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Garrett warns of bird flu threat
By KEVIN FRYLING
Reporter Contributor
An expert on global health care speaking at UB on April 6 called a potential bird flu outbreak in humans the "greatest disaster man has ever faced." Science and health writer Laurie Garrett—winner of all three major awards in American journalism: the Pulitzer, the Peabody and the Polk—outlined the complex intersection of socio-political, environmental and economic issues involved in the threat from the H5N1 virus, or "bird flu," during a lecture as part of the UB Distinguished Speakers Series.
"We are at a whole new scale of complexity and risk confrontation," Garrett said. "It is a scale that requires not only a new invention of global and public health, but a new invention of global international political cooperation."
The Graduate Student Choice speaker said global conflicts and foreign policies often deter the preventive measures that must be taken to curtail global disaster. She said current disputes about Iran's nuclear program bar international health workers from going inside the nation's borders, and outbreaks of bird flu in Iraq cannot be traced due to war. Morever, she said China remains a "big black box" in terms of bird flu transparency.
"We're trying to deal with a global problem, but we can't get by our nationalistic disputes," she said.
Garrett said U.S. Rep. James Leach (R-Iowa) is just one leader who has called pandemics such as bird flu and HIV a greater threat to the world than terrorism.
The death rate from H5N1 has been estimated at 50 percent, Garrett said. At the moment, the virus transmits from birds to humans. Even if a human-to-human mutation reduced its impact to 5 percent, she said it remains more powerful than the 1918 influenza pandemic, whose 2 percent death rate killed 700,000 people in the U.S. alone. Estimates from the Centers for Disease Control and Prevention put global deaths in 1918 at about 50 million.
Garrett said current science indicates the 1918 outbreak also originated in birds.
"No one in this room could mount a response to H5N1," Garrett said, noting that the virus is so unlike regular flu that the immune system launches a cytokine storm, or "thermonuclear response"—which, she said, can cause patients to drown in their lung's own fluids.
The first occurrence of bird flu was recorded in China in 1995. It was the official position of the Chinese government not to release information on the outbreak, so the world did not learn of the threat until six deaths were reported in Hong Kong in 1997. A similar cover-up took place in China with SARS in 2002, she said.
Garrett said international communication is critical because it is difficult to contain bird flu in a modern mobile society. She compared this to the pre-commercial-air-travel influenza outbreak in 1918. Moreover, the 17-day incubation period of H5N1 differs from that of the common 24-hour flu virus and adds to its potential to spread.
Garrett said outbreak of the virus in African fowl is a great concern. The combination of poor public health infrastructure in Africa and the presence of a current pervasive pandemic—HIV/AIDS—could present a watershed moment in the evolution of the virus.
"A person with HIV cannot mount this huge immune response," she said. This could result in "a permissive host in which the virus can thrive and perhaps mutate into a rapid human-to-human transmitter."
Garrett said HIV/AIDS is an example of how social attitudes can add to a failure to prevent a virus' spread. The disease went untreated because it was pushed off on marginalized populations—with officials claiming it was limited to prostitutes and homosexuals.
It remains the official position of the South African government that AIDS is not a problem, in spite of a 66 percent infection rate in some female populations, she said.
Environmental issues also are a factor in the spread of bird flu. Recent development in China has meant "huge industrial growth at the expense of the landscape," she said, which affects avian migration routes due to reduced wetlands. There was a massive die-off of birds at a major migration intersection at Lake Qinghai last May.
Garrett adds that an outbreak of H5N1 poses a foreign relations dilemma because the global stock of the vaccine TAMIFLU is scare and its production is limited to the world's nine richest nations. She also is skeptical it is a viable vaccine.
In terms of economics, the World Bank estimates the international losses associated with an outbreak at $1.3 trillion.
Garrett said there were reports of H5N1 in Russian birds in February. She predicts the virus will be found in Greenland and Iceland in June and soon after in northern Canada.
Now is not the time to panic, she cautioned. "Right now, this is a bird virus. There is no evidence you can contract H5N1 from cooked chicken."
But, she said, all nations—rich and poor—must learn to work in concert to prevent an outbreak. The threat demands the formation of a "global cooperative community."
"We've all got to stick together, no matter what our bank accounts," she said.