the death rate from the new bird flu strain is high—at 20%.
I’ve been accused of overplaying pandemic influenza. No need to scare the children, medical colleagues caution me. I did writee two books on viruses. One of them (Beating the Flu 2006) is specifically on pandemic influenza. But I don’t think I’m exaggerating the danger. Since SARS (Severe Acute Respiratory Syndrome) killed 775 people in 2003, we’ve had a bird flu crisis in 2004-2006 and the H1N1 swine flu pandemic of 2009.
During the SARS outbreak, fatality was less than 1% for people aged 24 or younger, but more than 50% for those over 65. In comparison, the fatality of seasonal influenza is under 0.03%, primarily among the elderly, and the death rate was 3% during the 1918 Spanish Flu pandemic.
Worldwide, at least one in five people were infected with swine flu during the first year of the 2009-2010 H1N1 pandemic. In the U.S., there were 61 million cases, which is a lot of sick people in one year. Originally, the death rate was reported at a low 0.02%. A major study in the prestigious British medical journal The Lancet in 2012 found that mortality from H1N1 was miscalculated and could be as much as 15 times higher than original estimates.
And, influenza strains don’t just go away. They morph, mutate, adapt. SARS is still with us as SARS 2 (nCoV). A cousin to the original SARS virus, nCoV is known to cause pneumonia and sometimes kidney failure. It’s popped up in southern France and Saudi Arabia. The 2009 H1N1 swine flu is still with us, and the CDC still tracks it. Look at the graph of 2013 flu cases.
In March 2013, yet another bird flu strain emerged in China. In just a few months, it jumped from birds to people. So far, there’s no major human-to-human contagion and it’s been mainly confined to China. So what, some say: “I’m not Chinese.” In an odd twist of fate, it turns out that Asians have a genetically different immune response to H7N9, the new bird flu strain, making them especially vulnerable. But that won’t stop Americans from getting sick if it gets here. This new strain is bad. With only a few hundred people infected so far, the death rate is around 20%. That’s high enough to get the U.S. government’s attention.
“H7N9 is a type Influenza virus A (avian influenza virus or bird flu). H7N9 virus first infected humans in March 2013 in China. Most of the cases of human infection have resulted in severe respiratory illness.”
In the month following the report of the first case, more than 100 people in China had been infected, an unusually high rate for a new infection, and a fifth of those patients died. It seems to hit hardest in those over 40 and is very serious with a higher chance of fatality in people over 65.
Declaring H7N9 a “significant potential for a public health emergency,” the U.S. has granted emergency authorization for use of rapid diagnostic kits. This means that the FDA hasn’t approved the kits. China is testing them out. You may soon see them used for screening purposes in the U.S., possibly even at airports. What’s the fuss?
A Lack of Potentially Helpful Antibiotics
It seems that H7N9 provokes a weak immune response making vaccines ineffective at normal doses. This bug requires up to 13 times more to stimulate immunity to make antibodies against it. That means that should it go global, even if an effective vaccine is made, there won’t be enough to go around. But, we don’t know the consequences of giving people such high a dosage of vaccine. Children would be especially vulnerable because they can react badly to vaccines. The news gets worse.
So far, H7N9 is resistant to the antiviral drug amantadine. And, it looks like it’s developing resistance to the other anti-influenza drug, Tamiflu. We’re assured that more and better antiviral drugs are in the pipeline, but scientists warn that influenza is highly resistant to all antiviral drugs, new ones included. And, none of the new generation of drugs are yet available and won’t be for some time.
Here’s another reason this new bird flu is scary. It’s coming on fast. In two months, more human cases have occurred than in two years with the H5N1 bird flu of 2004. The World Health Organization has described H7N9 as “unusually dangerous.” It is one of the most lethal influenza viruses seen so far.
Where is the Virus Coming From?
The incubator for bird flu is found in Chinese open poultry markets. Chickens, ducks, pigeons, and other birds are kept in cages in unsanitary conditions. On April 6, Shanghai and other cities in China virtually closed their live poultry markets. Chicken farms have been shut down. The outbreak caused billions of dollars in losses to China’s poultry industry as demand for chicken meat plunged. In many cities, only frozen poultry is available for human consumption. Nobody yet knows the real source of H7N9, but think it comes from city pigeons.
Influenza has been among humans for thousands of years. It knows us. But, we don’t know it that well. It’s expensive to prepare for a pandemic, so governments don’t want to do it. Even when vaccines and antiviral drugs are somewhat effective (they never “cure” the problem, just make symptoms less severe), there are not enough to go around. Government agencies are slow to act, and once it gets going, influenza spreads very fast.
Possible Seasonal Drop-Off
Now, the good news. Shanghai, one of the cities hit hardest by an outbreak of H7N9 in China this spring, ended its emergency response measures on May 11 following the absence of new cases in the past 20 days. The reason for the drop-off is not yet clear. It could be due in part to closing of live bird markets. It could also be the result of the changing seasons. Just like human influenza viruses, bird flu viruses follow seasonal patterns. Most influenza viruses like bird flu virus H5N1 are more active in the winter than the summer, so cases drop as the sun comes out and the weather warms. But, influenza doesn’t disappear. It will be back in the fall and winter of 2013-2014.
Experts warn it’s far too soon to gauge what H7N9 has in store for humankind. And while the virus initially seemed as if it might be another 2009 H1N1—new virus with lightning-fast global spread—at this point, H7N9 does not appear to be in a hurry to go pandemic.
If this new bird flu does go pandemic, however, meaning that it spreads easily between people through the air, everyone (even vegans and vegetarians) will be vulnerable. Your best approach to beating the flu is to avoid getting it. Washing your hands, wiping down surfaces, wearing a mask, and using gloves helps a lot. Keep your immune system healthy by taking zinc, vitamin C and D. Using antiviral herbal remedies have been proven to as effective in saving lives and getting people back to health as drugs.
How to Protect Yourself and Your Family
I won’t give all the details away because I wrote about how to beat the flu in my books. But you may want to start learning about these herbs, how the Chinese treat flu without drugs, and how you can get your hands on them should a pandemic rise up, or should a nasty seasonal flu stalk your town.
Some final thoughts might be warranted, because influenza is not going away. In fact, it’s likely to get stronger. The old way of thinking that a pandemic comes along every few decades and a really big one every 75-100 years doesn’t compute in today’s interconnected world.
Here are some of the reasons I believe we need to develop greater literacy about influenza.
- Disease is not static. Infectious diseases evolve, like all biological processes. New viruses emerge all the time. We cannot predict what’s going to happen with most of them.
- Once-stable environmental conditions and climate are becoming more variable and weather more capricious. Viruses exploit and adapt to these changes better than we do.
- The general health and immunity of post-modern people is weaker than in previous generations. Genetic variations make certain groups of people more vulnerable to infection.
- More people are living longer. The elderly are the most susceptible and have the highest fatality of all age groups. And, it’s astronomically expensive to try to save them.
- Infants and small children are also vulnerable, but there is less preparation and protection for them. They are also the most susceptible to side effects of vaccines and drugs.
While the World Health Organization (WHO) holds briefings and issues declarations, drug and vaccine companies count risk versus potential profit, and governments gather information, but mostly just stand by hopelessly, we are left without much help from agencies and experts. It would be far better to learn how to avoid infection and manage it better when it comes, because it’s not a matter of if, but when.