Megacities and the Pandemic of Doom

ON OCTOBER 2nd a British traveller, flying home to Glasgow from Afghanistan, began to feel ill. Within hours he was diagnosed with Crimean-Congo Haemorrhagic Fever, a virus nasty enough for him to be put onto a military transport aircraft for transfer to an isolation hospital in London. Less than 24 hours later he was dead.

This outbreak, on top of another death last month in Saudi Arabia from a previously unknown virus, a cousin of the Severe Acute Respiratory Syndrome (SARS), has set global health agencies on edge... _Economist

Metropolis of Tomorrow

Fast global travel brings the people of the world -- and their emerging infectious diseases -- closer together than ever before. Pandemics and plagues are spread by travelers, over distances both long and short. The human consequences of a widespread pandemic involving an emerging and deadly contagion, can be severe:

In the 1500s and 1600s, European epidemics killed perhaps 90% of the aboriginal Americans. In the 1400s, the plague killed one third of the humans in Europe. The worldwide influenza of 1918 killed 30 million, and AIDS had killed at least half that by 2000... newly-arising pathogens rarely seem to extinct their host species even in their initial outbreak. Genetically-engineered pathogens may be different. _Future Global Catastrophes

A pathogen would have to be designed to spread easily from person to person, persist in the environment, resist antibiotics and immune responses, and cause almost 100% mortality. Designing for long latency (e.g. months) might be necessary to ensure wide distribution, but no length may be enough to infect every last human. _Bioterrorism

There are barriers to the spread of epidemics. Airports, seaports, and train stations can be shut down for the duration of an epidemic. Infected travelers can be rapidly diagnosed and whisked into quarantine.

But in the emerging age of megacities, how would you stop an epidemic that has already established a strong foothold inside a city of 50 million people?

Infected persons would seek medical help soon after the outset of symptoms. If the early symptoms are not too severe, cases may be medicated and sent home -- but not before passing the infection on to health care workers and others they may have come in contact with in waiting rooms and in transit.

The contagion would rapidly spread through schools and workplaces across the megalopolis, perhaps infecting millions before the extent of the problem becomes apparent. By then, any modern methods of quarantine would not likely be effective at stopping the pandemic.

There are now 23 megacities in the world, compared with just two 60 years ago. Just over half of the population currently dwells in cities, and with the urban population expected to nearly double by 2050, that proportion is projected to approach 70%. “Almost all this growth will take place in the developing world,” says Jalkanen. _Nature

There is nothing new about large scale devastation and collapse from epidemics and pandemics. But the rise of megacities provides emerging infectious diseases -- to say nothing of engineered pathogens -- with an opportunity for devastation that may be too good to pass up.

Human history has been punctuated frequently by epidemics, and occasionally by pandemics, that have shaped the rise and fall of civilizations and the victories and defeats of warring armies. The outcome of the Peloponnesian War (431–404 B.C.E.) between Athens and Sparta—and the future course of Western civilization—might have been very different had it not been for the epidemic that decimated the Athenians at the beginning of the war. Some epidemic diseases, such as the plague, smallpox, typhus, and influenza, have persisted throughout recorded history. Smallpox was eradicated worldwide by 1980. Cholera appeared along the world's major trade routes in several devastating epidemics beginning in the eighteenth century, and it still causes massive epidemics, most recently in South America in early 1990s. _Timelines of Great Epidemics

If the contagion is sufficiently disabling, megacities will lose their health care systems fairly early on. Soon thereafter, parts of the critical infrastructure will begin to drop off line, one by one, as key personnel are put out of action -- or attempt to flee the pandemic.

Public supplies of necessities will be rapidly depleted -- first lawfully, then by mass looting. Organised law enforcement and fire departments will be among the first to go down, leaving most of the megacity to the mobs. Collapse of any remaining services should follow soon after.

There are inevitable problems when one tries to put all his eggs in one basket. Large systems are prone to chaotic instabilities that tend to grow along with the size of the system. It is possible to design redundancies, workarounds, and other attempts at resiliency. But in the third world and emerging world -- where most megacities are appearing -- few resources will be devoted to resiliency when poverty is already rampant, and open sewers are the norm rather than the exception.

The tendency toward centralisation and hyper-urbanisation appears to be inevitable across most of the world. Yet there are many vulnerabilities to such concentrations of people, resources, and infrastructure. Many people have no choice, if they wish to enjoy some of the many benefits and opportunities of civilisation.

But dangerous children know how to bring civilisation along with them, wherever they go. It is never too late to have a dangerous childhood.

More: Where will the next global pandemic originate?

Even More: The Armageddon Virus

New Magic Bullets Against Emerging and Chronic Infections?

Emerging infections -- both human engineered and naturally evolved -- present a difficult challenge for modern and future medicine. Recent scares from SARS and Bird Flu have sent journalists and health watchers into a frenzy, although fortunately neither outbreak proved as rapidly contagious and broadly lethal as anticipated -- so far.

A "magic bullet" that could provide resistance against a wide array of new viral, bacterial, and fungal infections would give medical practitioners and public health officials new confidence for a healthier human future.

Two potential "magic bullets" have been recently developed. The first is an artificial protein -- EP67 -- which appears to boost mammalian immune systems -- even when given alone without other drugs or vaccines.

Mice treated with EP67 within a twenty-four hour window of non-lethal infection were significantly protected from influenza-induced weight loss. Furthermore, EP67 delivered twenty-four hours after lethal infection completely blocked influenza-induced mortality (0% vs. 100% survival). Since protection based on innate immune induction is not restricted to any specific pathogen, EP67 may well prove equally efficacious against a wide variety of possible viral, bacterial, and fungal pathogens. Such a strategy could be used to stop the worldwide spread of emergent respiratory diseases, including but not limited to novel strains of influenza.

...In summary, this report shows that the C5a agonist peptide EP67 provides both prophylactic and therapeutic protection against influenza infection. Protection results from the rapid induction of a robust innate immune response that includes high local concentrations of anti-viral cytokines and the influx of several populations of innate immune effector cell types. These results have profound implications for influenza therapeutic development and, ultimately, for broad-spectrum emergency therapy against unidentified respiratory pathogens. _PLoS

Medical Express News Release on EP67

Another potential "magic bullet" approach to both new and old infectious diseases, is the T Cell vaccine.

For some infectious diseases, traditional vaccines just don't cut it. Microbes that hide inside human cells and cause chronic illness aren't stymied by the antibody response generated by the kind of vaccine available at the doctor's office. T-cell vaccines, which activate a different type of immune response, could, in theory, better prevent or control such chronic infections, but so far nobody has been successful at transitioning T-cell vaccines from the lab bench to the clinic.


A Cambridge, Massachusetts, biotech company called Genocea thinks its high-throughput method could change that. The company will begin its first clinical trial later this year, when its experimental herpes vaccine will be the first test of its claims.


All existing vaccines rouse the body into creating antibodies that attach to the surface of infecting microbes and flag them for destruction. But pathogens that live inside our cells, such as the viruses, bacteria, and other microbes that cause AIDS, malaria, herpes, and chlamydia, can evade this surveillance. "In order to deal with those types of pathogens, oftentimes we have to stimulate what we call cellular immunity. Unlike antibody immunity, which recognizes pathogens directly, cellular immunity has to recognize the infected cell and get rid of your own infected cells," says Darren Higgins, a biologist at Harvard Medical School who studies the interaction between hosts and pathogens and is a cofounder of Genocea.


... our understanding of how T cells control infection is still developing. The challenge is to identify the right protein—or antigen—from a pathogen that will grab a T cell's attention and signal that a human cell harbors an infectious agent. "If you can figure out what those protein pieces are, then you can use those proteins as a vaccine to sort of educate your immune system on what to respond to," says Higgins, who is now a consultant and scientific advisor for Genocea.


...Genocea plans to enter clinical trials with its genital herpes vaccine later this year. If successful, Genocea's herpes simplex 2 vaccine would be the first to combat the disease, which affects one out of every six people aged 15 to 49. Currently, patients can take antiviral drugs as a treatment, but there is no cure. Genocea's candidate vaccine would be used as a therapeutic treatment for patients who already have the disease.


Genocea's herpes vaccine program is moving faster than typical vaccine research, which can take 10 years to go from discovery to proof-of-concept and 20 years to reach the market, says Higgins. "Now you can screen very rapidly what is going to be the optimal vaccine component that allows you to get into clinical trials at a rapid rate." _TechnologyReview

These two distinct approaches to triggering immune system activity work on different parts of the immune system. EP67 protein induces an immediate immune response against acute threats. T Cell vaccines induce cellular immunity to destroy cells which are already infected, often chronically.

Human knowledge of the immune system was advanced significantly by the $billions spent on HIV / AIDS since the 1980s. Research tools and computational power have advanced along with this growing knowledge. Understanding the immune system better is one of the most important keys to effective treatment of a wide range of cancers, as well as to the development of effective anti-aging treatments.

Brian Wang looks at T Cell vaccines

Bird Flu Apocalypse: A How-To Guide

On one side of the world, bird flu claims the life of an Indonesian infant. On the other side of the world, the scientific journal Nature publishes research explaining how to modify H5/N1 flu viruses in ways that may eventually facilitate human to human transmission of the deadly viruses. (PDF Download)

Nature
Influenza viruses are modified naturally by spread within and between birds, pigs, and other animals. Some of the natural modifications make it easier for humans to contract the virus, and others make it more difficult. Likewise, human to human spread is facilitated by some natural viral transformations, and inhibited by others.

The ability to intentionally modify a deadly virus, to make it more contagious within and between human populations, suggests that we may be entering an entirely new phase in human bio-warfare. Nature's editorial staff debated the issue prior to the decision to go ahead with the publication of the risky research.

More from Fox News:

Bird flu is lethal in people and spreads among those who are in close contact with infected birds, but so far, the virus known as H5N1 has not had the ability to pass easily among humans through sneezing and coughing, and some scientists had begun to doubt that that was possible.

The studies by Kawaoka and Dr. Ron Fouchier of Erasmus Medical College in the Netherlands changed that view by proving that with a few genetic mutations, the virus could pass easily among ferrets, which are used as a close approximation of how a virus might behave in people.

"There are people who say that bird flu has been around for 16, 17 years and never attained human transmissibility and never will," said Malik Peiris, virology professor at the University of Hong Kong.

"What this paper shows is that it certainly can. That is an important public health message, we have to take H5N1 seriously. It doesn't mean it will become a pandemic, but it can," said Peiris, who wrote a commentary accompanying Kawaoka's paper in Nature. _Fox News

It was never possible to completely prevent such knowledge from being discovered and disseminated. It was only a question of whether the knowledge would become public, or would instead be classified by government biowarfare divisions.

When these common but deadly viruses are finally weaponised -- which is virtually inevitable -- we will all have something more to worry about.

Hope for the best. Prepare for the worst.

HIV and AIDS: A Question of Causation

A recent controversy has sprung up around the decision of the journal Medical Hypothesis to publish a paper by Peter Duesberg, a famous critic of the dominant medical belief that HIV causes AIDS. Several websites are dedicated to refuting the "HIV causes AIDS" hypothesis, including Heal Toronto. Millions of reasonably intelligent people have become highly skeptical of HIV as the cause of AIDS.

The problem goes back to the basic issue of causation -- specifically disease causation. Koch's postulates for establishing microbial disease causation include:

1. Isolate the organism from every case
2. Propagate in pure culture in vitro
3. Reproduce disease by injecting the organism into a suitable recipient
4. Re-isolate the organism
__microbiologybytes

These postulates have served quite well over the years, but for some microbial diseases they have proved insufficiently powerful to establish causation. Variations in microbe virulence and in host susceptibility can complicate the establishment of causation.

A more subtle set of postulates for establishing genetic virulence in  more ambiguous situations, have been dubbed the "Molecular Koch's Hypotheses"

1. Identify gene (or gene product) responsible for virulence determinant
2. Show gene present in strains of bacteria that cause the disease
3. Not present in avirulent strains
4. Disrupting the gene reduces virulence
5. Introduction of cloned gene into avirulent strain confers virulence.
6. The gene is expressed in vivo
7. Specific immune response to gene protects
__microbiologybytes

In the case of HIV / AIDS, the classical Koch's Postulates cannot be tested ethically, since intentionally injecting a human with HIV might easily lead to charges of attempted murder against the researcher.  Of course, not even Duesberg himself is likely to be so reckless as to inject himself or others with HIV intentionally.   Which may be one way of measuring the limits of skepticism for this particular hypothesis.  Is the skeptic willing to inject himself with HIV?

At one time, Peter Duesberg was better known as a leading cell biologist and discoverer of the first true human oncogene, src, in 1970.  A long-time tenured professor at UCB and a member of the NAS, Duesberg's vocal skepticism of the HIV to AIDS hypothesis has, since his 1996 book "Inventing the AIDS Virus", placed him well out of the mainstream of biomedical thought.

It is not the intent of Al Fin Epidemiiologists to refute Duesberg's various lines of arguments in a blog post.  Rather, it is the intent of this posting to take a short peek into the phenomenon of human belief itself.   Duesberg's various lines of attack against the HIV to AIDS theory have been sufficient to establish strong doubts in the minds of large numbers of intelligent thinkers. 

Al Fin Epidemiologists do not accept Duesberg's arguments as convincing, but then Al Fin Epidemiologists are trained to go to root issues when determining the likelihood of an argument -- particularly an argument dealing with disease causation.   For Al Fin Epidemiologists -- unlike most people -- the question is not one of belief.  It is a question of likelihood, and the most likely routes to efficacious disease therapies and cures.  These are things that can be tested -- or falisified -- as Karl Popper would put it.

Humans are prone to "beliefs", which may or may not be well supported by testable facts or observations.  Humans are easily seduced by "reason and rationality" into forsaking empirical testing of apparent "facts".   How much time is wasted in the media, in congress and parliament, in the social sciences, and in dorm rooms and homes -- on arguments that are not formulated to produce testable hypotheses? 

Instead of bullishly "believing" or "disbelieving", humans should always be asking, "How can I test that assertion?"  If assertions, assumptions, and lines of argument do not lend themselves to testing, they are essentially a waste of a practical person's time.

That is how Al Fin Epidemiologists view Duesberg's arguments over the "HIV to AIDS" hypothesis.  Worse than Duesberg's arguments, are the "meta-arguments" that spring up over Duesberg's original arguments.  These meta-arguments then spawn their own "meta-meta-arguments" in a recursive explosion of wasted hours, days, weeks, months, and years.

What can be tested?

If HIV infection leads to low CD4 cell count, and if low CD4 cell count is associated with much higher incidences of PCP pneumonia, Kaposi's sarcoma, CMV, and a host of other low-immunity associated and opportunistic infections and malignancies, these associations lead directly to testable hypotheses.

If a rebound to higher CD4 cell counts after retroviral treatments is associated with remission from opportunistic diseases, further falsifiable hypotheses can be generated.

In fact, the pertinent level of testable argument, scientifically, lies far away from most of Duesberg's arguments.  That is the main problem that Al Fin Epidemiologists have with Duesberg's arguments -- not his skepticism.  Al Fin applauds skepticism wherever it is productive of meaningful falsifiable hypotheses.

Humans in advanced, High IQ societies are not being taught to use their rationality, their judgment, their discriminatory powers of mind.  This leads to lifelong adult-children, incompetent on many fronts, and ineffectual in determining basic probabilities, likelihoods, and wise choices of everyday life.

Sure, We Still Kiss the Same Way as Always -- But We Use Protection When We Have Sex

With more than 100 people dead in Mexico and almost 30 infected in the US and Canada, the threat of a flu pandemic is gripping the world. Although there had been hopes that the emergency could be contained to the North American continent, Europe saw its first confirmed case on Monday. _Spiegel

A world-wide panic over swine flu is on, and the news media is primed and ready to pump up the panic to the popping point. Suddenly bird flu is out and swine flu is in? If I were a bird I would think about suing CNN for neglect. Nothing excites journalists so much as people dying unexpectedly.

In the real world, people die of flu, cancer, heart disease, pneumonia, diabetes, accidents, violence ... in large numbers every day -- but in "newsworld" all deaths are unexpected. They have to be unexpected to be news. Several "unexpected" deaths attributed to the same cause will make a newsroom positively giddy for days on end. Especially if the media can paint the cause of death as a threat to viewers and readers. That kind of threat has the makings of panic, and panic sells papers.

With the first case of swine flu confirmed in Europe, the world is gripped by fear of a global pandemic. German newspapers on Monday examine the measures taken to contain the disease and some warn against the spread of panic. _Spiegel

Global markets are down on swine flu fears -- at least partially. Of course, in an Obama depression global markets need little reason to be down. Coincidentally, Felipe Solis, an archeologist in Mexico who recently shook Obama's hand, and spent a great deal of time in close proximity to the narcissist in chief, died of swine flu shortly thereafter.

Panic, damn you! We're the government-media complex. We're here to help you. And we can't really help you unless you are thrashing about helplessly, gripped by an uncontrollable panic. So panic, already!

Pig Organs for Transplantation? An Increasingly Muslim Europe Says No!

Under UK and EU rules, his team has been banned from mating and producing offspring from the transgenic pigs. Research in developing transgenic pigs is now likely to move to the US where the regulatory system is more relaxed.

Europe is increasingly controlled by labile Muslim sensibilities. Although Muslim males often behave in pig-like ways toward women, the Islamic culture possesses a "pig phobia" that often verges into violent intolerance. No wonder research into pig organ transplantation has to move to the US. At least until the US Muslim population begins to attain the type of inordinate influence the European Muslim population wields over EU nation polities.

What are the prospects for pig organ tranplants to humans?

The first organs suitable for transplanting, most likely kidneys, are expected to be ready within three years and, if tests are successful, their use could be widespread by 2018...The humanisation process of the organs is expected to be achieved by breeding genes into the pigs, probably by injecting them directly into the parent boar’s testicles, that provoke a greatly reduced response in the patient’s immune system.

Patients who received pig organs would have to take immune suppressant drugs for the rest of their lives, but no more than those who received organ transplants from other people...Pigs are regarded as ideal for animal-to-human transplants, xenotransplantation, and other research because of the similarity in the physiological make-up and because they get many of the same diseases, such as diabetes. _Times

The main use of these pigs is for study as animal models of human diseases. But if the immune profile of pig organs can be made compatible enough with humans for transplantation, that would be an added bonus to this line of research.

Can you imagine transplanting a pig heart into a bigoted Muslim imam or mullah? Like most third world peoples, most Muslims are extremely superstitious. For a Muslim male, the only thing worse than receiving a pig heart transplant would be receiving porcine testicular transplants. Imagine the subsequent behaviour of such a Muslim male!

Wiping Out the Human Population of Earth Lovelock: This is the Real Thing Dammit

James Lovelock is the revered, grand old man of doom. Lovelock is quite cheerful about the coming demise of humanity. After all, what has humanity ever done for Lovelock?

Lovelock believes global warming is now irreversible, and that nothing can prevent large parts of the planet becoming too hot to inhabit, or sinking underwater, resulting in mass migration, famine and epidemics. Britain is going to become a lifeboat for refugees from mainland Europe, so instead of wasting our time on wind turbines we need to start planning how to survive. To Lovelock, the logic is clear. The sustainability brigade are insane to think we can save ourselves by going back to nature;....But he fears we won't invent the necessary technologies in time, and expects "about 80%" of the world's population to be wiped out by 2100. Prophets have been foretelling Armageddon since time began, he says. "But this is the real thing."

Faced with two versions of the future - Kyoto's preventative action and Lovelock's apocalypse - who are we to believe?...when I ask if he attributes the conflicting predictions to differences in scientific understanding or personality, he says: "Personality." ___Guardian

Lovelock...appears to have laughed and grinned and smiled his way through this interview. He predicts doom for almost all, and laughs about it.

"Well I'm cheerful!" he says, smiling. "I'm an optimist. It's going to happen."___Source

Lovelock is not the only one of his generation to predict massive human die-off. Modern prophets of doom have been profiting from the apocalypse since the late 1960s and early 1970s, when eco-apocalyptic books became best sellers. Paul Ehrlich, the Club of Rome, Rachel Carson--all these and more preceded Lovelock and Al Gore through the Valley of the Shadow of Human Apocalypse, and made money doing it.

According to these prophets, NYC should be underwater, the population of the Earth should already be below 1 billion from starvation and resource depletion, the entire Earth should be a wasteland, and the new Dark Ages should have long since fallen onto surviving human populations.

Remember Y2K? Sure you do. Unless you are too intent on the prophets making profits from the crises du jour, such as CAGW and Peak Oil? The Ozone hole scare has taken a backseat for now, but it can always be re-cycled, once the climate scare dies down and alternative energy sources predictably come on line one by one.

Or perhaps as Lovelock says, this is "the real thing." The evidence suggests otherwise, and it should be noted that Lovelock is promoting a new book. Should we simply put Lovelock up on the shelf alongside Ehrlich, the Club of Rome, the Y2K thrillers, and Al Gore? Perhaps we will.

Year of the Plague

I Am Legend topped the box office in a US record-setting December opening box office. Killer plagues make headlines, and attract readers and movie-goers.

A recent set of cautionary nano-revo scenarios from Nanowerk prominently featured biological plagues as significant existential risks. We know it could happen, because it has happened so many times before across the planet's times and places.

One of the reasons that killer plague is likely to hit the modern world, is how easy and powerful the tools of biological creation are becoming. A killer virus must be virulent and readily transmissible.

But the most disturbing news this week is that scientists have created the human killer virus in the lab. The dreaded H5N1 avian flu, as feared, finally mutated last August into a virulent form that can easily spread from person to person, increasing the likelihood of a pandemic that could kill hundreds of millions — much like 1918s infamous Spanish flu.

Luckily, this mutation was the creation of scientists at the National Institutes of Health, in Bethesda, Maryland, and the mutated strain lives — for now — only
in petri dishes. Source

A mass epidemic of killer virus (or bacteria) would initially be seen as a medical problem. As significant numbers of "weight-bearing members" of society fall to the virus, the epidemic becomes a massive social problem. As the medical infrastructure itself falls to the killer microbe, efforts to control its spread become medieval and draconian.

The killer plague scenario is but one of many existential risk scenarios that the Lifeboat Foundation, JG Matheny, Nick Bostrom, Michael Anissimov, Eliezer Yudkowsky, and many other futurist thinkers contemplate.

The risk of a naturally emerging super-killer microbe may be minimal. But given that human researchers have already modified the H5N1 avian flue in the lab to spread from person to person, we are not necessarily dealing with naturally emerging viruses. We will soon be dealing with intentionally created mass killers.

With the loss of the medical infrastructure and most civil security apparatus, the western world would begin to resemble Baghdad or Beirut at their worst. All the predictions of what would happen should George W. Bush be elected would suddenly and finally come true.

Uninfected refugees would flee the "hot zone", inadvertently carrying the killer microbe in their midst. The "wealth" of generations would be abandoned in a millisecond in the mad rush to escape the spreading death.

What I am suggesting is that with the tools of synthetic biology, modern medical tools--antibiotics, antivirals, the entire pharmaceutical R&D infrastructure--would be either ineffective or too slow to help anyone.

The type of proactive prevention that could hold back such threats have little to do with your government or the technological infrastructure of your society.

More later.

Waiting for Bird Flu

You can look at the top ten public health stories of 2006 for the US below, and not find a trace of Bird Flu.

1. AHA Dietary and Lifestyle Recommendations Revised
2. Guidelines Updated for Mumps Immunization
3. High Carb, Low Glycemic Index Diet Best to Reduce CV Risk
4. CDC Recommends HIV Testing and Screening in Routine Clinical Care
5. Calcium Plus Vitamin D May Not Reduce Hip Fracture or Colorectal Cancer Risk
6. CDC Updates Guidelines for Immunization Against Hepatitis B Virus Infection
7. Fat-Reduced Diet May Not Reduce Risk for Cancer or Cardiovascular Disease
8. Guidelines Updated on Secondary Prevention for Atherosclerotic Vascular Disease
9. Children May Need 90 Minutes of Physical Activity Per Day
10. New Guidelines Issued for Beverage Classification and Consumption

Sadly for Bird Flu, it did not even make it to the top ten "junk science" list of 2006. What does an over-hyped medical story need to do to get some respect? At least bird flu made it to #24 of the Discover top science stories of 2006. But the Discover blurb on Bird Flu was merely to explain why bird flu was not the global pandemic that all the newspapers and "science" blogs predicted it would be.

There are several emerging viruses that have the potential to mutate or recombine into pandemic killer viruses. This has always been true. It is the job of the CDC to remain vigilant to influenza transmission and infection worldwide, to advise governments, medical authorities, and vaccine makers how to prepare for the next six months or so. Meanwhile, viral surveillance and research into new vaccines is proceeding apace, just as it would do without all the hype.

In March University of Wisconsin virologist Yoshihiro Kawaoka looked for H5N1 receptors in the human respiratory tract and found them only deep within the lungs, on the tiny air sacs through which oxygen passes into blood. That deep location would make it difficult for an infected person to spread the avian flu virus through coughing or sneezing.

Source.

Science, including medical science, is too complex for most journalists to understand. Journalism students are typically among the least competent and least intelligent students in university. Paradoxically, journalists act as public filters of science, and magnifying glasses--selecting the stories the public will hear, often inflating selected stories to incredible size and significance. Such was the case with bird flu.

Why do the public and many bloggers fall for media hype of science and medicine, time after time--without catching on? Waiting for bird flu. Waiting for climate catastrophe. Waiting for Godot. Actually, the list of catastrophes the media would have us wait for is much longer. But the public has a short attention span for almost everything except faux catastrophe. They would rather wait, thanks.