How the United States is preparing for a possible bird flu pandemic

I first discussed the virus in an article published on January 7, 2020, which was headlined Doctors scramble to identify mysterious emerging disease in China. For this article, and many others that have followed, I spoke to experts in viruses, infectious diseases, and epidemiology. Often their answers to my questions about the virus, how it might spread, and the risks of a pandemic were the same: we don't know.

Today we face the same uncertainty with H5N1, the virus commonly known as avian flu. This virus has been decimating bird populations for years, and a variant is now spreading rapidly among dairy cattle in the United States. We know that it can cause serious illness in animals and that it can spread from animals to people who are in close contact with them. As of Monday this week, we also know that it can cause serious illness in people. A 65-year-old Louisiana man became the first person in the United States to die from an H5N1 infection.

Scientists are increasingly concerned about a possible avian flu pandemic. The question is, given all the continuing uncertainty around the virus, what should we do now to prepare for this eventuality? Can stored vaccines save us? And, above all, have we learned lessons from a covid pandemic that is still not completely over?

Part of the challenge is that it is impossible to predict how H5N1 will evolve.

A variant of the virus caused illness in humans in 1997, during a mild but deadly outbreak in Hong Kong. Eighteen people received a confirmed diagnosis and six of them died. Since then, there have been sporadic cases around the world, but no significant outbreaks.

When it comes to H5N1, we've been relatively lucky, says Ali Khan, dean of the University of Nebraska's college of public health. Influenza poses the greatest infectious disease pandemic threat to humans, period, Khan says. The 1918 flu pandemic was caused by a type of flu virus called H1N1, which appears to have spread from birds to humans. It is believed to have infected a third of the world's population and is responsible for around 50 million deaths.

Another H1N1 virus was responsible for the 2009 swine flu pandemic. This virus hit younger people harder because they were less likely to have been exposed to similar variants and therefore had much less immunity. That year, it was responsible for 151,700 to 575,400 deaths.

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