A Bird in The Head

For now, only those who handle fowl in Asia appear at high risk for avian flu.
For now, only those who handle fowl in Asia appear at high risk for avian flu. (Sakchai Lalit/ap)
By Marc Siegel
Special to The Washington Post
Tuesday, January 31, 2006

Bird flu fears are being stoked again by a rash of reports of deaths abroad from the virus. The human toll from bird flu in Asia and Europe has reached at least 82. Even though all cases so far have been traced to contact with birds and there is no evidence that the disease is being passed from human to human, the prospect of transmission is what worries ordinary people the most.

That fear is unnecessary, says New York internist Marc Siegel. His new book, "Bird Flu: Everything You Need to Know About the Next Pandemic" (John Wiley & Sons, Inc.), addresses some common fears surrounding the illness. We've excerpted and adapted some of the book's questions and answers here.

How likely is a human bird flu pandemic?

The government has reason to consider worst-case scenarios as it attempts to protect us, but I do not think a massive bird flu pandemic that kills many millions of people worldwide is about to happen. This form of H5N1 (the flu strain responsible for the deaths) appears to have been around since the 1950s. In the past eight years it has infected millions of birds, but documented human cases have been rare. We don't know how many thousands of people have developed antibodies to this virus and not gotten sick from it, so it may not be as deadly to humans as it seems to be. If it mutates sufficiently to infect us routinely, it may do so in a way that causes it to be far less lethal.

Should I prepare emergency supplies of food and water just in case ?

Absolutely not. Bird flu is one in a long line of things we've been warned about, and for which we supposedly need some kind of "safe room" with an ample supply of food and water just in case. First it was anthrax, then West Nile virus, then smallpox, then SARS. In each case we were warned that we had no immunity and could be at great risk.

The national psyche has been damaged by all these false alarms. On alert for potential threats, we're worrying more and more of the time. The emotional center of the brain, the amygdala, cannot process fear and courage at the exact same moment. If we could train ourselves to filter out dangers that don't threaten us by setting our default drives to courage or caring or laughter, we'd be a lot better off.

Should I wash my hands more frequently ?

Go ahead -- hand washing is good protection against all respiratory and gastrointestinal viruses -- but don't use bird flu as the excuse.

In the fall of 2005, the purchase of hand sanitizers was up almost tenfold. I'm sure this is a response to the fear of getting bird flu -- a way to reassure yourself that you are doing something to protect yourself. I would never discourage hand cleansing, but keep in mind that any quick remedy for bird flu fears also reinforces the notion that bird flu is almost here, when there is no evidence to support this. The same is true for avoiding poultry. It may make some people feel safer for a brief moment, but it also reinforces the misconception that our poultry supply is at risk.

Are there specific medical supplies I should stockpile against bird flu? What about Tamiflu ?

To the first question, the answer is no. As for Tamiflu, it's a bad idea to stock up on this medicine, even if it is found effective at reducing symptoms in humans -- something that's not yet been proven.

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