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Avian Flu: 10 Questions, 10 Answers

What You Can Do; What the Government Is Doing
By
WebMD Feature
Reviewed by James E. Gerace, MD

Bird flu: What can you do? WebMD answers 10 common questions about bird flu.

1. Is a bird fluflu pandemic imminent?

Short answer: probably not. But there are many unknowns involved, making accurate prediction impossible.

Sooner or later, pandemic flu will happen. Flu pandemics sweep the globe from time to time as new flu bugs emerge. These bugs cause global epidemics -- pandemics -- because humans have little or no immunity to these viruses. Sometimes, as in the war-torn world of 1918, it's a terrible plague. Sometimes, as in 1957 and 1968, it's relatively mild.

Bird flu is still a bird disease. The H5N1 bird flu in Asia does not spread well from person to person. It's a leading contender to be the next pandemic flu bug because it has caused an unprecedented epidemic in poultry and wild birds across Asia and Eastern Europe. But nobody knows for sure whether this will be the flu that causes the next human pandemic.

Bird flu could become a human flu in two ways.

If a person were infected with a human flu and the bird flu at the same time, the two viruses could swap genes -- reassort -- and a human version of bird flu could emerge. This is what happened in the last two flu pandemics in 1957 and 1968.

Bird flu could also evolve into a form adapted to humans, as was the case in the 1918 flu pandemic. There's evidence the H5N1 bird flu virus has begun this process, but scientists say it isn't yet very far along. Nevertheless, a few H5N1 viruses isolated from humans have acquired some key 1918-like mutations.

At a World Health Organization news conference in May 2005, Klaus Stöhr, PhD, DVM, project leader for the WHO's Global InfluenzaProgram, was asked whether a bird flu pandemic is imminent.

"With this virus we have had very many surprises; we have had a very steep learning curve," Stöhr said. "We are seeing that it is changing very rapidly. We have also seen that it is not reassorting as everybody thought 18 months ago. So we do not know if a pandemic can occur next week or next year, or perhaps if another virus is going to cause a pandemic. We should simply continue with our pandemic preparedness."

2. Is there a cure for bird flu?

No. There's no cure for any kind of flu.

The H5N1 bird flu bug has been particularly deadly for people unlucky enough to catch it from poultry. But if the bug learns to spread among humans, it almost certainly won't be as deadly as it is now, says Ira Longini, PhD, professor of biostatistics at Emory University's Rollins School of Public Health in Atlanta.

"Avian H5N1 looks like a [very high] case fatality in humans. But this has never been true of any human strain," Longini told WebMD. "There has never been any human influenza virus that has behaved that way in recorded or even unrecorded history. The case fatality of even highly virulent flu strains are a couple of deaths per 10,000 people."

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