My wife Sharon and I had the honor of interviewing Dr. Henry L. Niman last night. Dr. Niman is an expert in molecular virology, and he’s been tracking the news from Southeast Asia and Angola regarding the outbreaks of H5N1 (avian flu) and Marburg.
His assessment is basically that the WHO is understating the threat.
H5N1 seems to be most dangerous in Vietnam right now, where the virus appears to be changing. The good news is that it appears to be losing some of its potency; the case fatality rate, which had been 100%, is dropping as there are confirmed survivors who’ve been discharged from the hospital. The bad news is that it seems to be trading virulence for transmission efficiency, and the number of cases of human-to-human transimission is increasing.
H5N1 still does not transmit as easily as typical human influenza, such as H3N1. That’s a good thing. H5N1’s case fatality rate is still somewhere between 50% and 75%. For comparison, the Spanish flu (H1N1) of 1918, which killed somewhere between 20 and 100 million people worldwide, had a case fatality rate of only about 2.5%.
As for the Marburg outbreak, the news is still ominous. While transmission still appears to be primarily through contact with infected body fluids, there are some cases in Angola’s capital city, Luanda, which do not appear to have any known physical contact with victims near the outbreak’s center in the city of Uige. This indicates a more efficient means of transmission, and possibly undiscovered victims or contacts in Uige and/or Luanda.
Luanda, being Angola’s capital, has an international airport. Dr. Niman didn’t give odds, but he said there is a possibility that the outbreak may spread to other nations before it’s contained. That’s bad. There is no vaccine and no treatment for Marburg, and this strain has maintained a case fatality rate of 100% since the outbreak began in October.
In short, you catch it, and you’ve got about two weeks before you literally bleed out.
Among the unusual aspects of this case is the fact that it began in the very young; 75% of the first identified victims were children under the age of five, and 2/3 of them were less than one year old. This is inconsistent with past outbreaks of Marburg, and might be evidence that the disease got its foothold through a childhood vaccination program in Uige.
You can hear our interview with Dr. Niman later today, as soon as I convert the tape into mp3 files. Look for it at our MythArc Radio website.