It has been nearly 40 years since a pandemic influenza virus has massively threatened the health and safety of thousands of people across the world.
However, predictions for the next deadly epidemic have not been clear, according to John Barry, a best selling author and advisor to World Health Organization officials.
"It's one of the fastest mutating viruses in existence," he said in a speech Thursday at The University of Memphis. "It may have happened three weeks ago or could have happened in the next 20 years."
Barry authored "The Great Influenza: The Epic Story of the Deadliest Plague in History" and "Rising Tide: The Great Mississippi Flood of 1927 and How it Changed America." He said all flu viruses originate from birds and an outbreak, regardless of when, is guaranteed to happen.
"There are just so many statistics to say," he said.
The last time a mass population flu epidemic broke out was in the late 1960s. Although the virus, known as the "Hong Kong flu," claimed more than 100,000 lives worldwide, it was still considered a mild case.
Fifty years before the "Hong Kong flu," the "Spanish flu," which Barry wrote about in "The Great Influenza," accounted for more than 50 million deaths worldwide and was responsible for clearing at least a quarter of the population in isolated areas like Fiji and regions of Alaska.
The next pandemic influenza, known as the "Asian flu," appeared again in the late 1950s and killed more than 2 million people worldwide.
Since 1997, current outbreak trends have been brief, but potentially disastrous, according to a timeline on the National Institute of Allergy and Infectious Diseases Web site.
The majority of current direct victims, who so far have mainly been in Asia, are poultry farmers or merchants. In addition, H5N1, the virus that recently resurfaced in bird species in Nigeria, was already detected in Turkey, Thailand, Vietnam, Cambodia, Indonesia and China.
On Dec. 30, 2005, Asian nations confirmed 142 lab cases and 74 deaths due to H5N1, while the most recent cases a month ago brought seven deaths in China.
Last weekend India confirmed the virus was responsible for the death of 50,000 chickens in the state of Maharashtra, according to recent news reports. Meanwhile, France, Egypt, Iraq and Azerbaijan all confirmed cases of the H5N1 in their wild life.
If a major breakout occurs now, Barry said it would potentially be more drastic than the 1918 pandemic. He said the population today is much more vulnerable due to innovative treatments for life threatening illnesses, such as cancer, where there are much more survivors, but greater vulnerability.
"We have much more impaired immune systems," he said. "Chemo and radiation therapy both suppress you immune systems. If another one (pandemic) came then between 89,000 and 279,000 Americans will die. Back then there were no cancer survivors."
Despite efforts to counter the next pandemic, Barry also said an efficient defense would almost be impossible.
"In 1918, 99 percent of the people didn't even know they were hit," he said.
The process of making flu vaccines, which has been in place for decades, involves growing viruses in 11-day-old fertilized chicken eggs. Then millions of eggs must be available everyday for production. However, before a vaccine is developed, the virus has to be identified. Then it will take another six months to produce a vaccine.
Such a procedure will not be effective enough with a rapidly mutating virus such as H5N1, according to the U.S. Department of Health and Human Services. The growing rate of infected poultry also gives another reason for possible vaccine ineffectiveness.
Recent reports at DHHS also showed that H5N1 has shown resistance to oseltamivir, the anti-viral drug that makes up Tamiflu and the first line of defense against influenza on the market.
Seasonal flu shots could also help people stay healthy, but will not prove to be a complete and efficient counter for a pandemic, according to the government's official Web site on pandemic flu.
Economically, the United States alone is also not ready for a pandemic, according to Barry and Cyril F. Chang, professor of economics and director at Methodist LeBonheur Center for Healthcare Economics.
Chang referred to the 2002 and 2003 severe acute respiratory syndrome epidemic as an example. SARS left 774 people dead worldwide, but also caused an immediate economic loss of 2 percent of Gross Domestic Product to Asian economies in the second quarter of 2003.
Chang said a U.S. GDP loss of 2 percent would be about 250 billion dollars.
"This does not even include the pain and suffering to be experienced by the direct victims of bird flu and their families," he said. "The disruption to the U.S. economy and the spillover impact to the rest of the economy due to people taking necessary steps to cope with the epidemic will prove to be far more than the 2 percent loss of GDP in the immediate aftermath of a major outbreak. Our recent experience with hurricane Katrina suggests that the U.S. is not prepared to deal with a major outbreak of bird flu."
Nevertheless, the Centers for Disease Control and Prevention estimates that 25 to 30 percent of a whole community would be ill in six to eight week waves. The CDC also suggested that 10 percent of the total work force would be absent due to illness or caring for sick family members.
Nevertheless, other safety agencies and U of M students said strict and basic precautions would have to become routine if no other defense is available.
Lovell Pratcher, a graduate student in vocational rehab, said while non-perishable food, water and medical prescriptions will have to be easily accessible people will also need to be prepared financially.
"A lot of people need to be prepared for life emergencies and will have to think pro-actively."
