What's the message for GPs and hospital doctors?

The extensive media coverage of avian influenza (bird flu) over recent weeks has caused confusion and increasing concern that bird flu will imminently cause a human pandemic. This has been fuelled by the report of a parrot infected by the H5N1 strain of avian influenza in the United Kingdom this week. Is such a pandemic a flight of fantasy or a dead cert?

The influenza pandemic contingency plan presented by the chief medical officer1 is clear and comprehensive, but at nearly 450 pages, 11 downloadable documents, and many web links, it may not be ready reading for busy health professionals.

Everyone is familiar with seasonal human flu, which typically affects 10-15% of the UK population each winter and leads to around 12 000 excess deaths. Although minor antigenic drift in the human influenza virus A occurs continuously, a major shift in its surface protein antigens H or N can trigger a worldwide influenza pandemic because of absence of population immunity. Fortunately, this happens only rarely—“Spanish” flu in 1918-9 (H1N1 virus) with an estimated 250 000 excess deaths in the UK, “Asian” flu in 1957-8 (H2N2) with 33 000 …