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The real risk of an avian flu pandemic A group of public health and emergency services officials in Fayette and Coweta counties met last week, along with their counterparts in the other counties in Georgia Public Health District 4, to discuss a response to a potential pandemic of avian flu. While not generally on the public radar, the planning by those responsible for addressing such a crisis head-on cannot be underestimated. Here’s why. The H5N1 strain of avian influenza jumped the species barrier in 1997. If sufficient human-to-human transmission takes hold, the devastating effects of H5N1 would be linked to its extreme mortality rate. H5N1 is far more virulent than the H1N1 strain that caused the 1918 Spanish flu pandemic and the estimated 50-100 million deaths worldwide. Concerns among epidemiologists hit the world stage with megaton force in May 2006 when multiple members of a family in North Sumatra died of H5N1 after one was exposed to a chicken carrying H5N1. Whether by genetic predisposition or by means of some other undetermined variable, limited human-to-human transmission had occurred. Also in May 2006 the White House released the “National Strategy for Pandemic Influenza: Implementation Plan,” essentially informing states and communities that they will have to rely on themselves, with the feds assuming only an advisory role. If a pandemic does occur, it could infect up to 30 percent of the population and kill up to 2 million people, the plan said, predicting a 40 percent absentee rate of employees in the workplace. Consider for a moment what that means: Utility companies, police and fire departments, hospital staff, truck drivers delivering food to grocery stores, etc. You get the point. While apparently not wanting to alarm the public, the fact is that the federal government simply lied, apparently hoping that those reading the plan failed third-grade math. If a pandemic strikes and if the ongoing mortality rate holds, death rates in the U.S. would extend far beyond the 2 million predicted by the White House. Here’s why. It has long been estimated that 25 percent of the U.S. population became infected with the H1N1 virus of 1918. The U.S. population in 1918 was 104 million. Consequently, 26 million people became infected. Of those, an estimated 650,000 died. While staggering, those figures represent a mortality rate of only 2.5 percent. In stark contrast, today’s H5N1 virus has a mortality rate of 63 percent and growing. If an H5N1 pandemic were to occur and if infection and death rates are comparable to 1918, the picture begins to look dramatically different. Adjusting for today’s U.S. population, now at just over 300 million, the number of infected, at a rate of 25 percent (the 1918 rate), would reach 75 million. And projecting a continued H5N1 mortality rate of 60 percent, deaths in the United States would total more than 47 million, while worldwide more than one billion would die. If such a scenario were to manifest and if a vaccine is available, the first doses would understandably go to first responders who must be functional to look out for the rest of us. After that, said medical ethicists with the National Institutes of Health, vaccines should be given to healthy teenagers and those in their 20s, 30s and maybe some in their 40s, since they will be needed to rebuild society, literally. Since 2006, increasing numbers of local and state governments in the U.S. and nations worldwide have been holding drills and emergency preparedness exercises, like the one here last week. The importance of their current and future efforts and your attention to them cannot be overstated. Whether H5N1 continues its incremental worldwide spread and mutates sufficiently to reach pandemic status or whether it fades, it should not be allowed to fade into the state of collective amnesia that was witnessed worldwide after 1918. The stark reality in a world where far too many people know far too little of history is that, sooner or later, pandemics will occur. They always do. Wishing them away will not work. Unless some form of super-vaccine can be developed that will offset influenza’s penchant for rapid mutation, it is only a matter of time before the unthinkable happens again. Incalculable numbers of deaths and major disruptions to civilization will follow. That is the real risk of avian flu. login to post comments | Ben Nelms's blog
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