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Selling 'pandemic flu' through a language of fear

Traditional skepticism is missing in discussions of pandemic flu.

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Americans consider the United States to be a country where debate flourishes. Yet with regard to avian flu, hyped sound bites predominate. When President Bush asked Congress for $7.1 billion toward "pandemic flu preparedness," even his critics replied "not enough." Meanwhile, public health officials seem obsessed with preparing for an impending crisis - even before they have established that doom is truly heading our way.

What is lacking in the overall discussion about pandemic flu is disagreement, criticism, and skepticism - once the bedrock of science - from researchers willing to question and test the data. Further, little has been done to educate the public on what exactly defines a pandemic.

First, some facts: According to the World Health Organization, the first "outbreak" of the H5N1 virus, also known as avian flu, killed six people in 1997 in Hong Kong. Since then, H5N1 has allegedly killed 97 more worldwide, the majority of whom lived in poor, rural areas and had direct contact with dead or sick birds often kept in unsanitary conditions.

These numbers do not suggest the human population faces an insurmountable threat from this virus. Peter Palese, flu scientist at Mount Sinai School of Medicine in New York, told The New York Times in a Nov. 8, 2005, article that H5N1 is a false alarm. The virus has been "around for more than a dozen years, but it hasn't jumped into the human population." The reason? It probably can't. Dr. Palese points to studies of serum collected from rural Chinese populations in 1992. The results indicated that millions of people had natural antibodies to H5N1. This suggests they had been infected and recovered without becoming noticeably or extremely sick - not the outcome one would expect from a virus as feared as this one.

The Centers for Disease Control and Prevention (CDC) estimates that 36,000 deaths in the US occur during an "average" flu season. During the last "flu pandemic" of 1968, however, they state 34,000 Americans died.

In response to an article I recently published in the British Medical Journal, questioning the reliability of US flu death statistics, the CDC countered that "it cannot be assumed a priori that pandemics will cause more mortality than interpandemic seasons." Unfortunately, this information is rarely explained to the general public.

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