Intended for healthcare professionals

Rapid response to:


Research confirms human to human transmission of avian flu

BMJ 2005; 330 doi: (Published 27 January 2005) Cite this as: BMJ 2005;330:211

Rapid Response:

Avian flu - perspective?

More than 80 years ago the world faced a disaster that killed more
people than all wars before in human history. About 50 million deaths
during two Spanish-flu pandemic seasons occurred when international travel
took days for distances accessible in hours by modern travel by plane. I
believe that medical scientists are aware of the threat that fast travel
within incubation period of a disease is one of major threats to humans

None of terrorist attacks with conventional or nuclear weapons can
not cause so many deaths like spread of a disease with high mortality
rate. Sending letters with anthrax is a child game compared to
international travel of people infected with airborne deadly viral
infection. Let the numbers speak: death rate of the Spanish flu was far
less than 5/100; SARS outbreak two years ago had 8/100; avian flu in Viet
Nam since January 2004 had 77/100 (27/35 as mentioned in the article). A
quarter million tsunami victims is very low loss compared to potential
loss of maybe quarter of the entire human population from only one
disease. Governments must be aware that major threats are not only
«visible» enemies, but also «invisible» ones like natural disasters and
changes as well as emerging and new infections.

What we can do? For sure we know what we can not do: we can not cease
air travel; we can not close boundaries; we can not vaccinate against
unknown agent. Can we produce in substantial quantity effective antiviral
drugs and distribute the drug around the world? Maybe, but only one H5N1
effective antiviral agent oseltamivir is monopolised by just one big
pharmaceutical company. I can not even imagine how many people died in the
world from hunger, diarrhoea, malaria, tuberculosis and AIDS during typing
this letter! And that are all old, known and preventable diseases. Our
race spends more money to killing devices than to feed hungry people and
to prevent diseases preventable more easily than spread of avian flu. Can
we kill all birds? We can try, but some of them will survive and natural
balance will be impaired for sure.

I know that human race can build enough scientific facilities and
drug factories as well as can feed all humans in the world. Only
comprehensive action of the Organisation of United Nations can make
progress. With one big and few smaller epidemics of flu in 20th century
and facing deadly flu pandemic in 21st century, world leaders must act.
The treat is not a big flying saucer from some distant planet but small
«invisible» enemy. And every enemy uses our weaknesses.

Competing interests:
None declared

Competing interests: No competing interests

30 January 2005
Drazen Stojanovic
University of Rijeka, Institute of Public Health, Kresimirova 52A, 51 000 Rijeka, Croatia