Bird flu could be a disaster, or nothing too serious

3/20/2005

Pay close attention to news about avian influenza - the "bird flu" that has been ruffling the feathers of infectious disease experts around the world. Few horror films could top the real-life disaster scenario hidden between the lines in their reports.

If the experts are right, the world is on the brink of a terrible epidemic that could kill millions of people and wreck economic havoc.

If they're wrong, scientists' credibility in predicting flu pandemics (global epidemics) will get another black eye; the false alarms will divert people from real health problems that desperately need attention, and governments will squander hundreds of millions of dollars on stockpiles of anti-viral drugs.

That emphasis on the miscue is justified because scientists have been wrong about flu pandemics before. Check the Internet for details of the "swine flu" fiasco in the 1970s, in which scientists predicted a doomsday flu pandemic that never occurred.

The new predictions are not coming from the gloom-and-doom fringe, but from some of the world's most respected experts on influenza.

Consider, for instance, what Dr. Julie L. Gerberding, director of the U.S. Centers for Disease Control and Prevention (CDC), told a national meeting of the American Association for the Advancement of Science in February. She said the situation with bird flu in Asia "probably" resembles the period before the 1918 Spanish Flu outbreak, when that virus was quietly mutating into a strain that would eventually kill 50 million people.

Dr. Nancy Cox, CDC's chief influenza scientist, told the same meeting that further mutation in the avian flu virus in Asia could cause the worst pandemic in human history. That includes the plagues that swept Europe in the 1300s, killing 25 percent of the population.

They are concerned about a new flu virus that once affected only birds. It now has mutated into a form that infects people, who have no immunity to the new virus. Seven out of every 10 infected so far have died. The virus, scientists fear, may now be mutating into a form that could spread easily from one person to another - without losing any of its lethal punch.

Of course, the mutation also could make the virus a wimp - easy to catch and easy to shake off. There also are hints that the actual mortality rate already is much lower because nobody notices the mild cases.

Scientists are making a "seed" vaccine, for use in making an actual vaccine against any bird flu virus that might start spreading. It would take months, however, to produce the vaccine.

To fill that gap, governments around the world are stockpiling Tamiflu, an antiviral drug that may prevent infection and lessen symptoms of people who do get infected. High-priority people like health care and emergency workers would get first access to the stockpiles.

What's a person to do? Aside from talking to the doctor about a just-in-case Tamiflu prescription, the answer may be just watch and wait.