Outbreak: Could it happen here?

dateline.msnbc.com ^ | 4/23/06 | By Ann Curry

[Judith Anne]

1. SARS still exists in China.

2. All influenza is pandemic, strains go around the world every year. The vaccines given routinely every year are made up of the three most likely strains of flu that are expected to infect the most people. These influenza viruses originate in China, in waterfowl, then pass into pigs, which carry both human and waterfowl viruses, mix them into flus which humans can catch, and circulate the globe.

3. H5N1 is a novel influenza strain that has not infected humans before. Almost every other influenza strain has components that many humans have some immunity to. Not so with H1N1, the 1918 pandemic strain, and not so with H5N1, the present threat.

4. There have been many small clusters of H5N1 infection in many countries, including Turkey, Viet Nam, China, and Indonesia. There have been cases of human-to-human transmission, but there have not been documented cases of human-to-human-to-human etc. transmission.

5. The H5N1 virus is infecting mammalian species regularly, including feral cats, dogs, ferrets, tigers, etc. Some of these animals have passed the virus to others--a well-documented case of 140+ tigers in a Thailand zoo being infected with H5N1 from eating infected chickens, and passing it to other tigers in the same zoo. This leads most researchers to suspect on solid grounds that the same can occur in humans.

6. The fact that H5N1, an RNA (fast mutating) virus, has not yet acquired the ability to move freely among humans does not mean that it won't. H5N1 is pandemic in birds all over the world. It is being found in predators of birds all over the world, most recently in cats in Germany. The chances for beneficial (to the virus) mutations occurring are increasing.

7. Sooner or later, it will pass freely among humans. The necessary mutation(s) can occur in Guangdong province in China and be in Toronto less than a week later, as happened with SARS. Fortunately, SARS can not be spread before symptoms appear. With influenza, infected people can spread the virus BEFORE symptoms appear.

8. Incubation periods of H5N1 in humans range from 1-18 days. During that time, the virus could be spread by infected asymptomatic people to virtually all over the world. The real truth is that the virus has most probably made the jump several times in blind alleys--but it only has to succeed in one instance of becoming easily transmissable among humans for the worldwide pandemic to occur.

9. Studies have been done of groups of people who are around those who got the H5N1 virus. There are very few--not thousands, but less than a thousand--known cases of people who have had subclinical infection--mild cases. The present case fatality rate of >50% of infections is very close to the true case fatality rate. The virus does NOT have to become less lethal as it mutates to become more transmissable.

10. As with the 1918 influenza virus, and as with SARS, the body's own immune system causes most of the mortality in H5N1 human cases. This is called a cytokine storm, somewhat similar to anaphylaxis, but unlike anaphylaxis there is no specific effective treatment for cytokine storm.

11. Antivirals such as Tamiflu are being stockpiled by every nation on earth on a first come first served basis. Tamiflu takes a year to manufacture. There are indications that effective treatment of H5N1 with Tamiflu takes higher doses started sooner to be helpful in H5N1. Every fatality of H5N1 that occurred in a hospital was treated with both prednisone and Tamiflu. The USA has ordered millions upon millions of doses of Tamiflu. We don't have a chance in hell of getting it anytime soon, meaning within two years.

12. Secretary Leavitt of HHS has gone/is going to every single state in the union, discussing specifically the H5N1 threat, in person, with each state's leaders.

13. Congress has appropriated only half the money that President Bush requested for addressing the H5N1 threat.

14. The population of the USA is 80% urban, 20% rural, today, as opposed to the 1918 pandemic, when the opposite was true.

15. The FedGov is not going to ride in on a white horse and save everyone in the event of a pandemic. And they aren't planning to, either. In fact, Leavitt said specifically that they will not. It's up to self-reliant Americans to stock up on supplies that will see them through a pandemic wave in their own community, which will likely last at least 3 months, depending on the size.

16. Pandemic H5N1 human to human will mean: no church, no baseball games, no school, and no jobs.

So, you make the call....hype or not?

[FBD]

Yes, I'll call it hype.

You might find this interesting:

http://www.fumento.com/disease/flu2005.html

---

"The swine flu virus of 1976 really was antigenically quite similar to the Spanish flu virus; the "problem," if you want to call it that, was that 1976 had little in common with 1918. There are certainly scary "what-ifs" concerning H5N1. But what truly propels the more hysterical scenarios is the specter of a repeat of 1918-19.

Hard to believe that until recently this flu was known as the "Forgotten Epidemic." Today, you can't get through the day without hearing about it. On the other hand, people have been predicting another Spanish flu practically since the first one died out; so this is an old sport.

Yet in addition to realizing there have been astonishing advances in medical knowledge since 1918, it's important to realize that worldwide conditions then provided unique circumstances for increasing both the deadliness and the contagiousness of any type of influenza.

There was a war going on, remember? Not just any war, but history's worst war of attrition. He who throws the most bodies at the enemy wins. And it was a war of trenches. As University of Louisville biologist Paul Ewald observes in his brilliant 1994 book Evolution of Infectious Disease, it's the mildest strains of flu that tend to survive and spread, because those are the ones that live long enough for their hosts to communicate to lots of other people.

The virulent strains that kill quickly, by the same token, are least likely to be transmitted and to prevail. They quickly get buried with their victims. Trench warfare, he says, flipped this on its head.


The development of antibiotics, an anti-pneumococcal vaccine, and antivirals is hardly the only difference between 1918 and now.

At first, as is well documented, the prevailing influenza was indeed mild. But by late summer in France it was turning vicious, because soldiers with mild strains stayed in the trenches and nursed their aches while the sickest ones were packed onto crowded trains and trucks, then squeezed into hospitals already packed with casualties and soon to be bursting at the seams with flu victims.


We have no such disease factories today. Indeed, the only close parallel we have today is – the packed chicken farms of Asia. H5N1 intensified and spread among birds as the Spanish flu did among humans."

[FBD]

>"Sooner or later, it will pass freely among humans."<

Not according to Dr. Elizabeth Krushinskie:

“There is no selective [genetic] pressure to drive [H5N1] toward humans. It could just as easily move away.” ~Dr. Elizabeth Krushinskie, president of the American Assn. of Avian Pathologists

http://blog.simmins.org/index.php/category/medicine/influenza

[FBD]

"The reason why the [Spanish] Flu was so successful in 1918 was primarily the "terrain", namely the millions of immuno-deficient hosts and hostesses starved and stressed by 4 years of war.

Secondarily, one can speculate that the 1918 flu strain may also have been a "new" recombinant to the 1918 population and thus more successful than a more established seasonal strain may have been. As I found in 1968, flu, unlike practically all other animal viruses, has multiple RNA segments, equivalent to multiple chromosomes and thus can readily form new recombinants - the reason why we have seasonal flus, but have measles, mumps, polio, pox etc. only once in a lifetime.

Thirdly, the odds that the Centers for Disease Control alias World Health Organization ever predicts an epidemic prior to its arrival are not good: They have predicted in past several years numerous epidemics or "pandemics" such as the flu, the hanta-virus, anthrax, the rotavirus, the Ebola virus, the West Nile virus, "mad cow" epidemic, the Sars-virus epidemic, an epi-pandemic of "random, eg. heterosexual non-drug user-AIDS" - but none of these ever materialized (see, Inventing the AIDS Virus, Regnery publishing, Washington DC, 1996). The last one that came close to an epidemic was polio in the 1950s and that was not predicted by American public health scientists.

Fourth, the currently hyped prospective Flu pandemic has long missed its chances. It has been hyped almost daily in the San Francisco Chronicle since November. But all that happened was a dead chicken in Nigeria, a hamster in Germany, two sick (dead?) kids in Turkey, a euthanized swan in Sweden, several dead or euthanized chicken in Iraq (Yes Iraq!!) etc. That is not the pattern of a potential killer microbe. All "new" killer viral or microbial epidemics of the past have spread exponentially within weeks to months and then declined exponentially owing to the induction of immunity or death of susceptible hosts - take Albert Camus' "Plague" as a classical example.

The current Flu propaganda is thus a mix of ignorance and self-interest and an exploitation of general ignorance by the CDC, WHO, the vaccine, pill and test-kit manufacturers of our universities and pharma companies, and of our "science" journalists, who need to fill their daily columns - and must sell their aging vaccine stocks before they decompose and their Tamiflu pills before the summer.

But despite hyping in dozens of microbial Godots - no Godot has come since polio. People are just too well nourished these days, and thus have optimally maintained immune systems, for microbes to attack more than just the fringes of the ever growing human herd. That in fact is their historical share. The 150 million+ Flu pandemics are hype for fund raising by the ever more costly science/health armies in search for real enemies. Their success is based on the invisible monsters of the microbial epidemics of the times, when nutrition lacked vitamines, proteins and sanitation or was lacking all together - and on the never failing microbial and viral horror phantasies of our science writers, politicians and Hollywood producers."
~ Dr. Peter Duesberg

http://blog.simmins.org/index.php/category/medicine/influenza/page/2/

[Judith Anne]

Dr. Peter Duesberg? THE Dr. Peter Duesberg who "proved" there was no such virus as HIV?

THAT Dr. Peter Duesberg?

You, sir, are a fool.

Instead of answering any of the points I made, you dredged up the rantings of that pathetic monster.

I regret replying to you. I didn't know I was addressing a post to a scientific illiterate. It's your privilege to answer with cut and pastes from that discredited hack, but it doesn't do you any credit.

[blam]

"I've written extensively on the various Avian Flu threads about the precautions taken by both the public and private sectors in this area. I'm very impressed with it....the cooperation at all levels is totally unreal."

I've read that Intel has a 12 member group dedicated exclusively to addressing Bird Flu concern within the corporation worldwide.
The article stated that Intel and other corporations have signed agreements to share the costs associated with flying their employees out of countries with a Bird Flu outbreak, H2H. Their plan is to lease their own passenger jets with private pilots and not use commercial airlines.

[blam]

"FRiend, you seem like a very nice person, and I don't wish to put you down. "

No problem. My preparations are multi-purpose. It's become an annual spring event to prepare oneself for a potential cat-5 hurricane around here and once that is accomplished any additions (for Bird Flu or war with Iran) are fairly minor and I have the means and desire to be prepared for almost any disaster, how I sound or appear regarding these threats (real or imagined), is someone else's problem, I could care less.

My BIL has a large travel agency and he says that his Asian business has still not recovered from the SARS scare. SARS killed 883 people worldwide according to documents he showed me. The travel industry is real worried about Bird Flu.

[FBD]

>>"You, sir, are a fool."<
- and you, madam? Are you unable to respond in a civil manner? Note that I haven't insulted you in any way, or called you any names.

But, I'll take your snide insults as a compliment, since it's coming from someone who is still concerned about SARS.
(You mentioned that it: "still exists in China.")

>>"Instead of answering any of the points I made, you dredged up the rantings of that pathetic monster."<

-Is Dr. Edwin Kilbourne, emeritus professor of immunology at New York Medical College, also a "monster"?
He has stated: The bird flu, "is distantly related to earlier flus, and humans have already been exposed to them, providing some resistance."

Dr. Kilbourne has also said that:
[The fear] "is very much overdone, in my opinion,"

Dr. Kilbourne has also stated that "when viruses become more transmissible, they almost always become less lethal. Viruses that let their hosts stay alive and pass the disease on to others, he explained, have a better chance of spreading than do strains that kill off their hosts quickly.

As for the Spanish flu, he has pointed out that medical care has improved greatly since 1918.
"...many more died of what are now believed to be bacterial infections, which can be treated with antibiotics."

---

I note you had nothing to say about this article:
http://www.fumento.com/disease/flu2005.html

Apparently you never bothered to read it, as it didn't bolster you POV.

I don't know anything about this Dr. Duesberg, but I do know that his statement:
"They must sell their aging vaccine stocks before they decompose and their Tamiflu pills before the summer."...is right on target.

There are plenty of people who can't wait for the next pandemic, some, like Roche, are making a huge profits off of fear mongering.
Follow the money.
For others, like Osterholm, It's "follow the power."

He has been pushing for more public health authority for years. He has never met a virus that he didn't hope would turn into a pandemic, and that includes SARS.

He had been trying to predict a pandemic for years, hoping that the world will turn to him as their Saviour, and he wishes to be in charge of the levers of public health policy, *when* (and *IF*) his *fantasy* happens.

>>"Instead of answering any of the points I made,"<

You made several assertions, which I answered:
One, you made the statement that:
>"Sooner or later, it will pass freely among humans."<
Show us all the empirical evidence to back up that statement.

-An avian pathologist, Dr. Elizabeth Krushinskie, president of the American Assn. of Avian Pathologists: said there was NO evidence of that.
No response from you, about that.

You made comparisons to the Spanish flu:

-And it's been pointed out by many experts that:
There was development of antibiotics, an anti-pneumococcal vaccine, etc, since then. That is not the only difference between the 1918 Spanish flu epidemic, and now.

>>"Pandemic H5N1 human to human will mean: no church, no baseball games, no school, and no jobs."<

- Hoo-boy, talk about fear mongering! Go ahead, live like the Omega man, in constant fear of the next pandemic. Man your gun turrets and fill your moat with water. Worship at the feet of the fear mongers who can't wait for the next pandemic.

I'll be just fine without the scare tactics, (and the Tamiflu stockpile), thank you very much.

[FBD]

The quote below applies to the fear mongering lovers of bureaucratic power, (people like Dr. Osterholm):

"The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary." ~ H. L. Mencken

'Living Terrors: What America Needs to Know to Survive the Coming Bioterrorist Catastrophe' by Dr. Michael Osterholm

[sandbar]

>>>"We're all gonna die" ping>>>

Sam, you have picked up on my sarcastic attitude about this!!! I think your wife is a lucky woman, to have a man so observant. Or maybe I'm being presumptious and you are Sam's wife. Oh well.

Thanks for the ping. Interesting stuff.

[Judith Anne]

You don't deserve an answer. You don't understand what you cut and paste, and you personally know nothing about H5N1.

[FBD]

>"You don't deserve an answer."<

- That's because you don't have any answers to what Dr. Edwin Kilbourne, and avian pathologist- Dr. Elizabeth Krushinskie, (among others) have calmly and rationally stated.

You wild eyed statements:
>"Sooner or later, it will pass freely among humans."<
and this little gem:
>'Pandemic H5N1 human to human will mean: no church, no baseball games, no school, and no jobs."<

Those groundless statements reveal that you are someone who fantasizes of an apocalyptic pandemic.
You're a fear monger.

You remind me of those apocalyptic greenhouse gas bloviators who believe that [man made] global warming is going to destroy the earth's livability.

...And I don't need to be a scientist to see through YOUR B.S. either.

[FBD]

From the Inside Flap:
Life today for citizens of the developed world is far safer, easier, and healthier than for any other people in history. Modern medicine has all but wiped out many diseases that once were common killers. Science and technology have given us countless devices that protect our bodies from injury, secure our property, and warn us of impending disaster. And modern intelligence gathering can pinpoint threats to our domestic security as they arise. So why is an epidemic of fear sweeping America?

The answer, according to nationally renowned health commentator Dr. Marc Siegel, is that we live in an artificially created culture of fear. From the anthrax panic to the SARS "epidemic," from "official" rumors of bioterror to Orange alerts to West Nile virus—the media continually bombard us with breaking news of yet another super-bug, terrorist plot, or natural disaster that's about to wreak havoc. Most of the time the disasters never materialize. But even if they did, the odds that any of us would suffer harm from them is infinitesimally small—especially when compared to the much greater risks of dying in a car accident or from coronary heart disease.

In False Alarm, Siegel identifies three major catalysts of the culture of fear—government, the media, and big pharma. And, with the help of fascinating, blow-by-blow analyses of some of the most sensational false alarms of the past few years, he shows how those big three fearmongers manipulate our most primitive instincts—often without our even realizing it—to promote their political agendas, boost their ratings, and sell their products.

In his role as a dedicated healer, Siegel offers his prescription for inoculating ourselves against fear tactics. He shows us how to look behind the hype and hysteria and helps us to develop the emotional and intellectual skills needed to take back our lives from fearmongers.

About the Author:
MARC SIEGEL, M.D., is a practicing internist, an associate professor at the New York University School of Medicine, and a Fellow in the Master Scholars Society at New York University

[Judith Anne]

Well, you could be right, and I could be wrong. In that scenario, H5N1 (unlike many many many other influenza viruses that pass from waterfowl in China to pigs to humans all over the globe) could dead end in birds and mammals, and humans would never get sick.

You being right would be a GOOD thing. I am not opposed to it.

Or, you could be wrong, along with the "experts" you cut and paste in response to the points I made, and I could be right about the potential for serious mortality and morbidity among humans worldwide.

Me being right is a BAD thing. My nephew got ordinary influenza virus--he had a fabulous immune system--17 yo high school scholar and athlete, upper upper midde class kid. He got over the flu, but the virus got into his heart, and he developed myocarditis secondary to influenza. The heart muscle, over a period of six months, gradually died. So did he, waiting for a transplant, on Dec. 20, 2000.

Trust me, I do not want to be right. So let's just hope I'm wrong. It would please me greatly.

As far as panic, I have lived a long, useful, and very pleasant life. I don't care when I die. I DO, however, care about my children and grandchildren, all of whom are young and healthy with great immune systems, as my deceased nephew was. I never want to go through what my brother went through. Ever.

Let's all just pray you're right. Because prayer is all you have. Science is NOT on your side.

[JustDoItAlways]

I wouldn't call it hype.

If you look at SARS, even in a city like Toronto, we were extremely close to the pandemic society break-down scenario.

If the SARS virus had just been slightly different (infectious in 2 days instead of an average 3 days for example) it would have been the biggest disaster in history.

I don't know if the avian flu will be the pandemic flu or that it will even happen in the next 50 years, but we have been very close before.

[Judith Anne]

You make some important points, and I thank you.

[FBD]

I'm sorry about your nephew.
Yes, you could be right. But why do you just accept the worst case scenario as the most likely? I just don't understand that kind of thinking.

Yes, the experts I "clipped and copied", could be wrong....but they are experts on influenza, nonetheless:

---

(The fear ''is very much overdone, in my opinion,'' said Dr. Edwin Kilbourne, an emeritus professor of immunology at New York Medical College, who has treated flu patients since the 1957 pandemic and has studied the 1918 flu.)

http://www.ic.sunysb.edu/Class/bio318/readings/flu/flu_backgrnd.html

---

Dr. Elizabeth Krushinskie, president of the American Association of Avian Pathologists, told me that "there is no selective (genetic) pressure to drive (H5N1) toward humans. It could just as easily move away."
http://www.statesman.com/opinion/content/editorial/stories/04/9flu_edit.html

---

Dr. Marc K. Siegel:
http://www.doctorsiegel.com/
http://www.npr.org/templates/story/story.php?storyId=5183999

---

Please understand, I'm not pretending to be an expert. But I only need to look at all the fear and hype in the last 30 some years about every asteroid, earthquake/ tsunami, global cooling/warming viral/ bacterial epidemic, killer bees, ebola, etc, etc, etc, ad nauseum to understand that we are really are threatened with, is an "epidemic of fear".

---

>"I DO, however, care about my children and grandchildren, all of whom are young and healthy with great immune systems, as my deceased nephew was. I never want to go through what my brother went through. Ever."<

-I understand that, and again, I'm sorry for your loss.
There's something I don't want my children or grandchildren to live in either: A climate of fear.

Any one of us risk death in any number of terrible ways, including the far more likely incident of being in a car wreck. Yet we all get in our cars each day, in spite of that far more likely risk.

>"Let's all just pray you're right. Because prayer is all you have. Science is NOT on your side."<

-And why isn't it? You're a health care professional, I don't need to tell you that we aren't living in 1918, where there was a world war of attrition being fought. We aren't practicing 1918 medicine, after all, right?

And Friend, there's nothing wrong with prayer. But in the end? We are all going to die of something....so in the meantime, let's enjoy life, and lets' *let* our children and grandchildren enjoy life, also.

Take care, and best wishes for a healthy and happy future.
Regards

[Judith Anne]

Thanks for your courteous reply.

I don't go by the professionals that you quote. Marc Siegel is well-known for promoting his book, he is not an immunologist or virologist, and his behavior supposedly debunking his betters is simply attention getting, in my book.

As for the others, I haven't read them, and won't bother. My information sources are the CDC, USAMRIID, ProMed, and sometimes WHO, although the WHO is not very credible in my book due to it being an arm of the UN.

I interpret my sources with my own bias, as do we all. But there's plenty to be concerned about, and concern is not the equal of panic.

If the USA had better stockpiles of Tamiflu, if the USA had a vaccine producing infrastructure in place, if there were rapid accurate testing procedures in place in labs all over the USA, if hospitals had stockpiles of personal protective equipment instead of relying on just in time inventory cost control, if the actual supplies we will rely on to treat H5N1 in the most modern and effective way were in great supply instead of short supply--if staffing were not pared to the bone, if professionals weren't burnt out, if people were better informed about where the H5N1 risk will appear (and clue #1, it won't be in birds but on an international flight), if if if...

H5N1, sooner or later, will be passed human to human. We have no guarantee it won't be sooner. We are not prepared. I am concerned. I KNOW what regular ordinary seasonal flu can do--35,000-50,000 excess deaths per season....

I'm not an idiot, and I'm not a drama queen. I miss my tall, dark and handsome nephew, and I grieve with my brother.

And I won't be put off by physicians with an axe to grind and no professional props when they tell me that concern=panic and bird flu isn't a threat. For every person you quoted, there are ten genuine experts who disagree.

I assess H5N1 as a very real threat. Your mileage may vary, and I hope you are correct.

[SunkenCiv]

Ping!