Health & Science

Staving off a crisis

Four young men lie buried in the same row at River View Cemetery in Kennewick.

They could have grown up and gone to school together, played baseball on the same team, pursued the same hometown girls and signed up together as doughboys to fight the war to end all wars. We can only imagine.

But one thing is certain, all four died in the prime of life within five weeks of each other while an unseen flu strain was decimating the front lines in France and killing people around the globe in the fall of 1918.

Harry R. McDowell, 27, drew his last breath Oct. 18, and Harry Maupin died three days later. He was 24.

In the same row rests 23-year-old Perry D. Owens, whose parents, Emory and Minnie, lovingly remembered him as "our sacrifice." He died Nov. 1, and his death certificate now on file in Olympia lists pneumonia with influenza as the cause.

Nearby is the grave of Edwin L. Johnson, 23, "killed in World's War - France" on Sept. 27, 1918.

Was it mustard gas, a German soldier's bullet or bomb?

Chances are better than 50-50 that all three young men also were felled by the H1N1 flu virus.

That first and worst pandemic flu of the 20th century claimed an estimated 50 million victims in less than 18 months.

The flu killed 10 times the number of soldiers on both sides in 1918 and 1919 than the war itself claimed in the four years before Armistice Day, Nov. 11, 1918.

The epidemic's U.S. death toll was 675,000 - exceeding the number of Americans killed in all the wars from World War I through the current Iraq conflict.

Nearly 90 years later, another flu virus, as virulent as any before it, is spreading around the globe.

This killer, identified as H5N1 when discovered in Hong Kong in 1997, also has the potential to decimate kill millions of people.

Except for one fact: H5N1 is a bird flu that as yet has not been able to spread from human to human - although it's going through bird populations at an astounding rate.

As an avian virus, H5N1 is 100 percent fatal in chickens. For those humans who have somehow contracted the disease from infected fowl, it has been deadly half the time - with 108 human deaths confirmed to date.

Unless or until a genetic roll of the dice allows it to begin spreading human-to-human, H5N1 is not a pandemic flu.

But Dr. Larry Jecha, the public health officer for Benton and Franklin counties, is sounding a warning about this cousin to the deadly strain of 1918.

Health officials like Jecha are caught in a dilemma: Do they sound the alarm and trigger a panic, or do they downplay the worst-case possibilities of a coming pandemic?

Seattle Mayor Ole Hanson reacted to the influenza in 1918 by ordering schools and public places closed to limit the spread of disease. It worked, but not all citizens were grateful. Some people thought he overreacted.

"Ridiculous," declared school officials. A beleaguered Hanson resigned two years early and moved to California.

Jecha has decided not to wait for the first sick bird.

More than a dozen times since the first of the year, he has given an hourlong PowerPoint talk called, "Pandemic Influenza: Be Concerned, Be Prepared."

Audiences have included employees at Energy Northwest and Pacific Northwest National Laboratory, service clubs, veterans groups and public school administrators.

The message is blunt. The avian flu called H5N1 could arrive anytime, and there is no way to know ahead of time if and when it may acquire the ability to be transmitted from person to person.

If that happens, the spread of flu will be pandemic, with virtually no time to prepare.

If H5N1 makes the jump and matches the infection rate of the 1918 pandemic, Jecha said there won't be enough time to prepare a vaccine and boost supplies of antiviral medicines such as Tamiflu.

And indications are this virus has that potential.

Since 2003, the H5N1 virus has spread to 45 countries - with 30 of those added to the list in just the past three months. It has killed millions of birds, even as humans have slaughtered millions of others in so-far futile attempts to stop the spread.

Jecha and other health officials believe H5N1 likely is to arrive in the United States late this year via waterfowl winging their way from Asia through Alaska and south along the Pacific Flyway. That flyway includes the Mid-Columbia.

Michael Leavitt, secretary of the U.S. Department of Health and Human Services, said in a March 13 report that having the deadly avian flu in the country would not necessarily mean a pandemic is imminent.

But he also was cautious, telling TV interviewer Charlie Rose last week, "Anything you say before a pandemic sounds alarmist and anything you say after a pandemic is inadequate."

Jecha said being informed and prepared for whatever may come, whether it is later this year or a decade away, is the best protection.

"We are prepared for nuclear and chemical disasters, but we've never prepared for anything like this before," he said. Even if H5N1 doesn't develop the ability to go from human to human as a pandemic flu, the preparation will be worth it, he said.

Historically, Jecha said, there have been three to five pandemic flu outbreaks per century. The 1918 flu, which was called the Spanish flu because that country reported the most deaths early on, was the first.

The Asian flu came in 1957 and the Hong Kong flu in 1968. Both of those had much lower death rates.

Julie Gerbeding, director of the Centers for Disease Control and Prevention in Atlanta, commented in the interview with Charlie Rose that being prepared is critical.

"You must think in terms of worst-case scenarios and prepare for it. A pandemic could go on for one year or more," she said.

Jecha added, "If it all doesn't come true, we're still better off because we will be better prepared for other illnesses. This won't be a lost effort. That's the beauty of it."