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Science

Flight H5N1, Ready for Take Off?

Posted by Hannah / October 12, 2005

canadian medical staff flu.jpgOctober marks the beginning of the sneezy season. It's time to stock up on Kleenex and debate the merits of getting a flu shot. But this year, everyone's attention is focused on that other flu and its potential for developing into a pandemic.

It's been just a smidge under 90 years since the last devastating flu pandemic. The 1918 influenza epidemic struck suddenly and spread swiftly. It originated at an army camp in Kansas, swept to the east and soon around the world, killing between 50 and 100 million people in far less than a year.

There is no doubt that there will be another flu pandemic. The question is when.

The Hitchhiker's Guide to the Galaxy got it right: Don't Panic.

The current strain of bird flu sweeping through Asia has killed millions of poultry. In addition to chickens, ducks and other fowl friends, it has infected pigs and killed tigers at the Bangkok zoo. It has also infected humans--not often--but when it does it is highly lethal. As of October 10, the WHO reported 117 confirmed human cases of avian flu and 60 deaths in four countries--Indonesia, Vietnam, Thailand and Cambodia.

Why do we care about a bird flu? A recent analysis of the 1918 flu virus showed that it probably originated in brids and that it contained several mutations that allowed it to directly infect humans. The concern with today's avian flu is that it already has some of these mutations. If it accumulates more it might jump more readily from person-to-person and cause a large outbreak.

One model estimates that 15-35% of Canadians would become ill and be unable to work or go to school for at least half a day, and as many as 138,000 would need to be hospitalized. There would be between 11,000 and 58,000 deaths in Quebec alone.

Are we prepared? Yes and no. A recent estimate suggests that an influenza pandemic might lead to 200,000 deaths in Canada. Unlike our neighbours to the south, the Public Health Agency of Canada has had a pandemic plan in place since early 2004. We're also ramping up vaccine production and should begin testing one early next year. Also, Ottawa will host an international conference October 24 and 25 to flesh out global cooperation in response to a pandemic.

But there has been a dearth of solid reporting about the Quebec and Montreal plans, and where the sick will be treated. With about 23% of the Canadian population living in Quebec, we'll likely need tens of thousands of hospital beds over the course of the pandemic. Combined, the MUHC and the CHUM currently have about 2800 beds. Perish the thought that the pandemic hits during the hospital reorganization.

Links to good information include Nature's web focus on avian flu and the Wikipedia entry. You can also find Declan Butler's fictional blog of the unfolding of a flu pandemic on the Nature website, and CanadaSue's lengthy proposal of what would happen in Kingston, ON at the first signs of H5N1 infection at the Flu Wiki.

And if you've got time on your hands, some good books:
The Great Influenza, by John M. Barry
The Coming Plague, by Laurie Garrett

Discussion

27 Comments

John Mac / October 12, 2005 at 10:05 pm
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Eeek. And I don't mean that in a funny headline sense.<br><br>OK, but tell me more about the vaccines. Is mine in the mail.
John Mac / October 12, 2005 at 10:05 pm
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Eeek. And I don't mean that in a funny headline sense.

OK, but tell me more about the vaccines. Is mine in the mail.
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