If H1N1 joins with the bird flu, pandemic may be much worse

Several Asian countries (notably China, Indonesia, Thailand and Vietnam) covered up their bird flu outbreaks, sometimes until it was too late to contain the virus's spread — then later claimed to have cornered the virus. But it keeps coming back, and each time it gets another chance to reassort with another virus.

And now, along comes swine flu. Although its mortality rate is well below 1 percent, there have already been tens of millions of cases worldwide. Is this more-contagious virus the key that might unlock bird flu's terrible full potential? Swine flu is so new that researchers have yet to plumb its secrets. How exactly is it transmitted, how does it attack the body, and why, in very few cases, is it catastrophic? Could it reassort with another flu strain?

Last summer, scientists from the University of Maryland, the Virginia-Maryland Regional College of Veterinary Medicine and the National University of Colombia published the results of their swine flu research on ferrets (ferrets are susceptible to human flu viruses and display some of the same symptoms as people). The study suggested that swine flu is unlikely to reassort with ordinary seasonal strains and instead is more apt to crowd them out. We can only hope that it will be equally chaste when it comes to bird flu.

But another study, also published this summer, showed that bird flu has the ability to reassort with at least some other strains of flu. A team at the Centers for Disease Control and Prevention in Atlanta confirmed this by infecting ferrets with bird flu and ordinary seasonal flu simultaneously. Testing secretions from the ferrets' noses, researchers found that they carried new flu strains that contained genetic material from both of the parent strains.

We cannot predict the twists and turns of the flu virus, which has repeatedly confounded some of the world's brightest scientists. No one expected bird flu would leap from birds to humans — until it did. Its initial, withering attack on a boy in Hong Kong 12 years ago was like a “visitation from outer space,” according to flu specialist Keiji Fukuda, who investigated the initial occurrences.

He recalled how the Hong Kong outbreak eluded understanding, even as it spread and began resembling the 1918 Spanish flu. “You feel like: 'I don't know what is going to happen. I don't know what is going on. But what is going on is not good, and it reminds me of the worst not-good of the century,'” he said.

Fukuda, now WHO's top flu official, says he remains humbled by the flu's stubborn unpredictability.

Already, the swine flu epidemic has chastened us by revealing the sorry state of our antiquated technology for producing vaccines and the limits of our brittle, under-funded system for emergency medical care. But swine flu is not merely a warning shot. The virus itself could be the catalyst for a new flu — and an even deadlier pandemic.

Sipress, The Washington Post's economics editor, is the author of “The Fatal Strain: On the Trail of Avian Flu and the Coming Pandemic.”

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