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Book and Media Reviews
October 24/31, 2007

Bird Flu: A Virus of Our Own Hatching

Author Affiliations

Book and Media Reviews Section Editor: John L. Zeller, MD, PhD, Contributing Editor.

JAMA. 2007;298(16):1943-1949. doi:10.1001/jama.298.16.1945

Worries about a forthcoming influenza pandemic have a solid historical foundation. Although the timing remains uncertain, flu pandemics have a relapsing pattern and incur enormous human and economic costs. Of the three 20th-century influenza pandemics, that of 1918-1919 is considered the most deadly disease event in human history.

The US Centers for Disease Control and Prevention (CDC) estimates that in a normal flu season some 200 000 individuals in the United States are hospitalized and 38 000 die of influenza, mostly elderly persons, with annual direct medical costs and lost productivity calculated at $12 billion. However, these figures pale before the catastrophe implied by a severe influenza pandemic. The CDC predicts that a medium-level epidemic would affect a third of the US population, hospitalize 734 000, and kill almost 210 000. With failure to produce an effective vaccine and with a virus untouched by anti-influenza drugs, an epidemic of the H5N1 avian influenza via person-to-person transmission could wreak havoc. With a probable 80 million disease episodes, a 20% mortality rate would result in 16 million deaths. The human tragedy and economic upheaval would be unprecedented.

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