Bird flu: an infectious panic

Everything You Need to Know About Bird Flu and What You Can Do to Prepare For It, by Jo Revill, Rodale, 2005

Bird Flu: Everything You Need to Know, John Farndon, Icon Books, 2005

‘It was nothing like a winter flu. Victims suffered intense pain and terrible rib-cracking coughing spells, and their skin, their eyes and their ears started to bleed profusely. Worst of all, they turned deep blue as the clogging up of their lungs starved their blood of oxygen…over the space of a few hours or a few days at best, they literally suffocated as their lungs filled up with fluid and blood.…’

John Farndon’s description of how the 1918 flu put paid to its victims illustrates why so many medical experts have cause to be afraid of the consequences of the current bird flu becoming infectious among humans. His book, Everything You Need to Know: Bird Flu, is one of various books published in Britain and America on the subject in the past few months.

But it is worth putting this danger into some perspective. Some three years after the latest outbreak was identified in east Asia, the number of books published in Europe and America on bird flu (Amazon UK stocks at least eight) greatly outnumbers the number of people killed in the same area (zero).

The threat is something that should rightly concern experts and planners in this field, because if a human pandemic were to occur, many people would die. However, the fear of bird flu runs way ahead of the actual danger posed by it.

The situation as it stands hardly requires a weighty tome. There is a disease that appears to be very contagious, and frequently deadly, among birds caused by the H5N1 form of the influenza virus. A few people, almost invariably working in close proximity to birds, have been infected and become seriously ill. Of the 170 human cases reported to the World Health Organisation (WHO), 92 have died.

At present, H5N1 does not appear to be infectious between humans unless they are in very close and sustained proximity to one another, such as the case of a mother cradling her sick daughter for many hours. The concern is that if the virus were to mutate, it may become more easily transmissible among humans, causing a pandemic.

The twentieth century witnessed three flu pandemics. The ‘Spanish flu’ of 1918 may have killed 50million people – more than the Great War that preceded it. The ‘Asian flu’ of 1957-58 killed around two million globally, including 70,000 in the USA and 30,000 in the UK. In 1968-69, the milder ‘Hong Kong’ flu spread, which is thought to have killed 750,000 worldwide.

The comparisons with previous situations are not necessarily that helpful, other than to suggest that these things do happen from time to time and do not generally cripple society. It is surely the case that in 2006 we are better placed to deal with a pandemic than in 1918.

For starters, we actually know that there might be a pandemic on the way. We also have the capacity to make a sensible attempt at treating such illnesses through intensive care and the use of anti-viral drugs like Tamiflu. We have steroids to reduce the overwhelming immune response that this virus can produce. If we can manage to get any reasonable amount of warning between the emergence of the disease and its wider spread, we have the capacity to mass-produce vaccines that will provide longer-term protection.

More generally, people are in better health today than after the privations of war, and a society that has not been turned upside down by conflict is better placed to focus resources to tackle the problem.

To sum up: it is by no means inevitable that bird flu will transform into a human pandemic. However, if it does, we are better placed than ever before to tackle it.

The other difference between today and 1918 is that now we live in an excessively risk-conscious society. Hence, a disease that has killed fewer than 100 people to date can be described by the publishers of another book as ‘the biggest health threat of the 21st century’. The book, the unimaginatively titled Everything You Need to Know About Bird Flu – and What You Can Do To Prepare For It, by Jo Revill, shows how the relatively few facts about bird flu can be transformed into another excuse for private panic.

Revill is the health editor of the Observer and can’t resist the urge to turn bird flu into a story filled with characters (‘the Virus Hunter’, ‘the Man at the Helm’) and little vignettes. She also includes a handy Q&A section at the back of the book that probably doesn’t help anyone understand the situation but does give vent to many misplaced fears.

Just reading through the last chapter on preparing for the pandemic could give you a seizure. Once you’ve bought the emergency food and first aid kit for when distribution grinds to halt, considered fleeing the city for the sake of the children (presumably to your second home in Cornwall), avoided touching door handles, worked out your business emergency plan, and mentally prepared for quarantine (with its attendant risk of post-traumatic stress disorder), you will probably be so frightened that you’ll never leave the house.

You might be grateful for having made these kinds of preparations in some kind of 28 Days Later scenario when the entire social fabric has disintegrated – in which case, failing to get hold of a shotgun is surely remiss. It is almost certainly pointless for any realistic scenario of what might happen in the next few years. It is middle-class parental fretting projected on to the latest passing panic.

The truth is that as an individual there is nothing you can do to stop a pandemic from happening and not a great deal you can do thereafter to avoid catching it – but even if a pandemic were to break out, it almost certainly won’t be anything like as bad as the nightmares presented to us at present.

The biggest lesson from SARS was that the fear of disease caused more damage than the disease itself. The way the discussion of bird flu is heading, we won’t need an actual outbreak of bird flu to start running like headless chickens.

Buy Everything You Need to Know About Bird Flu and What You Can Do to Prepare For It, by Jo Revill from Amazon (UK) and Bird Flu: Everything You Need to Know, John Farndon from Amazon (UK).

Read on:

Bird flu and Chicken Little culture, by Mick Hume