Wasn't there going to be a Pandemic? - (Jul/18/2008 )

BSE, SARS, Bird fly (H5N1) and, for folks who remember, swine flu were all major scares about which WHO and CDC shouted their concerns of profound pandemic. To date, none of these have risen above the level of "scare" headlines - in fact 200 seems to be the common total death level globally in their respective years of existence.
BSE, SARS and swine flu were clearly overblown and no knowlegeable folks argue the measures taken diverted the respective issue, includng those for bird flu. However, there are still folks warning H5N1 pandemic is "only a matter of time".

How do you see it?

Just as the Spanish flu epidemic at the end of WWI came about by a random mutation of the virus, statistically, it's just a matter of time that a more dangerous version of H5N1 will do so too. It seems that the lethality of Spanish flu was due to the virus causing a "cytokine storm", and it was this that kills the victim, rather than the viremia per se. From my recollection, the same cytokine storm occurs in both SARS and H5N1 high fatality bird flu. Who knows: it might just take the virus infecting one person with a specific mixture of endogenous viral particles to make the next super-virus... Recombination can be a very scary thing.
The conditions that increase the risks of pandemic from an animal virus are still around (ie highly intensive farming practises with a variety of species cooped up in close proximity, close to humans and including species related to migratory birds).
I think it's a bit strong to say that none of the isolation measures used, for example, in the SARS outbreak, did anything. In highly infectious dieases, isolation does seem to be most prudent; the problem arises when infected people are contagious while still feeling OK (and therefore able to transmit the virus).

Dispute it's a matter of statistics. The 10 years of bouncing around in animals and man are more than enough to bring that event.

My point is that the constant repeating that H5N1 is the virus is not justufied by the 10 years and limited fatalities - about 200 total. There indeed may be a flu pandemic (there were three in the 20th century) but the solemn droning "it's only a matter of time" is silly. You could say that about any pathogen - it's only a matter of time 'til SARS com,es back, BSE kills us all, swne flu pops up (some will remember the 60's), etc. etc.

If you know the subject, take us through your stats for H5N1 so it will be evident and identify the specific mutation you envision.