This is a guest post by Bam Bam
Well I started off writing a nice little piece about being prepared for the 2011-2012 flu season. We have a lot of new pack members so I thought it would be good to do a basic write up on what you need to stock in preparation for flu season. I did the necessary research and started writing. But I stumbled across something that doesn’t make sense. Two and two are not adding up. The CDC and WHO report that H5N1 does NOT pose a significant threat to the human populations; yet governments around the world are spending billions preparing for it.
H5N1 is also known as the “bird flu”. On December 20, 17,000 chickens were culled at a poultry market in Hong Kong after a dead chicken tested positive for (the non-airborne strain of) the virus.  Although the chicken tested positive for the non-airborne strain, governments around the world have been preparing for H5N1 to go airborne.
In Indonesia, for example, the Health Ministry has opened the country’s first isolation rooms with negative pressure. To quote the article at length:
“Health Minister Endang Rahayu Sedyaningsih said that the newly developed airborne infection isolation facilities in Tangerang Regional Hospital in Tangerang, Banten, and in Persahabatan Hospital in Jakarta, were specifically designed to help contain avian influenza outbreaks in the country.
Human fatalities from H5N1 or “bird flu” virus were mostly caused by delayed diagnosis and improper treatment, she said.
“By developing such airborne infection isolation rooms, we hope that hospitals can offer better treatment for patients infected by the virus so that we can reduce bird flu-related deaths,” she said on the sidelines of a ceremony to hand over the two isolation rooms from the World Health Organization (WHO) to the Health Ministry in Tangerang.”
If you are thinking two and two are not adding up, you are right. (I don’t think they are building such facilities to house infected chickens.)
Let me give you a bit of history on H5N1. This strain of the influenza virus spread from wild birds to poultry. The virus is found worldwide.  This strain (at this point in its evolution) causes high death rates in birds but is not easily transmitted to humans. However, humans that are in close contact with infected birds can contract the disease. When humans contract the disease, mortality rates are 60 percent. 
(Note: The hoopla in the media this past week was about scientists in the U.S. and the Netherlands who have created an airborne strain of H5N1. In essence, scientists have created an influenza virus which can be easily transmitted from human-to-human and which kills 60 percent of those it infects. The ethical question, of course, is whether the research should have been done in the first place and whether the U.S. government should have funded the research. The NIH (National Institute of Health funded the research.) There are good arguments on both sides of this debate.)
CDC/WHO: Don’t Worry, H5N1 Rarely Infects Humans
Let me be a bit more precise when I say that two and two are not adding up. On the one hand we are told that H5N1 only rarely infects humans. (Deaths have been reported in 15 countries.) And yet governments around the world are spending billions to prepare for an H5N1 pandemic. We seem to have a contradiction.
Let us examine each claim in more detail. I begin with the claim that H5N1 rarely infects humans (and therefore should not pose a grave threat to humans). Here’s what the CDC has to say. Again, I quote at length.
“The majority of H5N1 cases have occurred among children and adults younger than 40 years old. Mortality has been highest in cases aged 10-19 years old. Most human H5N1 cases have presented late to medical care and have been hospitalized late in their illness with severe respiratory disease. However, some clinically mild H5N1 cases have been reported, especially in children. Clusters of human H5N1 cases ranging from 2-8 cases per cluster have been identified in several countries. Nearly all of the cluster cases have occurred among blood-related family members, especially those living in the same household. Whether such clusters are related to genetic or other factors is currently unknown. While most people in these clusters have been infected with H5N1 virus through direct or close contact with sick or dead poultry or wild birds, limited non sustained human-to-human transmission of H5N1 virus cannot be excluded and likely occurred in some clusters.
The current cumulative number of confirmed human cases of highly pathogenic avian influenza A (H5N1) is available on the WHO Avian Influenza website. Despite the high mortality, human cases of H5N1 remain rare to date.” 
If you follow the link to the WHO Avian Influenza website, you will learn that the “evolution of H5N1 avian influenza virus does not increase risk to public heath.”  The above, if true, would indeed lead us to conclude that the avian flu does not pose a grave threat to the human population.
Governments Spending Billions To Combat H5N1
Why, then, are governments around the world spending billions of dollars preparing for the avian flu? Let us begin by citing the facts. According to a 2006 report by The New York Times, governments across the world are spending billions preparing for a flu pandemic. “Governments worldwide have spent billions planning for a potential influenza pandemic: buying medicines, running disaster drills, developing strategies for tighter border controls.”
A 2006 congressional report entitled “U.S. and International Responses to the Global Spread of Avian Flu” notes that the U.S. government has spent billions to combat avian flu.
“For FY2006, Congress has provided $25 million for global initiatives to prepare for pandemic influenza through Foreign Operations appropriations; directed $33.5 million to global disease detection through Labor, HHS, and Education appropriations; and reserved for international avian flu efforts a portion of $3.8 billion through Defense appropriations. Bills introduced in the 109th Congress would increase U.S. resources allocated to the global fight against avian flu; develop a “Pandemic Fund” to augment ongoing U.S. and international avian flu and pandemic preparedness initiatives; increase funding for preventing the spread among animals of the H5N1 virus; and strengthensurveillance capacity within affected countries.” 
A 2009 congressional report entitled “Global Health: USAID Programs and Appropriations from FY2001”
“Concerns about a possible influenza pandemic also prompted increased appropriations to USAID’s global health programs between FY2004 and FY2008. In FY2005, Congress began providing emergency supplemental funds for U.S. technical assistance efforts related to global pandemic influenza preparedness and response. Those funds have been used to train health workers in foreign countries to prepare for and respond to a pandemic that might occur from any influenza virus, including H5N1 avian flu and the newly emergent influenza virus, H1N1 “swine flu,” which was characterized as a pandemic by the World Health Organization (WHO) on June 11, 2009 (discussed below). Influenza A/H5N1 is one of many strains of avian influenza that can cause illness in poultry and has killed about 60% of the people who have contracted the virus. Bird (or avian) flu outbreaks have occurred at various times around the world. Until 1997, there were no known human H5N1 cases. That year, 18 people in Hong Kong contracted the virus, including 6 who died. To contain the virus, 1.5 million birds were killed. Since 2003, when the virus resurfaced and killed four people, scientists have closely monitored resurgent H5N1 outbreaks. As of July 30, 2009, the last human H5N1 case was reported to WHO on July 1, 2009, with a total of 436 people having contracted the virus, of whom 262 died.
The State Department announced in October 2008 that the United States has pledged nearly $950 million to international avian and pandemic influenza efforts, accounting for 30.9% of overall international donor pledges of $3.07 billion since 2005. The funds have been used to support international efforts in more than 100 nations and jurisdictions. The assistance focused on three areas: preparedness and communication, surveillance and detection, and response and containment.”
If the avian flu is not readily transmitted to humans, why is the government spending billions in preparation for an avian flu epidemic? Why did the U.S. government (National Institute of Health) fund research to create an airborne strain of H5N1?  The U.S. government is now asking the scientists who made it to keep mum.
“The discovery has led advisers to the United States government, which paid for the research, to urge that the details be kept secret and not published in scientific journals to prevent the work from being replicated by terrorists, hostile governments or rogue scientists.” 
To add another piece to the puzzle, the scientists who created the airborne strain were surprised at how easy it was to engineer—it only took five mutations. “What shocked the researchers was how easy it had been, Dr. Fouchier said. Just a few mutations was all it took to make the virus go airborne.” Even more disturbing is that four out of the five necessary mutations already exist in Egypt. Fact: The world is one mutation away from the deadliest infection the world has ever seen.
Some scientists are already raising red flags. Hong Kong virologist Kwok-yuen, M.D., recommends that governments around the world prepare for the pandemic. We currently have no vaccine for H5N1 and the anti-viral medications commonly used to treat influenza such as Tamiflu are not effective against H5N1.
A mutant or reassortant virus capable of efficient human-to-human transmission could trigger another influenza pandemic. The recent isolation of this virus in extrapulmonary sites of human diseases suggests that the high fatality of this infection may be more than just the result of a cytokine storm triggered by the pulmonary disease. The emergence of resistance to adamantanes (amantadine and rimantadine) and recently oseltamivir while H5N1 vaccines are still at the developmental stage of phase I clinical trial are causes for grave concern. Moreover, the to-be pandemic strain may have little cross immunogenicity to the presently tested vaccine strain. 
As one scientist has concluded, “This research brings H5N1 viruses to the very top of the ones we should be concerned about,” said Richard Webby, a virologist who studies flu pandemics at St. Jude Children’s Research Hospital in Memphis, Tenn.” 
Let me emphasize this point. The world is one mutation away from seeing a flu epidemic that could very well kill 60 percent of the world’s population. The CDC and WHO have gone on the record to say that increased incidence of avian flu among birds does not pose a threat to the human population. This strikes me as manifestly false. As the population of infected birds increases, there is increased interaction between infected birds and humans. With increased interaction between humans and infected birds, the probability of mutation increases. Now, no scientist can predict which mutations will occur. But we all know that the more humans interact with infected birds, the greater the risk of a mutation.
The foregoing includes me to conclude that the government has been sitting on this information since at least 2006. This explains why world governments have spent billions in preparation for a deadly avian flu pandemic. This explains why the NIH funded studies to create the virus in a laboratory setting. Scientists must have a sample of the virus before they can engineer a vaccine. This much makes sense. But why would the government keep its citizens in the dark, claiming that the avian flu did not pose a risk to the human population? The best answer I can come up with here is that the government did not want a panic on its hands.
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