The real risk of an avian flu pandemic

Ben Nelms's picture

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.

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Submitted by johannabartley on Tue, 10/21/2008 - 11:01am.

I always thought the world will be cleansed by some epidemic and only the strong and healthy will survive. I don't want to adopt a Nazi point of view, but something like that will happen. The waters are rising and there's less and less land to populate. Our crops are not what they were and the changing climate will diminish those too. We should start respecting our environment and leave healthier lives. You all know why some deadly diseases, such as the black plague, disappeared. We invented soap.
I use recycled thermal paper. What do you do for your world?

Mike King's picture
Submitted by Mike King on Wed, 08/13/2008 - 6:54am.

Much has been done and continues to be done regarding this very real threat. To obtain a bit more insight into pandemic influenza I recommend reading the book "The Great Influenza" by John Berry. Further, the website '' maintained by CDC here in Atlanta contains a wealth of information fo both corporate entities as well as families.

Submitted by Bonkers on Wed, 08/13/2008 - 1:03pm.

What am I supposed to do about Pan Flu? I get my shot.

The trouble is 5 of the last 6 shots were mostly ineffective for the type flu that got to the USA! The CDC screwed up and continues to do so.

The "wealth" of info the CDC might have---I don't trust.

A lot of our problem also is that we don't make much effort as a county to see to it that old people and kids get shots. One can't simply walk into the health department and get a shot. You have to call and make an appointment.

Kids are considered expendable. Not even recommended for jr high and high school!

The county is afraid to buy the shots ahead of time and have plenty. Afraid it will be the wrong one and they will be stuck! Same with doctor's offices.
There is where we need to be aware! Where the problem is---not just talk it up!

Submitted by Sabrina on Wed, 08/13/2008 - 4:58pm.

Cactus is right. The flu shots we get in the fall/winter are for the seasonal flu that plagues us each year – those shots will NOT protect us from pandemic flu.

We won’t have a vaccine for the pandemic flu virus for six to nine months after a pandemic starts, and in the beginning it will probably be given to first responders and healthcare workers.

During seasonal flu very young babies, the elderly and people with compromised immune systems are most at risk.

The H5N1 virus - the virus we are concerned will cause a pandemic - targets healthy children, teens and young adults. The vast majority of patients who have been infected with H5N1 have been under 40. Unfortunately many pandemic flu plans don’t take this into consideration.

We do have antiviral drugs, but we only have enough for about 20% of our population, and many strains of H5N1 have become resistant to antiviral drugs.

Staying at home and avoiding contact with anyone who could be infected is the best way to protect our families. We will need to have a stockpile of food, medication, baby food, pet food, etc at home before a pandemic hits to be able to stay at home for weeks.

Back to seasonal flu. They have changed the recommendations this year and they are saying that kids up to age 18 should get flu shots. Hopefully the vaccine will be a better match this year.

Also some pharmacies do flu vaccination clinics – sometimes you have to wait in line for a few minutes but that might be less hassle than having to make an appointment with a doctor.

Submitted by prepguy on Wed, 09/03/2008 - 3:05am.

I am a microbiologist located in Texas, but my hobby - and new career - is as a software architect. For the past five years I have been working on a software suite for emergency preparedness; it will be ready by this time next year (Sept 2009). Originally, I was thinking of preparations for hurricanes that we have along our Gulf coast, but the principles of good emergency preparations are more universal than my first vision. The suite addresses preparation and recovery and the first offerings will be for the most efficient users: organized groups of people, whether civic organizations or churches. The new type of geographical interface displays people and resource locations; it is a type of interface unlike Mapquest or Google Maps. For recovery, different categories, called criticalities of damage, are queried and displayed on the map, along with a table identifying the residence with household name and an area to enter specifics of damage or casualties. In this way, a coordinated effort is more likely and more efficient. With my minor in nutrition, I've added a page for food supply (do not confuse with food are storing to use by rotation so that the food is available when needed but is used and replenished on a regular basis). The software does address quality of storage, even mentioning the importance of "comfort foods," which most nutritionists would consider to be "junk foods," but remember, it may be a time of great personal loss. Nutrition will not comfort the child who feels overwhelmed and incapable of conveying their loss to an adult. When using the cache page, you will be able to keep track of all emergency cache supplies, including such items as baby supplies, pet food, batteries and, of course, your solar-powered radio. I am only beginning to add capability for a possible pandemic, but if you have your food and your N95 masks than you have the two most important components of a pandemic preparation plan. I understand the possibility of utility outings and overwhelmed hospitals...and so am recommending SIP (stay in place) and alternate plans for blackouts. I don't mean to frighten anyone with this, but I refer you to for a reading of the 1918 pandemic.


Submitted by cactus on Wed, 08/13/2008 - 2:11pm.

The problem with stock piling for the PI flu, is that you can`t make a vaccine until you have a disease.
Flu viri change so rapidly that if they made one today from ,lets say, an existing H5N1 virus,said virus may have drifted so much when it gets the right mutations lined up to cause a pandemic, that the vax would be ineffective.
This is why the recent crop of seasonal flu shots have been duds.
As it takes 6 months to manufacture a flu vax, there is no way os assuring that one started today will work when done.
Scientists are working on a more rapid way to manufacture these vaccines, but they`re not there ,yet.
One way that some folks have determined to stay safe during a pandemic event is to have sufficent supplies to SIP (stay in place), during the 6 weeks or so it seems to take for a wave to pass.
There are several blogs online that can you assist you to makes plans for your families safety.
A quick Google search will show you many.
Good luck.

Submitted by Bonkers on Wed, 08/13/2008 - 6:23pm.

Why didn't you just tell me the things I can do?

Wash my hands; stay away from people; wait for it to pass; stay healthy; and other BS!

Submitted by nigelthomas on Tue, 08/12/2008 - 10:24pm.

Good article. We need to keep Bird Flu preparedness at the forefront of every business manager's mind. It won't go away so better start preparing.

Nigel Thomas
For free references and tools go to Bird Flu Manual Online or, if you need more comprehensive tutorials and templates, consider Bird Flu D-I-Y eManual for business preparedness and survival.

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