ABCNEWS: 50% CHANCE BIRD FLU WILL GO H2H

ExaminedLife wrote: Has anyone put out a model showing it would be that lethal in human pandemic form in areas lacking comprehensive medical care, though? I thought that the mortality rate in developing nations is around 55%, even absent medical intervention.

And as far as I can tell anyone getting infected now is getting some medical care as the rate of infection is still so low that the numbers aren't so great as to overwhelm what medical care there is that exists in developing countries.

SophiaZoe, I went back to listen to it again (thanx to DVR) and this is exactly what he said.

World News Tonight   on ABC  March 14, 2006

narrator (and interviewer) for the piece is Jim Ovilar(sp?)

Dr. Robert Webster was introduced as "the father of bird flu".  He discovered (bf) 8 years ago in China. Collecting the virus and the cells they live on in his Memphis lab.

narrator. Dr. Robert Webster is one of the few bird flu experts confident enough to answer the key question:

narrator:  "Will the Avian flu switch from the terrible hazard for the world's birds and become a real threat to humans?"

Dr. Webster:  "About even odds, at this time, for the virus to learn how to transmit human to human."

narrator:  "Right now Avian H5N1 is strictly a bird flu. It can be transmitted from bird to human but only by direct contact with the droppings and excretions of birds. But viruses morph and the big fear among the world scientists is that the bird virus will join the human virus, change it's genetic code and emerge a new and deadly flu that can spread airborn directly from human to human."

Dr. Webster:  "I personably believe that it will happen and make personal preparations."

narrator:  "Dr. Webster has stored three months of food and water at his home to prepare for an outbreak."

Dr. Webster:  "Society just can't accept the idea that 50% of the population could die. I think we have to face that possibility. I'm sorry that if if I'm making people a little frightened, but I feel that it's my role."

narrator: "Most scientists won't say it that bluntly, but most acknowlege that Webster could be right. Even though they believe that the 50% figure could be too high. Here in New York one reknown researcher says that the human form may not mutate this year or next or ever but it would be foolish to ignore the dire consequences." 

narrator: (looking at a monitor in a lab whose screen was black with lots of pink dots) "So this is bad."

Dr. Anne Moscona: "This is bad, alot of virus has gotten in."

narrator: "No one knows how long or how many mutations it would take for bird flu to become a direct threat to humans."

Dr. Anne Moscona (NY Presbyterian Hospital/Weil Cornell):  "It may not do it. It may just be too many changes. This virus may not be able to be a human virus."

narrator: "But that hasn't stopped Dr. Anne Moscona from desperately searching for new types of anti-viruls that both prevent and slow the spread of bird flu."

Dr. Anne Moscona: "Well I don't think that once we have human to human transmission it's going to be possible to contain it."

narrator : "Which is why nearly every virul scientist in America, perhaps the world, is waiting, watching the avian flu virus to see if it remains a terrible threat to birds or changes it's DNA and becomes just as deadly to humans.  Jim Ovalar, ABC News, New York."

Elizabeth Vargas: "It's important to note that while Dr. Webster says there's a  50-50 chance the virus could adapt to spread easily among humans that does not necissarily mean it would be as lethal to people as it is to birds." 

that's it

By David Brown
Washington Post Staff Writer
Tuesday, August 23, 2005; A01

Robert G. Webster is watching his 40-year-old hunch about the origin of pandemic influenza play out before his eyes. It would be thrilling if it were not so terrifying.

Four decades ago, Webster was a young microbiologist from New Zealand on a brief sojourn in London. While he was there, he did an experiment that pretty much set the course of his scientific career. In just a few hours, he showed that the microbe that swept the globe in 1957 as "Asian flu" bore an unmistakable resemblance to strains of virus carried by certain birds in the years before.

Webster's observation was a surprise -- and a troubling one. It suggested an origin of the unusually virulent strains of influenza virus that appear two or three times each century. His hunch, that at least some of these pandemic strains were hybrids of bird and human flu viruses, was correct.

Since then, Rob Webster has become arguably the world's most important eye on animal influenza viruses. These days, he is deeply worried about what he's seeing.

Strains of influenza virus known as A/H5N1 have been spreading in wild and domestic birds across Southeast Asia and China since 1996. In recent weeks, the virus has apparently struck poultry in Siberia and Kazakhstan.

Since late 2003, about 100 million domesticated birds -- mostly chickens and ducks -- either have died of the virus or have been intentionally killed to keep the viruses from spreading. But what has Webster and other experts so worried are the 112 people who have been infected with the H5N1 "bird flu," more than half of whom have died. The fatality rate of 55 percent outstrips any human flu epidemic on record, including the epochal Spanish flu of 1918 and 1919 that killed at least 50 million people.

, although scientists have hints.Why this new virus is so deadly is not entirely understood

Influenza viruses invade cells lining the throat and windpipe, where they replicate and cause inflammation but are eventually suppressed by the immune system. In some cases, the microbe invades the lungs and leads to viral or bacterial pneumonia. Some H5N1 strains, however, have two features that make them even more dangerous.

Normally, the flu viruses can replicate only in the throat and lungs. With H5N1, however, the protein that triggers replication can be activated in many other organs, including the liver, intestines and brain. What is usually a respiratory infection can suddenly become a whole-body infection. Simultaneously, a second "defect" in the virus unleashes a storm of immune-system chemicals called cytokines. In normal amounts, cytokines help fight microbial invaders. In excessive amounts, they can cause lethal damage to the body's own tissues.

The trait H5N1 has not acquired is the ability to spread easily from person to person. The 112 human cases since late 2003 may turn out to be simply rare events in a bird epidemic that will eventually subside, as all epidemics do.

What is worrisome, though, is evidence pointing the other way.

Webster's insight about the origins of pandemic flu led to an unavoidable conclusion. If scientists had any hope of preventing the pandemics, they had to keep watch on influenza in many species, not just human beings.

Learning how the virus is changing in birds, and what it may need to get real traction in people, are what keep Webster, 73, working full tilt at an age when many people are slowing down or have retired.

"I probably have more energy than is good for me," he says, sitting in his glass-walled corner office that looks out over green suburbs.

Since 1968, he has been at St. Jude Children's Research Hospital in Memphis, a cancer hospital established by the late actor and comedian Danny Thomas in gratitude to the patron saint of hopeless causes, whom Thomas credited with rescuing his career. It's an unlikely landing spot for Webster, who grew up on a 240-acre farm on New Zealand's South Island. But then, he came to the object of his scientific work mostly by chance, too.

After getting a doctorate in microbiology at the Australian National University in Canberra, he went to work in the laboratory of Frank Fenner, an expert on pox viruses. (Fenner would later help lead the 10-year campaign that successfully eradicated smallpox.) Webster expected to work on that family of microbes.

"On the day I arrived, Frank had me into his office and said so-and-so needs help in influenza virus. That's where you're going to go," he recalled.

Today, Webster heads his own lab of four principal investigators, a dozen graduate students and post-doctoral researchers, and a $7 million annual budget. The lab has chambers for handling high-risk pathogens and uses nearly 3,000 fertile chicken eggs a week for growing influenza viruses. Elsewhere on the St. Jude campus is a small plant licensed by the Food and Drug Administration to make experimental vaccines. The "seed strain" of virus used to make an H5N1 vaccine now in human trials in the United States was made at St. Jude by one of Webster's colleagues, Erich Hoffmann.

Since 1997, Webster has also spent three months a year as a visiting professor at the University of Hong Kong. That gets him closer to the historical breeding ground of new flu strains: China. With H5N1 steadily gaining momentum this year, he has returned to Asia twice since his Hong Kong stint ended in March. One trip was to brief prime ministers of the Association of Southeast Asian Nations (ASEAN) about what they can to do to stanch the spread of H5N1.

The World Health Organization "will help in the initial outbreak," he says he told them. "But if it breaks through, guys, you're on your own."

On this day, Webster is back in Memphis. Pointed ears and a puckish smile give him the look of a superannuated pixie, perhaps a character out of "The Lord of the Rings," which was filmed on his native ground. But his words these days are dark, his outlook grim.

He thinks an avian flu pandemic "is just inevitable. One of these is just going to blow."

H5N1's potential as the next pandemic virus is all a matter of probability and opportunity.

Influenza A is a simple virus. That is one of the things that makes it so adaptable and potentially dangerous. It flourishes in hundreds of animal species with only 10 genes and a genome of 13,600 nucleotides, or "letters." (The human genetic code, in comparison, has about 25,000 genes and 3 billion nucleotides.) Of course, influenza virus needs more than 10 genes to replicate itself and spread. Like all viruses, it gets what it needs from the cells it invades, hijacking their molecular machinery.

Influenza A's adaptability arises, in part, because its genes are carried on eight unconnected strands, called "gene segments."

The segments can be traded like cards in a game of hearts, producing new strains of flu, the equivalent of new hands of cards. But that can happen only if two different viruses find themselves in the same cell, which is a very rare event. However, when millions of people, chickens and pigs -- the last animal can be infected by both human and bird influenza viruses -- live close together, as they do in China, rare events happen.

This gene-trading is called "reassortment." In the 1960s, Webster hypothesized that something like reassortment -- the process had not yet been discovered -- must explain the really big changes that appeared every once in a while in human flu viruses. This is the theory he tested in his London experiment decades ago.

There he asked for a little space at the National Institute for Medical Research at Mill Hill and access to the famous lab's collection of human serum and influenza viruses.

He mixed antibody-rich serum from victims of the 1957 flu pandemic with samples of avian flu viruses. In a matter of hours, he saw the human antibodies attack some of the microbes. This showed that the 1957 human virus shared features with some of the bird viruses.

"It's the only paper I've ever done based on just one day of experiments," he recalled recently, still both proud and amazed.

It turns out that of the Asian flu's eight gene segments, three had recently arrived from birds, according to an analysis of the genes' molecular fingerprints that was done much later. Two of the bird genes were for surface proteins that give a flu virus its immunological identity -- hemagglutinin and neuraminidase (denoted "H" and "N").

Something similar happened in 1968, when the Hong Kong flu strain got a new "H" from birds through reassortment, as well as a bird version of another, less important, gene segment. That strain, too, caused a pandemic.

The other way avian flu viruses can adapt to become human viruses is by slowly acquiring mutations. As small changes pile up, the virus's behavior can evolve. One trait that can appear is the capacity to enter human cells easily. That, and the ability to replicate efficiently once inside, are the two requirements for contagiousness.

Evolution of flu viruses is inevitable because the microbe is prone to making mistakes as it copies its genes. The more times a virus replicates, the more opportunity there is for a new mutation to arise that allows easy person-to-person transmission. For that reason, suppressing H5N1 outbreaks in birds -- where the microbe is replicating trillions of times a day -- is a crucial tool in preventing a human outbreak. China and Indonesia have vaccinated poultry flocks against H5N1, and Vietnam this month is starting a two-year, $35 million campaign to do so, too.

The highly lethal H5N1 viruses isolated from last year's human cases of avian flu were genetically 99 percent identical to each other. The slightly less lethal -- but perhaps more transmissible -- virus taken from patients in northern Vietnam early this year is only 98 percent identical to last year's; more important, it isn't completely inhibited by antibodies to last year's strain. It may be on its way to becoming a new, human-adapted strain.

But H5N1 flu isn't evolving just in human hosts. It's also changing in birds in a dangerous way.

Decades ago, Webster demonstrated that waterfowl are the true "home range" of influenza A viruses -- another of his key scientific contributions. For nearly 30 years, he and his colleagues have annually sampled wild ducks in the birds' nesting grounds in Alberta, looking for new flu strains. Since 1985, they have also sampled the feces of more than 5,000 migrating shorebirds along Delaware Bay.

H5N1 strains with slightly different traits have appeared several times in East Asia since the first one emerged in southern China in 1996. Last fall, while analyzing a strain circulating after an outbreak in Hong Kong in 2002, one of Webster's post-doctoral researchers, Diane Hulse, made an unusually important observation.

Many ducks experimentally infected with thevirus didn't die, even though the strain was highly lethal to chickens. But one of the duck viruses was highly lethal to ferrets, the animal whose susceptibility mirrors that of people. This meant that killing infected chickens wasn't going to be enough to stop the spread of the microbe. Ducks could serve as a permanent reservoir of H5N1 virus.

Webster immediately informed officials at the WHO, who in turn sounded the alarm. They announced that ducks -- there are 2 billion domestic ones in East Asia -- might be "silent carriers" of H5N1 influenza strains potentially fatal to people.

The discovery by Hulse and Webster led, in part, to an extreme program Thailand mounted last November. About 70,000 investigators went into every village in the country looking for sick ducks and sampling the feces of healthy-looking ones. Flocks carrying H5N1 influenza virus were killed.

The strategy appears to have worked. Last year, Thailand had 12 human deaths from H5N1 flu. So far this year, it has had none.

Stretching out before Webster and public health experts is a long list chores the world must complete if it is to abort the bird-to-man transfer of disease he long ago proved could happen.

Last month, two teams of scientists based in China, one assisted by Webster, proved that H5N1 is now circulating in several species of migratory birds capable of carrying the virus to India, Australia and Central Asia. Tests announced last week suggest that some of those long-distance fliers have already carried H5N1 into Mongolia, where it hadn't been seen before.

A task equal in importance to charting the spread of H5N1 is developing and distributing a good duck vaccine for the billions of those birds in East Asia.

Those countries, which collectively are the likely ground zero of pandemic flu, also need to improve their disease surveillance. In particular, they need to develop laboratories capable of safely isolating and testing influenza viruses.

And while they are doing that, they -- and the rest of the world, Webster believes -- would be well advised to draw up a plan to limit human movement and distribute vaccine and antiviral drugs should a pandemic flu strain emerge despite the efforts to prevent it.

It's a long list with an uncertain deadline, and it's enough to keep Rob Webster at work.

Yeah?  But I care.  Intensely.

It would be quite interesting to see what ABC left on the floor of the cutting room ( what they edited out).  I think Webster knows way more, probably said way more than we will ever know.

Why do you think 50% is like nothing to worry about??? I dont have a 50% chance of getting breast cancer, uterine cancer, pancreatic cancer, lung cancer any frigg'n kinda cancer you can think of but I worry about them anyway. You don't have a 50% chance of your plane crashing when you take a vacation but it is a big concern to alot of people. There isn't a 50% chance of a dirty bomb going off in NYC but that is a major concern to authorities here.

50% is huge!!!!!! 

It's not heads or tails we're talking about here!

Are you waiting for it to be an 80 - 90% chance???

50% is huge!!!!!  

I was blown away by this figure!

prprd1: good idea, go ahead and concern yourself with other matters. If your so unconcerned, what are you doing here? People have been taking this virul threat seriously when it was only maybe a 20% possibitity and then it went on to about 30 or 40% and now we have a top expert come foward and say it's a 50% possibility of our worst nightmares coming to fruition and you think that is nothing to worry about?

Why don't you go light up a cig, sit in the desert sun for a couple of hours and fry yourself up some bacon and try not to loose too many brain cells when you poop nextime! What an a$$!!!! You couldn't recognize brilliance if it sneezed on you!  

(BTW, what the he!! is the deal with "bird flu in general" that does worry you ???  .....talk about ludicrous statements!)  

and where did you get your little factoid on ebola anyway?

Let's look at this another way.

There is some probability of Ebola and BFmutating to H2H via straight mutation or recombination with other virus, the likelyhood that it will do so is based on the number of infected hosts. For Ebola. this number is to my knowledge some remote pockets of monkeys and other mammals.  For BF, this is now 100's of millions of birds infected now almost WORLDWIDE, growing exponentially daily, soon to be on every continent and corner, in an animal that millions of humans eat and handle, and worse, live with closely in and around their homes and environment.  We further take some of these birds, pack them by the 1000's into a single room on factory farms, where they share water, vaccine needles, feces, blood, and then pack up their meat and egg products and ship them worldwide for others to eat or handle or to be put into other jammed filthy environments as new stock.

In the back of my mind, I think about the possibility of Ebola tranferring to humans from the 10's of 1000's of remote mammals that may carry it who can travel 10 or 50 miles maximum in their lives.

In the FRONT of my mind, I think about BF transferring to humans from the more than 100 billion birds of the world who are CURRENTLY, exponentially, being exposed to the BF virus at a fast rate by cross continent migration, along with the 100 million estimated domesticated birds in millions of households. From this worldwide pool, H5N1 needs to find ONE situation where it can mutate and recombine to infect humans with readily transferrable traits, and have a few humans nearby to pass it on to.  This will go on for years.

Gonna bet against those odds?

Would anybody get on a plane if it only had a 50% chance of arriving at it's destination?

I think you could probably have any seat you wanted on that flight. 

prprd, your comments seemed to me to be insulting to the guy and making him not look very credible. I didn't want people new to the board to think there wasn't any real reason to prep. I am pretty well prepped and continue to do so everyday but there are alot of people who don't prep as a way of life and stumble on here looking for straightfoward information, not sarcasm. I appologize for the name calling. Not usually my style. Just the way I react I guess to finding out half the world has a 50% chance of disappearing. Or is it 50% of the world has 100% chance? Or 100% of the world has a 50% chance? Dunno anymore.

and guess what, I have not gotten on a plane in years! lol