- Nuclear detonation: 10 kiloton nuclear device*
- Biological attack: aerosolized anthrax*
- Biological disease outbreak: flu pandemic
- Biological attack: pneumonic plague
- Chemical attack: blistering agent
- Chemical attack: Toxic industrial chemicals*
- Chemical attack: nerve agent
- Chemical attack: chlorine tank explosion*
- Natural disaster: earthquake
- Natural disaster: major hurricane
- Radiological attack: dirty bomb*
- Explosives attack: improvised bombs*
- Biological attack: food contamination**
- Biological attack: foot and mouth disease
- Cyber attack*
The third scenario, above, identified a pandemic flu outbreak.This scenario is summarized below.
Scenario 3.Biological Disease Outbreak: Flu Pandemic
This scenario involves an influenza pandemic that begins in south China and spreads within months to four major cities in the US.The scenario estimates 87,000 dead and 300,000 hospitalized in the US alone.The economic impact is estimated at being between $70 and $160 billion.
A pandemic is defined as an outbreak of infectious disease that strikes a very wide area, hemisphere-wide or world-wide.It can last for one or more years.Influenza can be a pandemic since it has the ability to rapidly spread around the entire world.
The bird flu, or the H5N1 virus, or avian flu as it is also known, is a type of influenza virulent in birds.It was first identified in Italy in the early 1900s and is now known to exist worldwide.This virus is spread through exchange of mucus or feces, generally without creating sickness or death in the birds, who are considered to be hosts of the virus.This virus mutates quickly and also has the ability to jump to other species such as pigs, and now humans.
Symptoms of Bird Flu in Humans
The symptoms of bird flu in humans have ranged from typical flu-like symptoms such as fever, cough, sore throat and muscle aches to other specific symptoms like eye infections, pneumonia, viral pneumonia and other severe and life-threatening complications.
Will a pandemic occur? Scientist say there are three components that must come together to create a pandemic.The first is a highly virulent strain of the virus.Virulent refers to the ability of a virus or a bacterium to cause damage.The second is a lack of human immunity to the virus.The final component is the ability to be easily spread from human to human. Given the rapid way the virus mutates, the natural spread through bird migration and the history of the 1918 outbreak, a pandemic would seem likely.
We already know that this outbreak has spread from Asia (where the outbreak began) to Europe.The race is on around the world to stop the rapid spread of the bird flu.While drug companies around the world work to find a vaccine to prevent bird flu, there are other steps that must be taken to slow the spread.Based on my research, the following six actions must be taken.
- Increase awareness of healthcare professionals and the public
- Vigilant monitoring of the spread of the virus
- Early identification of persons or animals infected with the virus
- Real-time reporting of suspected and documented infections
- Rapid isolation of infected humans and animals
- Destruction of the hosts
A global mapping system with a fully integrated reporting and document management system would aid in not just tracking the spread of this virus but also the many mutations we can expect along the way.Another benefit to a fully integrated real-time tracking system would be the dynamic distribution of vaccines and anti-virals.It has been reported that there aren't enough supplies of drugs to combat the bird flu.So maximizing the value of these supplies will be critical.Immediate flooding of an area with an anti-viral where an outbreak is identified could slow or stop the spread of the virus, thus decreasing the need for the drugs.
This Web-based system must allow for quick and easy reporting of suspected outbreaks, and include attachments that provide specific scientific data defining what strain of the virus is present, the number infected (human and animal), the number of deaths (human and animal) and the specific geographic location of all points of infection.Additional information would include the virus verifying agency and contact information, agency in charge of outbreak control, and a point of contact there.
On the technical side, the system would require a robust set of APIs. All the scientific instruments used to isolate and validate the strain of the virus should be integrated.In addition, the system would need to integrate with dozens of agencies around the world that would in turn need to integrate this data into their scenario planning and outbreak management systems.
A graphic user interface would allow click-thru navigation that allows drill down capability into a single event of an infected individual.In addition, an alert function would need to be included with user selectable thresholds to instantaneously initiate communications to a predefined distribution list upon certain conditions being met.At this time no such system exists.There are smaller, less robust systems that operate in isolation in the US and other countries around the world.
Here are some examples of bird flu mapping efforts.
- Documented Avian Influenza Infections in Humans - Current, 2005 (European Commission)
- Recent (since December 2003) outbreaks of H5 Avian Influenza in Asia and Confirmed Human cases, 2005 (European Commission)
- Avian Influenza Maps - Asia, Bi-Weekly (FAO)
- H5N1 Wild Bird Flu Outbreaks October 2005
- Interactive Map: The Spread of H5N1 Influenza in Asia
One critical issue that cannot be addressed by technology is transparency.We have already heard concerns that not all governments are reporting that they have active cases of bird flu.In some countries, the economic impact of a bird flu outbreak could be significant.The economic damage could persuade government officials to delay disclosure or not to disclose the outbreak at all.
So are we ready? No! Our ability to rapidly isolate and neutralize the virus at a specific geographic point is hindered by lack of real-time reporting systems, a point I've brought up in several articles.Given that the carriers at this point are birds, any rural area would seem to be the most likely place where an outbreak will occur.The paper-based reporting systems used by emergency management systems and local heath care facilities in many of these remote areas could slow the flow of information; and thus decrease the ability to rapidly intervene and stem the outbreak early on.Here are a few points to consider.
- The United Nations estimated a global bird flu pandemic could result in between 5 and 150 million deaths.
- Currently there are believed to be hundreds of millions of birds already infected.
- Migration of wild birds is one way the virus is spread.
- In 1918 there was a bird flu outbreak that also infected humans, and killed between 20 and 40 million people.
- All known subtypes of influenza A viruses circulate among wild birds, which are considered the natural hosts for influenza.
- In 1997, an outbreak of bird flu in Hong Kong saw 18 documented cases of human infection and six deaths.
- Multiple studies suggest that people are as concerned about the bird flu outbreak as are concerned about terrorist attacks.
- The continuous mutation of the virus will lead to human-to-human infection.
- According to the World Health Organization, a vaccine being developed for the strain in 2003 is no longer of use against the newer strain.
- Reports indicate that 3,673 wild waterfowl had died in Iran.Is this the further spread of the virus?
- Multiple sources suggest the bird flu has between a 50% and 55% mortality rate.
The threat is real.The crisis is just around the corner.Whether naturally occurring or brought on as a terrorist act, this must be addressed.What? You don't think Al Qaeda would use the bird flu as a weapon against the US? Think again.Remember the West Nile Virus (WNV)? Reports that the US strain of the WNV is more deadly than anywhere else in the world have not been fully investigated.Could the WNV outbreak in the US have been engineered? I am not sure anyone has the answer. But it is something to consider.
Ever consider how a pandemic in the US might impact you? How will businesses, government, education and other entities cope with the bird flu? Will telecommuting become the norm rather than the exception? We have all become accustomed to walking though metal detectors and explosives detection portals as we go about our daily lives.Will we now be subjected to having our body temperatures taken? Terrorist attack or not, the time to respond is now before it is too late! Or is it already?