NHS Blog Doctor: Bird Flu and the middle class

Middle class dinner-parties in England ground to a halt a few days ago following the horrific announcement here that someone in the UK, a human no less, had contracted “bird flu”

In fact, he had not contracted influenza. He had developed an irritant conjunctivitis, caused by the H7N3 strain of the virus related to the H5N1 but posing no significant threat to humans.

The chatter continues, and the anxiety mounts.

Meanwhile, our dear friends at Roche have clocked up over a billion pounds in profit for adding to the government stock-pile of Tamiflu. Reassuring to know that that nice Mr Rumsfeld has personally profited from theses sales. You cannot keep a good man down.

Profiting from Tamiflu

Well, better than being an arms dealer, I suppose.

It is not only Mr Rumsfeld.

Those equally nice on-line pharmacy companies, who bombard me with emails offering to enlarge my penis, have taken a break from Levitra and Viagra, and are now offering on-line, no prescription needed, supplies of Tamiflu. Go here, and you can buy ten Tamiflu tablets for as little as $125 dollars. Well done, chaps. The pharmaceutical industry at its ethical best.

Meanwhile, Flutrackers.com reveal that down in Ohio, the government has already laid in a stock of body bags should they be needed.

And further advice in "Bird Flu Update" :

“When burying a body in the backyard, don't put it too close to the septic system."

That was one piece of advice offered on Wednesday to a business conference on preparing for a potentially lethal bird flu pandemic.

In Seattle, public health officials are weighing the ramifications of hospitals overwhelmed by hundreds of thousands of sick people and the need for thousands of body bags.

"We talk about how people should bury their dead in their backyards, how far from the septic systems," said Dorothy Teeter, director of the King County public health department in Seattle.

"In case you're wondering, it's $20 apiece for high-quality body bags. In New Orleans (after Hurricane Katrina) they had to double-bag bodies."

That is a whole hour of dinner party natter.

Everyone is cashing in on the anxiety. Those unlucky enough not live in Ohio may worry about the disposal of their loved ones in the case of a flu epidemic. Fortunately, a complete service is offered here:

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The middle class, stirred up by the media, has gone quietly crazy.

To date, the death rate from bird flu in the UK and the USA has been zero. Over the last year, there have been more people struck by lightening, more lottery winners and, I daresay, more people who have been abducted by aliens.

What would happen if there really were an epidemic of a fatal infectious disease in the UK and the USA? Eight hundred thousand people dying in Massachusetts and two hundred thousand people dying in Middlesex. A million deaths in one year in the Western World. The governments would respond. A solution would be found.

It has not happened. It is not going to happen.

Meanwhile, and I apologise to all the chattering middle-classes for bringing this up and further interfering with your dinner party, there IS a serious problem with a frequently fatal infectious disease. Unlike bird flu, this disease is a real killer. And we are not talking a few hundred deaths; we are talking between one and two million deaths a year, every year. We know what causes this disease. We know how to treat it. We know how to prevent it. So we have a head start on those virologists currently looking at bird flu.

This disease is called malaria. Three thousand people a day die of it, most of them children.

Anopheles mosquito takes lunch

Why have we not done something about it?

We ignore it because it does not affect the USA or the UK. We ignore it because the people who get malaria are black or dark brown, have unpronounceable names, speak guttural incomprehensible languages and all look the same. So it does not matter if a few thousand of them die every day. No one notices. No one cares.

Who cares if they die?

It was always the same. Remember the frenzy over SARS? A transient media favourite that received far more attention than malaria.

Malaria is not perceived as a threat in the UK. SARs was. Bird flu is. In fact, even in the UK there is no room for complacency about malaria, but the problem is trivial compared with sub-Saharan Africa.

Here are some facts:

• Malaria is one of the planet's deadliest diseases and one of the leading causes of sickness and death in the developing world. According to the World Health Organization there are 300 to 500 million clinical cases of malaria each year resulting in 1.5 to 2.7 million deaths.

• Children aged one to four are the most vulnerable to infection and death. Malaria is responsible for as many as half the deaths of African children under the age of five. The disease kills more than one million children - 2,800 per day - each year in Africa alone. In regions of intense transmission, 40% of toddlers may die of acute malaria.

• About 40% of the world's population - about two billion people - are at risk in about 90 countries and territories. 80 to 90% of malaria deaths occur in sub-Saharan Africa where 90% of the infected people live

• Sub-Saharan Africa is the region with the highest malaria infection rate. Here alone, the disease kills at least one million people each year. According to some estimates, 275 million out of a total of 530 million people have malaria parasites in their blood, although they may not develop symptoms.

• Of the four human malaria strains, Plasmodium falciparum is the most common and deadly form. It is responsible for about 95% of malaria deaths worldwide and has a mortality rate of 1-3%.

• In the early 1960s, only 10% the world's population was at risk of contracting malaria. This rose to 40% as mosquitoes developed resistance to pesticides and malaria parasites developed resistance to treatment drugs. Malaria is now spreading to areas previously free of the disease.

• Malaria kills 8,000 Brazilians yearly - more than AIDS and cholera combined.

• There were 483 reported cases of malaria in Canada in 1993, according to Health Canada and approximately 431 in 1994. The Centres for Disease Control and Prevention in the United States received reports of 910 cases of malaria in 1992 and seven of those cases were acquired there. In 1970, reported malaria cases in the U.S. were 4,247 with more than 4,000 of the total being U.S. military personnel.

• According to material from Third World Network Features, in Africa alone, direct and indirect costs of malaria amounted to US $800 million in 1987 and are expected to reach US $1.8 billion annually by 1995.

Malaria could be eradicated.

It there were half a million deaths a year in Massachusetts and Middlesex from malaria, it would be eradicated. Mussolini tackled the problem in Italy eighty years ago by draining the Pontine Marshes.

It would not be easy to eradicate malaria, but just because we cannot do everything does not mean we should do nothing.

We could make a start. A few millions gallons of unfashionable DDT. Sorry, Greenpeace. Mosquito nets. Education.

Most of all, a concerted efforted from Europe and the USA.

Last month, the Lancet highlighted the scandal.

“April 25th 2006 was designated as “Africa Malaria Day”. It is timely therefore to remember that an article by public health experts published online in…The Lancet on Africa Malaria Day, April 25, blamed the World Bank for failing to make good on its pledge to wipe out the disease by 2010.

In fact, the critics accuse the international aid agency of spending far less than promised on malaria, wasting money on ineffective medicine and cooking the data to make it appear that progress is being made when it isn't." (Muster against Malaria)”

Whilst you have read this article, six children have died of malaria.

Africa Malaria Day has come and gone, and no one noticed.

Nothing has been done.