Walking through the small Iowa town of his upbringing, retired school teacher Bill Angler moves forward with purpose as worried people scurry around him. Though the summer breeze makes him want to hide behind the walls, he knows in his heart that there is no way to truly elude the possibility of airborne transmission.
It's in the hands of God.
The proof is in the pudding.
But then someone stops only feet from him. At first, Bill guesses that the person is merely tired of the rush. But then that familiar 'someone is watching me' feeling creeps upon him. He stops.
And Charlie Brummer pulls off a medical mask. "Hey, Bill. How goes it?" he says before putting it back on.
Bill just nods, then throws his hands up in the air before lifting the white mask off of his own mouth. "How's Katie?"
Ole Charlie tries to answer but instead turns away for a moment, clearly fighting back the tears. Bill wants to touch him, to put an arm around an old friend.
But under the circumstances. . .
"Doesn't look good for her," Charlie finally answers, still looking away. Then he whispers, "They said it couldn't be transmitted from person to person."
The Avian Influenza, more commonly referred to as the Bird Flu nowadays, had ripped through their small town as fast as lightning. Heck, it had been tearing through the entire country like that for the better part of a month. Some died, some lived. Most of the dead, in fact, were senior citizens like he and Charlie. The kids in town were also getting hit hard.
That was the worst part. The second worst? Seeing the pain on old friends' faces as they watched their loved ones crumble before them.
"You're lucky you lost Amy before this, Bill. I'm sorry to say it."
Bill just nodded. His wife, Amy, had died of a heart attack five years ago- quick and painless. On the other hand, Charlie's wife had contracted pneumonia after catching the H5N1 virus and was still fighting a relatively pointless battle.
"I'm sorry, Charlie," Bill said.
As Charlie moved on by him, Bill though he heard him whisper, "me too."
Later, as Bill walked home after buying a box of cereal from a cashier with surgical gloves, someone sneezed in the streets.
It sent a chill through his spine.
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Along with this, Avian Influenza really refers to flu from viruses adapted to birds. Symptoms from such viruses can range anywhere from those of typical flu, to conjuntivitis, respiratory failure, pneumonia, and several other death- wielding ailments.
How's that for not knowing what to expect?
In the past, there have likely been innumerable instances where flu from viruses adapted to birds have been, in some form, caught by humans. However, these have only reached pandemic proportions in three known instances.
In 1957, a strain of flu virus that emerged as the result of a recombination of human and avian viruses ( H2N2 ) wrought havoc on the world. Further, another ( H3N2 ) did the same in 1968.
Perhaps the most famous and deadly of pandemic avian flu situations occurred in 1918. In this instance, the 'Spanish Flu' killed 500,000 people in the United States and over 50 million worldwide.
That's right: 50 million dead.
Still, all of that is ancient history, right? After all, there's nothing like that out there right now, so this article is merely blowing smoke.
Not quite true.
A strain of Avian Flu called H5N1 has caused the largest number of cases of severe disease and death in humans in recent years.This first became a supposed problem in 1997 in Hong Kong when- for the first time ever- an influenza A virus was transmitted directly from birds to people. During this episode, 18 people were hospitalized and six died. In order to control the outbreak, 1.5 million chickens were killed.
In addition- and perhaps most frightening- is the fact that there were rare situations where this virus spread from person to person in 1997.
You see, unlike the garden variety seasonal flu that sprouts only mild respiratory symptoms in most people, the disease caused by H5N1 was shown to follow an unusually aggressive course. In fact, in many situations H5N1 seems to cause an overwhelming immune response in people to, the point that their own immune systems in essence attack them.
Much like the Spanish Flu of 1918.
Still, despite outbreaks in parts of Europe, Asia, the Pacific, Africa, and the near East- particularly in regard to their animal populations- this virus has only left 167 people dead in 10 countries since 2003. That's especially strange considering about half the people who have come down with it have died.
So why the low numbers? Simply because at present the virus rarely transmits from human to human. It seems that in order for a flu strain to truly become a pandemic threat to humanity, a protein that coats the virus' surface called hemagglutinin must prefer to attach to cells in the human nose and windpipe.
Hence, why a sneeze in the earlier fictional situation would send a chill down Bill Angler's spine.
The good news is that right now H5N1 still prefers to attach itself to the gastrointestinal tract of birds. Thus, the majority of exchanges with humans are due to direct contact with the animal, including its feces or secretions.
Unfortunately, viruses change all the time. Thus, the virus could mutate to a form that prefers to attach itself to the sinus passages at any time. In fact, the likelihood of a pandemic outbreak from a mutation of H5N1 in the future, according to some scientists, is as high 43%.
Further, if there was an outbreak, humans hardly possess any natural immunity to H5N1 viruses at all. Along with this, there is evidence that two of the more utilized antiviral medications ( amantadine and rimantadine ) were shown in Vietnam and Thailand to be relatively powerless against H5N1, which leaves us very little to fight with.
Even worse, it appears that the virus is becoming more capable of reaching animals than earlier strains. There have been reports of its spread to ducks (an animal that could very easily pass the virus to humans via contact), cats (only thing worse would be dogs), and even the stone marten.
Thus, the best answer to combat this problem is a vaccine. But, as is the case often in this world, that answer isn't as easy as it sounds.
The CDC and World Health Organization ( WHO ) have been hard at work planning for just such an outbreak. At a recent two day WHO meeting, chairman Ian Gust indicated that the first doses of such a vaccine, once a mutation was discovered in H5N1 that could pass from human to human more easily, could be available within three months. Though this is promising, it is not without problem.
Simply put, a lot of people would be dead by the time that the vaccine did reach the masses. This is the case because the vaccine really can't be made in advance, particularly because the mutation has not occurred yet.
Thus, we don't know completely what we're targeting.
On an interesting note, in an effort to gain better understanding of what the world might be up against in the event of a pandemic outbreak, a professor of virology at Queen Mary's College in Britain named John Oxford has asked to exhume the body of Sir Mark Sykes, a diplomat that died of the Spanish Flu in 1919. The hope is that they can learn something about whether or not he experienced an overly aggressive immune response where his immune system actually ended up attacking his own body.
If so, then the parallels to H5N1 might serve to help scientists figure out ways to combat the problem of outbreak before the problem occurs.
Bird Import Ban -At present, there is a ban on bringing birds and/ or bird products from H5N1 - affected countries. This would of course will be continued for the foreseeable future ( it also pertains to the importation of dead birds as well ).
Termination of infected poultry -Sounds terrible, but what China did years ago in destroying 1.5 million chickens under the threat of outbreak was a valid preventative measure.
Cessation of international travel -No one has really discussed this. However, if and only if there was a pandemic outbreak, certain international flights from infected countries would likely cease immediately.
In sum, the first way to survive a Bird Flu outbreak is to hope and pray while continuing preventative practices noted above. However, if the virus does eventually mutate to a form that more easily transfers from human to human, the only answer would be a vaccine.
Would it be fast enough?
For some, definitely; but for you?
Regardless, that's the lone secret of survival if such an event were to occur. Therefore, let's hope and pray that none of this ever comes to bear.