The Flu Hunters

* * * At 49, Dr. Keiji Fukuda, the top influenza epidemiologist at the Centers for Disease Control and Prevention, looks distinguished in a scruffy, academic way and reassuring. * * * So when Keiji Fukuda admits to being as concerned as ''I have ever been,'' people who know him start really worrying.

[CDC doctors] live with the specter of the 1918 flu pandemic, which killed somewhere between 20 million and 50 million people around the world and 500,000 in this country, and with the assumption that another pandemic is inevitable.

Events in Asia, in particular, are escalating almost daily, with more human deaths, more different species becoming infected and more questions arising about how the virus there behaves. At the same time, some governments in the region are remaining closemouthed about what is happening within their borders. This reticence exponentially increases the difficulty of epidemiologists' work. Flu hunters are expected to forestall any big outbreak. But Fukuda and Uyeki's real fear is that they might not know one is starting until it is too advanced to stop.

This is a very long article but well worth reading in detail. A major flu pandemic is a frightening reality with air travel increasing risks of exposure (E.g. SARS).

Photo from National Museum of Health and Medicine, Armed Forces Institute of Pathology: The 1918 Spanish flu pandemic, in which between 20 million and 50 million, some 500,000 of them in the United States, haunts modern influenza investigators. This photograph shows victims crowded into an emergency hospital at Fort Riley, Kan.

A "bird" Flu strain that genetically shifts to allow propogation in humans could KILL hundreds of millions of people around the world during the a single 10-week Flu season. This is not a sci-fi movie. This could happen and make AIDS look like a picnic.

Read the article because it contains details possibly never revealed before. One Example: Cock fighting is very popular in Asia. Farmers raise their own birds and train them to fight. Asian men commonly clean out the birds' air passage ways by personally sucking mucous out of the bird's beak. That virtually guarantees infection from animal to man. Have you read about this cultural practice before? It was a complete mystery to me until an hour ago.

How many Asians go to cock fights, or have relatives who shop in large public markets where people mingle with others who may have been exposed to bird flu?

Another excerpt:

To cause a pandemic, an entirely new human influenza subtype must emerge, one that most people would never have been exposed to and would not have immunities to. This flu also must be able to be transmitted efficiently from person to person. In recent history, three main types of influenza A have circulated freely in humans. (Many more exist in birds.) Each of these strains caused a pandemic when they were introduced into the human race. The catastrophic 1918 Spanish flu pandemic was caused by H1N1. The 1957 Asian flu pandemic, which killed 70,000 in the United States, was brought about by H2N2. And the 1968 pandemic of Hong Kong flu introduced H3N2. That outbreak killed about 34,000 people in the United States.
Science doesn't quite understand how a nonhuman flu virus adapts and becomes a human flu, and why more, in fact, don't. But they do suspect that it is a process of gene swapping. If an avian flu infects a person who, coincidentally, suffers from a human flu, the two bugs might exchange genetic material. The resulting virus could be essentially avian, but possessing genetic components of the human flu that would allow it to be easily transmitted from person to person. This is how the Asian flu and the Hong Kong flu pandemics began.
An example of really great reporting from the New York Times.

This is exactly what could happen...the intermixing of Influenza A genetic materials from avian and human Flu strains...to generate a hybrid that is immunologically similar to avian types and that can propogate in humans. Because the human population has not been exposed to the avaian sub-types, we have no natural immunity. Such a viable hybrid could have a devastating effect on the world population, and very quickly. That is why the recent cases in Asia of "Bird Flu" are so disturbing.

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