WE'RE FLU'D
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WWW.NYPRESS.COM | MARCH 2, 2005
THE NEWS HOLE
"The world is now in the gravest possible danger of a pandemic," the World Health Organization's Shigeru Omi said last week, prophesizing a pestilence that may make the Black Plague look like a recreational club drug. Ladies and gentlemen, welcome to the super-flu, which may just solve New York City's pesky overcrowding problem.
In a healthy virus cycle, pandemics (diseases that affect at least 25 percent of the world's population) occur every 20 or 30 years. They wreak havoc, then burn out and disappear. Kind of like forest fires. Only there hasn't been a flu pandemic since 1968. That means a lot of kindling is waiting for a spark.
The super-bug comes from China, the great pandemic breeding ground. On Chinese farms, ducks and pigs (virus carriers) live together directly beneath people. If the virus reassorts and infects farm workers, it's a short leap to the general population. The super-flu first popped up in 1997 in Hong Kong poultry, killing chickens quicker than workers could slit their throats and turn them into two-piece meals. The virus was known as avian flu H5N1 or "chicken Ebola"—infected chickens died within 48 hours due to massive, bloody hemorrhaging. Nearly 100 percent of stricken fowl died. Worse, the virus jumped the species barrier, infecting 18 humans, of whom six died.
"Bird viruses live in the guts of birds. They should not infect people," says flu specialist Dr. Jack Bernstein, my father, and chief of infectious diseases at the Veteran Affairs Medical Center of Dayton, Ohio. There are three major flu strains, Bernstein says, which vary to certain degrees. For the most part, we've been exposed to these strains and have developed some antibodies. Avian flu, however, serves as an antigenic shift—a departure from any known strain.
"And humans don't have a smidgen of immunity for avian flu."
In response to the threat, China and its Asian neighbors culled and incinerated millions of ducks and fowl. H5N1 disappeared. Until 2003, that is. In December of that year, H5N1 popped up in Korea. Then Vietnam. Then Thailand. As of last week, 46 people have succumbed to avian flu, at a mortality rate (so far) in excess of 70 percent.
Flu is an inefficient murderer, preying on the elderly and infirm. Death (occurring in 0.1 percent of cases) is caused by a lethal pneumonia, which plays sloppy seconds to the initial infection. But the 1918 to 1919 Spanish flu was a nasty sumbitch, killing patients at about a 2.5 percent clip: The virus, like the avian flu, caused uncontrollable hemorrhaging. Patients literally drowned on their frothy blood.
More disturbing, Spanish flu flipped infection patterns: Instead of selecting gramps, the influenza had a taste for healthy adults. Ninety-nine percent of the people who succumbed were younger than 65. When the flu finished its rampage, nearly a fifth of the world's population had been infected. Upward of 40 million people died, including about 675,000 Americans. By contrast, only around 8 million people died in World War I.
Such mortality tallies may soon seem trivial. If H5N1's pathogenic potential (i.e., how well it kills) proves to be half as effective as that of the Spanish flu and the virus mutates to efficiently spread between humans (there's already been one case: an 11-year-old Thai girl infected her mother, killing them both) we could enter an epidemiological apocalypse. World Health Organization officials predict, in an optimistic scenario, two to seven million people worldwide would die. The toll could reach 100 million.
In other words, bye-bye Big Apple.
According to Bernstein, within days of the first super-flu case hitting New York City, hospitals would be overwhelmed. Tent cities could form in the streets. Then, if the doctors and police officers started dying, anarchy, martial law and looting would ensue. "It'll be just like the good old days," he says.
"To stop the virus from spreading, you'd have to lock down the city in a 28 Days Later–like dramatic quarantine," according to Bernstein. The flu would eventually burn out, he says, but how many people would perish first?
"Influenza has been known to wipe out entire islands," he notes.
If the scenario sounds pretty bleak, it is. We're stuck in a waiting game, not knowing when the flu might hit, if it can infect humans or its murderous capability. It could be as harmless as a minor cold. Or it could be a cataclysmic population cleansing. If that's the case, then expect to suffocate on your blood while ducks and fowl quack and cluck their sweet revenge: payback for eons of breakfast, lunch and dinner.
—Joshua M. Bernstein
Volume 18, Issue 9
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