Pandemics
A pandemic is an epidemic that spreads around the world. There is a current infection which is killing off a lot of different kinds of birds in several countries now. A lot of people are worried about it. The main people that should be worried about it are the people who raise birds.
There are some rules about sanitation that don’t get followed everywhere. If you have a sick bird, don’t eat it. If you have a lot of sick birds wear a mask when you clean them up and dispose of their waste products. Wash your hands when you come into contact with animals.
These rules are hard to follow if your birds live in your house. Lots of people in Asia have their birds live very close to them. My mother lived in Hunan for a time. She had a pet bird. No, she didn’t get bird flu. She got the anticipated heart attack. But people get to live in fairly close quarters with chickens, pigs, ducks, geese and turkeys. They live on rural farms. They know their animals. They are poor. They sell their animals in open markets in large groups. People are in close contact with animals all the time. As a result people catch viral infections that migrate from animals to humans.
This is the case with the H5N1 virus. Mainly is goes from 1 bird to another and causes the bird to become sick. Lots of people who regularly live among birds are appaarently immune to the infection. Young people and some older people who come into contact with sick birds become sick. So far there have been no cases of any people transmitting the virus to other people.
But what people are worried about is that if someone with the flu catches H5N1 then it might be possible to transmit this virus to another person. It will take up to 36 hours for that peron to know they are sick. By that time the first person may have infected many other people. Computer models of H5N1 with influenza A make it look like it might have up to a 50% mortality rate. About half of the people who contract the disease may die. That figure may be erroneously high. It’s based on the people who get sick from H5N1 now and from the flu now.
The regular flu kills somewhere around 10,000 people a year in the US. Most of these are the elderly, the very sick, and children. It’s a complication of diseases already present and weakened immune systems. No one pays much attention to “flu season.” People get a fever, chills, a sore throat, and are miserable for several days. The flu is caused by a virus. There are preventive flu shots for at risk groups to lessen the risk of getting into that 10,000 or so group that dies from the illness. A year or so ago it was predicted that there was going to be a very bad flu season and few flu shots. Lots of elderly people lined up to be vaccinated. There were shortages. The one major lab had it’s license pulled and vaccines had to be imported. There was a big outcry. As it turned out, the “flu season” that year was relatively mild.
So now people are trying to think about what to do for a pandemic. By and large this is an intellectual exercise. What would you do if you were the last person alive? What would you do if a tire came off your car while driving? What would you do if your house was on fire? What would you do if someone approached you with a gun? What would you do if you saw a lost child crying? What would you do if a virus to which few people had immunity was going around the globe? These are all things people can think about. A government needs to think about the last one. They should have some sort of basic plan in place.
We had a bad flu when I was a child. It was in the late 1950’s. Both I and my brother caught it. Lots of people were sick. We recovered. But people have the memory of the stories of the Spanish Flu pandemic. It killed lots of people. People get scared about something like that coming back.
Right now there’s no need for people to be afraid. Birds, on the other hand, should be awfully worried. There is a current bird pandemic. Birds have been reported to be sick in Mongolia,Vietnam, Indonesia, Romania, Tibet, and a sick bird was stopped from entering the country at customs in England. Birds will continue to spread the virus along normal wild bird migratory paths and along the routes used for smuggling exotic birds and poultry. As long as the virus stays with birds, with a few cases of birds to people, there is no problem. The US has good surveilance on sick birds. Sick birds in most places are killed and the flocks are killed. In small family farms, especially in Asia and in other third world countries, what people do is eat sick animals after they kill them. Not a bright idea. So, predictably, those people seem to be getting sick. To stop sick birds from possibly entering the food supply some countries like Canada have proposed a ban on poultry from China or all of Asia. It’s a proposal. In most cases it’s not needed. Good, safe food handling is needed. Most viruses are killed with proper food cooking and freezing. If you undercook meat or poultry you get sick. Poultry needs to be done to an internal temperature of 180F. The juice should run clear when the bird is punctured with a knife when taken out of the oven.
If you own birds try to keep them separate from your home. Don’t let them wander in and out of your house. Give them their own space. Make them their own small house and keep it enclosed to keep away migratory birds. If you have a sick bird, keep it away from the rest of the birds and get it tested by your vet for bird flu. Most birds are dying of Newcastle disease and not H5N1. It’s a different type of bird virus, and doesn’t transmit readily to humans. It’s common this time of year. If your sick bird dies, don’t eat it. If your sick bird dies don’t feed it to other animals. If your sick bird dies don’t compost it. Have your bird examined and necropsied. Governments are looking to contain H5N1 virus. It can wipe out large bird manufacturers. Contact your vet for assistance. Yes they may quarantine your farm, but you may save a lot of other livestock and you may ultimately save some lives.
As for antivirals, there are currently several on the market. Tamiflu is the one getting the most press. Flumadine and Symmetrel are othera. Acyclovir is an antiviral for herpes type viruses. Epivir-HBV is effective against hepatitis B. Repitol is effective against hepatitis C. Combivir, Crixivan, Emtriva, Hivid, Viracept, Viramune, Zerit, are AIDS medications. Synagis is effective against the RSV virus. There are other antivirals on the market as well. My list here was designed to cover the manufactures of antivirals, all of whom have the capability to produce anti-influenza drugs.
So what stops the big pharmaceutical companies from producing anti-flu drugs? Several things. There’s a limit on the profit the drug companies can make from producing vaccines for children. The US has a low cost vaccination program for children which limits profit. Second, there’s a limit on how the SEC wants the profit documented for shareholders. Lastly, since all drugs have side effects and some people get sick from vaccines, people sue the manufacturer making it a problem to produce vaccines for very large numbers of people. So big business will want to either limit the number of people who will get their vaccines or limit litigation or both.
So here is the worst case of a pandemic of H5N1 in the hypothetical. Remember this is an intellectual exercise. There is no human to human transmission of the virus in existance. But if there is, then the US is planning to develop 20 million doses of vaccine. The H5N1 in computer models (and remember the computer model is believed to be overestimating mortality) is 50% and the majority of death is for victims at age 49 years and younger. The average is 14. If you develop the vaccine then at least 1% of the people vaccinated will develop some side effect to the vaccine itself. Side effects will range from mild to severe. The severe side effects may include the possibility of death. 50% of the people who get sick who are not vaccinated may die. There are around 6.5 billion people in the world. If a flu pandemic occurs, everyone will consider whether or not to be vaccinated. There will not be enough vaccine to vaccinate everyone. Some people will not want to be vaccinated. Some people will not be able to be vaccinated based on how the vaccine is developed. It’s likely that concern over who will get the vaccine may be worse than the pandemic itself. If you recall what happened last year with the flu vaccine, that’s what happened.
At some point in our future there will be some illness which travels around the globe. It’s likely to be some type of virus. We have global travel and a global economy. It’s important to put safeguards in place and to plan now for things that might happen. It’s also important to keep in mind that for the most part these are intellectual exercises and there is no need for panic.
