the case of Asia, the international community has failed to come forward with enough money to finance desperately needed public health and veterinary measures and research on vaccines.

For their part, some of the affected countries were initially reluctant to share information about the outbreaks because they feared losing tourist and export business. Others, in their eagerness to contain the economic damage, prematurely declared the disease under control. But, bowing to reality, they are now acknowledging that bird flu is endemic and are seeking help from abroad; in Vietnam, for instance, which requested help this week, a strain of the virus has killed 12 of the 16 people affected so far.

And there is reason for great worry. If the virus acquires the ability to jump easily to humans and then transmit from person to person, we could experience an influenza pandemic involving huge numbers of people. Because it is a new virus, most people would have no immunity to it, and it would spread rapidly to the rest of the world. Best-case estimates talk of more than one billion people worldwide requiring medical care, 20 million to 30 million being hospitalized and two million to seven million deaths.

These estimates are based on data from relatively benign pandemics in 1957 and 1968. However, the virus that causes bird flu has killed more than 70 percent of the people it is known to have infected in outbreaks in Vietnam and Thailand, and if it were to spread at the same disease-causing level in a pandemic, the global death toll could be much higher than seven million.

Although most affected countries have instituted measures aimed at more rapid detection and control of the disease, much more needs to be done. Necessary changes in animal husbandry practices and farm hygiene still have to be undertaken. The affected countries will need international expertise and financial assistance, including money to compensate farmers for their losses and investments that encourage changes in poultry production. Surveillance and control both in animal and public health need to be improved, and the health care services would need additional resources to manage large numbers of severely ill patients.

This will be expensive, but the cost will be nothing compared to the financial impact of a worldwide influenza pandemic.

During the last year, governments and international agencies like the Food and Agriculture Organization and the World Health Organization have learned a great deal about bird flu, but there are still a lot of questions. Why, for instance, did none of the many thousands of farm workers culling sick birds without wearing protective equipment contract the disease? Why are children and young people predominantly infected and not older people? Why do some ducks infected with the virus not show any symptoms? And what is the role of these animals in the transmission of the virus? To answer these questions, more information needs to be made available.

The governments concerned and the international community need to act now to find solutions to the challenges posed by these outbreaks. The threat of an influenza pandemic transcends the capacities of any individual nation or region.

For the tsunami, the world had no warning. For avian influenza, the warning is there.

Hans Troedsson and Anton Rychener are the representatives in Vietnam, respectively, for the World Health Organization and the United Nations Food and Agriculture Organization.

TOPICS: Culture/Society; Editorial; Foreign Affairs; Government; Japan; News/Current Events
KEYWORDS: avianinfluenza; birdflu; cambodia; china; indonesia; laos; malaysia; showmethemoney; southkorea; thailand; unmoneygrab; vietnam

1 posted on 02/04/2005 10:24:59 PM PST by neverdem
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To: El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; ..

FReepmail me if you want on or off my health and science ping list.

2 posted on 02/04/2005 10:49:50 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: Mother Abigail


3 posted on 02/04/2005 11:20:08 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem
It is only a matter of time before the world is hit by a disease pandemic. Travel is too fast, populations are too close, and immunity systems too protected. It just needs the right hotspot, the right vector, and the right affliction, and the whole world would face nigh apocalypse.

I'm even surprised it hasn't happened yet. That is the really surprising thing. A virulent pathogen, that was easily transmisible, had a moderate incubation period (to allow efficient spread, unlike Ebola that basically flash-burns its victims too fast for it to spread far), and starting from a place like Hong Kong, could easily circumnavigate the globe in less than a week. In a month it could be entrenched in too many places for effective measures to be fully applicable.


4 posted on 02/04/2005 11:27:30 PM PST by spetznaz (Nuclear tipped ICBMs: The Ultimate Phallic Symbol.)
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To: neverdem
People should have a look at the Demon in the Freezer article.

5 posted on 02/04/2005 11:29:12 PM PST by spetznaz (Nuclear tipped ICBMs: The Ultimate Phallic Symbol.)
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To: neverdem
Here's the real summary line:

In the case of Asia, the international community has failed to come forward with enough money....

6 posted on 02/05/2005 12:28:53 AM PST by Dont Mention the War (Liberal radio can be summed up in five words: Dead air, um, dead air.)
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To: Dont Mention the War

The Asian countries have pretty hefty treasuries of their own after selling trillions worth of goods to the Americas and Europe - - - perhaps they can cash in a few billion of their reserve Euros, US dollars, and US Treasury bonds to fight this epidemic? I doubt they need any more than they have already earned, fair and square, from trade.

7 posted on 02/05/2005 2:31:37 AM PST by Blue_Ridge_Mtn_Geek
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To: Blue_Ridge_Mtn_Geek

China is the bad guy here. Said they had it under control and do have the money to combat it.

Interesting that the most affected are Communist countries. Power to the people. Disease too.

8 posted on 02/05/2005 3:57:40 AM PST by KeyWest
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To: neverdem

I wonder where the authors got the idea the World Health Organization actually DOES anything ?

Right now-actually,for the last 2-3 years,the only meaningful research is being done in that (awful,hateful,stingy,neglectful) USA.

9 posted on 02/05/2005 4:57:04 AM PST by genefromjersey (So much to flame;so little time !)
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To: neverdem; All
Very interesting article and comments.
Can chickens act like coal-mine canaries? Should each American family own one? Or do chickens mainly serve as the incubators in the early stages?
How about pet pigs? I think pigs can be involved in the early stages of influenza epidemics, too.
Actually, meanie that I am, I hope starlings are especially susceptible.

Sorry about inflicting my pre-second-cuppa-coffee thinking...I'd better get my second cup now.

10 posted on 02/05/2005 5:14:04 AM PST by syriacus (Ted Kennedy MIS-learned how to unseat dictators by watching JFK's Bay of Pigs fiasco.)
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To: spetznaz

We need to put infectious disease control into the defense budget.

China's self interest is not the same as ours. For them, the fewer people the better, and killing off the older population would save bundles of money.

Making a vaccine is not rocket science; it was begun in the 19h century. But it is not cost effective for a corporation to develop a vaccine for something which may or may not occur. It is also not "cost effective" to develop weapons which may or may not be needed. Nevertheless it's a very good idea!

11 posted on 02/05/2005 6:05:42 AM PST by From many - one. (formerly e p1uribus unum)
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To: neverdem
Well, there's something going around Arkansas and it's not pretty.

It's not just one thing. "It has run the gamut from strep throat to stomach virus to influenza. It started Monday all of a sudden."

Yes, I got the flu shot, and so did a friend of mine and we are both extremely ill with this. Starts out with just a sore throat for a couple of days then transforms into a deep cough, aches and pains.

It's spreading like wildfire here. Very strange.

12 posted on 02/05/2005 6:16:23 AM PST by spectre (Spectre's wife)
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To: spectre

As a flu sufferer and observer for many years, I have been told by doctors that there are more than a few strains of flu out there at all times. They only put the most likely strain or two that are out there into the vaccine. You obviously have one of the strains that were not included in the vaccine.

We used to live in a small town where everyone went down with the flu every year. The high school had a rule if a child had at least a C average and had not missed a day of school they didn't have to take the finals at the end of the semester. High school kids would drag themselves to school sick and pass the flu around until the whole town had it. I was glad to move from there.

13 posted on 02/05/2005 6:32:37 AM PST by Ditter
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To: Ditter
Oh boy...lucky ME!

"At Little Rock Catholic High School for boys, 85-90 students have been absent each day this week, said Assistant Principal Straesle. That's in contract to the typical 30 abscenes a day in the student body of 600"..

Trust me, this surprise virus should keep anyone at home (I hope)..sw

14 posted on 02/05/2005 7:17:20 AM PST by spectre (Spectre's wife)
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To: spectre; neverdem

The flu is going around in South Texas, and the subtypes at the CDC show that there are a couple of strains of A and B subtypes that weren't in the vaccine. Which would explain why those of us who were lucky enough to get the vaccine before the supply was cut still got sick. This makes 2 years in a row that I've caught the flu, even though I get my shot as soon as it's out, since I work in walk-in clinics.

To monitor the Center for Disease Control influenza information:

15 posted on 02/05/2005 10:01:45 AM PST by hocndoc (Choice is the # 1 killer in the US)
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To: From many - one.

Actually, there is a large budget for bioterrorism, which includes infectious disease, in the defense budget.

As a matter of fact, defense funds have paid for all sorts of health-related research.

16 posted on 02/05/2005 3:27:24 PM PST by hocndoc (Choice is the # 1 killer in the US)
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To: Blue_Ridge_Mtn_Geek

"The Asian countries have pretty hefty treasuries of their own after selling trillions worth of goods to the Americas and Europe -"

Good point. Wonder when US Citizens will stop having to bankroll whatever the World wants.

17 posted on 02/07/2005 9:44:58 AM PST by Spirited
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To: hocndoc

Thanks for the info and link. I gather I've got one of those sub-types...lucky me. I'm going to the Doctor tomorrow, and maybe find out something since it's hanging on..sw

18 posted on 02/07/2005 9:54:15 AM PST by spectre (Spectre's wife)
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To: neverdem

I've had this idea for a while. I wish there were a reliable illness-reporting web site. Perhaps with a clickable map. A voluntary thing. If my children were ill with something, I would post their symptoms and the location in which we live.

That way, if there were a particular virus going around, a vulnerable person could choose to stay home from the grocery store, church, or school that day or week.

19 posted on 02/07/2005 9:54:55 AM PST by agrarianlady
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