See, it’s posts like this (and many of the comments that follow; hat tip to Mike) that make me worry about “bird flu.” I’m more concerned about the inaccurate information and attacks on those who work in the field (and the effect this may have on public acceptance of real public health advice) than I am about the actual virus at the moment. Too many people think avian influenza is either just “media hype” or a government conspiracy (one commenter even cited the oft-refuted notion that HIV was a man-made virus. Aargh). They downplay it because it’s killed relatively few people thus far, because we’ve known about it since 1997 and it’s not become easily human-to-human transmissible yet, because of the 1976 swine flu situation, because few Asian birds make it into America, because Americans aren’t in as close contact with farm animals, because predictions about other diseases have been wrong before. Thing is, we can’t always rely on history to predict the future. We’ve learned a lot from 1976, and as described at the link above, folks who deal with influenza today are well aware of the specter of the events that happened that year. That’s why we try to be careful to say that our predictions are just that–estimates based on the data available at the time. Those estimates might change as we get additional information, and we revise them accordingly. Bill Robinson seems to think this is a bad thing.
Additionally, just because it’s not become HTH transmissible *yet* doesn’t mean it never will. Revere over at Effect Measure has an excellent series of posts on mutations in the Turkish H5N1 strains (Part I, Part II, Part III, Part IV). As you can see, it’s a complicated issue, and we don’t know exactly what mutations are necessary to make one virus HTH transmissible. What we do know, however, is that several H5N1 viruses have mutations similar to ones we’ve seen with the 1918 strains, and others that are associated with increased virulence. It’s also shown up in species which generally aren’t susceptible to influenza–such as cats. It’s just a strange virus, and it’s killing people. Add this to the fact that it’s a highly mutable RNA virus of a species that, in “normal” years kills 36,000 Americans, and I’d hope one can see that there’s more to this than just Rumsfeld owning stock in Tamiflu, or Wolf Blitzer and Sanjay Gupta needing a disease crisis to talk about.
As far as the idea that we’re safe because of different influenza strains in American migratory birds, or different agricultural practices–those who point to that aren’t seeing the big picture. Sure, because migratory birds carrying H5N1 from Asia are less likely to make it to America than Europe, that makes us less likely for the virus to be introduced into our own poultry and cause an epidemic that way. I’ll agree (provided surveillance data of those birds bears this out). The problem is, however, if a HTH transmissible strain starts to spread in Asia, or Europe, or Africa, the birds are going to be the least of our concern. While Asian birds may have a tough time getting to America, Asian travellers–or American citizens in Asia, or Europe, etc.–do not. The concern currently isn’t about a de novo, highly pathogenic avian influenza virus arising in the U.S. (though theoretically, there’s no reason it couldn’t); it’s about it being brought over here by infected humans, and spreading like wildfire through our cities. Culling birds isn’t going to help us if that happens.
Anyhoo, just a bit depressing to see so much of the misinformation swallowed, and then people coming back for seconds. That just means that we have to work harder to correct it, which means more backlash due to additional stories on influenza, which means more accusations of conspiracy and “fear-based” politics…*sigh*