Avian flu, immigration and the nightmare scenario

Mortimer Zuckerman:

Last week's disclosure that an Indonesian man tested positive for the bird flu that has already killed more than 50 people in Southeast Asia was just the latest chilling news about the disease. Should it develop certain genetic changes, international health experts warn, bird flu could spark a global pandemic, infecting as much of a quarter of the world's population and killing as many as 180 million to 360 million people - at least seven times the number of AIDS deaths, all within a matter of weeks.

This is utterly different from ordinary flu, which kills between 1 million and 2 million people worldwide in a typical year. In the worst previous catastrophic pandemic, in 1918, more than 20 million died from the Spanish Flu. That's more than the number of people who died from the Black Death in the Middle Ages, and more people killed in 24 weeks than AIDS killed in 24 years.

There are three elements to a pandemic. First, a virus emerges from the pool of animal life that has never infected human beings, meaning no person has antibodies to fight it. Second, the virus has to make us seriously ill. Third, the virus must be capable of moving swiftly from human to human through coughing, sneezing or just a handshake.

For avian flu, the first two elements are already with us. Well over half the people who have contracted it have died. The question now is whether the virus will meet the third condition: mutating so that it can spread rapidly from human to human.

The new flu has already moved from chickens to other birds and on to pigs. The latter often serve as a vessel for mixing human and animal viruses because the receptors on the respiratory cells of pigs are similar to those of humans. This illustrates the dangers we face, because this mixture of bird flu and human flu, in an animal or a person, could cause the viruses to exchange genetic materials and create an entirely new viral strain capable of sustaining efficient human-to-human transmission.

That would be the tipping point to a pandemic.

Nobody knows just how close we might be to such a crisis, but experts are alarmed because we are singularly ill-prepared. Worldwide, we currently produce only about 300 million doses of flu vaccine a year to serve more than 6 billion people. A pandemic that began in Asia could race around the globe in days or weeks, given the number of airliners crisscrossing the oceans from Tokyo, Vietnam and Indonesia to New York, Los Angeles and London.

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