As the Bird Flies/Flew/Flu...

      Have you seen the price of eggs?  Hmm, a silly question for most of us, despite friends telling me that eggs are still inexpensive in countries such as Mexico.  But unless you're looking at that frozen turkey in the fridge, you'll notice that the prices of "fowl" have also jumped substantially, in some cases doubling or tripling in price.  The issue is the culling of entire flocks of chickens due to the spread of bird flu, which for many commercial producers, can amount to millions of birds per farm.  But first, a few basics of the flu in general.  Here's a quick summary from UCLA Health on the difference between a cold and the flu: The common cold is caused by a virus, usually rhinovirus and sometimes coronavirus.  An identifying characteristic of a plain old cold is that the symptoms it causes occur from the neck up.  These include a sore throat, clogged sinuses, a runny nose, sneezing, the production of thick (and seemingly endless) mucus, ear congestion, watery eyes and sometimes a headache...[but] the flu hits hard and fast.  Symptoms can be similar to those of the common cold, but are markedly more intense.  People with the flu often have a high fever; chills, exhaustion and widespread body aches are common.  The infection can also affect the respiratory tract, causing a persistent cough and mucus production.  

     No big deal, you say, we all get through it...maybe.  Our friend recently died from the flu.  Her flu, as with so many other cases, worsened into pneumonia.  To date, the number of flu infections are striking: 430,000 hospitalizations; 19,000 deaths as of February 21st, reported Today (based on CDC data).  But again, no big deal...apparently.  Wrote STAT: The decision on which flu vaccine strains are recommended to manufacturers is normally made by the heads of seven WHO influenza collaborating centers and four key regulatory laboratories.  Traditionally, U.S. government agencies have two of the 11 votes in the room; the Centers for Disease Control and Prevention is one of the collaborating centers and the Food and Drug Administration is one of the essential regulatory labs.  None of that will happen since the U.S. won't be attending, wait, they'll send an advisory panel, wait, no they won't -- at least not this year and likely not for the next 4 years.*  The US has pulled out of the World Health Organization.  Again, no big deal...or is it?  Judd Walson, MD, MPH, and Robert E. Black Chair in International Health said this in an episode from the John Hopkins Public Health podcast: Let's talk through a hypothetical scenario: A new disease emerges in a small country in Asia...the U.S. is no longer part of the WHO.  This disease emerges, the same things happen.  Meanwhile, we in the U.S. have no idea.  There's no communication that anything is happening.  The U.S. has no visibility.  We have no access to the data.  Maybe others in the system decide the disease is not a threat, but we in the U.S. have had no voice to say whether we agree.  We don’t hear anything about it until suddenly it poses a huge threat, and it’s too late.  Or, let’s say that WHO members decide it is a threat and they start mobilizing all sorts of resources.  The U.S. wouldn’t be a part of that decision.  We also wouldn’t have a voice in what the response to the threat should be: how containment should happen, what sorts of air travel restrictions might be needed, what sorts of treatment strategies might be employed.  Now, we’re not part of that discussion.  We have no access to the data.  We don't have access to the sequences of the actual pathogen to help us develop a response in terms of vaccines or other treatments.  All of that now becomes a black box.

     This "black box" scenario happened during WW I, wrote Carl Zimmer in his book on infectious diseases, Air-Borne: A five-hundred page Sanitary Corps handbook published in 1917 includes just a brief mention of influenza...When the flu arrived in camps the following year, its savagery took the army by surprise...So many soldiers died that four new morgues had to be built in a day...While 227,000 American soldiers were wounded in battle during World War I, 340,000 were hospitalized with influenza...In November 1918, the influenza pandemic was at its peak when Germany and the Allies signed an armistice...the pandemic was largely over.  It had killed somewhere between 50 and 100 million people -- an estimated 3 to 5 percent of humanity. 

     So let's change gears for a moment and jump into healthcare in the US in general, especially since the White House has now made cuts to research and such.  This came out from the Commonwealth Fund: As of 2022, women in the U.S. had the lowest life expectancy of 80 years compared to women in other high-income countries.  As of 2021, women in the U.S. had the highest rate of avoidable deaths...Women in the U.S. have among the lowest rates of access to a regular doctor or place of care and among the highest rates of unnecessary emergency room visits...and they have among the highest rates of mental health needs and social needs compared to women in other countries.  None of that sounds good.  But as we continue to slide backwards in our health care, there was this from Bloomberg: Americans spend more of their years in poor health than any other country, a new study shows.  People in the US live with illness for 12.4 years on average—up from 10.9 years in 2000, according to a study published by the American Medical Association Wednesday.  The US offers the starkest illustration of a so-called healthspan-lifespan gap that is widening around the world, as chronic illnesses take up larger portions of people’s lives.  Wait, did that headline really read, "Americans spend more years sick than rest of the world?"  

       As a rule, we're all exposed to a lot of infectious diseases, many of them airborne.  Not counting all of the bug diseases such as malaria and dengue, or the "droplet" diseases such as measles and Covid, there are still a host of germs floating in the air.  And many of these were, and likely still are, being explored as biological weapons.  Some target food crops such as wheat fields, while others target food animals such as cattle and chickens.  Diseases we once eradicated with "herd" immunity, such as measles, are now reappearing as vaccine target rates decline; and in other cases (such as with antibiotics added to animal feed), diseases are adapting and mutating, forcing us to look up what data we may need to change and what trials we need to complete...except much of that data has been wiped or shredded (as ordered by Trump) and final-stage trials of vaccines --in this case, the vaccine being tested by Moderna-- have stopped as funding has been halted (or inspections and inspectors cut back, wrote the Associated Press).  It's as if the bird has flown the coop...which it has, in a sense.  Per Trump's executive order, wrote epidemiologist Alexandra Fella in a London Review blog post: Around eight thousand webpages and datasets went dark, including decades of resources on vaccine efficacy; studies on race and health disparities; data on HIV prevalence and STD prevention; and the Youth Risk Behaviour Surveillance System (YRBSS), an expansive survey of young Americans’ health habits, tracking everything from exercise to gender identity.  Metrics on obesity, depression, disabilities in the elderly, healthcare access, frequency of doctor visits and cancer rates were all taken down.  The Social Vulnerability Index (SVI), which identifies a community’s vulnerability to disasters, went offline.  And while some data has returned, heavily redacted in many cases, Fella asked: ...has this data been doctored?  It is an uncanny feeling to be made a stranger to one’s own discipline.

      So the bird flu?  What the heck is it and should we be worried?  Wrote the LA Times: The current version of the bird flu --known as H5N1 2.3.4.4b-- is highly contagious and highly lethal.  It has plowed through the nation’s commercial chickens, turkeys and ducks with a mortality rate of nearly 100%.  “There’s a reason why they call it ‘highly pathogenic avian influenza,’” said Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization in Canada.  “It just goes straight through a flock like a hot knife through butter.”...highly pathogenic avian influenza, or HPAI, has spread to all 50 states.  The number of commercial birds that have died or been killed exceeds 166 million and the price of eggs is at an all-time high.  Added an article in Bloomberg: The prevalence of the infection has exploded in wild ducks and geese, where it manifests as a gastrointestinal disease and spreads through droppings.  The waterfowl’s long-distance migrations allow the virus to travel further, and it’s now been found on every continent except Australia...The newest variant, D1.1, has caused more serious infections, including the hospitalization of a Canadian teenager in critical condition and the first reported human bird flu death in Louisiana last month.  Last week, scientists announced they’d found D1.1 in infected dairy cattle in Nevada for the first time.  A dairy farm worker tested positive for H5N1, the state’s first reported human case...Last week, the Centers for Disease Control and Prevention posted, and then took down, a report about how cats infected with the virus might have infected humans in the same household and how a person might have transferred the virus to a cat, the New York Times reported. More than 85 cats have been reported infected since 2022.  And that vaccine by Moderna which was in its final phase and stopped?  Yup, it was for the bird flu strain (Zoetis has received conditional/emergency approval for its vaccine for chickens; Moderna's vaccine was being developed for humans).  As for the bird flu mutating and infecting cattle, here's what Discover wrote: The first case of bird flu in cattle was reported on March 25, 2024.  In less than a year, the virus has hit 973 herds, according to the U.S. Centers for Disease Control and Prevention.  

      Wind and air currents, along with bird droppings and flight migrations, can spread various avian viruses.  But so can humans, and often on purpose.  Biological (or germ) warfare has been around for centuries, usually developed for use in times of war.  Wrote author Carl Zimmer: After World War II, the United States tried more than five thousand Japanese for war crimes.  The leaders of the biological weapons program were not among them.  American officials chose to keep those interrogations secret in order to keep the Japanese officers talking.  They hoped to use what they learned from the interrogations for their continuing efforts.  The war might have been over, but the Americans had no plans to stop building their own biological weapons...Hitler might have lost the war, but fascism still seemed to be winning.  But it wasn't just the Japanese or the Germans secretly trying out new biological weapons, so did the US Navy off of San Francisco (which they blamed as coming from "enemy ships" when the story leaked).  From Zimmer's book: In September 1950, a navy mine-layng vessel headed for San Francisco...the army offered no warning of the experiment it was about to run.  The crew loaded the ship wuth Serratia marcescens, along with Bacillus globijii, another supposedly harmless microbe.  When the weather turned in their favor, the sailors opened up giant hoses and sprayed a cocktail of the two microbes into the air.  They sprayed bacteria from the hosses for an hour a day for six days in a row, and then sailed away...By 1956, biological weapons work at Camp Detrick had progressed so far that the government made the camp a permanent installation, changing its name to Fort Detrick.  It also began building facilities in Utah and elsewhere so that it could start testing the weapons outdoors.  In one trial, a plane streaked over the Pacific while releasing plumes of microbes that caused Q fever and tularemia.  The clouds descended on cages of monkeys hauled by tugboats.  While no one is known to have died in those exercises [humans at least; unknown on the monkeys], lab accidents at Fort Detrick took a toll.  More that our hundred workers became infected between 1943 and 1969, and three died.

Parrots in LA.  Photo: Chon Kit Leong / Alamy

      Zimmer goes on: A network of factories also opened up for manufacturing the pathogens.  By the mid-1960s, the air force had enough weapons to unleash germ warfare on a staggering scale.  A single B-52 bomber sortie could shower anthrax bomblets over ten thousand square miles.  Alternatively, the planes could be fitted with spray tanks to unleash microbes over fifty thousand square miles.  Along with making human pathogens, the US military began mass-producing crop-killing spores.  Elvin Stakman continued helping the biological warfare efforts after World War II, developing standardized weapons-grade form of wheat rust.  The army also built up stockpiles of other fungi that could attack oats, rye, and rice.  Detrick scientists maximized the destructive force of the spores by ensuring that they fell together, instead of dispersing in the wind.  Inspired by some of Japan's World War II experiments, the scientists sprinkled the spores onto turkey feathers, which they dropped on farms in New York and California.  In some tests, the feathers were loaded into balloons; in others they were dropped from planes in bombs originally designed for showering leaflets on enemy territory.  These tests and others like them led the air force to estimate that a single sortie could trigger 100,000 rust outbreaks over a fifty-square mile stretch of wheat farms.  Officials drew up plans for dropping the spores across the Soviet Union's grain fields and China's rice paddies.  All told, the United States stockpiled enough rust to kill all the wheat on Earth...

      Who, or what country's leaders, would think like this, to destroy and test and infect not only silently but invisibly and almost with impunity.  As George Harrison once wrote in a song: We were talking about the love that's gone so cold, and the people who gain the world and lose their soul. They don't know.  They can't see.  Are you one of them?  After the war, research on anthrax spores rose to an industrial scale while tripling its deadliness.  But the pathogen that showed the most promise for germ warfare was yet another bacteria, Chlamydia psittici, also spread by birds.  It was simply called Parrot Fever.  There is no known vaccine for parrot fever. That was all happening over 50 years ago, with treaties and assurances coming and going as easily as trust and mistrust came and went.  What pathogens are out there now, whether a naturally mutated version of a virus just trying to replicate, or a human-made pathogen being helped along in its lethality.  It all brings to mind the words of Sting: If blood will flow when flesh and steel are one, drying in the colour of the evening sun.  Tomorrow's rain will wash the stains away but something in our minds will always stay.  Perhaps this final act was meant to clinch a lifetime's argument that nothing comes from violence and nothing ever could.  For all those born beneath an angry star, lest we forget how fragile we are.  

 

Part of one of nearly 27,000 cattle feedlots in ths US.  Satellite photo: Maxar.

* There was a "virtual" attendance by members of the CDC and the WHO advisory committee, but it was all for naught since the FDA decided to cancel all meetings about creating a flu vaccine for next fall, wrote NBC...and if you're at all curious about the number of Congressional Republican'ts applauding Trump's State of the Union speech on transgender mice ("$8 million for making mice transgender.  This is real," said Trump), wonder no more.  It isn't, the transgender mice part.  But those Congress folk cheering Trump on, the ones who are supposed to know the difference between transgender and transgenic?  Sadly, they are real...