Bird Flu of H5N1 virus threatens world pandemic
Public health has traditionally been an area of concern as anything that poses a threat to humans should be considered a top priority societally. From a global standpoint if public health is neglected then the amount of preventable deaths would rise exponentially. In the past few years several events have been noted as threats to public health, but society had identified them quick enough so that the threat to humans was minimized. One such event occurred in 2006 and was known as the bird flu. Although there is currently no vaccine for this strain of bird flu the rapid identification of this deadly virus helped to minimize its spread.
According to Medline, birds just like humans can be stricken with the flu but the virus historically only affected avian species without the potential to affect humans. This remained true until 1997 in Hong Kong when the first case of the avian flu was reported. This avian virus has the ability to mutate or change its genetic makeup so that it can be easily incorporated into the human genome, thus causing a new form of flu that can be deadly and difficult to treat. Since 1997 the avian flu has spread to several countries and has severely affected both the commercial poultry supply and humans alike. Although the viral transition to infecting humans is rare, the avian flu is responsible for approximately 600 infections since its inception with a mortality rate of 60% (National Library of Medicine, 2014).
Once the bird flu was recognized as a concern to public health the United States began monitoring the poultry that is being imported from other countries where the bird flu is endemic. This monitoring by the United States was and continues to be highly successful because no incidence of the avian flu in humans or animals has every reached the States. According to the World Health Organization, “the WHO and animal health sector partners are working at the human-animal interface to identify and reduce animal health and public health risks within national contexts” (WHO, 2014). I decided to pick this topic because it was highlighted in the media not too long ago. I also find it fascinating that an avian virus can incorporate itself into the human genome to create such a threat. According to the CDC, “Influenza A viruses circulating among poultry has the potential to recombine with human influenza A viruses and become more transmissible among humans. If HPAI H5N1 viruses gain the ability for efficient and sustained transmission among humans, an influenza pandemic could result” (CDC, 2012). Being a former researcher while attending undergraduate studies I can see the potential for genetic research in this area. I also chose this topic out of my own curiosity to see the progression of this infection since its initial discovery. This topics potential for future treatments was the main reason for choosing it, because vaccines for avian flu strains are currently unavailable. The emergence of the avian flu fits into several of the historical criteria in which public health events typically fulfill. These criteria as highlighted throughout the class are known as postulates. I will touch upon three out of the six postulated in which we reviewed during class. The first postulate I will touch upon is “Events like wars, natural disasters; migration and urbanization challenge public health and have marked defining moments in the evolution of the field”. The way American society now views Influenza is significantly different than the way American society viewed Influenza prior to the onset of the avian flu. Society now takes more precautions during flu season, encouraging annual flu vaccines and discouraging travel when feeling any onset of flu symptoms. In fact, the federal government can disallow an individual from traveling to another region or country if they are suspected of having any type of infectious disease, particularly Influenza. This is synonymous with other historical events where wars and natural disasters created fear of migration and contamination from society to society. During wartime, sick individuals were often contained and prohibited from travel, much like sick individuals today. Also throughout history, particularly the history of immigration to the United States, individuals were thoroughly examined prior to being permitted entrance into the country. This is seen today by strict United States policies of mandatory vaccinations when traveling to and from high risk parts of the world. A division of the Department of Health and human services created the “The Pandemic Influenza Response and Preparedness Plan which stresses ways to speed up vaccine production, limit the spread of such a super-flu, and care for the ill” (Obesity, Fitness, & Wellness Week, 2004).
The second postulate, “All societies had faced the realities of disease and death, and had developed concepts and methods to manage them”, is a historical reality that proved itself during the avian flu epidemic. For as far as history can recall, all major civilizations were faced with disease and death. For example in Ireland the Potato Famine paved the way for malnutrition, making adults and children more susceptible to infectious diseases. These civilizations developed concepts to manage the spread of these diseases by researching preventative medicines, improving sanitary conditions, and also assisting members of society to obtain more adequate or alternative modes of nutrition. Much like these former civilizations, during the time of the avian flu epidemic Americans were faced with a new disease that could bring about death to members of society. This was a significant realization for Americans, particularly the medical professionals, seeing as it gave light to the fact that no civilization is immune to death and disease no matter how advanced they may be.
The realization that all societies have faced the realities of disease and death leads directly to the next historical postulate “The prevention of disease in populations revolves around defining diseases, measuring their occurrence, and seeking effective interventions.” Historically, defining diseases, measuring their occurrence, and seeking effective interventions was a top priority not only to prevent disease but also to save entire civilizations. This was seen in many historical civilizations, including ancient Greek and Roman times. One person who historically prevented disease was ancient Greek physician, Hippocrates, who was known as the father of Western Medicine. Hippocrates raised many ethical questions that dealt with public health as the well-being of his civilization was his main concern. Presently medical professionals take what is known as the “Hippocratic Oath,” which in essence states that as a new clinician they will do no harm. Agneta Sutton stated that “The questions raised by Hippocrates in 400 BC seem even more urgent today as we witness a world-wide destruction of human life by abortion and, in some countries, the taking of life by euthanasia--practices prohibited in the Hippocratic Oath” (Sutton, 2009). Although some of these public health practices highlighted by Ms. Sutton are controversial, the ethicality of disease prevention is deeply rooted in public health. In society today, medical researchers consistently analyze occurrence of diseases, particularly influenza, and research effective interventions and treatments. While the thought of saving society may seem far-fetched, the scary reality is that without consistent research and prevention a highly prosperous civilization such as that of the United States could be wiped out.
Throughout the last century there have been three significant pandemic flu outbreaks that were responsible for thousands of deaths. The first one which was the most deadly occurred in 1918 and was known as the Spanish flu. This flu caused approximately 40 million deaths worldwide (Oklahoma Nurse, 2007). The other two pandemics were not as deadly and were the 1957 Asian flu and the 1968 Hong Kong flu. These pandemic infections caused approximately 100,000 deaths combined, although still of importance they were not as deadly as the Spanish flu (Oklahoma Nurse, 2007). These events along with the avian flu of present have prompted the use of antiviral therapy for prophylaxis, because currently there are no vaccines for pandemic flu strains. Current antiviral therapy includes Relenza and Tamiflu and according to the Oklahoma Nurse Journal these therapies “have potential benefit in reducing the severity and duration of illness” (2007). Unfortunately the emergence of the avian flu has not prompted the discovery of new medications or a vaccine but the CDC is currently working on resolving this issue. Initial discovery of the disease along with the progression of developing a treatment plan are essential to public health.

References
Centers for Disease Control and Prevention. (2012). Public Health Threat of Highly Pathogenic
Avian Influenza A (H5N1) virus. Retrieved from http://www.cdc.gov/flu/avianflu/h5n1
-threat.htm
National Library of Medicine. (2014). Bird Flu. Retrieved from http://www.nlm.nih.gov/medlineplus/birdflu.html Obesity, Fitness & Wellness Week. (2004, September). U.S. prepares for possible flu outbreak.
Retrieved from http://www.newsrx.com/newsletters/Obesity,-Fitness-and-Wellness
Week.html
Sutton, A. (2009). The New Medicine: Life and Death After Hippocrates. Ethics & Medicine: an international journal of bioethics. 25(2), 127. Retrieved February 20, 2014, from http://www.bioethicspress.com/journals/em.html The flu and you: what you need to know about seasonal flu, pandemic flu, and avian flu
[Electronic version]. (2007, May). Oklahoma Nurse, 52(1), 10.
U.S. Department of Health & Human Services. (2014, February). H5N1 Avian Flu (H5N1 Bird
Flu). Retrieved from http://www.flu.gov/about_the_flu/h5n1/index.html
World Health Organization. (2014). Avian influenza in humans. Retrieved February 13, 2014, from http://www.who.int/influenza/human_animal_interface/avian_influenza/en/