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What does the poultry industry think about the possibility of its own industry leading to a worldwide epidemic that kills millions of people?  

The Executive Editor of Poultry magazine wrote an editorial on that very subject in its April/May 2005 issue: "The prospect of a virulent flu to which we have absolutely no resistance is frightening. However, to me, the threat is much greater to the poultry industry. I'm not as worried about the U.S. human population dying from bird flu as I am that there will be no chicken to eat."[1]

Update: June 2005 Early in 2005, the head of the World Health Organization in Asia held a press conference. He said: "The world is now in the gravest possible danger of a pandemic."[2]

According to the World Health Organization (WHO), the situation is now even graver.

The WHO convened an emergency meeting last month, May 2005, to discuss the latest findings. They issued a press release: "[The findings] demonstrate that the viruses are continuing to evolve and pose a continuing and potentially growing pandemic threat."

There are three essential conditions necessary to produce the next pandemic. First, a new virus arises from a nonhuman animal reservoir (such that humans have no natural immunity to it). Second, the virus evolves to be able to kill human beings efficiently. Third, the virus must evolve to be able to spread between humans easily--via a sneeze or handshake. So far, conditions one and two have been met in spades. Three strikes and we're out.

At this time, nearly all of the human deaths have "involved people who lived or worked with poultry, poultry meat or eggs in Southeast Asia."[3] USDA researchers tested thigh and breast meat in chickens and effectively proved in a study published March 2005 that chicken meat from infected birds can indeed be a source of infection.[4] While UN officials have urged people to stop drinking duck's blood[5] and eating "tiet canh" (congealed duck blood pudding) the fear is that once bird flu has enough chances to mutate inside of human hosts, it can then flood across the world human-to-human like the bird flu epidemic did in 1918.

The global mortality from the 1918 pandemic has recently been revised upwards to as many as 100 million people dead.[6] Experts fear this new virus may turn out many times more deadly. "This is the worst flu virus I have ever seen or worked with or read about," one virology chair who has been studying avian influenza strains for decades told a reporter. "We have to prepare as if we're going to war and the public needs to understand that clearly... if this does happen, and I fully expect it will, there will be no place for any of us to hide. Not in the United States or in Europe or in a bunker somewhere. The virus is a very promiscuous and efficient killer."[7] The top Russian virologist offers a potential death count: "Up to one billion people could die around the whole world in six months... We are half a step away from a worldwide pandemic catastrophe."[8]

Dr. Michael Osterholm, director of the U.S. Center for Infectious Disease Research and Policy, is probably our nation's top expert. He continues to make attempts to describe the ensuing unimaginable horror. He suggests people consider the devastation of the recent tsunamis in South Asia: "Duplicate it in every major urban centre and rural community around the planet simultaneously, add in the paralyzing fear and panic of contagion, and we begin to get some sense of the potential of pandemic influenza.[9] An influenza pandemic of even moderate impact will result in the biggest single human disaster ever--far greater than AIDS, 9/11, all wars in the 20th century and the recent tsunami combined. It has the potential to redirect world history as the Black Death redirected European history in the 14th century."[10]

"Nature" is considered by many to be the most prestigious scientific journal in the world. They commissioned their senior reporter in Paris to write a fictional yet realistic account of how the pandemic could be expected to unfold. Writing as a blogger in December 2005, it's fiction, but not fantasy. Read it in full at www.nature.com/news/2005/050523/full/435400a  .

According to the top experts in the world, these bird flu scenarios are not just Chicken Little stories. "We're not crying wolf," swears Canada's top expert, head of the national microbiology lab. "There is a wolf. We just don't know when it's coming."[11] The head of the CDC's International Emerging Infections Program in Thailand agrees: "The world just has no idea what it's going to see if this thing comes," he said, but then stopped. "When, really. It's when. I don't think we can afford the luxury of the word 'if' anymore. We are past 'if's."[12]

So what can we do? Almost all of the antibiotics ever created only work against bacteria. There are a few classes of drugs, including drugs like amantidine, that work against certain viruses as well. But the present bird flu virus has already evolved resistance to this first generation of antivirals. How? "The Chinese have been incorporating amantadine in their chicken feed, so we have lost that as a treatment," notes one U.S. flu expert.[13]

Scientists are pinning their hopes on oseltamavir (also known as Tamiflu), the best prospect in the latest generation of antiflu drugs. Unfortunately, there is not enough to go around. Made from star anise, a plant in limited global supply, there is now a two-year waiting list for new orders.[14] And the orders, of course, are coming from dozens of rich Western countries who are attempting to stockpile the drug,[15] not the poor countries like Vietnam where any pandemic is likely to start.

"The only effective way to stop a global pandemic is to stop it in Southeast Asia," writes the editorial board of the journal of the Canadian Medical Association. "Although likely to have only a limited effect, stockpiles of oseltamavir need to be created throughout Southeast Asia." Scientists reason that if the human outbreak can be caught early enough, maybe they could even stop it. Once the pandemic hits, writes one leader in the field, "School closure, quarantine, travel restrictions and so on are unlikely to be more effective than a garden hose in a forest fire."[16]

It's like a spark and a squirt gun, describes the director of the U.S. National Vaccine Program. "If you aim properly you can get the spark and be done with it. If you miss, though, the fire is going to spread and there is nothing you can do to stop it."[17] When a senior public-health official was asked if he could imagine the developed world sending its resources to combat the flu in Southeast Asia, the reply was, "Who are you kidding?"[18]

The Western world is continuing in its "narcissistic planning,"[19] ignoring pleas from the World Health Organization to pour resources into Southeast Asia.[20] The U.K., for example, is spending $700 million to stockpile antiviral drugs. That's ten times the entire health budget for Vietnam. In Cambodia, the total annual budget for a campaign to encourage citizens to report suspected cases of bird flu is about $3000.[21]

Once the outbreak spreads globally, though, stockpiles in rich countries will provide no more than a pandemic "speed bump."[22] Canada, for example, has ordered 20 million doses although they suspect they'd need more than 200 million.[23] Who's going to have access to the limited supply? Priority for prophylactic treatment goes first to "key decision makers."[24] The current U.S. stockpile would treat less than 2 percent of the population.[25] Some scientists are advocating it just be sold over the counter and let whomever can afford it have access.[26]

From the editorial board of one of the most prestigious medical journals in the world, "If the greatest pandemic in history is indeed on the horizon, that threat must be met by the most comprehensive public-health plan ever devised."[27] If one reads the behind-the-scenes policy journals like Foreign Affairs, though, senior officials admit that planning for what they call "the most catastrophic outbreak in human history" is "abysmally inadequate."[28] Realizing that given the current political situation the prospects for preventing the pandemic are practically nonexistent, chief scientists like Osterholm are going to the business community to at least work on providing an infrastructure for survivors of what is being predicted in policy journals as the "shutdown of the global economic system."[29]

Speaking to a conference of agricultural bankers, Osterholm laid it all out: "This is going to be the most catastrophic thing in my lifetime. When this situation unfolds, we will shut down global markets overnight. There will not be movement of goods; there will not be movement of people. This will last for at least a year, maybe two."[30]

If we can't stop a human outbreak once it's started, can we stop a human outbreak in the first place? The WHO advises that "[p]revention of... avian influenza in humans is best achieved by controlling infection in poultry." [31] At this stage though, with over a hundred million birds dead so far and confirmed spread into migratory wild bird populations, this prospect seems similarly untenable. [32]

Asia provides a veritable genetic-reassortment laboratory for the virus--the mix of an unprecedented number of people, pigs, and poultry. "It is sobering to realize," Osterholm writes, "that in 1968, when the most recent influenza pandemic occurred, the virus emerged in a China that had a human population of 790 million, a pig population of 5.2 million, and a poultry population of 12.3 million; today, these populations number 1.3 billion, 508 million, and 13 billion, respectively. Similar changes have occurred in the human and animal populations of other Asian countries, creating an incredible mixing vessel for viruses."[33] In that kind of environment, New Yorker reporter Michael Specter wrote that "one sneeze from a pig could be enough to start a pandemic."

Large commercial poultry operations provide an ideal spawning ground for new pandemic strains. Tens of thousands of broiler-type chickens are crammed into large sheds. Because they live in their own manure, the virus has an opportunity to be excreted in the feces and then breathed in or swallowed by the thousands of other birds, allowing the virus to rapidly and repeatedly circulate. With so many birds to mutate within and pass back and forth, low virulence strains can readily turn into deadly ones.[34]

Describing another deadly animal-to-human virus that arose in Asia, this one in 1999, the Thai Minister of Public Health explains: "A hundred years ago, the Nipah virus would have simply emerged and died out; instead it was transmitted to pigs and amplified. With modern agriculture, the pigs are transported long distances to slaughter. And the virus goes with them." And countries trying to protect their poultry industries have covered up their outbreaks, making it that much more difficult to stem the tide early.[35]

Charun Boonyarithikarn is another senior Thai public-health officer. "Chickens used to live in our backyards," he told a New Yorker reporter. "They didn't travel much. Now, throughout the world, farms have become factories. Millions of chickens are shipped huge distances every day. We can't stop every chicken or duck or pig. And they offer millions of opportunities for pathogens to find a niche."

Dr Samuel Jutzi of the Food and Agriculture Organization told the conference: "There is an increasing risk of avian influenza spread that no poultry-keeping country can afford to ignore."[36] Vietnam has already banned duck and goose farming, but this may be a case of too little too late.[37] Another pandemic may force humanity to realize that it may have to give up the habit of raising birds completely.

In response to the February 28, 2005 lead New Yorker story on the threat of bird flu, staff writer Michael Specter was asked if, based on his research, we would "have to rethink such things as large-scale poultry farming?" He replied "Well, I can't imagine a better prescription for killing large numbers of animals with a single disease than packing tens of thousands of them into factory farms where they are lucky if they have fifteen inches of personal space. Still, the economic incentives toward factory production of food are huge--we want cheap meat. So it's going to be very difficult to change."[38]

[1] Thaxton YV. "Are you Prepared for AI?" Poultry April/May 2005:5.

[2] Schuettler D. "World Must Act on Bird Flu or Face Pandemic -- U.N." Reuters 23 February 2005.

[3] Editorial. "Avian influenzavirus: Are we prepared?" Canadian Medical Association Journal 172(2005):965.

[4] Swayne DE and JR Beck. "Experimental study to determine if low-pathogenicity and high-pathogenicity avian influenza viruses can be present in chicken breast and thigh meat following intranasal virus inoculation." Avian Diseases 49(2005):81-5.

[5] Schuettler D. "Asia's Bird Flu Here to Stay, FAO Says." Reuters 23 February 2005.

[6] Johnson NPAS and J Mueller. "Updating the Accounts: Global Mortality of the 1918-1920 "Spanish" Influenza Pandemic." Bulletin of the History of Medicine 76(2002):105-115.

[7] Specter M. "Nature's Bioterrorist." New Yorker 28 February 2005: 52-61.

[8] "Russian Expert Says Flu Epidemic May Kill Over One Billion This Year." Moscow News 28 October 2004.

[9] Kennedy M. "Parallels with the 1918 Spanish flu outbreak." National Post 9 March 2005.

[10] "Bird Flu Could Kill Millions" The Gazette (Montreal) 9 March 2005:1A.

[11] Kennedy M. "Parallels with the 1918 Spanish flu outbreak." National Post 9 March 2005.

[12] Specter M. "Nature's Bioterrorist." New Yorker 28 February 2005: 52-61.

[13] "Can Tamiflu save us from bird flu?" New Scientist 2 June 2005.

[14] "Roche faces Tamiflu production bottleneck following WHO bird flu warning." Forbes 29 May 2005.

[15] "Can Tamiflu save us from bird flu?" New Scientist 2 June 2005.

[16] Editorial. "Avian influenzavirus: Are we prepared?" Canadian Medical Association Journal 172(2005):965.

[17] Specter M. "Nature's Bioterrorist." New Yorker 28 February 2005: 52-61.

[18] Specter M. "Nature's Bioterrorist." New Yorker 28 February 2005: 52-61.

[19] Editorial. "Avian influenzavirus: Are we prepared?" Canadian Medical Association Journal 172(2005):965.

[20] "WHO's call for international pandemic action unheeded." Canadian Medical Association Journal 172(2005):1429.

[21] Ibid.

[22] "Feds to stockpile antivirals as pandemic 'speed bump.'" Canadian Medical Association Journal 172(2005):1428.

[23] Ibid. [24] Ibid.

[25] Fox M. "U.S. still unprepared against new flu, experts say." 26 May 2005.

[26] Laver G. "Influenza drug could abort a pandemic." Nature 434(2005):821.

[27] Editorial. "Avian influenza: perfect storm now gathering?" The Lancet 365(2005).

[28] "Q&A with Laurie Garrett." Foreign Affairs July/August 2005.

[29] Osterholm MT. "Preparing for the Next Pandemic." Foreign Affairs July/August 2005.

[30] "Bird Flu Seen as the Next Pandemic." Star Tribune (Minneapolis) 16 November 2004.

[31] Center for Infectious Disease Research and Policy. "WHO: flu pandemic threat may be growing." 18 May 2005.

[32] Schuettler D. "Asia's Bird Flu Here to Stay, FAO Says." Reuters 23 February 2005.

[33] Osterholm MT. "Preparing for the Next Pandemic." New England Journal of Medicine 352(2005):1839-42.

[34] HorimotoT and Y Kawaoka. "Pandemic threat posed by influenza viruses." Clinical Microbilogy Reviews 14(2001):129-49.

[35] Specter M. "Nature's Bioterrorist." New Yorker 28 February 2005: 52-61.

[36] "WHO warns of bird flu pandemic" BBC 23 February 2005.

[37] Piller C. "Vietnam officials ban duck, goose farming to staunch bird flu." Los Angeles Times 5 February 2005. [38] Specter M and B Greenman. "Fighting the Flu." New Yorker Online. 21 February 2005.

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