Limelight: Can we stop H5N1? By Lubna Abdel-Aziz Rushing madly across the globe, it traverses borders and boundaries, mountains and valleys, continents and oceans, brooks and streams, disturbing, disrupting, destroying at will and without control. The calm waters of a lazy lake, the flowing flush of a rippling river, once proud of its many migratory waterfowl of elegant swans, cackling ducks and graceful geese, now stand lonely and bare. Their wild and wonderful visitors have been ravaged by a mysterious, malicious intruder, known by the code name -- H5N1. Sweeping through three continents, it has annihilated hundreds of millions of domestic fowl, including our beloved domestic chicken. It is expected to reach the US West coast this summer, and as concerns rise, the powers that be seem nowhere near a solution. Like Chicken Little, they are still running around crying: "the sky is falling". It is neither a cell nor a living organism. It is merely a tiny parasite, with a non-cellular structure, so minutely small it can only be seen through an electron microscope, magnified up to a million times. It cannot even multiply unless it enters the cell of a plant, animal or human. Once it finds a host cell, its power begins. It uses the host cell's chemical energy, protein, and synthesising ability to replicate itself. This tiny, teeny, minuscule non- living organism that spreads ruin wherever it lands, breeds terror in the human heart, still triumphs over science. It is what we call a virus, and it has paralysed man and medicine since it was first discovered last century. It is ruthless, unpredictable, stubborn and deadly. It is said that when physicians are stumped in identifying a disease, they call it a virus, and most times they are right. Viruses are responsible for a wide variety of infectious diseases, ranging from the common cold to AIDS. Of the estimated 1,000 to 1,500 types of viruses, about 250 cause diseases in humans. The frantic race to stop or cure the world's "bogey man", is less than encouraging. It has been six months since we first reported on this impending world disaster. So far it has caused severe sickness in 186 humans infected by the virus, killing 105. Is there any good news on the horizon? H5N1 has yet to be transmitted from human to human. Should that happen, scientists fear a global pandemic of a deadly flu strain, unfamiliar to the human immune system, that could potentially kill up to l50 million people worldwide. WHO, FAO of the UN together with 88 governments have addressed the situation through planning, monitoring, truthful reporting and thorough investigations of bird flu occurrences. What is urgently needed is of course a vaccine to stop the disease by boosting our immune system. More than 30 trials of an H5N1 vaccine are underway, involving several drug companies. The experimental vaccine Tami-flu by Sanofi-Aventis, based on a 2004 virus produced only a satisfactory immune response among 50 per cent of volunteers, last week. The whole of the US stockpile at present, which falls short of total effectiveness, would only protect four million Americans. If this is the situation in the US, how much worse is it elsewhere? Anti-viral drugs are in limited supply everywhere despite the coordinated effort of governments and drug companies who are speeding up production of vaccines. The maximum existing capacity however, is only 900 million worldwide, not even one sixth of the world population. Moreover it is still unknown how an H5N1 vaccine will work. GlaxoSmithKline drug company plans a test on 800 volunteers from Germany and Belgium, and is expanding production facilities, but the best estimate is that they will start producing the vaccine by the end of the year. Apart from the Tami-flu, another form of vaccine surfacing is Relenza, or Zamofir, inhaled through the nose. Fearing the loss of time and financial investment, no one is rushing to production. What is the best scenario of all? What if the virus does not jump from bird to human? What if no pandemic occurs? Some epidemiologists believe that this is a possibility. The fact that it has not mutated already into humans in nine years, since it was discovered in Hong Kong in 1997, is a good sign. It is up to us to help ourselves. All evidence to date indicates that only close contact with dead or sick birds is the major source of human infection... those include slaughtering, defeathering, butchering, and handling of infected birds. Exposure to chicken faeces, or swimming in waters where dead bird carcasses have been discarded, is a clear and present danger. Drastic action such as taken by Hong Kong, which was the rapid destruction of the entire poultry population of 1.5 million, may have averted a pandemic. What is that unusual name of coded letters and numbers? Avian flu is a disease, avian flu virus is a species. Avian flu virus subtypes are labeled according to an H number and an N number. Even familiar names such as La Grippe, the "Spanish Flu", was caused by the H1N1 virus, the Asian flu by H2N2, the Hong Kong flu H5N1, etc. H5N1 in humans is still poorly understood. It is also capricious and selective. While it may infect your relative, and kill your neighbour, it may very well skip you and dozens of others, with little rhyme, and less reason. What are we poor souls supposed to do? Are we not better equipped now than we were almost a century ago, when the Spanish flu destroyed 50 million lives? Are we not more advanced, more learned, more savvy today than we were then? Yet for all our sophistication we seem to be helpless in front of a teeny, tiny, non-living organism that winds and weaves its way inside the cells of our plants, our flocks, and our very own bodies, destroying our organs and our lives. The virus, together with the mosquito seem indestructible So far, Nature still has the upper hand. Diseases, of their own Accord, But Cures, come difficult and hard -- Samuel Butler (1612-1680)
