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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The latest National Academy of Sciences report investigating the rising tide of new diseases spoke of myriad factors creating the microbial equivalent of a “perfect storm.” “However, unlike a major climactic event where various meteorologic forces converge to produce a tempest,” it reads, “this microbial perfect storm will not subside. There will be no calm after the epidemic; rather the forces combining to create the perfect storm will continue to collide and the storm itself will be a recurring event.”1244 And there is no storm like influenza.

The dozens of emerging zoonotic disease threats that have characterized this third era of human disease must be put into context. SARS infected thousands of human beings and killed hundreds. Nipah only infected hundreds and killed scores. Strep. suis infected scores and only killed dozens. Influenza infects billions and can kill millions.

Influenza, the “last great plague of man,”1245 is the only known pathogen capable of truly global catastrophe.1246 Unlike other devastating infections like malaria, which is confined equatorially, or HIV, which is only fluid-borne, influenza is considered by the CDC’s Keiji Fukuda to be the only pathogen carrying the potential to “infect a huge percentage of the world’s population inside the space of a year.”1247 “Make no mistake about it,” Osterholm says. “Of all the infectious diseases influenza is the lion king.”1248

Because of its extreme mutation rate, influenza is a perpetually emerging disease. Anthony Fauci, the NIH’s pandemic planning czar, calls it “the mother of all emerging infections.”1249 In its 4,500 years infecting humans since the first domestication of wild birds, influenza has always been one of the most contagious pathogens.1250