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To: Maurice Winn who wrote (53669)	9/25/2004 7:29:06 AM
From: Henry Niman	Respond to of 74559

Mquice, The 1918 flu pandemic is thought to have killed 20-50 million, so the virus clearly can become a major killer. Right now, its ability to transmit human to human seems somewhat limited. It seems likely that the same scenario happened in Vietnam last month recombinomics.com and Thailand this month recombinomics.com One or two family members were infected and the infection was transmitted to other family members who cared for them. The big problem is the fact that the H5N1 virus is becoming endemic to the area and recombining with other flu viruses such as the most prevelant H9N2 which is in migrating birds, and mammalian isolates like H1N2, which is in humans and pigs. recombinomics.com These recombinants can become more adapted to infecting mamals, like humans, and if a high transmission rate is acheived a catastropic pandemic can emerge. Right now WHO is looking for re-assortments (where entire genes are swapped), while the sequence data indicates that recomniation is the main driver. Thus, detection may come late, and once the virus takes off, it is very hard to control, especially if it infectious but virulent, and as you noted, avian flu is certainly virulent.