Page 1 of 3 1 2 3 Next 72 replies to this topic

[Buff-horns]

Bird flu catastrophe may start hand to mouth
Tue Oct 18, 2005 1:01 PM BST164



By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - The scenarios all start out the same way -- at a small farm somewhere, perhaps in Southeast Asia, some chickens become infected with H5N1 bird flu.

They end with a global pandemic in which millions of people die, a catastrophe beyond all living human experience.

The especially virulent H5N1 strain of avian influenza has been found in flocks from Japan to Indonesia, and has moved west into Turkey and Romania, and this week possibly Greece, where tests are pending.

The virus has infected 117 people in four countries, killing 60, and is steadily mutating. Experts say it is only a matter of time before H5N1 bird flu changes enough to make it a disease that transmits easily from human to human.

These changes may also make it less virulent -- but they may also make it more dangerous. No one knows.

In a few potential scenarios, the world gets lucky and officials act quickly to vaccinate populations and distribute lifesaving antiviral drugs. The damage, while enormous, is limited and economies recover after a few months.

But health experts are unusually united in warning that if H5N1 makes the jump from birds to people in the next two years, it will cause an unprecedented disaster.

"I want to emphasize the certainty that a pandemic will occur," Dr. Gregory Poland of the Mayo Clinic Medical School in Rochester, Minnesota, who represents the Infectious Diseases Society of America, told a briefing last week of Congressional staffers and lobbyists.

"When this happens, time will be described, for those left living, as before and after the pandemic."

STARTING WITH A SICK CHILD

So how will it start? Perhaps a child whose job it is to care for the chickens will become ill with H5N1. Her desperate mother will tend to her day and night. Inside the child's body the virus will mutate, just a little bit.

She will cough as the virus affects her lungs, causing pneumonia. Her mother will wipe the brow of the feverish, sweating child and unthinkingly bite her hand to hold back the sobs of despair.

Neighbors hug and comfort the mother at the funeral. A week after the child's death, the mother will become ill. News spreads through the village. A nervous neighbor, fearful for her own children, takes them to relatives who live far away.

Influenza spreads before people show any signs of illness. Within days, H5N1 could be carried across an entire country before health officials could be notified.

The neighbor could infect her relatives, one of whom has a business trip to a major regional capital. The virus could easily infect a passport agent, a doorman handed a tip, a baggage handler.

Like any other influenza virus, H5N1 is most likely to spread hand to mouth -- and human beings are constantly touching their mouths, their noses, and leaving small, wet, infected drops of saliva and mucus on everything they touch.

Health officials in the province where the child has died suspect H5N1 but they are afraid of being quarantined, their economy stifled.

Probably all the flocks will be destroyed, and entire livelihoods with them. The officials decide to err on the side of caution. Days pass while the sick villagers are tested, and the unsuspecting flu-infected traveler has passed the virus to dozens of people before becoming ill himself.

WAITING FOR TEST RESULTS

Tests for H5N1 require days to run. By the time it is clear what has happened, two weeks have gone by and the new H5N1 mutant has been carried by jet to eight cities around the world.

There is no controlling it.

The World Health Organization estimates range from 2 million to 150 million deaths, depending on how virulent the mutated virus turns out to be. These will occur within months. AIDS has killed 34 million people, but has taken 20 years to do it.

The 1918-1919 influenza pandemic killed between 20 and 100 million people in 18 months.

"Even if you take every year the problems of malaria, tuberculosis and HIV/AIDS, which are horrible, pandemic influenza has the potential in just one fell swoop to kill so many more people than those diseases kill in decades," said Dr. Mike Osterholm, a University of Minnesota infectious disease expert who has been issuing some of the most dire warnings.

"Twenty-five percent of the population could get sick at the same time," said Penny Hitchcock, an infectious disease specialist at the University of Pittsburgh's Center for Biosecurity.

Hospitals around the world will be overwhelmed, and may themselves serve to spread the infection. There will not be enough ventilators to keep the very sick alive and breathing. Most people will elect to stay at home, dying quietly in bed or, if they are lucky, surviving and becoming immune to the virus.

"How do we handle the dead bodies?" Osterholm asked.

IDLED FACTORIES

Shipments of raw supplies will stop as countries close their borders. Entire industries could grind to a halt -- including medical suppliers.

"You have two companies that make 90 percent of N-95 masks," said Osterholm. These are masks that can filter out particles likely to carry viruses, and that are the gold standard for protecting health care workers.

"How will healthcare workers come to work?"

Schools will close, and parents will be unable and unwilling to leave their children to come to work. Many of these parents will be essential workers -- nurses, firefighters, bus drivers, power plant employees -- who cannot telecommute.

Antiviral drugs such as Roche's and Gilead Science's Tamiflu can be used to treat patients and perhaps to prevent infection among family members of known cases, but they are in extremely short supply.

"If it happened today, we have no Tamiflu and we have no vaccine," said Dr. Isaac Weisfuse of the New York City Department of Health -- which is more organized than many cities after the September 1, 2001 attacks.

An H5N1 vaccine will take six months to make, during which time hundreds of millions of people could become infected.

Poland said the United States would need 600 million doses of an H5N1 vaccine, because two doses will probably be needed for full protection.

The most flu vaccine the United States has ever been able to pull together was 95 million doses in 2002. The factories that can make the vaccine do no exist and would take years to build if efforts started tomorrow.

source: reuters.com

[britmaveric]

Or Scientists will find a vaccine and all is well!!!

[The_Other_Mac]

britmaveric, on 2005-10-18 23:39:01, said:

Or Scientists will find a vaccine and all is well!!!

<{POST_SNAPBACK}>

There are a few "all is well" scenarios, but that's not one of them. Despite the wonderful trust in science to solve all the world's problems.... it isn't hard to see that science can't find a vaccine for a disease that doesn't exist yet.

The thing that is now in Romania, that we call bird flu, is not dangerous. It's killed 60 people, which barely registers. The only reason to worry about that disease, is the economic damage caused by the necessity of slaughtering millions of poultry. If we find a vaccine for that disease, no drug company will bother to produce it. Not much point, since the victims already die before they are diagnosed.

The disease that we are worrying about, is a hypothetical one. We know that flus mutate easily and frequently. We know that there is currently a flu that has a nasty tendency to kill everyone, but fortunately can't be passed from human to human. Since mutations happen constantly, eventually one will turn up that is similar in many ways, execpt that it can be passed from human to human. At that point, it stops being bird flu.

When a sample of that new flu is isolated, science can then do its job, and when a vaccine is produced, then production can begin. That is estimated to take six months, but we can't start yet.  

[britmaveric]

Another likely scenario - bird flu won't mutate and just fizzle out.

[The_Other_Mac]

britmaveric, on 2005-10-19 00:18:11, said:

Another likely scenario - bird flu won't mutate and just fizzle out.

<{POST_SNAPBACK}>

No, that's not likely. Flus do mutate, constantly, all the time. That's why we talk about "flus", in the plural.

Viruses don't "fizzle out" either. The population acquires immunity, whether through surviving infection, or passing antibodies from mother to baby. Once a sufficiently high proportion of the population has immunity, the rate of infection slows to a point where infected individuals have no contact with non-immune individuals. At that point it may well disappear before every last individual has immunity - it depends on whether immune individuals can act as carriers and transmit the disease. In the case of flu, that's not possible (although if there's a non-lethal reservoir in another species, such as poultry, that could continue to transmit).

I believe it's suggested that typically 70% of a population needs to acquire immunity, before further infections become isolated.

In that respect, vaccines work rather quicker than natural forces.

[Nam Kao]

I read its a miserable / painful death

[Buff-horns]

surely it would be better to eradicate all chickens ,ducks and roosters then there can be no more bird flu. compensate the farmers for their losses and that must be less than the 100 million $ contingency fund. no more problem and save some $ .
ok no eggs and gais for maybe a year but eat pigs instead.
and we can get some sleep too.

[george]

Well cooked/BBQ'ed  chicken is not a problem. If they are dead.

[britmaveric]

george, on 2005-10-19 03:31:27, said:

Well cooked/BBQ'ed  chicken is not a problem. If they are dead.

<{POST_SNAPBACK}>

George - words of wisdom!!!  

As far as no mutations - I'm still looking for the links, but read someplace that its not out of the realm this wont jump to humans.

Pandemic - I'm leaning against it.  Case in Point - how far did SARS get when all was said and done? It won't hurt to be prepared, but I've got a nagging suspicion we all will be fine. This reminds me similarly to all the doomsayers when Y2K was looming. (same panic/feeling is prevalent)

[Davey]

britmaveric, on 2005-10-18 20:41:26, said:

george, on 2005-10-19 03:31:27, said:

Well cooked/BBQ'ed  chicken is not a problem. If they are dead.

<{POST_SNAPBACK}>

George - words of wisdom!!!  

As far as no mutations - I'm still looking for the links, but read someplace that its not out of the realm this wont jump to humans.

Pandemic - I'm leaning against it.  Case in Point - how far did SARS get when all was said and done? It won't hurt to be prepared, but I've got a nagging suspicion we all will be fine. This reminds me similarly to all the doomsayers when Y2K was looming. (same panic/feeling is prevalent)

<{POST_SNAPBACK}>

I agree, people are panacking because they are misinformed and the media always prefer to sensationalise, that is what attracts custom.  People should just go for their flu jabs as normal, particuarly if you are elderly, and the virus shouldn't be able to mutate into the form which is contracted human to human, as the fears are that is someone with the flu contracts the virus from a bird with a cold, they could merge into a form which is able to infect human from human.

I think rationale is the best option here.  I'm still barely getting over some persons comments (I think Rigger) about baracading himself if it all kicks off, interesting to say the least

[xbusman]

Well here are some scary points.

All forms of influenza virus are avian in origin. The flu virus always comes from birds but we dont know about how they start or understand the mechanism that allows that to happen.

Second, of all the avian influenza viruses we have ever found, not a single one ever showed up and then just disappeared. Every avian flu has made the jump to humans.

The good news is that we have really only understood viruses for about 70 years, not a lot of experience to be sure about anything. Based on what we know, the probability that this virus wont come to us is too small to consider.

This is no comparison of flu virus with SARS and Y2K, to do so is to not understand the very nature of influenza. If you want to make comparisons use the 1918 avian flu outbreak when H1N1 made the jump.

What we dont know is what this influenza will look like when it changes to a form that will come for us. It could have a mortality rate of anything between .1% (usual type A flu) and 57% which is the current mortality rate. Everyone following this is hoping that it lands at .1% and it could very well do so. For reference, the 1918 avian flu had a mortality rate of approx 2.5%

Eradicating birds is no answer. The virus has found a way to survive in wild birds without killing them. We would have to destroy all avian species to stamp this thing out now. I am not sure I would want to live in a world without birds...

No, we are going to have a visit from this thing but have no idea what it will be like or when it will come. Here is hoping that it will take another fifty years to find its way to us and when it does its just another day off work.

[cathyy]

xbusman, on 2005-10-19 01:13:24, said:

All forms of influenza virus are avian in origin. The flu virus always comes from birds but we dont know about how they start or understand the mechanism that allows that to happen.

Second, of all the avian influenza viruses we have ever found, not a single one ever showed up and then just disappeared. Every avian flu has made the jump to humans.

<{POST_SNAPBACK}>

You are so right, xbusman. All influenza does start out as Avian flu. The USUAL path is then a mutation that allows it to infect pigs. Pigs are physiologically very similar to humans, so a virus that can infect a pig can infect a human. Someone becomes infected from a pig, and the annual flu season begins. It typically originates in China or SE Asia because that's where you have the right environment: chickens, pigs, and people living in very close proximity. The good news is that the mutation that allows the flu virus to infect pigs usually decreases the virulence. Most years the "new" flu is really only a variant of flus that have been around before.

A so-called Avian flu is one that skips the pig step. H5N1 is a brand new virus to people, so nobody has any immunity no matter how many flu shots they have had, or how may times they have had the flu. We can hope that H5N1 will follow the usual path, but it doesn't look like it will. It's going to be an Avian flu pandemic, and the only question is when.

There have already been a very few isolated cases of possible, but not absolutely certain, human to human transmission. It can mutate to transmit person to person, but it's not very contagious when it does. So far. It will mutate to become highly contagious. It will do it by swapping genes with a flu virus in a person or pig who has the old flu virus in their system and becomes infected with the new flu. Researchers have noticed how often this particular flu virus swaps genes with other viruses. Bad news for people.

And no, not all Avian flus have jumped to people. Most types simply cannot infect a human. It's a rare one that can. Yes, they cull flocks for those viruses, but only because of the danger to the poultry industry, not to people. Better to say that all the Avian flus that were able to infect people at all have made the jump to human to human transmission.

With the virus now found in Europe as well as Asia the likelihood of the mutation we are all dreading increases. It's going to happen. Tamiflu won't help. People like me and my husband, with asthma, are the most likely to die from it.

[britmaveric]

Stop worying about it then if you think its inevitable. No worries here!!!

[xbusman]

All forms of type A and type B virus have found varying combinations to make the jump. There are no other avian influenza viruses other than H5N1 that have not recombined (or mutated) and been exposed to humans that we know of. (I want to say "according to what I have been able to read and find out from vetinarian virologists") Even H5N1 (1918 bird flu) is still present in a greatly mutated form and we all have residual resistance from having been exposed to far lesser virulent forms during the usual flu season. I would be interested in reading anywhere about other forms of avian influenza that are completely unknown to our immune system in any permutation. Its important to remember that viruses have only been recognized since about 1930 and our understanding of them is pretty rudimentary.

Tamiflu is really an open question because H5N1 is an open question and nobody can claim to answer it definitively. Anyone who claims that it will work or wont work is just talking to hear the noise. The biggest brains with the most experience in avian influenza are GUESSING that it is our best defense IF bird flu does not mutate radically AND it is administered in time. Thats a lot of guessing, ifs and ands. Because I dont have a virology degree I tend to listen pretty carefully to those that do. It has appeared to be effective so far with only one partial exception but the field results have been far to small to draw any meaningful conclusions.

If anything ever gets through the clutter of our busy life, this might be the issue to do so. While I dont advocate panic or worry, it is something to take note of and learn enough about to adequately asses the risks. Those of us in Thailand should even be more aware of the potential and have an idea of what we might do in an effort to react with our heads instead of our adrenaline should things go south. Having a dose of Tamiflu and some N95 masks does not constitute panic or worry given the nature and background of this beast.

One of the reasons I enjoy Thai Visa so much is the wealth of information members share from their hard earned experience. I have avoided the dreaded sick buffalo, the Elite scam, learned how to get a drivers license, even got the hang of those darn squat toilets thanks to some rather overly graphic discussions. Still, despite this information being so generously shared and readily available, buffaloes get sick every day to the great distress of the new punters.

Dont be a punter when it comes to Bird flu. Turn off the footie and read a bit about what it is and what it means. Dont confuse it in ignorance with SARS or Y2K or any of the other hysteria de jour.

Thanks for the great post Cathyy, I would be interested in learning about any avian influenza virus that has not made the jump. Thanks

[cclub75]

A very interesting thread.

Since we are talking about "scenarios", what would be your scenario to (try to) avoid the epidemic, if it occurs ?

Do we have figures for the epidemic of 1918, regarding the geographical distribution ?

Is it reasonnable to assume that the virus can not survive or spread in a very cold environnement like Iceland ? Or is it only slowing the process ?

Or very hot and dry ? Like a desert ?

I guess the best theoritical solution would be to avoid human contact, and to live in a hostile environnement.

Like Phuket for instance ?

[chownah]

cclub75, on 2005-10-19 14:45:16, said:

A very interesting thread.

Since we are talking about "scenarios", what would be your scenario to (try to) avoid the epidemic, if it occurs ?

Do we have figures for the epidemic of 1918, regarding the geographical distribution ?

Is it reasonnable to assume that the virus can not survive or spread in a very cold environnement like Iceland ? Or is it only slowing the process ?

Or very hot and dry ? Like a desert ?

I guess the best theoritical solution would be to avoid human contact, and to live in a hostile environnement.

Like Phuket for instance ?

<{POST_SNAPBACK}>

The first step needed to avoid the epidemic is to panic.

[britmaveric]

chownah, on 2005-10-19 16:05:33, said:

cclub75, on 2005-10-19 14:45:16, said:

A very interesting thread.

Since we are talking about "scenarios", what would be your scenario to (try to) avoid the epidemic, if it occurs ?

Do we have figures for the epidemic of 1918, regarding the geographical distribution ?

Is it reasonnable to assume that the virus can not survive or spread in a very cold environnement like Iceland ? Or is it only slowing the process ?

Or very hot and dry ? Like a desert ?

I guess the best theoritical solution would be to avoid human contact, and to live in a hostile environnement.

Like Phuket for instance ?

<{POST_SNAPBACK}>

The first step needed to avoid the epidemic is to panic.

<{POST_SNAPBACK}>

Exactly - stop all the doom chatter - its tiring rubbish!

[Clip_My_Wings]

I suggested to my friend that as a precaution she remove her chickens from her farm

would some of the knowledgable people on this topic approve of such an action ?? or be able to advise??

[britmaveric]

Clip_My_Wings, on 2005-10-19 18:06:55, said:

I suggested to my friend that as a precaution she remove her chickens from her farm

would some of the knowledgable people on this topic approve of such an action ?? or be able to advise??

<{POST_SNAPBACK}>

Are they sick? If its smth you can go without and can buy elsewhere then why not send them packing.

[Clip_My_Wings]

britmaveric, on 2005-10-19 11:17:53, said:

Clip_My_Wings, on 2005-10-19 18:06:55, said:

I suggested to my friend that as a precaution she remove her chickens from her farm

would some of the knowledgable people on this topic approve of such an action ?? or be able to advise??

<{POST_SNAPBACK}>

Are they sick? If its smth you can go without and can buy elsewhere then why not send them packing.

<{POST_SNAPBACK}>

as far as i know there not sick ... i say sell them as they are not vital and the eggs they provide can be bought easily enough ..

i think this is a cautius approach but i guess its better to be safe than sorry

anyone elses opinion please

i feel my friend's opinion may be a little bit mai pen rai ?

[AlexLah]

Birdflu, puh!

How many people die each year from Malaria, cholera, huh?

Did the world do anything to stop that?

And now we have a big media hype about the birdflu.

Get a life.

Alex

[phibunmike]

Clip_My_Wings, on 2005-10-19 19:06:55, said:

I suggested to my friend that as a precaution she remove her chickens from her farm

would some of the knowledgable people on this topic approve of such an action ?? or be able to advise??

<{POST_SNAPBACK}>

I think that is sensible. All cases I have read about so far came from intimate contact between a family and their domestic chickens (please, no jokes   )

I was going to buy some chickens but decided to put it off for now - even if they are isolated from other flocks, we now know that H5N1 is being carried by migratory birds.

I don't think this issue is about doom-mongering. There is a very real threat of a major pandemic, in fact I think perhaps it is being played down too much if anything. I would like to know what sensible precautions we can take. Can individuals purchase Tamiflu? Can it be kept in a refrigerator? For how long?

Another scenario I have never seen in print: the worst case scenarios consider manufacturing capabilities for a vaccine if/when the mutation takes place, and point out inadequacies in existing manufacturing facilities. But there is no guarantee that only one mutation will take place: what if two more more strains develop with the capability to infect human-to-human ?

Edited by phibunmike, 2005-10-19 20:36:01.

[phibunmike]

AlexLah, on 2005-10-19 21:10:57, said:

Birdflu, puh!

How many people die each year from Malaria, cholera, huh?

Did the world do anything to stop that?

And now we have a big media hype about the birdflu.

Get a life.

Alex

<{POST_SNAPBACK}>

Do your homework...

Malaria about one to three million, depending on statistics used.

Cholera a few thousand.

Nothing like a flu pandemic with possibly a hundred million in a couple of months  !!!

Edit>>

What was done ?  There is a cholera vaccine. There are malaria prophylactics. There are malaria vaccines undergoing clinical trials...

Edited by phibunmike, 2005-10-19 20:48:52.

[britmaveric]

"Bird Flu" Similar to Deadly 1918 Flu, Gene Study Finds
Brian Handwerk
for National Geographic News
October 5, 2005

Scientists have reconstructed the genetic code of the deadly 1918 "Spanish flu," which swept the globe and killed an estimated 20 to 40 million people. Among their findings: The 1918 virus strain developed in birds and was similar to the "bird flu" that today has spurred fears of another worldwide epidemic.

By studying the once deadly 1918 virus's genetic information, scientists may become better able to predict future pandemics, or widespread epidemics. It may also aid the development of new vaccines, antiviral medicines, and other treatments to cope with flus.

"The purpose was to get at questions relating to the 1918 pandemic," said Jeffery Taubenberger, of the Armed Forces Institute of Pathology (AFIP) in Rockville, Maryland. Taubenberger co-authored one of several related papers in this week's issues of the journals Nature and Science.

"How did this particular virus form and get into humans? How did a pandemic start?" Taubenberger said. "Why was this particular virus so virulent? And in a broader sense what can we learn from the lessons of 1918 that can help us in the future?"

Influenza viruses were unknown in 1918, so there was no way for doctors or scientists to directly study the flu during or after the outbreak.

But some institutions, like the AFIP, preserved tissue samples from 1918 flu victims. Those 87-year-old samples—and others from a victim who was buried in, and preserved by, Alaskan permafrost—yielded tiny fragments of genetic material that were used to piece together the virus's genetic coding signature.

The final genes of the virus's genome sequence are being published this week. Scientists used the completed, full viral sequence to create a live virus with the eight viral genes of the Spanish flu, named for an early, devastating outbreak in Spain.

Even if somehow released, that virus would be unlikely to cause a pandemic like that of 1918, because humans have likely acquired some immunity in the intervening decades. Nonetheless, it is currently contained at Atlanta, Georgia's Centers for Disease Control and Prevention (CDC) under extremely strict security.

A Weapon Against the Next Pandemic?

Many experts warn that the world is overdue, and unprepared, for a global influenza pandemic. The next outbreak could well be as deadly as the Spanish flu, also known as H1N1, and potentially leave tens of millions dead.

Currently experts can't determine exactly which viruses might spark pandemics, though the Spanish flu data may help to identify which strains bear close observation.

H5N1, a strain of avian influenza called the bird flu, is the most likely candidate. The largely Southeast Asian disease is commonly found in birds but also occurs in mammals like pigs, cats, and humans. It has killed several dozen people, but as of yet it cannot be easily transferred from person to person and so has not developed into a pandemic outbreak.

Analysis of the 1918 strain revealed several mutations also found in H5N1. The findings suggest that both strains share an ability to jump directly to humans from other animals without having to first combine with a flu strain already adapted to humans.

"The sequence evidence from 1918 suggests that the virus is from completely avian origins," said Adolfo Garcia-Sastre, a microbiologist at Mount Sinai School of Medicine in New York City.

Human immune systems would likely be caught off guard by a purely avian virus to which they have no acquired immunity.

The century's other great pandemics, of 1957 and 1968, were sparked by hybrid flu viruses—human flus that acquired some genes from an avian source.

"This [finding] suggests that pandemics can form in more than one way, which is an important point," said the AFIP's Taubenberger. "We've been identifying a series of mutations that we believe are important in the way that an avian virus would adapt to become a human virus," Taubenberger added.

Though the evidence is compelling, only pre-1918 samples would allow scientists to be 100 percent sure that no aspects of the Spanish flu were previously present in contemporary human flu strains and that the flu was of completely avian origin.

"What makes a virus able to go from an avian reservoir to humans?" Mount Sanai's Garcia-Sastre asked. "That's important. Influenza is mainly a virus of birds. There are many different strains in birds and only a few affect humans. Pandemics occur when one of these jumps into the human population and can affect people by propagating from person to person."

Deadly Virus May Save Lives

CDC officials are taking extreme care to safeguard the re-created 1918 virus, though it would not likely lead to a major pandemic if the strain spread among the general population.

Tests have shown that mice that had been injected with current flu vaccines were protected from the 1918 strain.

"We know that all documented pandemic episodes have involved the emergence of a completely new strain," Garcia-Sastre said. "That happened in 1918, 1957, and in 1968."

"There is also evidence that people who were 40 years or older in 1918 were spared," he added. "One hypothesis to explain that is that persons 40 years old or older were exposed to an H1 virus before and had some immunity."

Now, decades after its outbreak, the 1918 virus may be a weapon rather than an opponent.

"I think we've been able to unmask the 1918 virus, and it's revealing to us some of the secrets that will help us prepare for the next pandemic," said Julie Gerberding, Director of the CDC.

[chownah]

phibunmike, on 2005-10-19 20:42:16, said:

AlexLah, on 2005-10-19 21:10:57, said:

Birdflu, puh!

How many people die each year from Malaria, cholera, huh?

Did the world do anything to stop that?

And now we have a big media hype about the birdflu.

Get a life.

Alex

<{POST_SNAPBACK}>

Do your homework...

Malaria about one to three million, depending on statistics used.

Cholera a few thousand.

Nothing like a flu pandemic with possibly a hundred million in a couple of months  !!!

Edit>>

What was done ?  There is a cholera vaccine. There are malaria prophylactics. There are malaria vaccines undergoing clinical trials...

<{POST_SNAPBACK}>

Doesn't malaria kill a million people every year? The flu is usually a one time thing mostly...and 100 million is probably way high of an estimate....I've read that most likely it would be 5 million world wide.