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500 million birds are migrating from Asia to Africa this week and next, flying over the Mideast. Farmers have spotted dozens of storks and other birds falling from the sky near Tyre in Lebanon.
Meanwhile, health experts are investigating the mysterious deaths of 'many birds' in Negev, Israel.
These are only two incidents out of many more that may occur as officials in Israel and in other Mideast countries are nervously watching the massive annual winter migration of 500 million birds from Asia to Africa. The hope is to catch early cases of the disease, and avoid the need to cull (kill) very many domestic birds, as this would affect the farming industry.
However, according to one researcher, the Mideast migration presents a special opportunity for the bird flu virus to adapt to human to human transmission.
According to research by Dr. Henry Niman, a non-lethal form of bird flu endemic to Israel could provide the missing genes to the lethal virus to make it human to human transmissible.
There are three types of influenza virus (A, B and C). Influenza type A viruses cause avian flu (bird flu) and also are a major cause of human influenza.
There are 15 avian influenza virus subtypes, but we're interested in only two of them: Subtype H5N1 is the deadly pathenogenic form that's been killing so many birds recently. It mutates frequently, with the result that it's also spread recently to pigs and tigers. It is not yet transmissible from human to human, as far as is known.
Subtype H9N2 is a far less deadly form of avian flu. It's also a non-deadly form of human flu, and it can spread from human to human.
According to Dr. Niman, H9N2 has become endemic in Israel, meaning that it appears commonly in Mideast chickens, turkeys and geese.
With hundreds of millions of birds flying over Israel this week and next, and with many of those birds releasing droppings containing H5N1, there are many opportunities for H5N1 and H9N2 to infect the same birds in the Mideast. Once a bird is infected with both of these subtypes simultaneously, the genes can recombine to create a new virus with the lethality of H5N1 and the human to human transmissibility of H9N2.
It's thus possible (though, of course, by no means certain) that a bird flu pandemic could begin in Israel in the next few days or weeks. If it's avoided now, then it may happen in March, when the same birds fly north again over Israel, following the same route in reverse.
Thus, many researchers are concerned that there is a non-negligible possibility that a bird flu pandemic could begin in the next few days or weeks, rather than next year as most people hope.
Meanwhile, bird flu has been spreading in other regions as well.
Bird flu has already touched most countries in Europe, as the adjoining map shows. So far, rapid action by health officials in the different countries of Europe has contained the spread to isolated regions of the continent. Europeans will breathe a big sigh of relief if they can extinguish all H5N1 outbreaks in the next few weeks, since that will probably leave them safe for the winter.
However, the greatest danger will only be postponed to the spring, when hundreds of millions of migrating wild birds returning from the Black Sea and eastern Mediterranean will be harder to contain.
Europe, Asia and the Mideast are not the only regions in danger, of course: Africa is next.
The wild birds migrating over the Mideast this week are heading into east Africa, where it will have a devastating effect. Open air bird markets are common in the crowded cities of Africa, especially near the bodies of water that migrating birds will be headed for.
While European and Mideast countries have the veterinary infrastructure necessary to respond quickly to H5N1 outbreaks, most African countries do not.
Even worse, disease is common in the backyard chicken farms that are common throughout Africa, and bird mortality is already fairly high. Even if 80% of a backyard flock is killed by bird flu, the outbreak may not be reported. As a result, H5N1 may spread rapidly throughout Africa this winter. This will present further opportunities for recombinations of H5N1 with H9N2 and other human-transmissible type A viruses, making a human-transible H5N1 even more likely.
The development of a human-transmissible form of deadly H5N1 is basically a numbers game, a roll of the dice. If you roll a pair of dice just once, the probability of getting "snake-eyes" (1-1) is just 1 chance out of 36; but if you roll the pair of dice 100 times, then the chances of getting snake-eyes at least once are almost certain.
Similarly, if you put a duck infected with H5N1 in contact with a
duck infected with H9N2, then that one pair of ducks has a small
probability of being the "mixing host" for the creation of a
human-transmissible virus; but if you have hundreds of millions of
migrating ducks available, then the chances of a "mixing host" are
far from negligible.
(28-Oct-05)
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