You've been seeing plenty of stories about bird flu in the media since last week's post. It's now in over 40 countries in Europe, Africa and Asia, sparking controversy about how it's spread and what it's going to cost to deal with it (see Taking stock, part I and Taking stock, part II by the reveres at Effect Measure, a Koufax-nominated specialty site, for a nice summary of what we don't know).

The World Health Organization has also issued a clarification of what we know and what we don't. For example, the question of human-to-human (H2H) transmission often comes up on these threads.

WHO officials said this week there are three confirmed cases of suspected person-to-person transmission:

In January 2004, Ngo Le Hung, a 31-year-old Vietnamese schoolteacher, became infected and died from a chicken he bought for his wedding, and his two sisters also died.

In September 2004 a dying 11-year-old Sakuntala Premphasri infected her mother Pranee, 26, in Thailand and both died. And in July 2005 a 38-year-old father is believed to have infected his two daughters, aged one and eight -- all three died.

Cheng said there may be other cases in which people became infected through human-to-human transmission, but there isn't enough evidence to prove it. There may also be many less severely ill people going unnoticed.

We have known about the Thai case for some time (it was published in the New England Journal of Medicine a year ago), and we know of many clusters of cases not yet fully investigated, particularly in Turkey. Still, the H2H transmission at this time is rare.

We know that cats and stone martens (a weasel-like mammal) are affected, meaning the virus is adapting to mammals and their human-like receptors. Not a good thing to happen. Where's the Intelligent Design in that? Still, the implications for humans are not so clear.

We don't know how many mild cases are happening, though seroprevalence studies suggest not many. Another thing we don't know is why younger people are affected so heavily.
With the World Health Organization set to announce the 100th death from bird flu any day now, data compiled by the Toronto Star lead to one particularly compelling question: Why does the H5N1 virus attack the young?

The Star's analysis shows that all but six of the 97 people who have died globally so far from bird flu were under 40.

People, in other words, with the strongest immune systems and not, as one might expect, the elderly and those already sick. The median age was 19, and a quarter of them were under age 12.

Children, teenagers and young adults are the unfortunate victims of the deadly H5N1 bird flu sweeping through poultry farms in Asia, Africa and now Europe.

What we don't know about H5N1 can fill a library. So when folks come on here and claim there's fearmongering going on whenever the virus is simply discussed, understand that knowledge is power and preparation is prudence, not fear. The virus is likely to be in North America within the next year (if not sooner), and hopefully these Flu Stories will give you a reference when you need one. Of course, there's always Flu Wiki, and many of the other excellent flu sites on the net.

Ejumicate yourselves however you prefer. There's plenty to do and we're not nearly ready to deal with H5N1 in the US, whether it's in birds or in humans. And hope that Chertoff isn't still running the show when TSHTF.

Originally posted to Daily Kos on Sat Mar 11, 2006 at 06:51 AM PST.

Your Email has been sent.