Confirmation that the H5N1 avian flu strain has spread to Turkey and Romania from Asia over the last six months has suddenly brought it home that Europeans need to prepare seriously for a possible human influenza pandemic.
On previous occasions millions have died in similar outbreaks. Health authorities know they come in cycles and contemporary conditions would facilitate its transmission. Nevertheless those preparing for this possibility - and media publicising them - face a real challenge to balance relevant information and cautionary action against extravagant and unnecessary public alarm.
A pandemic could happen if the particular type of bird flu involved mutates into a form capable of being passed between humans. So far that does not seem to have occurred, since nearly all of those who have died in Vietnam and China caught it from birds, not humans. But medical factors justify taking the threat seriously. The number of deaths so far is worrying; mutation of the virus is possible; this strain is far more virulent than previous such pandemics like the one which killed 50 million Europeans in 1918; humans do not have immunity against H5N1; and antiviral drugs will take time, tests and experience to develop. One firm, Hoffmann-la Roche, has a monopoly on the main one involved and resists efforts to develop generic alternatives.
So preparedness is vital if this danger is to be handled effectively. Precautionary action needs to be taken at local, national, European and worldwide levels. Our global connectedness is vividly illustrated by the facts of this case. The virus has travelled from Asia to Europe with migrating birds, a perfectly natural annual journey. But the human conditions the birds encounter en route have changed in such a way as to make pandemics more virulent when they do occur. The huge growth in factory farming of poultry close to humans in China and elsewhere is matched by the population explosion in many Asian and Third World cities, which would be especially vulnerable to any pandemic. Globalisation and cheap air travel link all parts of the world, increasing vulnerability.
There is a lively debate in the United States about levels of preparedness for this threat compared to those for terrorism or biological warfare. The Senate Republican majority leader Bill Frist has criticised the lack of action by the Bush administration and called for a research effort on the scale of the Manhattan Project to tackle such pandemic risks. In Europe emergency measures focus on reducing contacts between wild birds and poultry and bringing in an early detection system in high-risk areas such as the Romanian wetlands.
Governments will now have to implement these nationally and locally. There is merit in the call by Dr Mary Upton of the Labour Party for a national bio-security unit to supplement the steps already taken. An urgent task is to secure sufficient stockpiles of drugs capable of dealing with the virus. Co-ordinated international action to research and develop them should also be a high priority.