Issue in Brief
A big flap over bird flu
Bird Flu (Avian Influenza) has been making a lot of headlines lately. People in science, politics and the media are pointing to past flu pandemics, and suggesting that we’re due for another one. The suspect strain, H5N1, has raised eyebrows—and TV ratings—over the past decade as it’s spread through bird populations worldwide. But most folks aren’t worried for their chickens—they’re afraid that a mutation in the virus might allow it to spread through human-to-human contact. If that happened, governments worldwide would have a pandemic* on their hands, which everyone agrees would be very bad. Not everyone, though, agrees on how bad a pandemic would be, how likely it is, or what we should do about it.
Note: recent news suggests that Avian flu has mutated into a form that can spread between humans, but not in the dangerous way everyone’s scared of. See the “what’s going on now” section below for details.
Many see avian flu as a critical health issue, and back up their claims with a bunch of facts: the CDC estimates that, in the United States, 36,000 people die each year from the annual (not avian) flu alone. (CDC) If the avian flu pandemic were to occur, some warn, 1.9 million people could die in the US alone, and up to 150 million worldwide. (CDC, BBC)
These fears are compounded by the knowledge that humans have no natural immunity to the virus—of those infected to date (229), about half of them have died. (WHO) In medicine, many are quick to add, a 50% mortality rate is high. Some note that despite much talk and clinical work about possible vaccines, the truth is that a foolproof vaccine probably cannot be made until the H5N1 strain mutates into a pandemic-causing version (though some vaccines are in development anyway). (CDC)
If and when the pandemic does occur, others fret about problems with vaccine production. Vaccines are generally made in egg embryos, in a process that’s time consuming. (CT) And, were there to be an epidemic, time is one thing no one would have much of. Also, these eggs are hard to come by, and because avian flu infects the birds that produce them, a pandemic would cut an already limited supply.
Lots of people take issue with the bird flu buzz. They say the concern is overblown for a variety of reasons: some claim that the CDC’s projections are alarmist, and based on sketchy ‘indirect’ estimates.** Others note that despite all the hype, avian flu is now nearly ten years old, and hasn’t mutated into the killer super-flu that many predicted. If it were going to, these critics say, it would have happened already (there are plenty of animal diseases that don’t mutate in this way)—and there have been so few bird-to-human cases that they don’t deserve the attention they’re getting, especially compared to other, more deadly diseases. (CRS)
Many also criticize the ways in which the U.S. government is responding to the so-called ‘crisis,’ noting that we’ve spent 3.8 billion dollars in 2006, with more spending on the docket for 2007 (CRS), on a disease that doesn’t yet exist. The way the money’s being spent has also drawn fire—some have estimated that under the current plans, we won’t even be prepared until 2011. (Wired) Others note research that suggests that the drugs we’re stockpiling—the famous Tamiflu and Relenza—might not actually work that well against an avian flu pandemic (Lancet, BMJ). Not only that, but many are also frustrated that congress passed legislation largely freeing the companies that make these drugs from liability, should they cause adverse effects. (CRS)
What’s going on now?
The house and senate have already approved up to 2.3 billion dollars in discretionary spending on avian flu for 2007. (HR376) 100+ million of those dollars are up for debate now in the Agricultural appropriations bill (HR5384)--it's currently being debated in Senate committee.
Budget Caveat: As always with the budget, nothing's over 'till it's over, and everything could change really, really quickly.
It’s also worth noting that the first human-to-human case of avian influenza has been recently reported (NYT); however, it’s not the easily-transmissible variety of which everyone’s afraid. A child in Indonesia got it from a bird, and his father contracted it while caring for him in the hospital. However, none of the other family members or friends who saw the child caught the virus, so it seems that it can only be spread by close contact, and, as far as anyone knows, the virus mutated in the boy and so exists only in him.
The CDC has an extensive and fact-filled Avian Flu site.
*Word Geek note: The media has latched onto the term "pandemic," but not everyone's clear on what exactly that means, or how it's different from an epidemic. An epidemic is an outbreak of disease that spreads quickly within a specific population or community, but a pandemic is worldwide by definition--a global epidemic. ('Pan' in Greek means 'all,' and 'demos' means people, as in 'demo-cracy.' So, a pandemic affects all people.)
**Policy Geek note: The CDC claims that since many flu deaths are unreported, or thought to be just pneumonia, the hard numbers of reported deaths (far below the much-quoted 36,000 mark) are inaccurate. So they use a mathematical model to project what they consider to be the true number of deaths. Not everyone thinks this is a good idea, or accurate. For contrasting opinions on the issue, see this editorial by Harvard graduate student Peter Doshi in the British Medical Journal and a response to it, written by the CDC’s William Thompson.
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