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World prepares for flu pandemic that could kill millions of people

*** "If you were going to have a pandemic this is how it would start. It emerges suddenly and infects a lot of people. It doesn't look good but it's an emerging situation." (John McCauley, National Institute For Medical Research) ***

How swine flu could be a bigger threat to humanity than nuclear warfare

When a new animal virus emerges in some crowded corner of the Third World and the experts start talking gravely about pandemics, the inevitable question is: How much should we worry?

Well, it probably isn't time, quite yet, to be heading for the hills but the emergence of a new and deadly strain of swine flu in Mexico is a matter of serious concern.

If we are lucky, we will see something like a rerun of the SARS or bird flu scares seen earlier this decade - scary but containable outbreaks of disease which have (so far) killed a few dozen to a few hundred people.

But if we are really unlucky, and experts stress that so far this is looking unlikely, we could be witnessing the beginning of a global catastrophe that could kill tens or even hundreds of millions.

For it remains the fact that in a world awash with new and exotic fears, from computer bugs to terrorist dirty bombs, old-fashioned infectious disease - particularly the numerous influenzas which infect humans, pigs and birds - probably still has the greatest capacity to kill the most people in the shortest time.

In 1918, the 'Spanish Flu' avian flu pandemic (which actually had nothing to do with Spain) probably killed between 50million and 100million, far more than the First World War. If something equally virulent and infectious were to emerge today it is possible that the toll would be even greater.

Firstly because the potential pool of infection is far larger. There are nearly four times as many humans alive today as in 1918. The world's cities are gargantuan (21million live in Mexico City) and the teeming slums of today's Third World, insanitary and packed with livestock, are textbook breeding grounds for any emerging new zoonose (a virus that spreads from animals to people).

Then there is travel. Nine decades ago, moving around the globe was time-consuming and expensive, and this alone helped to limit and slow the spread of disease. Today, probably one million passengers are in the air at any time, each potentially carrying a disease.

Already, reports of pig flu are coming in from as far afield as New Zealand and France. If a pandemic begins, governments will talk tough about sealing their borders and screening visitors at airports, but these measures will probably be too late.

Of course medicine is much better now than it was in 1918, but influenza is caused by a virus and we still do not have an effective cure for viral diseases.

Vaccination is possible but these influenza viruses mutate rapidly, mak-So we have to hope that the virus is not very deadly. The H5N1 Avian Influenza strain which hit the headlines five years ago killed about 60 per cent of its human victims, a very high mortality rate. An easily transmissible virus which killed this many would cause a devastating pandemic.

Fortunately, although H5N1 was deadly, it has not to date mutated into a strain which is infectious between humans.

To avoid disaster this new swine flu must either be relatively mild, or hard to transmit (or, preferably, both). Finally, we have to hope we have some natural immunity. The flu strains that come from animals can be particularly difficult to combat because humans often have no immunity against a virus which has previously affected only animals. Humans have none against the H5 viruses, increasing the pandemic potential dramatically.

So far it seems that the mortality rate for the H1N1 Mexican swine flu is around 1 per cent or so at most. This is uncertain, however, as although thousands have reported flu-like symptoms it is not known if they have definitely contracted H1N1.

It is possible that the 83 known deaths are drawn from a much smaller pool of infection, suggesting a higher mortality rate.

It also seems to be the case that H1N1, which normally circulates only between pigs (and is transmissible to humans only after contact with live animals) has mutated into a strain which allows human-to-human transmission.

This is bad news but the infection does seem to respond well to anti-viral treatments such as Tamiflu. The UK, which has a well-rehearsed pandemic strategy, has enough Tamiflu to treat 30million people. And even if this swine flu has pandemic potential, the fact that we are entering summer (when we are generally healthier and less vulnerable) should slow its spread in Britain probably long enough to develop a vaccine.

Finally, and most hopefully, it seems that humans have quite a lot of immunity to H1N1. But sooner or later something like the 1918 disaster will strike again.

Nothing, short of perhaps nuclear war, has such potential to kill so many. The humble virus, our oldest enemy, remains the most deadly of all.


Daily Mail, "How swine flu could be a bigger threat to humanity than nuclear warfare", 27 April 2009.


The Guardian, "Swine flu death toll exceeds 100 as pandemic fears grow", front page, 27 April 2009.
    World Health Organisation urges global vigilance
    US declares national health emergency
    Governments around the world are on high alert for a swine flu pandemic today as the death toll from the virus in Mexico rose to more than 100 and possible cases were reported as far afield as Israel, New Zealand and Scotland.
    The US has found 20 confirmed cases of swine flu: eight students in New York and other sufferers in California, Kansas and Texas.
    The WHO is likely to raise its pandemic alert level within days if more cases are confirmed. It will go to phase four if the virus shows sustained ability to pass from human to human, and to phase five if it is confirmed in two countries in the same region."Declaration of phase five is a strong signal a pandemic is imminent and that the time to finalise the organisation, communication, and implementation of the planned mitigation measures is short," the WHO said. Phase six is the declaration of a global pandemic.

Metro, "Swine flu 'could kill up to 120m'", 27 April 2009.
    The sudden rise of swine flu may trigger a pandemic that could wipe out 120million people, an expert has warned. More than 80 people are now thought to have died as the first scare hit Britain. The death toll of the H1N1 virus could reach 50million as high as the Spanish Flu of 1918, according to John McCauley, of the National Institute For Medical Research.
    He claimed the virus a contagious respiratory disease of pigs caused by type A influenza is much more similar to the Spanish Flu than the feared H5N1 bird flu.
    'It could be a similar death rate to back in 1918,' he said.
    'If you were going to have a pandemic this is how it would start. It emerges suddenly and infects a lot of people. It doesn't look good but it's an emerging situation.'
    Nigel Dimmock, Emeritus professor of Warwick university, warned that if the virus spreads around the world it could have a more lethal impact than in 1918 and wipe out 120million people.
    'I am worried but you don't want to panic too much it may go away,' he added.


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Tags: flu, pandemic, Swine Flu, epidemic, global, Mexico, Pig Flu, Porcine, Influenza, Mexico, prophecy, , conspiracy theories.

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