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Flu Current Topics in Flu

The Threat of Bird Flu


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Summary & Participants

Doctors and healthcare officials are preparing for the possibility that a virulent strain of avian flu may become a serious threat to humans.

Medically Reviewed On: July 15, 2008

Webcast Transcript


ANNOUNCER: A strain of avian, or bird, flu is spreading around the world and millions of birds have died.

MIKE MAGEE, MD: Geographically, this problem has remained fairly focused in Asia. The two countries most affected have been Vietnam and Indonesia, but we now have seen spread throughout Europe and into Africa.

ANNOUNCER: This strain of influenza is called H5N1. It is likely to spread further. What especially worries experts is the possibility of an increased danger to humans.

BRUCE POLSKY, MD: Most experts anticipate that bird flu will come to North America and the United States. At least infected birds will be seen. And whether this infection gets transmitted to humans is an open question. And even more open is the question in general of human-to-human transmission, which has been documented but apparently, occurs rarely and is difficult to accomplish.

ANNOUNCER: Worldwide, there have been less than 250 reported human cases. Among those, the death rate is around 50 percent. However, there have been very few known cases where a person got the disease from another person, as opposed to from close contact with poultry.

MIKE MAGEE, MD: Recently in Indonesia, there was a family of seven that died who it has been shown were able to carry it from one to another member of the family. So it did go from human to human, but it stopped within that cluster.

ANNOUNCER: The fear is that H5N1 will change or evolve to become much more contagious among people. That's what happened in 1918. That represents the worst-case fear for avian flu today.

BRUCE POLSKY, MD: The most destructive and fatal human pandemic, the one in 1918, was an avian influenza. It was a flu strain that came from the avian population.

I think this is the fear. This is most experts' fear that whenever some critical mass of human infection has been reached, then, you know, it'll break out of its contained mode into a more epidemic or pandemic mode. This is the concern; that's the doomsday scenario.

MIKE MAGEE, MD: There's a fairly strong divergence of opinions about whether we actually will have a pandemic from H5N1. On the one end of the spectrum are professionals from the World Health Organization and elsewhere who believe that with such an enormous virus load being carried by birds around the world and other species, with mutations occurring day-in and day-out, that it's only a matter of time before they hit on that perfect mutation that will allow easy spread from humans to humans. Therefore, in their eyes, when it comes to a pandemic for H5N1, it's not a question of "if," it's just a question of "when."

Now, on the other end of the spectrum are clinicians who are working in the field, who are in Vietnam, who are in Indonesia, who have seen huge numbers of birds die from H5N1 but very few humans become infected, even though they're in close proximity to each other. Those clinicians are saying, "Look, if this was going to spread, it would have probably happened in the last ten years and the fact that it has not shows that it probably won't in the future."

ANNOUNCER: The World Health Organization and the Centers for Disease Control and Prevention, among other health agencies, are working hard to prevent a widespread outbreak of H5N1 among humans.

BRUCE POLSKY, MD: There have been literally armies of scientists and public health workers around the world who have taken measures to see that this doesn't happen. So I don't think it's just a matter of good luck and biology being entirely on our side. I think it's because of certain interventions that have been undertaken.

ANNOUNCER: The interventions include providing protective equipment to poultry workers and educating them to better recognize sick flocks. There is also close monitoring of bird shipments from country to country. On the scientific front, there's research into diagnosis, medical treatment and experimental vaccines. Whether the currently-spreading avian flu becomes a major health threat to humans remains unknown, but many scientists believe advances in medicine plus quick action may offer good protection.

MIKE MAGEE, MD: If H5N1 began in an area, the best thing that we could do is to shut that area down, to isolate that area, to massively treat the population within that area and then have very, very careful surveillance of everyone else. That's the way you protect yourself in a modern, mobile world.

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