Tuesday, November 02, 2004

WHO Flu Summit

Partly because I'm getting tired of posting about politics (and we haven't even gotten to the recounts yet!)...

The World Health Organization will host representatives of vaccine manufacturers and of large nations (including the US) in Geneva, Switzerland on November 11 for a summit on the potential for an influenza pandemic.

The World Health Organization's influenza chief recently told the American Society for Microbiology that the world is closer than ever to a pandemic, a world-wide epidemic in which tens of millions of people die. Influenza normally kills about 36,000 people in the US and 1,000,000 worldwide every year, but a pandemic would push the global death toll into the tens of millions.

He said the bird flu is becoming established in Asia, and several worrisome human cases can't be linked directly to exposure to infected poultry. A pandemic is likely to develop when a flu strain changes so dramatically that people have little immunity from previous exposure.

Of course no discussion of influenza epidemics would be complete without mention of the influenza pandemic of 1918-1919, which killed between 20 and 40 million people, more than World War I. It is widely considered one of the most devastating epidemics in recorded world history. More people died of influenza in a single year than in four years of the bubonic plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe," the influenza of 1918-1919 was a global disaster. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years - particularly striking because this is the age range normally least affected. For more information on that particular epidemic, visit this page.

Also in the related realm of epidemiology readings, I recommend Laurie Garrett's excellent book The Coming Plague, which includes a thorough discussion of the 1918-1919 influenza epidemic. The focus of the book is on how global climate change and weakened public health systems (see also Laurie Garrett's Betrayal of Trust) have left us more open than ever before to the possibility of a devastating epidemic. Her thesis has already been partially borne out by the continuing spread in the US of West Nile Viral Encephalitis and other previously tropical (or rare) diseases.

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