Avian anxiety: If bird flu comes, fly!

The world needs to laugh a little more. Isn't laughter the best medicine? Elizabeth Taylor sang, "Send in the Clowns" (ouch, bad example!). Okay, Donald O'Connor sang, "Make 'Em Laugh" in Singing In The Rain. Do comedians use rubber chickens anymore, or am I dating myself to Steve Martin in the '70s? There's so much heartache and disease out there, but unfortunately, you can't even use a rubber chicken these days because of Avian influenza. Can chicken soup be deadly?

The World Health Organization has announced that Avian influenza is a public health crisis because we are pecking precariously close to the next pandemic (a furious widespread infection, e.g. The Plague). If Whoopi Goldberg said it to us, as she did in Ghost, she would look us straight in the eyes and say, "Girl, you's all in trouble!"

Avian influenza is nothing new– unfortunately. In the 20th Century, three influenza pandemics were due to viruses with an avian component (in 1918, 1957, and 1968). The pandemic of 1918 killed more people in one year than the Bubonic Plague.

When Avian influenza H5N1 was first identified in Hong Kong in 1997, 18 people were infected, half of whom ended up in the intensive care unit, and six of them died.

In 2004-2005, over 88 humans were infected with Avian influenza H5N1 virus, and 51 of them died. Avian influenza H5N1 tends to infect children and young adults, and young people tend to be healthy and strong, so this death toll shows how mean-spirited this virus is.

When does a bird virus become a human virus? When pigs fly– well, sort of. It appears that pigs can be infected with both human influenza and Avian influenza viruses, which can lead to a new, mutated influenza virus. In Asia, a lot of people live near pigs and poultry like that song from Oklahoma, "Chicks and ducks and geese better scurry"– especially when a pig comes by.

I know some people are considered to be pigs, but there is evidence recently of human-to-human transmission of the Avian influenza H5N1: Thailand, the Netherlands, British Columbia, Egypt– and most recently– Turkey. (We should have seen that coming!) The virus becomes airborne when someone coughs or sneezes, and nearby people inhale it. Bingo– they're infected!

One hundred percent of people with Avian influenza will have a high fever. Most people will have upper respiratory tract symptoms (sore throat, stuffy runny nose, ear congestion). Over half of people with Avian influenza develop pneumonia– one of the main reasons this flu is so deadly. Also, half of the people get nausea, abdominal discomfort, and liver enzymes elevations.

Sixteen percent have been reported to have bone marrow suppression, which means the immune system stops working, anemia occurs, and bleeding develops. Shelley Duvall had a better time in The Shining.

There's no easy way to make a true diagnosis of Avian influenza– it's kind of like trying to figure out if someone's Louis Vuitton bag is a knock-off. Unless we know there's an outbreak of Avian influenza, most people will be diagnosed with traditional flu, a cold, or even SARS. A blood test needs to be sent for viral culture or RT-PCR assay to diagnose Avian influenza H5N1, which can take days.

A vaccination is being worked on, but it won't likely be available this year, and we won't be sure if it will work (kind of like Windows) because the virus mutates. Tamiflu is the only medicine that appears to treat Avian influenza, but there is a severe shortage of this medication.

If there's an outbreak today, with no effective vaccine and limited stocks of Tamiflu, we can all say One Flu over the Cuckoo's Nest.