Customer Reviews

The Monster at Our Door: The Global Threat of Avian Flu

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Another great 'Doom, Doom, the End is Near' book. It may even be true.

But somehow after the prospect of nuclear war, then nuclear winter, Hong Kong flu, then Global Warming, AIDS, Ebola and so on you get just a bit jaded.

First the bad news. Avian Flu is a killer. The 1918 flu pandemic killed about 2.5% of the people it infected. This new one seems to kill about 50% (this book says two out of every three) of the people that get infected. It is rapidly spreading. This week there were cases reported in Turkey, right on the threshold of Europe (Birds do fly around a lot).

Second, the good news. In order for the virus to really be deadly to large numbers of people it has to mutate to make it capable of being transmitted from human to human instead of just bird to human as it is now. When it mutates it isn't as likely to be as deadly as it is now. A virus only has so much ability to carry things around. If it develops a 'skin' tough enough to travel by air, it will likely lose some of its deadlyness. Why? Because of all the flu's around this is about the worst. When it mutates, the skin is going to take more virus stuff, and some of that comes from the deadly stuff. Ebola has a higher mortality than Avian flu, the virus can't live outside of body fluids. Still at 50% mortality for Avian Flu, even if it goes to 5%, that's still worse than the 1918 variety. Another good point is that all of the governments around the world from Viet Nam to the UN are concentrating on the problem It's going to be tracked very carefully. As soon as an airborne variety mutates, a vaccine will be developed on an emergency basis.

Is there a risk -- absolutely. It it an emergency -- not yet. Is the book worth reading, absolutely, even if for no other reason than to see how our Government operates when faced with problems like this.

"The Monster at Our Door" provides an excellent summary of key flu characteristics, assessment of the current serious avian flu threat, and the shocking failure of our government to take appropriate action.

Davis reports that RNA viruses evolve up to millions-fold faster than their our antibody sources. One key point is that the co-infection of a host by two different subtypes can result in reassortment of constituent genes, and a new, more virulent strain.

A second key point is that starvation, malaria, and coo-infections act as flu impact multipliers - thus, Asia, Africa, and Latin America are particularly vulnerable.

Davis also summarizes the failure of recent "market-solutions" to the flu problem. Vaccine producers waited until demand strengthened in '57, resulting in availability that was generally too late and a total of about 80,000 U.S. deaths. This happened again in '68, and about 34,000 deaths followed. Another serious problem with past market-based solutions is that they failed to focus on those most vulnerable - elderly, asthmatics, and pregnant women - often corporations bought up the supply to give to their relatively healthy workers.

Still another key point brought out by Davis is the likely success of isolation and quarantine in a slow-moving virus (eg. SARS), vs. H5N1 flu. SARS has a five-day incubation period and only becomes contagious well after the onset of obvious fever and dry coughing. Infectiousness and sickness with other viruses (eg. HIV), however, do not coincide - HIV can be contagious for years without symptoms being present. Further, pandemic flu spreads much more easily than SARS. Thus, while SARS was controlled largely by authoritarian China's ability to quickly isolate and quarantine, this would not be possible with a faster-moving flu - especially in a democratic nation with advanced travel systems such as the U.S.

Another problem with the new flu is that it benefits through traveling and mutating via swine and poultry. These food sources represent 76% of the developing world's increased meat consumption; further the problem is acerbated by the increased tendency for their being concentrated in large-scale production centered around processing facilities. Destroying the affected livestock has proven effective, but this is increasingly difficult in areas with limited diagnoses capability and where the local population relies so heavily on the affected sources.

H5N1 has broken out in a number of Asian countries, and recently has been found in Russia, Africa, and Eastern Europe. Experts increasingly are concerned that eventually it will mutate into a form that is easily transmitted between humans. At that point, it's anyone's guess how strong the flu will be (the mutation may make it weaker, or it may retain its current strength; further, mutations may or may not render current vaccines and treatments being developed inpotent) - thus, estimates of world-wide fatalities range up to ONE BILLION!

As for defenses, in '76 the U.S. had 37 vaccine producers - now there are only two, and production for one of them is located in England and was shut down last year for quality problems. Japan has acquired enough Tamiflu medication for 20% of its population, while as of '04 the Bush Administration had only arranged for less than 1% of U.S. coverage. Davis also points out that in '04 the U.S. spent more on abstinance education than avian flu vaccine, and until very recently there has been greater focus on bio-terror defense (anthrax, smallpox, etc.) than influenza.

"The Monster at Our Door" is a great educational and wake-up contribution; I recommend it to EVERYONE!

This book is a comprehensive look at just what bird (or avian) flu is all about, and what the world is, or is not, doing about it.

Influenzas are divided into three major categories. Types B & C are relatively mild, leading to the common cold, or, at worst, the winter flu. But Type A is the unpredictable, and lethal, strain that is fully entrenched among the bird population of East Asia. It is very easy for the disease to jump from migratory birds, to ducks, to chickens, to swans and egrets, and back again, mutating along the way. Until now, the human deaths have come from direct contact with infected birds. But the time is coming when that last mutation will click into place, causing it to jump from person to person. A worldwide flu pandemic, with a death toll in the hundreds of millions, is, as one researcher put it, "late."

What is America doing to prepare for the coming pandemic? Not much. Industrial chicken farms, with millions of chickens crowded into one building, are a wonderful breeding ground for diseases of all sorts, not just bird flu. Remember SARS from a couple of years ago? Among the reasons why it was contained is that the cities where it happened, Toronto and Hong Kong, are modern cities with modern health care systems. Imagine if SARS had shown up somewhere in Africa, with a much less modern health care system.

The major drug companies have opposed moves to allow other countries to make cheap copies of flu vaccines, even though there are nowhere near enough doses of vaccines even for first responders, out of concern for their corporate bottom line. The Bush Administration is more interested in spending money preparing for a smallpox or anthrax outbreak, something which has much less chance of ever happening, than in spending it on bird flu, which is coming in the near future.

This is a very spooky book, which I guess is the idea. It is written for the layman, and does a fine job at showing how unprepared America is for the next flu pandemic. It is very highly recommended.

`The Monster at Our Door' is distressing, engaging and a well researched book. Unapologetically, this book shakes one up, and creates anxiety Plague, epidemic, pandemic, apocalyptic, no matter what word writers use, the outcome is the same: massive death. Will we, in next 18 months, see millions of deaths in the span of a dozen weeks? Mike Davis, and many of the other accomplished professionals he quotes, thinks so.

In `Monster' Davis brings together mountains of data (334 notes and citations), writing with an almost obsessive attention to detail and clearly chronicling and depicting the onslaught of this coming plague. He is meticulous in showing how the virus attacks, and how paltry will be the world's defense against such a monstrous force (thus the title).

For this new strain of influenza virus, H5N1, we have no immunity. Pneumonia often developed quickly, with death usually coming two days after the first indications of the flu. Mike, and others, use the influenza epidemic of 1918-19 as a reference point. During this H1N1 influenza pandemic the number of dead was staggering: estimates range from 25 to 100 million.

The incompetence of governments, the greed of the giant pharmaceutical corporations and the failure of the Bush administration to prepare and safeguard Americans "from the greatest biological threat since HIV-AIDS," are all forefront in Davis's writing.

What Davis does not address is what will be the devastating effect from the carnage of millions dead. What will happen to the social and economic fabric of the world? He also says nothing about how the reader is to survive. There are no survival tips, outside of the drug oseltamivir (Tamiflu), to help one prepare. Regarding these two points, there are two sources worth mentioning. On the CDC website there is a very good article titled: `The Economic Impact of Pandemic Influenza in the United States', and in the November 2005, `Men's Health' Magazine, there is an excellent article on the Avian Flu. Within these article are survival tips and a survival supply list.

Mike Davis, an accomplished writer, social critic and unconventional scholar, is sounding an alarm loud enough that "those with ears to hear" will look up and see H5N1's impending attack. Read the book by all means, and then decide, is this for real or is it more hype than horror? Highly recommended. 4.5 stars.

The free market approach to procuring vaccine when signs of epidemics of Influenza A arise has been disastrous, Davis shows. In the U.S. epidemics in 1957 and 1968, companies could not manufacture enough vaccine in time to prevent it from spreading and killing tens of thousands of elderly people, pregnant women, etc. Vaccines for infectious diseases are very unprofitable for pharmaceutical companies to manufacture. The need for flu vaccine is uncertain and seasonal. And the flu mutates and reasserts into new forms that make a previous season's vaccine obsolete so the companies get left with a worthless stockpile. Health and Human Services Secretary Mike Leavitt recently bragged that he had set up a contract with Sanofi Pasteur to procure new production lines for cell-based vaccines. The head of the Centers for Disease Control Julie Gerberding, much disliked amongst her employees for being a political operative of the Bush administration, in contrast, acknowledged that vaccines become obsolete after one season, that the production lines being set up by Sanofi Pasteur were limited and also that the doses puchased were more adequate for common cold/flu. Leavitt, also dodged questions about the relatively tiny purchases compared to those made by other countries, of Tamiflu, the one drug that can inhibit the explosion of Avian flu in the body after it has gotten set up in the body.

Currently the U.S. has two companies under contract to produce flu vaccine. One of them is the San Francisco based Chiron. FDA officials i.e. appointees of the Bush administration, waited nine months before sending the inspector's report to Chiron officials about finding many sources of potential contamination in its production and then assured congress that the company was working on the problem. Then in July 2004, Chiron discovered massive doses of bacteria that can cause death from septic shock, just as it was bragging in a press release that it had shipped one million doses of Fluviron vaccine to the U.S and planned to ship 52 million more doses. Chiron waited a month to tell the FDA. FDA acting head Lester Patterson and company officials assured congress everything was fine but shortly after those assurances, British inspectors closed their planned and withdrew their license to manufacture vaccines.

Devastatingly he notes how the Bush administration has used the scare over anthrax, which seems to have come not from Muslim terrorists or Saddam, but from Fort Detrick Maryland, to ramp up funding for vaccines against the very remote possibility of smallpox or anthrax transmission by terrorists. At the same time Bush has slashed funds for public health protection against infectious diseases like the evolving strains of Avian flu. They are, of course, only following the course set by the Reagan administration. Rates of infectious disease among poorer Americans have increased since the cuts of the Reagan years, weakening immune systems and thus giving diseases like Avian flu and SARS an easier pathway. Neither Democratic nor Republic politicians, both heavily funded by Pharmaceuticals, have been willing to even timidly suggest that the patent rights of the flu vaccine manufacturers should be violated and governments should be able to produce their own generic version of vaccines. Maintaining the level of Pharmaceutical company profits, the most profitable industry in the world is more important than slightly cutting into those profits by allowing governments to produce their own generic version of Tamiflu (a proposal which the U.S. and France blocked at a WHO conference in 2002) to say nothing of producing drugs to combat Malaria and reduce AIDS deaths in Africa (also blocked by the U.S.). . He notes how AIDs must have got started. Fisherman in West Africa could not longer compete in procuring fish for protein and commerce as their governments lifted restrictions on corporate foreign fishing on their shores. Meanwhile, West Africa's previously isolated rain forests were logged over and exposedtheir pathogens to the rest of the world, particularly through their animals which many Africans turned to as a source of protein in lieu of the fish.

Government spending on public health in third world has been dramatically slashed in the third world as governments are compelled to undergo IMF (i.e. U.S.) imposed structural adjustment so government preparedness in these countries for public health disasters is even worse than before. He mentions the Indian government's response to a Pneumonic Plague outbreak in the slums of Suratt, where there is one toilet for every 250 persons. The rapidly expanding slums of the third world are extremely dangerous for spreading disease as are the crowded conditions among sweatshop laborers in China's poultry center, Guangdong province, who suffer from pollution related respiratory disease and cacner.

In the United States and in Thailand and the rest of Asia, mass chicken farms tens of thousands of chickens co-exist with other poultry, wildfowl and human beings and thus Avian flu has the chance to go through many different hosts and evolve. One chicken farm in Utah produces more excrement than the entire city of Los Angeles. In 2000-01, chicken farms in the Tilgore valley in Californian and in British Colombia both covered up the spread of Avian flu among their fowl.

Davis describes how the Thai poultry conglomerate CP, in collusion with the Thai govt., bribed its sources of chickens to keep quiet while its workers at its processing plants were unknowingly exposed as they prepared to export the chicken. The Thai government blamed small scale chicken producers who are very poor backyard producers and went around butchering all their chickens while offering them terms for compensation which they could almost never abide by.. The CP has been blamed for one particular Avian flu outbreak at one of its open air poultry farms in Vietnam. CP apparently sent campaign donations to Clinton through John Huang in the scandal that got right wingers all excited. One insightful thinker at the Weekly Standard tried to tie CP and its close connections with China as a Commie front company that was influencing Clinton. . Of course, Davis points out, CP actually has had strong business relations with Bush Sr. and Neil Bush and the Carlyle group.

I get the jitters every time I hear about the "coming pandemic", especially since the news is usually accompanied by reports that we don't have enough vaccines, there is a high mortality rate, etc. No matter how hard I try, I can't seem to stop that small tinge of worry at the back of my mind that keeps coming to the forefront when I'm not doing something else. All the "what ifs?" that make me consider the possible scenarios and how we'd deal with them IF and WHEN this very deadly flu starts passing from person to person...they keep floating around, with question after question accompanying my inner dialogue. Questions like: Would the schools be closed? Would cities be quarantined or just specific neighborhoods? How would our economy be affected? What can we do?

So I decided to read this book, even though it would seem like the LEAST rational thing to do, considering my already anxious state...and, oddly enough, I felt better afterwards. The facts about HSN1, this virus which lives in poultry and other birds, were laid out quite clearly. At least I knew more than I had before and that knowledge made me aware of other possibilities and changes that might make a difference.

I could see how certain vital changes in the way government, the food industries and others who'd be at the forefront of handling a health crisis could make significant differences in how many people lived or died during a pandemic. I realized the urgency in getting vaccines made and dispensed to everyone as quickly as possible and was motivated to do what I could to work towards that goal, in whatever way possible, large or small. I stopped worrying and started to push for solutions as well as finding out about those who were trying to make truly useful vaccines in mass quantities.

This is a "must read" for those who want to be in the know when it comes to what may be coming our way. But be forewarned- if you're looking for reassurance, this book isn't the one you want. But if you can handle the facts, you will definitely want to put this at the top of your book list.

I just finished this book en route from a conference in New Mexico, where I gave a presentation on avian influenza, to my home in Tallahassee.

Mr. Davis' book is superbly footnoted and is an excellent digest of events and publications dealing with "bird flu" over the past nine years. His bashing of the Clinton and Bush (43) administrations aside, his work is a sobering "what if?" that all who deal with pandemic planning should read.

Since the Federal Government has issued pandemic plans covering the Worse Case Scenario, I would suggest two books are essential reading, to get one up to date on things. First, of course, is John M. Barry's superb "The Great Influenza," covering the 1918 pandemic. The other book is this one. After reading this work, you'll never trust Asian flu reporting again.

As a confirming note, a press account today (5/7/06) reported that half the A/H5N1 cases coming out of Asia were reported in a timely enough manner as to be of value in alerting the planet of a human-to-human pandemic. In that context, Mr. Davis' book should be taken even more seriously.

Sometimes books like this have a tendency to overstate their claims in hyperbolic fits. Here, Mike Davis does an excellent job of describing the history and pathology of Avian Flu, without resorting to hyped up Hollywood plots. The reality is frightening enough and doesn't need to be magnified in any way. Although this book explains the scientific aspects of H5N1, it is not a difficult slog through incoherent jargon. If you want to know the nature of the Avian Flu Crisis, its likely impact, and the policies that got us here, this book is a good choice.

Awesome book. very well written & informative, well researched. It was recommended to me by an immunologist.

With avian flu so much in the news - and spreading around the world - it's important to run, don't walk, to pick up a copy of The Monster At Our Door: The Global Threat Of Avian Flu to fully understand the threat and why scientists are so concerned. In 1918 the flu killed over 40 million people in three months - now researchers believe avian flu to be on the same magnitude, on the verge of mutating into a pandemic form that can kill two out of three people infected. The Monster At Our Door is a frightening look at not just this latest threat, but the ongoing possibilities of a pandemic flu's effect on the world's population.