Table of Contents:

Foreword

Introduction

I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chicken's Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Don't Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse

Topics

References 1-3,199

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According to the Smithsonian Institution, there have been three great epidemiological transitions in human history. Epidemiology is the study of the distribution of epidemic disease. The first era of human disease began with the acquisition of diseases from domesticated animals. Entire ancient civilizations fell prey to diseases birthed in the barnyard.777

The second era came with the Industrial Revolution of the 18th and 19th centuries, resulting in an epidemic of the so-called “diseases of civilization,” such as cancer, heart disease, stroke, and diabetes.778 Chronic diseases now account for seven out of ten deaths in the United States779 and the majority of deaths worldwide.780 Thankfully, these diseases are considered “largely preventable” through changes in diet and lifestyle.781

We are now entering the third age of human disease, which started around 30 years ago—the emergence (or re-emergence) of zoonotic diseases.782 Medical historians describe these last few decades as the age of “the emerging plagues.”783 Never in medical history have so many new diseases appeared in so short a time. The trend is continuing. We may soon be facing, according to the U.S. Institute of Medicine, a “catastrophic storm of microbial threats.”784

Most of these new diseases are coming from animals, but animals were domesticated 10,000 years ago. Why now? What is responsible for this recent fury of new and re-emerging zoonotic disease?

Starting in the last quarter of the 20th century, medicine has been examining emerging disease within an increasingly ecological framework. The director of Australia’s National Centre for Epidemiology and Population Health says we shouldn’t be surprised by the recent explosion in zoonotic disease given recent environmental changes. “We need to think ecologically,” he said. “These viruses are trying to evolve.”785 Just as plants and animals in the wild try to adapt to new environments to spread their species, viruses also expand to exploit any newly exposed niches. “Show me almost any new infectious disease,” said the executive director of the Consortium of Conservation Medicine, “and I’ll show you an environmental change brought about by humans that either caused or exacerbated it.”786 To quote the comic-strip character Pogo, “We have met the enemy and he is us.”787

Two centuries ago, Edward Jenner, the founder of modern vaccines, proposed that the “deviation of man from the state in which he was originally placed by nature seems to have proved him a prolific source of diseases.”788 This observation dates back to the 2nd century, when Plutarch argued that new classes of diseases followed profound changes in the way we live.789 The same can be said for animals. “Something is not right,” reflects Professor Shortridge. “Human population has exploded, we are impinging on the realms of the animals more and more, taking their habitats for ourselves, forcing animals into ever more artificial environments and existences.”790 We are changing the way animals live.

According to the World Health Organization’s coordinator for zoonoses control, “The chief risk factor for emerging zoonotic diseases is environmental degradation by humans….”791 This includes degradation wrought by global climate change, deforestation, and, as described by the WHO, “industrialization and intensification of the animal production sector.”792 Along with human culpability, though, comes hope. If changes in human behavior can cause new plagues, changes in human behavior may prevent them in the future.793