H5N1 very virulent
The Sun, 26 Nov 2005

Avian influenza The first documented outbreak of the H5N1 avian influenza infecting humans occurred in Hong Kong in 1997. It killed six people. Hong Kong culled 1.5 million chickens. The H5N1 variant has been found to be particularly virulent as it resurfaced again among poultry populations in Hong Kong and other parts of Asia in 2003.

Since then tens of millions of birds have been culled and more than 60 people of the more than 120 people infected have died. Today, it has expanded its range to more than 12 countries in the world, including Europe and the Middle East.

The fear The fear is that the virus would mutate into a form that can spread easily from human to human, like other flu. This will trigger a global pandemic that could kill millions.

At present, most human cases of avian flu are linked to contact with sick birds, but in September last year, the mother of an 11-year-old victim in Thailand died of H5N1 after catching it from her daughter.

The avian flu virus could also mix with a human flu strain and create a new virus. The danger is, no one would have immunity against this new virus because the old antibodies in the human immune system do not recognize the new virus.

Transmission Infected birds shed the virus in saliva, nasal secretions, urine and faeces. The H5N1 virus can live up to 30 days in infected faeces.

The disease can spread from infected birds to humans through direct contact with infected birds and inhaling faecal dust, through water ponds which are contaminated with infected bird or chicken faeces and transfer of infected faeces on clothing and contaminated equipment.

Symptoms of avian influenza in humans are similar to the common cold such as high fever, sore throat and dry cough. In severe cases, it can lead to severe respiratory distress secondary to pneumonia, bloody nose and gums, and diarrhea. The young and the elderly and those with low immunity are more susceptible.

The cost WHO projects 7.4 million deaths worldwide. The impact would be greatest in Asia. Consumption and trade would be reduced and the Asian Development Bank estimates a severe outbreak would cost the Asia Pacific region between US$250 billion and US$290 billion (RM945 billion and RM1.096 trillion) while a mild pandemic would cost about US$90 billion to US$110 billion (RM340.2 billion to RM415.8 billion).

The World Bank estimated a pandemic would cost up to US$800 billion (RM3.024 trillion) a year, or 2% of global GDP.

Like during the SARS outbreak, a lot of the cost is caused by panic and disruption as people try to avoid infection. Travel and agriculture will be the most affected.