Scott McPherson's Web Presence

After an unnaturally quiet summer and fall, we are seeing the signs of an increase in bird flu activity across Asia and Europe, in poultry and in people. In just the past few weeks, we have seen increases in suspected bird flu cases and one confirmed death -- a 15-year old Indonesian. Poultry cases are cropping up again in Laos, Vietnam and Thailand, and we can expect these to accelerate as temperatures drop.

But I suspect we will be more prepared this season if we expect the unexpected from our nemesis H5N1.

Recently, I had a dialogue with one of my subject matter experts, Dr. Richard Webby of St. Jude. I asked him about the roll-off in bird flu cases and gave him my theory of being in the middle of a mutation/evolution of the virus that infects neither poultry nor human with lethality -- yet.

Here's part of what he said:

I guess a number of possibilities here

1) we are just not hearing about ongoing activities as much as we used to (at least in birds)

2) a seasonal affect?

3) Some evolution of the virus as you have suggested.

Also worth considering is the use of vaccine and methods of detection of the virus. We may not be hearing as much about the bird infections if the infection is not lethal (dead birds are easiest way to spot H5). This could be vaccine related in some regions but also could be virus related. So one could argue that birds are still getting infected, but the lethality of the infection is diminishing. This would be expected as a pathogen and host start to co-evolve. Of course this is all hand waving.

In any hypothesis in terms of virus evolution you also need to keep in mind that in essence we have a number of different viruses out there now. So if there is an evolution of the virus in a biologic sense then it is happening simultaneously in all clades?? I am not sure of precedent for any of this. As you know, we really don’t have good data on what was going on before the last pandemics.

I thought about his last statement. We would need to scour the almanacs and agricultural records of the past 100 years to see if any of our flu pandemics were preceded by a sudden reduction of such things as fowl plague, large-scale poultry die-offs and other events.

Let's say that we saw a big die-off of wild birds and poultry worldwide in, say, 1914 through 1916. Then, suddenly, poultry stopped dying in large numbers. Would this have signaled the coming ofthe 1918 pandemic? We have read anecdotal information suggesting the 1918 pandemic was actually around in humans as early as 1915, although this is unproven and could be explained as nothing more than a severe epidemic of whatever strain was going around back then.

But what if it wasn't? What if we saw deaths in 1915-1916 from people exposed to H1N1 Spanish Flu in the same way we see people exposed to and dying from H5N1 today? A case here, a death there. Poultry dying in numbers too large to count. Suddenly, domestic poultry stop dying in large numbers. Everyone slaps themselves on the back, claiming victory over the fowl plague, then WHAMO! The pandemic hits. Hard.

Maybe this is the new direction our historical flu researchers should take. These records should not be hard to find, considering the agrarian history of our nation and the comparatively good diaries and records kept by farmers. If we know the 1918 virus was a bird flu that jumped straight to humans, and if we believe that Kansas was the epicenter, then American farm records might yield a pivotal clue.

We have speculated that H5N1 might evolve away from human pandemic status. Perhaps this has happened or is happening as we speak. But another scenario which I washoping Webby would dismiss -- but he did not and by not dismissing it, actually gave it some credibility-- is the possibility thatH5N1 is once again evolving and mutating into a form whose ultimate victims are as yet unknown.

But considering influenza's proclivities, I am not optimistic for us.