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Fears of Global Bird Flu Outbreak Increase

Human Pandemic Would Kill Many Millions, But Crucial Facts Still Missing
WebMD Health News

Dec. 1, 2004 -- Last fall, a 26-year-old Thai woman spent the night holding her 11-year-old daughter in her arms. The little girl died after catching bird flu from an infected chicken. On Sept. 20, the mother died, too. She was the first known person to catch bird flu from another human being.

She may be far from the last. Officials at the World Health Organization (WHO) warn that millions of people, perhaps tens of millions, may die if the bird flu virus spreads among humans.

That isn't happening yet. It still takes very close contact with infected birds -- or, it seems with another infected human - for a person to catch the bird flu virus. It's a rare event. There have been only 44 known cases. Why the worry? Those 44 human cases resulted in 32 deaths.

"The great concern is there is an incredibly virulent avian flu that shows ability to jump to humans," Jeremy Farrar, MD, DPhil, tells WebMD. "And when it gets to humans, it is clearly a very nasty disease with a high mortality rate."

Farrar should know. He's director of the Oxford University Clinical Research Unit at the Hospital for Infectious Diseases in Ho Chi Minh City, Vietnam. Farrar's team recently described 10 cases of humans infected with bird flu, officially known as type A H5N1 avian influenza virus.

In an editorial appearing in the Dec. 2 issue of The New England Journal of Medicine, Farrar argues that efforts to combat a worldwide flu outbreak -- what public health officials refer to as pandemic influenza - should be top priority.

"The current situation is not a concern. There are not hundreds of people dying," Farrar says. "But this reminds us that avian influenza is not just a runny nose. It is a phenomenally destructive virus. If this came to be -- if this virus developed a more efficient way to jump from human to human -- you'd have a very virulent virus with high infectivity. It would be a very nasty global event."

The WHO is paying close attention, according to spokeswoman Maria Cheng.

"We are closer to a pandemic now than we were in the past," Cheng tells WebMD. "This is a virus that has the ability to jump to humans. As long as it circulates in animals, it will jump to humans. The more that happens, the greater the chance a human pandemic will occur. We think this is a very worrying situation. Now is the time to take action."

Bird Flu Virus Evolving

Why worry? In the 20th century, there have been three global flu pandemics. The first, the 1918 Spanish flu, was the worst. Coming on the heels of World War I, it killed between 20 million and 40 million people. Milder outbreaks in 1956 and 1968 killed about 1 million each.

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