How dangerous is the bird flu? While “deadly” has been repeatedly attached to it, until last week, no one had actually asked.
“Deadly” got attached because about half of the small number of people, mostly in Asia, who have been diagnosed with the H5N1 virus have died. These were people who made it to a hospital or clinic in a city. This doesn’t tell us much about what’s going on in the countryside. That’s important because so far all the known cases have occurred because a human was infected by a bird. Most of that contact happens in the countryside.
Then last week, researchers from the Karolinska Institute in Stockholm published a paper that suggests that the avian flu might not be as scary as it’s advertised. These researchers have been working on health issues in a province in Vietnam for over seven years. During the spring of 2004 they collected information about the incidence of what they called flulike symptoms and exposure to sick birds. So far, it’s the best estimate of the avian flu’s effects on an entire population.
Only about 18% of the people exposed to domestic poultry developed “flulike symptoms”—which is not, as the researchers take pains to point out, the same as being diagnosed with H5N1. In addition, the birds were not diagnosed with H5N1—they were simply sick birds. However, these are the conditions that give rise to avian flu in a country that has had one of the highest number of bird flu deaths. Allow me to point out, by the way, that no deaths were reported in this study.
The researchers speculate, as do I, that infection by H5N1 in Vietnam and likely elsewhere is more common than supposed and that its effects are not nearly as “deadly” as we’ve been told. Another way to say this is that many more people than we know have been infected and survived because their immune systems worked.
Before going on, I want to emphasize that I don’t advocate ignoring the threat posed by bird flu. However, I think this has less to do with the alleged deadliness of the virus and much more to do with how we support our immunity.
And what makes for a healthy immune system? One clue is in the research paper. In classifying people from very poor to very rich, the researchers found that the poorest were almost 2½ times as likely to get sick as the very rich, with a nice gradient in between—the better your circumstances, the better you chances of avoiding the flu.
This isn’t news to many people. Researchers who study the social causes of sickness and health have observed that in Europe during the late 19th Century and in developing countries in the 20th Century, it is not the miracles of modern medicine that turn health statistics around, it’s the rise in economic security.
This is not a topic of polite conversation in the halls of government. And yet I think we all know it to be true. Security from disease is bound to security from want. The flu doesn’t just happen to us individually. It happens to us all, whether we’re exposed, infected, get sick, or die. The flu runs through a population. Some are safer than others because their lives are safer. Don’t you think we all deserve to be equally safe?
The issues in this article are developed (with references) in issue #9 of the Progressive Health Observer in the article titled “Avian Flu Roundup” and in issue #6 in the article titled “Flu Vaccines.”
Related resources are available on the Immunity, Infections, and Allergies page.
