Critical Update On Bird Flu

[sriracha john]

Judging by the content of this article, it appears the government has been withholding the truth from the population.... truly shocking where bird flu is concerned as previously it's always been so open and honest.

PANDEMIC RISK: Bird flu at ‘turning point’

Published on September 05, 2005

Human-to-human transmission in four Southeast Asian countries prompts scientists to upgrade danger alert level

The threat of a new bird flu pandemic is looming large as scientists begin to concede that the flu virus has entered the turning-point phase of pandemic development with reports of human-to-human infections in four countries, including Thailand.

“It’s apparent to us insiders that [the virus] has already moved from phase 3 to phase 4 [in terms of the World Health Organisations’pandemic alert levels],” said Dr Kamnuan Ungchusak whose work on human-to-human H5N1 strain of avian flu was published in the New England Journal of Medicine in January.

Reports of the infection spreading among humans in four countries including Cambodia, Thailand, Indonesia and Vietnam have suggested to scientists that the virus has become more pathogenic than ever, the doctor said.

“The virus remains virulent enough to sicken or kill another victim who is in close contact with the infected person, said Kamnuan who is the director of the Disease Control Department’s Bureau of Epidemiology.

Reports of human-to-human infection have been most recently documented in a cluster of infections in Indonesia, he said, adding that all of the infected people were in the same family and had not been in contact with any poultry or other sources of disease, aside from infected family members.

All of the group infected with the virus in Indonesia died, said Kamnuan.

“The transition between phase 3 and phase 4 would be a significant shift, any confirmation of human-to-human infection means we are in phase 4,” he explained.

Kamnuan’s revelation contradicts authoroties’ assurances to the public that there has never been a confirmed case human-to-human transmission of the flu virus.

He encouraged the top health authorities to stop providing the public with false information and said that it was time to revise the country’s strategies to handle the pandemic.

“We (the region) have continued to witness the spread of the epidemic across Vietnam, where cases of infections [of the H5N1 virus] among people belonging to the same family have been constantly reported –and this is not a good trend,” Kamnuan said.

----------------------------------------------------------------------------------

I applaud the good doctor for HIS openness and honesty in revealing the nature of this very real threat.

[Davey]

I wonder how the loonies in this topic are going to react ...I guess they're diggin out their bunker already now, I can see it now, something like 'A blast from the past'.

[Rigger]

I wonder how the loonies in this topic are going to react ...I guess they're diggin out their bunker already now, I can see it now, something like 'A blast from the past'.

<{POST_SNAPBACK}>

This loonies going to be prepare as possible and for the guys like your self dont think about banging on my door for help because you where unprepared

Because I will drop you where you stand

But I guess you dont have to worry just yet Davey as you are not even in Thailand

Edited September 4, 2005 by Rigger

[opothai]

this is a scary situation, and it is good to be prepared, but how far do you go,

i can not see the WHO raising the threat level which would cause panic, without good reason.

by the sound of things it's coming

[Belfastboy]

well for all of those people like myself and rigger were waring people how serious this was....i hate to say we told u so....but...

where are u now CV Civic!!! in a chicken coup no doubt!

[ArtfulD]

I wonder how the loonies in this topic are going to react ...I guess they're diggin out their bunker already now, I can see it now, something like 'A blast from the past'.

<{POST_SNAPBACK}>

This loonies going to be prepare as possible and for the guys like your self dont think about banging on my door for help because you where unprepared

Because I will drop you where you stand

But I guess you dont have to worry just yet Davey as you are not even in Thailand

<{POST_SNAPBACK}>

Great, so you will have a rotting corpse picking up disease on your doorstep as well as bird flu to contend with!

Be wise in your isolation attitude, I very much doubt you can store enough to last several months and you will need to go to others for help/supplies. Your previous attitude may increase hostility towards you. Think about it also, Farang holed up in his house with supplies trying to shoot anyone who comes close...dont think others wont/cant bash your door down if they need/want what you have desperatly. Are you going to stay alert all night? Are you going to be able to fend off a larger group of people?

Through the ages its always been those who can band together with others for protection and support who have survived and not those trying to do it all alone.

[Rigger]

I wonder how the loonies in this topic are going to react ...I guess they're diggin out their bunker already now, I can see it now, something like 'A blast from the past'.

<{POST_SNAPBACK}>

This loonies going to be prepare as possible and for the guys like your self dont think about banging on my door for help because you where unprepared

Because I will drop you where you stand

But I guess you dont have to worry just yet Davey as you are not even in Thailand

<{POST_SNAPBACK}>

Great, so you will have a rotting corpse picking up disease on your doorstep as well as bird flu to contend with!

Be wise in your isolation attitude, I very much doubt you can store enough to last several months and you will need to go to others for help/supplies. Your previous attitude may increase hostility towards you. Think about it also, Farang holed up in his house with supplies trying to shoot anyone who comes close...dont think others wont/cant bash your door down if they need/want what you have desperatly. Are you going to stay alert all night? Are you going to be able to fend off a larger group of people?

Through the ages its always been those who can band together with others for protection and support who have survived and not those trying to do it all alone.

<{POST_SNAPBACK}>

Yes you are wright I would not think of trying to do this alone. We have some close family so I guess we would band together (half the village is family no that I think that it would stand for much if things got bad) . I was just simple putting forward the idea that people will not be in a hurry to help anyone and people will not be letting in strangers into there homes or villages. Personaly I think the village would close all the roads going into the village and wait it out. The whole world could stop and about the only thing that would change in the village would be no beer chang or fuel or power. as there is plenty of water and rice ,veg ,bugs, fruit, but I hope it never gets that bad.

PS as for rotting corpse my dogs got to eat to you Know

[ArtfulD]

Well, g'luck to anyone if they find themselves in the thick of such a situation...pretty scary if this all comes to pass.

[Rigger]

So what else have Vietnam been bullshiting about. And how bad do you think the problem is in china or going to get before someone reacts there. I guess all the Thai goverment will be worried about will be the blow to tourist numbers so how much have they hidden??.

[sriracha john]

More bad news...

Bird flu risks spreading to Europe

By Sarah Stewart in Bangkok

September 05, 2005

The bird flu virus that had leapt to Russia and Kazakhstan after causing deaths and huge economic losses in Asia risked spreading further, borne by migratory birds criss-crossing the globe, experts said today.

Wild birds are widely credited with spreading avian influenza far beyond its epicentre in the backyard farms of Asia, where the mingling of species gives virologists nightmares about the risk of mutation into a far deadlier form.

Once deposited in a country, courtesy of the annual migrations which take flocks of birds from Asia to the north during the European summer, the H5N1 strain moves among poultry with ease.

"Birds play a role in the primary infection of the country, but then after that there's no need for wildlife. It will spread very easily from one village to another through trade," Joseph Domenech, the UN Food and Agriculture Organisation's chief vet, said.

"Given that it is a highly contagious disease, we were sure it could spread from one region to another, either through wildlife or through trade and movements of products. So this happened and we are not surprised at all."

Asia has been battling bird flu since late 2003, with vaccination campaigns and huge culls of tens of millions of chickens and ducks that have wrecked poultry industries, particularly in Thailand and Vietnam.

While sporadic outbreaks continue to emerge in Asia, attention has now shifted to the discovery of the virus in poultry in parts of Russia and Kazakhstan, raising fears it will cross the Urals mountain chain into Europe.

The alarm has already been raised in western Europe, and French President Jacques Chirac has called for a strong international response to the threat, warning it could develop into a serious health crisis.

"If the virus is coming from wildlife, then next year or the year after it could happen that it goes to western Europe," the chief vet said.

The virus threatened to contaminate all the migratory paths, bringing the disease to Africa, South Asia and the Middle East as well, he said.

"Recent events are obliging us to say that the risk exists and it must be monitored and surveillance must be put in place."

Mr Domenech said Europe has more weapons at its disposal to fend off bird flu than Asia, and a developed agricultural system that was easier to defend. But it also had a lot to lose in a financial sense.

"We are very worried. If it comes to countries like those in western Europe it could be a very severe economic disaster," he said, listing poultry export bans and expensive changes in farming methods as among the fallout.

The Netherlands, one of the biggest European chicken producers, has already ordered poultry be kept inside in the hope of avoiding a repeat of a flu epidemic two years ago which nearly wiped out the country's stock.

Apart from the economic threat, the spread of H5N1 also poses a hazard to human health, by increasing the chances of a mutation that could create a pandemic capable of killing tens of millions.

Bird flu has killed 62 people in Asia in the past two years, including 43 in Vietnam.

"The farther this virus is being spread, the more opportunity it has to infect humans and mutate with a reassortment with a human influenza virus and that is what we are concerned about," Dick Thompson, spokesman of the Geneva-based World Health Organisation, said.

Mr Thompson said the emergence of bird flu in Europe had created a sense of alarm, but that wherever a pandemic erupted, it would circulate around the globe with deadly effect in a few months anyway.

[taxexile]

its worse than we could have imagined......

this just in...........

Edited September 5, 2005 by taxexile

[sriracha john]

other photographic perspectives of bird flu:

Culling of bird flu-infected ducks in South Korea

Hospitalized victim of bird flu in Vietnam

[UncleDonald]

Spent some time reading about the impact of the 1918 pandemic in Thailand in the daily English-language newspaper for Oct-Dec 1918. (Believe it or not, there was a very good one published in BKK). About one percent fatalities, but not as much panic as you might think, I'd side against the bellicose response. Got some ideas on this, will post when I get a chance.

[Galong]

So what else have Vietnam been bullshiting about. And how bad do you think the problem is in china or going to get before someone reacts there. I guess all the Thai goverment will be worried about will be the blow to tourist numbers so how much have they hidden??.

<{POST_SNAPBACK}>

With the constant threat of terrorism, bird flu, SARS, war, etc. I think we might get a tourist mindset that says 'just get on with it'! Obviously, every country is a potential terrorist target. The bird flu and SARS are NOT limited to SE Asia and China.

In my opinion, this will not impact tourism all that much [fingers crossed of course]

The underlying message in all of this is that governments lie... surpise!!

The possible good side is that it'll decrease numbers and adversely affect environmentally-irresponsible mass tourism companies. Educated and higher-end tourists don't stop traveling because of bad press. I run a small-group nature tour company and we're having a banner low season, despite the trouble in the Deep South, bird flu, SARS, war and all that jazz.

[Pattaya_Fox]

its worse than we could have imagined......

this just in...........

<{POST_SNAPBACK}>

...Mine`s a roast leg please

[AmeriThai]

Seems to me I recall that the jump from person to person within a family in Thailand was suspected in the past. If I'm not mistaken though, it was also suspected that the family members were subject to the same environmental exposure. Sanitation should be a vital concern regardless of whether it's bird flu or any other disease.

So far what it appears to be is that we're still talking about isolated cases of people who have contracted bird flu. What isn't known, or at least not mentioned, is whether unsanitary conditions may have played a part in this. Regardless, at the very least, that it has gone from bird to bird and made the leap to bird to human, in itself is a concern and warrants some serious attention.

Sorry if I've overlooked this, but what medical preventions such as vaccines are available? And exactly how effective are they? A big concern is whether the virus would mutate to be resistant to any known medications. The risk that infection can and has been fatal seems to suggest that prevention before infection may be better that trying to cure it after.

[sriracha john]

Seems to me I recall that the jump from person to person within a family in Thailand was suspected in the past. If I'm not mistaken though, it was also suspected that the family members were subject to the same environmental exposure. Sanitation should be a vital concern regardless of whether it's bird flu or any other disease.

So far what it appears to be is that we're still talking about isolated cases of people who have contracted bird flu. What isn't known, or at least not mentioned, is whether unsanitary conditions may have played a part in this. Regardless, at the very least, that it has gone from bird to bird and made the leap to bird to human, in itself is a concern and warrants some serious attention.

Sorry if I've overlooked this, but what medical preventions such as vaccines are available? And exactly how effective are they? A big concern is whether the virus would mutate to be resistant to any known medications. The risk that infection can and has been fatal seems to suggest that prevention before infection may be better that trying to cure it after.

<{POST_SNAPBACK}>

From WHO, CDC, Medline sources:

The mortality rate for bird flu (the percentage of people that die after getting the virus) is an astounding 75%. In contrast, SARS is 4%.

There currently is no vaccine to protect humans against the H5N1 virus that is being seen in Asia. However, vaccine development efforts are under way. Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005.

An available vaccine prototype virus, developed using the 2003 strain of H5N1 (which caused the two human cases in Hong Kong), cannot be used to expedite vaccine development. Initial analysis of the 2004 virus, conducted by laboratories in the WHO network, indicates that the virus had already mutated significantly.

As for treatment for someone with the virus, four different influenza antiviral drugs (amantadine, rimantadine, oseltamivir, and zanamivir) had been approved for the treatment and/or prophylaxis of influenza. All four have activity against influenza A viruses. However, often influenza strains can become resistant to these drugs, and therefore the drugs may not always be effective for long. For example, analyses of some of the 2004 H5N1 viruses isolated from poultry and humans in Asia have shown that the viruses are already resistant to two of the medications (amantadine and rimantadine).

H5N1 seems particularly adept at developing resistance to drugs.

[AmeriThai]

Seems to me I recall that the jump from person to person within a family in Thailand was suspected in the past. If I'm not mistaken though, it was also suspected that the family members were subject to the same environmental exposure. Sanitation should be a vital concern regardless of whether it's bird flu or any other disease.

So far what it appears to be is that we're still talking about isolated cases of people who have contracted bird flu. What isn't known, or at least not mentioned, is whether unsanitary conditions may have played a part in this. Regardless, at the very least, that it has gone from bird to bird and made the leap to bird to human, in itself is a concern and warrants some serious attention.

Sorry if I've overlooked this, but what medical preventions such as vaccines are available? And exactly how effective are they? A big concern is whether the virus would mutate to be resistant to any known medications. The risk that infection can and has been fatal seems to suggest that prevention before infection may be better that trying to cure it after.

<{POST_SNAPBACK}>

From WHO, CDC, Medline sources:

The mortality rate for bird flu (the percentage of people that die after getting the virus) is an astounding 75%. In contrast, SARS is 4%.

There currently is no vaccine to protect humans against the H5N1 virus that is being seen in Asia. However, vaccine development efforts are under way. Research studies to test a vaccine to protect humans against H5N1 virus began in April 2005.

An available vaccine prototype virus, developed using the 2003 strain of H5N1 (which caused the two human cases in Hong Kong), cannot be used to expedite vaccine development. Initial analysis of the 2004 virus, conducted by laboratories in the WHO network, indicates that the virus had already mutated significantly.

As for treatment for someone with the virus, four different influenza antiviral drugs (amantadine, rimantadine, oseltamivir, and zanamivir) had been approved for the treatment and/or prophylaxis of influenza. All four have activity against influenza A viruses. However, often influenza strains can become resistant to these drugs, and therefore the drugs may not always be effective for long. For example, analyses of some of the 2004 H5N1 viruses isolated from poultry and humans in Asia have shown that the viruses are already resistant to two of the medications (amantadine and rimantadine).

H5N1 seems particularly adept at developing resistance to drugs.

<{POST_SNAPBACK}>

75% of the people die after getting bird flu. How many people does that represent? Not to minumize the potential risk and hazard, but I'd guess worldwide the total number of people infected, including those who survive as well as those who die from it, is still pretty small.

However, I agree that a vaccine would likely be helpful. How long it'll take to develop not to mention produce sufficient quantities to combat a large-scale global outbreak would be anyone's guess. So if some of the viral strains are already showng signs of resistence to various medications, those meds could be rendered useless in a short time. Stockpiling might be pointless depending on the shelf life of the meds.

Just thinking out loud.

[chownah]

I question the 75% mortality rate. This is probably the mortality rate for people who have been diagnosed with bird flu. Probably only the worst cases get reported and there could be hundreds, thousands, or even millions of people who have contracted it already...how many of you have had flu like symptoms in the last two years and not gone in to be diagnosed? It is possible that a significant number of them were bird flu and never diagnosed....this could bring the mortality rate way down.......but then again none of us are epidemiologists....any epidemiologists out there?

[sriracha john]

A bit of researching I found more recent stats since the 75% figure was published. According to WHO epidemiologists (as I don't have direct contat with others) has published the following figures:

As of May 2005, WHO stats are as follows -

Vietnam: 76 cases, 37 deaths - 49%

Thailand: 17 cases, 12 deaths - 71%

Cambodia: 4 cases, 4 deaths - 100%

Totals - 97 cases, 53 deaths - 55%

------------------------------------------

Since then, the death totals have gone up. As of yesterday,

Monday, September 05, 2005

HANOI (AP) - Officials on Thursday said bird flu has killed another person in Vietnam, bringing the regional death toll to 62.

---------------------------------------

There are 15 different strains of avian flu viruses out there. The concern is specifically with only one in particular, the H5N1 strain, where by the above stats, you have less than a 50/50 chance of surviving it.

What makes H5N1 so dangerous?

It's because it mutates rapidly and has an amazing ability to acquire genes from viruses attacking other species. The spread of infection in birds increases the opportunities for direct infection of humans. If more humans become infected over time, the likelihood also increases that humans, if concurrently infected with human and avian influenza strains, could serve as the “mixing vessel” for the emergence of a novel subtype with sufficient human genes to be easily transmitted from person to person. Such an event would mark the start of an influenza pandemic.

It's certainly possible that people have gotten sick over the past 2 years from flu viruses and didn't seek treatment and weren't diagnosed. Was it the specific H5N1 strain causing their illness? Not likely... people that contract this illness get deathly ill and fewer than half survive...

-----------------------------

direct quoting now:

"Based on historical patterns, influenza pandemics can be expected to occur, on average, three to four times each century when new virus subtypes emerge and are readily transmitted from person to person. However, the occurrence of influenza pandemics is unpredictable. In the 20th century, the great influenza pandemic of 1918–1919, which caused an estimated 40 to 50 million deaths worldwide, was followed by pandemics in 1957–1958 and 1968–1969.

Experts agree that another influenza pandemic is inevitable and possibly imminent."

[chownah]

The statistics in the previous post are for diagnosed cases..it is easy to compute mortality for diagnosed cases....I'm wondering what is the estimate for mortality for ALL cases...no doubt it is much lower....I'm not trying to deny that a pandemic will come...I'm just trying to get the facts straight and I believe that the statistics reported are for the diagnosed cases which are always the worst cases since they have come to the attention of physicians and in every emerging pandemic there are always a lot of infected people who have not come to the attention of a physician and these are usually the less serious cases.

[sriracha john]

Are you saying that there are people walking around that have contracted bird flu, specifically the H5N1 strain, and were not even ill enough to get tested?

If so, you're failing to understand the situation.... as ALL people that have tested positive for it have been critically ill.

There have been many, many people screened and tested for it (routinely all family members and contacts of those people who WERE diagnosed with it are tested). None of them has ever tested positive that didn't quickly become gravely sick themselves.

This is not something that people thus far have been asymptomatic carriers of... nor is this something that you catch and get over it without dramatic live-saving medical care.

[chownah]

Are you saying that there are people walking around that have contracted bird flu, specifically the H5N1 strain, and were not even ill enough to get tested?

If so, you're failing to understand the situation.... as ALL people that have tested positive for it have been critically ill.

There have been many, many people screened and tested for it (routinely all family members and contacts of those people who WERE diagnosed with it are tested). None of them has ever tested positive that didn't quickly become gravely sick themselves.

This is not something that people thus far have been asymptomatic carriers of... nor is this something that you catch and get over it without dramatic live-saving medical care.

<{POST_SNAPBACK}>

You may be right but I think its too soon to know. By the way, do you know what treatments are being given.

[drummer]

The point about uniagnosed cases is pretty apt. It is really hard to tell exactly what is going on, but I would hazard a guess that it hasn't broken out yet.

There have been a few cases on HtH transmisssion before, such as here in Thailand when the Mom caught it from holding and kissing her sick daughter.

If Bird FLu does cross over, I think there will be worldwide haedlines reading "oh SH!T" Doesn't sound like its done any such thing, though. Just the keep on keepin on. It WILL happen, though ....

[sriracha john]

Are you saying that there are people walking around that have contracted bird flu, specifically the H5N1 strain, and were not even ill enough to get tested?

If so, you're failing to understand the situation.... as ALL people that have tested positive for it have been critically ill.

There have been many, many people screened and tested for it (routinely all family members and contacts of those people who WERE diagnosed with it are tested). None of them has ever tested positive that didn't quickly become gravely sick themselves.

This is not something that people thus far have been asymptomatic carriers of... nor is this something that you catch and get over it without dramatic live-saving medical care.

<{POST_SNAPBACK}>

You may be right but I think its too soon to know. By the way, do you know what treatments are being given.

<{POST_SNAPBACK}>

The two common antivirals, amantadine and rimantadine, used to treatment for flu have been found to be useless as the H5N1 virus is resistant to it. Currently oseltamivir is the drug of choice, but even their own advertising states:

Tamiflu™ (oseltamivir) could be effective in the treatment in avian influenza.

That's their bold print, probably in an effort to limit their liability if treatment fails.

Unfortunately, most treatment is limited to "supportive care," e.g. Paracetamol when the fever peaks, Ibuprofen for muscle aches, respirators when breathing becomes too difficult. These are more a means of trying to make the sufferer more comfortable rather true treatments aimed at restoring health.

The Koreans are experimenting with kimchi (yeah, the exceedingly hot cabbage dish) as a treatment.

A research team led by Kang Saouk a microbiology professor at Seoul National University, experimented on chickens infected with avian flu and found that those given kimchi extract survived, Birds not given the extract died.

Edited September 6, 2005 by sriracha john

[SiamOne]

There is plenty of nonsense talked and published about this bird flu.

Today there is an article in the BBC news about fake blogs

http://news.bbc.co.uk/2/hi/uk_news/magazine/4215984.stm

from rumours and lies, to panic and nonsense

[sriracha john]

There have been a few cases on HtH transmisssion before,  such as here in Thailand when the Mom caught it from holding and kissing her sick daughter. 

If Bird FLu does cross over,  I think there will be worldwide haedlines reading "oh SH!T"  Doesn't sound like its done any such thing,  though.  Just the keep on keepin on. 

If you read the OP, that's EXACTLY what raising the Pandemic Level to Level 4 is trying to do. They are starting to put more pieces of the puzzle together and are realizing that "keep on keeping on" is NOT the message to send.

Cases of human to human transmission have occured and have been documented as "probable," including your example and another in Vietnam.

From the WHO Guide:

Phase 3:

Human infection, but no human-to-human transmission.

Phase 4:

Small cluster(s) with limited human-to-human transmission but spread is highly localized.

Phase 5:

Larger cluster(s) but human-to-human transmission still localized, suggesting the virus is becoming increasingly adaptable to humans.

Phase 6:

Pandemic. Increased and sustained transmission in the general population.

Translation: Shit! We're really screwed now.

[sriracha john]

There is plenty of nonsense talked and published about this bird flu.

Today there is an article in the BBC news about fake blogs

http://news.bbc.co.uk/2/hi/uk_news/magazine/4215984.stm

from rumours and lies, to panic and nonsense

<{POST_SNAPBACK}>

Which is why it's essential to stay with reliable sources such as CDC and WHO, like I do...

I wouldn't trust a blog on avian flu anymore than I would trust one on just about any other topic.

Edited September 6, 2005 by sriracha john

[drummer]

There have been a few cases on HtH transmisssion before,  such as here in Thailand when the Mom caught it from holding and kissing her sick daughter. 

If Bird FLu does cross over,  I think there will be worldwide haedlines reading "oh SH!T"  Doesn't sound like its done any such thing,  though.  Just the keep on keepin on. 

If you read the OP, that's EXACTLY what raising the Pandemic Level to Level 4 is trying to do. They are starting to put more pieces of the puzzle together and are realizing that "keep on keeping on" is NOT the message to send.

Cases of human to human transmission have occured and have been documented as "probable," including your example and another in Vietnam.

From the WHO Guide:

Phase 3:

Human infection, but no human-to-human transmission.

Phase 4:

Small cluster(s) with limited human-to-human transmission but spread is highly localized.

Phase 5:

Larger cluster(s) but human-to-human transmission still localized, suggesting the virus is becoming increasingly adaptable to humans.

Phase 6:

Pandemic. Increased and sustained transmission in the general population.

Translation: Shit! We're really screwed now.

<{POST_SNAPBACK}>

OOPS I didn't say that clearly. I meant to say the VIRUS is keeping on keeping on. WE need to act.

Good link regarding the stages - that does indeed seem to be an accurate description

[UncleDonald]

Unfortunately the government here has taken the "official position" that bird flu has not been transmitted between people, in spite of the fact that the most famous medical paper on the subject published in the NE Journal of Medicine this year says the opposite in documenting a family case here in Thailand. The article was coauthored by half a dozen or so Thai doctors, who apparently were not willing to stick to the party line.

These pandemics usually come to town for one to two months. One conclusion from past records is that though the fatality rate for known cases of the severe form may be high (1918 maybe 10 percent) many people, perhaps the majority, don't come down with it in the first place. Amazingly, the experts don't seem to know whether this is some natural immunity or contact avoidance. My bet is mostly the latter; if so the most important thing for the individual or family may be preventing anyone in the family getting it. Think of it this way: if you didn't get the (ordinary) flu last time it came around, (its contagiousness was probably the same as the dreaded impending pandemic, it just didn't kill people) how can you duplicate the performance this time?