Hysteria over bird flu

Editorial

Remember SARS? Remember being inundated with the message that it would become a global killer? Remember the scary hype surrounding mad cow disease and anthrax? Keep this in mind as you process news about the next pandemic reportedly on the way: avian flu.

Avian influenza is a contagious viral infection that can affect all species of birds. Last year, there was an outbreak of the H7N3 strain of the virus on poultry farms in British Columbia: 17 million birds were killed, but only two people showed mild symptoms of the disease. The avian flu viruses that have caused illness in people include several types, with H5N1 being associated with the most serious effects. The ability of the H5N1 strain – that can jump from birds to people – to mutate is what makes experts think it could spawn a pandemic.

The first documented human infection with H5N1 occurred in Hong Kong in 1997: 18 people were hospitalized, six of them died. Since then, the disease has either killed or led to the culling of 140 million birds. According to the World Health Organization, 62 human deaths have been attributed to the H5N1 form of the virus and there have been 122 confirmed human cases since its appearance in Asia in 2003. To put this in perspective, in 2002, more than 74,600 deaths in Canada were due to diseases of the circulatory system; malignant neoplasms (cancers) accounted for 65,103 deaths.

The media and some organizations have, purposefully or inadvertently, fed panic. Based in part on the theory that influenza pandemics occur an average of three to four times each century, WHO warns that another pandemic is "inevitable and possibly imminent." Governments worldwide are spending tens of millions of dollars on preparedness programs, stockpiling antiviral drugs, ordering the destruction of poultry on a huge scale and other measures. People everywhere have been rushing to buy the antiviral drug Tamiflu to protect themselves against bird flu even though it is not clear that the medicine is effective against the virus.

According to WHO, oseltamivir (commercially known as Tamiflu) and zanamivir (known as Relenza) can reduce the severity of illness caused by seasonal influenza. For cases of infection with H5N1, however, the drugs may improve prospects of survival if administered early, but clinical data are limited.

United Nations Secretary-General Kofi Annan has already put forward the notion that "the usual patent rules may have to be suspended" so that other companies than Switzerland's Roche could make the medicine as well. He has suggested that Roche may need to have their product, in essence, stolen from them, because, according to WHO, at present manufacturing capacity, it will take a decade to produce enough oseltamivir to treat 20 per cent of the world's population.

There has been some sanity. For example, messages from officials in Israel and Canada have stressed that, while there have been changes in the virus, there is no indication that the virus has changed to a form that could result in a pandemic. WHO, Israeli and other countries' officials have emphasized that bird flu cannot be contracted by eating cooked fowl. The Israeli health minister has urged calmness, saying that even if a person became infected, that did not mean he or she would go on to infect other people because there is no evidence of human-to-human transmission.

Israel has purchased enough flu medicine to treat about six per cent of its population. Despite saying it is prepared, the health ministry wants an additional $50.7 million Cdn to buy medicine to treat a quarter of the population, as most western European states plan to do. Canada has done this and has allocated $15 million to build public health capacity in South East Asia.

Although there have been no reported cases of bird flu in the country, Israeli agricultural officials have met with their Jordanian counterparts to discuss co-ordinating efforts to combat bird flu. The states lie in the path of birds migrating from countries – Turkey, Russia and Romania – that have confirmed cases of the flu. Israel says it would deal with any outbreak through the culling and vaccination of birds.

Canada has an emergency plan and, while a recent survey of wild migratory ducks detected avian influenza of the H5 subtype in Manitoba and Quebec, the Public Health Agency of Canada said there is nothing suggesting a new threat to human health. It noted that the H5 avian influenza virus is commonly seen in migratory bird populations and various types and strains have been detected in North America over the last 30 years, with no impact on human health.

Most human influenzas begin as bird flus, but many bird flus never change to a form that can harm us. There is no evidence that the avian flu virus is ready to jump the species barrier. Scientists working on the structure of various viruses are tracking whether the current bird flu mutates further and will contact health officials if it does. And, there is news from Europe and the United States that an effective vaccine for humans against avian flu is on its way.

Bird flu, though a theoretical threat and a potential global danger, is not impending and is not inevitable. Hysteria helps no one.

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