is your academic background and current position?"
G: "I have background in both agriculture and medicine.
I graduated from the Cornell University School of Agriculture and the Tufts
University School of Medicine. I'm now the Director of Public Health and
Animal Agriculture at the Humane Society of the United States."
M: "Let's cut to the chase: there's human flu, pig flu,
bird flu... what kind of flu are we talking about here?"
G: "Avian influenza has existed for millions of years
as a harmless intestinal water-borne infection in aquatic groups, like ducks.
Under extreme conditions, though, this virus can mutate into a form much more
dangerous to birds, and particularly more dangerous to human beings as well."
M: "What is H5N1, and what makes it so unique and
of special interest?"
G: "H5N1 is a strain that started killing people
in 1997, in Hong Kong. The significance is that no human being has ever,
to our knowledge, been infected with an H5 virus, and therefore there
is global universal vulnerability to such a virus --- no one has any
prior immunity. The reason that the seasonal regular flu doesn't kill
more people, doesn't infect more people, is because we have immunity
to last year's flu. Every year the flu virus mutates just a little bit,
just enough to keep infecting people, but every few decades a strain
comes along to which there is essentially zero immunity and it spreads
like wildfire around the globe, thereby triggering what's called a "flu
pandemic." There's been a number in the past, there will be a number
in the future. The concern, though, is about H5N1 in particular because
most flu viruses are the cause of relatively limited illness, yes...
here in the United States this could mean more than a million Americans
come down with the flu every year --- may kill as many as 30,000 Americans,
mostly the elderly, the infirmed, small children... but young healthy
people are out of work a few days, feel pretty lousy, and live through
H5N1 is different. H5N1 is like no flu virus that we've ever seen before...
it's killing over 60% of people that have come down with it --- a coin toss
whether one lives with this disease. In 2006 it was more like 70% dead, in
the first cases in 2007, more like 80% dead. These are Ebola statistics.
It doesn't sound like the flu at all. If this flu were to trigger, were to
mutate to a form easily transmittable from one person to the next, it would
spread around the world as another flu pandemic, and if it retained any semblance
of its current human lethality it could be a truly catastrophic event."
your book, "Avian Flu," you refer to the virus as a "tiny
terrorist" and producing "mutant swarms," yet you also
say that in terms of its mutations, it's very sloppy. Why is this a
G: "RNA viruses, in general,
have no kind of "proofreading" mechanism
when they multiple, unlike DNA-based organisms
like human beings. Obviously if our cells divided
and didn't have an exact copy of the progenitor
cells, we could come down with cancer or worse.
That's where birth defects come from --- some kind
of mutation in the DNA. But our bodies have evolved
a DNA proofreading mechanism. Each cell is an exact
copy or attempts to make an exact copy of it's
RNA-based organisms, however, based on the biology of the replication of the
RNA, don't have a proofreading mechanism, so each progenitor virus in this
case, is a slightly different mutant. In fact, most of the viruses that get
spawned from its host are actually useless, so crippled from its mutation,
that it cannot go on and replicate further, or be infectious, or hurt anyone.
Well, you might think that evolutionarily that seems crazy, that the vast majority
of one's progenitors would be unable to reproduce further. The reason why this
has been maintained by evolutionary history is because that gives these viruses
an edge: they can rapidly rapidly evolve. When placed under new environmental
pressure, or in a new host for example, even though 90% of the reproduced viruses
may be useless, among that small 10% there may be one even better adapted to
that new situation, and therefore after a few generations can evolve more rapidly
than the host. That virus is kind of the ultimate parasite... able to "overwhelm" or
be one step ahead of the host's immune system, otherwise we would rapidly evolve
immunity to it. So if you look at something like the chicken pox virus, we
get chicken pox one time, hopefully, and we never get it again because our
body remembers that same chicken pox virus. But the reason we get the flu,
year after year, is because the virus is just one step ahead of us --- changing
just enough to evade our initial defenses.
If you think about the viruses that we can't make vaccine for, essentially
can't make universal vaccines for, something like HIV or influenza, these are
RNA viruses that mutate so rapidly we can't pin them down with a vaccine. That's
why every year we have to make an entirely new flu vaccine, because the virus
keeps changing. Of all the disease threats in the world, we're most concerned
about RNA-based viruses because of their ability to mutate, to bring us new
surprises. AIDs has indeed infected 20 - 25 million people in the past decade,
but there's only one virus on the planet capable of infecting billions, and
that's one of the reasons you mention in your book
that great quote from a microbiologist: "Never
underestimate an adversary with a 3.5 billion year
head start." What's the difference between a
pandemic and an epidemic?"
G: ""Epidemic" from its roots means essentially "upon
the people." "Pandemic" means "upon all of the people." An
epidemic, like most natural disasters, is relatively limited in both
time and space. You're talking about an earthquake, a terrorist attack,
or a hurricane. Whereas a pandemic, by definition, occurs everywhere.
That's the entire world. It's a disease outbreak affecting the entire
world. AIDs, for example, has been described as a pandemic... yes, it's
been a pandemic in slow motion, but over the last few decades it's literally
killed millions of people on every populated continent around the globe.
Now influenza can similarly cause a pandemic, but can do it in a space
of a matter of months. It can literally infect half of humanity. In fact
the last time that bird flu jumped species from birds to people, back
in 1918, the virus killed 50 to 100 million people around the globe ---
the worst plague in human history and it did that in a very short amount
of time. It basically killed more people in 25 weeks than AIDs has killed
in 25 years."
1918 & EMERGING
your book you pointed out that more people died from
that plague than in all of World War I."
G: "Yes indeed... in fact, no war, no plague, no
famine, has killed that many people in so short in time as the 1918 pandemic,
and we didn't learn until October 2005 where this pandemic came from.
It's kind of the ultimate medical detective story... what was that masked
killer virus? Back then we didn't have the kind of DNA fingerprinting
techniques we have now. We were able, this is straight out of "Jurassic
Park," to dig up a corpse discovered frozen in the Alaskan permafrost
that died in 1918, get tissue from her lungs, and re-create the genetic
code, letter by letter, of the entire virus. This has been done up in
Toronto and Atlanta. We have the 1918 virus back, we can study it and,
lo' and behold, it was a wholly avian virus... it was a bird flu virus
that jumped species, and in light of the unprecedented appearance of
H5N1, and its unprecedented human lethality, we put those two together
and that is when alarm bells went off around the world."
unusual are emerging infectious diseases like this
G: "Over the past 30 years more than 30 new diseases
have emerged at a rate really unprecedented in the history of medicine.
Emerging infectious diseases have gone from a mere curiosity in the field
of medicine to a whole discipline that's moved to center stage. Medical
historians have called this time in which we live in the age of "the
emerging plagues," some of which come from animals."
is kind of confusing in that the mainstream press
implies it's all an Indonesian or Chinese problem
with large open markets and wild birds, yet in your
book, you make the case that this isn't necessarily
G: "Chickens used to peck around the barnyard.
Now we cram tens of thousands of birds into these filthy football field-sized
sheds where they stand beak to beak in their own waste. It's a veritable
breeding ground for disease, in fact, if you go back to a number of new
emerging diseases we can trace them back to these industrial practices
--- something that really didn't exist decades ago. Let's look at mad
cow disease, a familiar story from these industrial cannibalistic feeding
practices. These antibiotic-resistant so-called "super bugs." How
many of them are because of the mass feeding of millions of pounds of
antibiotics in the animal's feed? The animals aren't sick at all, it's
just to promote growth and prevent illness from this stressful and unhygienic
environment. Now we have these antibiotic-resistant super bugs, and we
as physicians, are running out of good antibiotic options. The way we
raise animals has global health implications.
Now, much of the focus has been on these small backyard free range flocks,
but that's missing the larger picture. One needs to take a step back and say "where's
this virus coming from in the first place?" People have been keeping chickens
in their backyards for thousands of years, and birds have been migrating for
millions. This is more of an unnatural disaster of our own making. What has
changed recently to bring this all upon us? Why do we have a flu virus with
unprecedented lethality? Why, over the last decade or so, has there been an
exponential increase in the number of highly pathogenic outbreaks of bird flu
viruses? Why has there been an unprecedented of bird flu viruses affecting
human beings, not just H5N1, but four other chicken flu viruses have infected
people from Hong Kong all the way to New York City? What has happened recently
is the industrialization, the intensification of the global poultry sector,
particularly down in southeast Asia. They cram these chickens by the thousands
into these warehouse scenarios, and because of a number of factors inherent
to those kind of systems, seems to have birthed a virus unprecedented in history
that may very well lead to disaster."
of the factory farming-related statistics you've
presented in your book are unbelievable in scope.
I'll be putting several in the Mad
Yet, according to industry and government officials,
have the "safest
food supply in the world?"
G: "Well, that's according to industry, and they
love to parrot that phrase. It's simply not true. In fact, a number of
Scandinavian countries are far ahead of us in even just the most basic
food safety measures. The kinds of things that happen in this country...
we don't even have mandatory food recalls for contaminated meat we are
at such a primitive stage in terms of protect the health of Americans."
was quite surprised when I realized from your book
that it's not just a "flying bird" issue
regarding transmission of avian flu. What's the current
G: "Once it goes human, then it spreads just like
the regular flu, and that's from person-to-person in closed confined
spaces, people coughing, sneezing, or touching a contaminated object
like a doorknob and touching one's face, one's eyes, nose, and mouth.
It spreads by global commercial airline travel all around the world.
Particularly children are considered as kind of a "super spreader" of
this disease... they can be infected up to a week before they start showing
symptoms, and so school closures are considered a primary containment
In birds, currently the primary spreader is the poultry trade in birds and
bird products. People don't realize that in globalized trade we export chicken
meat around the world and likewise. Thailand was the fourth leading exporter
of chicken in the world. People don't realize that the meat they buy in the
supermarket may come from another hemisphere. In this globalized system it's
very easy for viruses to be shipped around. In fact there has evolved duck
viruses that are used to the cold wintering in Michigan lakes, and freeze quite
well, and they can be found in frozen poultry products ordered from China.
So there's a real concern about bringing fresh or frozen poultry products into
one's household if there's any potential infection. Although migratory birds
may indeed play a role, the primary role considered by the Food and Agriculture
Organization (FAO) of the United Nations is the transport of live birds."
your book you raised the issue that during the Pennsylvania bird flu outbreak
(17 million birds killed in the 1980s) they found signs of the virus on flies
and small animals?"
G: "Literally... on houseflies, garbage
flies... you know, the industry claims that their operations
are "biosecure," that the virus could not get into
the environment, into these factory farms... but I've yet to
find a factory farmer knowing how they intend to keep flies
out of these poultry sheds. They have these huge ventilation
fans, people have to walk in and out --- there's no way you
can keep this contagion out of a heavily contaminated environment,
and so the factory farms are what changed the mild, low pathogenic
harmless virus into a highly pathogenic type. Instead of trying
to take away the fuse by somehow locking the birds inside,
one really has to take away the explosive --- one has to take
away the opportunity for this virus to mutate into a highly
pathogenic form, a relatively new phenomenon seen only since
we started raising birds in this fashion."
BIRD FLU IN U.S.
noted that the United States has reported more bird
flu outbreaks than any other country in the world
since the mid-1960s. What is the reason for this
and how is it contributing to a possible pandemic?"
G: "We've picked up this virus every year for decades.
Minnesota is avian flu capitol of the world. That's because they have
a very large turkey industry, they're the "land of 10,000 lakes" and
all those lakes means migratory aquatic birds. But it's important to
recognize that these were low pathogenic strains... up to a third of
juvenile ducks can be infected with this virus, but it doesn't hurt the
ducks. The ducks don't hurt the virus and the virus doesn't hurt the
ducks. This has been going on for millions of years. No one gets hurt
--- unless you take one of these ducks to a live bird market or something,
one of these "viral swap meets," where it can infect a land-based
terrestrial bird like a chicken, then the virus can mutate into an airborne
variety which can become much more dangerous to people."
M: "I love that
phrase "viral swap meet." I notice that you coin
many creative phrases and clearly had some fun in choosing
chapter titles in your book... "One Flu Over the Chicken's
getting too gruesome, I wonder if you can discuss,
should the virus mutate to easy transmission among
humans, what this might mean to more than just deaths?
Impact on social infrastructures? That it's not just
AIDs on steroids?"
G: "Certainly. Some segments of infrastructure
wouldn't be able to survive a 30 to 40% employee absenteeism. In our "just
in time" global delivery system, we no longer have warehoused stockpiles
of food --- even one good winter storm can empty out grocery shelves.
Can you imagine if a storm would last for months? All international trade
could eventually collapse. The World Bank has estimated that even a moderate
pandemic could cost the world a trillion dollars.
Part of this really comes back to what we can do to prepare in our communities
and in our families. Much of it comes down to being able to "shelter in
place" and stay at home and having the supplies to do that, as there is
a concern that even if there were supplies available, one would want to minimize
one's contact with other people so as to limit one's risk."
is your opinion of the how our government is preparing for a possible pandemic?"
G: "Well... much better than they
were in the past. Ever since 1970 there's been a process
in Washington to try and come up with a Pandemic Preparedness
Plan, and only recently, in fact this last month, federal
guidelines for mediating the impact of this next pandemic
were released to States and localities. So it's been a
slow process, but they are ramping up. For example, by
2012, we should have the vaccine production capacity to
cover Americans six months after the pandemic strikes.
Of course, that's only after the pandemic strikes, but
that's certainly significantly better they we're at right
The question is: what does one do during the first six months of a pandemic?
The government has set-up a website [here]
with information and a checklist for schools, for families, and for faith-based
institutions to help them prepare for the next pandemic."
guess the "Devil's Advocate" position here
is, well... are professionals like you "crying
wolf," I mean, what are the real odds that we
could have the kind of incredibly destructive pandemic
potential you're describing?"
G: "Unlike Y2K, unlike SARs, influenza has a track
record... we know what influenza is capable of... the last time a bird
flu virus jumped from birds to people, it became the worst plague in
human history and 50 to 100 million people lost their lives. We know
another pandemic is inevitable, we don't know when, we don't know how
bad it will be, but with this unprecedented spread of this truly unprecedented
virus in terms of human lethality, we need to make practical concrete
preparations. That's why all leading health authorities on the planet
now are urging governments to prepare for the next pandemic. This is
not like 1976, for example, with the swine flu affair, in which President
Ford ordered the vaccination of millions of Americans after the death
of a single person from a swine flu variant. The World Health Organization
[WHO] disagreed, the British government disagreed... they thought the
U.S. government was over-reacting from this one fatality. Indeed, it
turned out, it wasn't a problem at all.
But this is different... there's now a consensus among the medical and public
health community around the world that this is perhaps the greatest health
threat facing humanity currently. Things to that effect have been said by the
Head of the CDC [US Centers for Disease Prevention and Control], by the Director
General of the FAO ---
not something to be dismissed lightly, not some kind of "conspiracy theory" by
some kind of marginalized opinion. This is the mainstream public health and
medical opinion: the global populace should prepare for another pandemic."