BMJ  2006;332:1220 (20 May), doi:10.1136/bmj.332.7551.1220

reviews

TV

Hollywood fights bird flu

An entertaining worst case scenario

So what's bird flu going to be like, assuming that it comes? In this television movie we get to see all the scary things the writers have learned about a possible avian influenza pandemic crammed into two hours: a highly virulent, rapidly transmissible virus, inept attempts at containment, overwhelmed medical facilities, mass graves, food and water shortages, and looting and rioting.

The programme begins with a solemn disclaimer telling us that the H5N1 virus has not (yet) been transmitted from person to person. Cut to geese flying over the ocean and chickens being slaughtered by the million in China. The virus has mutated and is spreading among the Chinese in a market town soon to be visited by an American businessman. He catches it from a coughing factory worker and then begins shedding virus as he travels home. In dramatically effective microscopic close-ups now common on television shows such as CSI: Crime Scene Investigation, a graphic portrayal of forensic police work, viral particles are shown being passed to unsuspecting people via serviettes, martini olives, hot face towels, and handshakes.

The hero of the story is, of course, a beautiful blonde, an Epidemic Intelligence Service (EIS) officer played by Joely Richardson, who is rather wooden and has traces of her English accent remaining. She is called away from a tryst to fly to China to confirm that the virus has mutated. She then breaks the news to the US health secretary and they convene a meeting of state governors to inform them that bird flu is on the way.

The rest of the movie follows the pandemic through three major story threads: the death of the index case and the grief, quarantine, emotional paralysis, recovery, and subsequent community leadership of his widow; the mistakes made by the governor of Virginia and his redemption after losing his son and realising that quarantine is not the answer; and the everyday heroism of a New York City emergency room nurse and her National Guard husband.

Gripping stuff, mostly very well done. Particularly effective visual scenes include a vast temporary hospital set up in a New York subway station and a huge burial pit into which trucks dump hundreds of wrapped bodies. And likely problems—such as a shortage of medications, the time lag until a vaccine is developed, and the problems of rationing both—are realistically portrayed.

There are some scientific inaccuracies. It makes no sense to quarantine people beyond influenza's four day incubation period, so the Virginia governor's prolonged quarantine of portions of Richmond with fences and barbed wire seems unlikely. Migrating wild birds are made out to be the big villains, although we've now learned that they don't, in fact, seem to be transmitting the virus. But these are rather minor slips.

What the movie does very well is to entertain and get people thinking. I watched it with two teenagers who paid rapt attention and kept asking whether this could really happen and what we would do about it if it did. Good questions.

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BMJ dkamerow{at}bmj.com

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Fatal Contact: Bird Flu in America, a film on ABC television, aired in the United States on 9 May 2006

The US Centers for Disease Control has prepared a viewer's guide to provide answers: http://pandemicflu.gov/news/birdfluinamerica.html#guide.

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