Cute, Dangerous Or Both?

[ABCDE]

Volume 5, Issue 6 Cute, Dangerous or Both?

ASSOCIATED PRESS

Newborn chicks, at a poultry farm in Burgos, northern Spain, might someday be carriers of a disease called bird flu.

An Integrated Curriculum For The Washington Post Newspaper In Education Program

Endemic, Epidemic or Pandemic? Health Watch

Lesson: As individuals, companies, • Seasonal (or common) flu kills www.who.int/csr/disease/influenza/ health officials and governments thousands each year. It can be pandemic/en/ confront an outbreak of mumps transmitted person to person, but Epidemic and Pandemic Alert and Response and a potential virulent spread most people have some immunity (EPR) of the avian flu, students can to it and a vaccine is available. World Health Organization provides explore public health, privacy • The influenza viruses that cause background and preparedness plans, rights and economic decisions. avian (or bird) flu occur naturally including the WHO global influenza The concerns about avian flu among wild birds. The H5N1 preparedness plan. Latest information on also provide opportunity to teach variant is deadly to domestic situation in countries around the globe. students about the Spanish Flu that fowl and can be transmitted from killed more than 50 million people birds to humans. There is no www.pandemicflu.gov/ around the world and to introduce human immunity and no vaccine PandemicFlu.gov students to careers in virology and is available. U.S. government avian and pandemic flu epidemiology. • Pandemic flu is virulent human information, press releases, issues and Level: Low to high flu that causes a global outbreak monitoring, including maps and travel Subjects: Health, English, Language of serious illness. Because there information. Review the “School Planning” arts, History is little natural immunity, the section. Information on the National Vaccine Related Activity: Business, disease can spread easily from Program also found on the U.S. Department Economics person to person. Currently, there of Health & Human Services Web site. is no pandemic flu. Many health issues provide www.cdc.gov stimulus for lessons in economics, Explain Bird Flu Centers for Disease Control and Prevention privacy vs. public health concerns, A May 2006 KidsPost article and Up-to-date information on influenza, mumps illegal vs. legal transport of goods sidebar provide the basics. Give and health and safety topics. Learn about and medicines, laws and ethics. students “Cause for Concern” and the National Immunization Program, get This guide focuses on the current “Worldwide Scares.” local and international travel information news: an outbreak of mumps in The excerpt from the Sunday and collect data and statistics. the Midwest and the spread of the Magazine article, “Can We Stop H5N1 strain of the influenza virus. the Next Killer Flu?” by Joel www.dh.gov.uk/PolicyAndGuidance/ The following activities suggest Achenbach provides a more in- EmergencyPlanning/PandemicFlu/fs/en the range of approaches that can depth understanding of the avian flu Pandemic Flu be taken using Washington Post and the work of scientists. Visit the United Kingdom Department of news articles, features, graphics and What are the symptoms of having Health Web site. Travellers advice, pandemic commentary. the common flu? How do they contingency plan and command paper. compare and contrast with the Define the Terms symptoms of having the mumps? www.fao.org/ag/againfo/subjects/en/ Use the etymologies of health/diseases-cards/special_avian.html “outbreak,” “endemic,” “epidemic” Get Graphic Animal Health/Avian Influenza and “pandemic” to form a Graphics from The Post are FAO (WHO Food and Agriculture foundation for discussion of current provided. “Assessing Bird Flu” Organization) Animal Production and health issues. Give students “What provides a world map where H5N1 Health Division bulletins, disease card, Do We Call This?” In addition to has been detected and a bar graph videos, safety measures, scientific reports. clarifying the definitions, you may representing the human toll. “How wish to discuss the connotations Does Bird Flu Spread?” presents www.whitehouse.gov/homeland/pandemic- that are attached to each term. a graphic of wild bird flyways as influenza.html For a little perspective, we provide well as ways to stop the spread of National Strategy for Pandemic Influenza this summary of information Homeland Security provides strategy presented at PandemicFlu.gov: pillars: Preparedness and Communication, continued on page Surveillance and Detection, Response and Containment. June 1, 2006 © 2006 THE WASHINGTON POST COMPANY Volume 5, Issue 5

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page million individuals in America and In the Media the world from late 1918 to spring flu among birds and to contain a 1919. Why would scientists want www.washingtonpost.com/wp- human pandemic. to revive this virus? Post writer dyn/content/linkset/2005/10/17/ Give students “Global Graphics.” David Brown states, “It may also LI2005101700979.html Questions require that they prove to be unusually useful — not Focus on Bird Flu respond to the map, bar graph and an elaborate biological parlor Post Special Report: The latest information presented. trick, but a vital service to global developments in U.S. and the world, public health.” Give students archived articles, maps and graphics, quick Meet the Scientists “Resurrecting 1918 Flu Virus Took facts and key stories. Meet Jeffery Taubenberger, from Many Turns.” his high school science project in In addition to learning about www.npr.org/templates/story/story.php?sto Fairfax County to cutting edge the Spanish Flu, students will ryId=4949542&sourceCode=gaw research at the Armed Forces appreciate the work of different Health Officials Keep Close Watch on Bird Flu Institute of Pathology, and other scientists, building on the work The latest global information, news, scientists at work in an excerpt of previous scientists and using interviews and historic perspective in the from the Sunday Magazine different approaches to reach a goal. collection of features. article, “Can We Stop the Next This is also a lesson in the use of Killer Flu?” by Joel Achenbach. technology to benefit mankind. www.pbs.org/wgbh/amex/influenza/ Gain perspective and appreciation Influenza 1918 for the study that has gone from Compare Approaches “… the worst epidemic the United States observation and microscopes to How are influenza, avian flu, has ever known” from a PBS American electron microscopes and the 3132 mumps and other contagious Experience program. Maps, graphs, program Genetic Analyzer. diseases affecting other countries? transcript, interviews, bibliography and “Changes Cited in Bird Flu Virus” Read the articles and graphs in this teacher’s guide. by David Brown can be found online guide to learn what has happened in Special Reports in the Health in 2005 and early 2006. Review www.washingtonpost.com/wp- section (www.washingtonpost. current issues of The Post for dyn/content/linkset/2005/10/11/ com/health). This Oct. 6, 2005, more recent coverage of health LI2005101001030.html article provides background on the concerns. Then review other news Flu Basics avian flu and the scientists’ study of sources online to compare how Post Health section Special Report on mutations in its structure. health concerns are covered. What vaccines, symptoms and treatment of additional health information can influenza. Replicate the Spanish Flu you gain about other parts of the This part of America’s history is world by reading their “local” news www.newseum.org often overlooked in history classes. online? Newseum The Influenza of 1918 followed the Daily new pages from across the U.S. and routes of trade and human travel. A Connect the Dots around the world severe outbreak in Spain gave it the How does illness spread and name Spanish Flu, but early in 1918 become an epidemic or pandemic? in military camps in Kansas the flu Review the maps and wild bird had already made its appearance. flyways in “Assessing Bird Flu.” No steps were taken in spring to Do any of these coincide with the face the spread of flu as those who presence of the H5N1 strain? survived entered battlefields in Using a map of the United Europe and many soldiers began to States, mark where the outbreak die in Massachusetts. As the war of mumps has been reported. From ended, in some areas more had died early cases in the Midwest how of flu than bullets. has the virus spread? Is there a The Spanish Flu was responsible for the death of more than 40 continued on page

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page • Who is going to benefit from Vocabulary this contract? Impact on people pattern? After reviewing the map getting the drugs, the companies Contagious: Capable of transmitting by and reading articles about the developing the vaccines? direct or indirect contact; carrying a outbreak of mumps, can students • Upon whom will this vaccine be disease make a connection between the tested for its efficacy? viruses being spread via migration • Would this be a good time to Contaminate: To make unclean or impure patterns of people (flying around invest in one of the companies by contact or mixing the country and world) and birds that received this contract? carrying the H5N1 virus with their The Post reported that federal Health: State of complete physical, own migration patterns as well as health officials want airlines tainted meat being sent around the to collect personal information mental and social well-being; not merely world? about domestic and international the absence of disease or infirmity The World Health Organization, passengers to help track potential (WHO Constitution) the public health division of the epidemics. In 2003 airlines United Nations, monitors disease cooperated by helping to locate Imminent: About to take place; impending outbreaks and assesses the passengers who might have been performance of health systems. Use exposed to SARS and then traveled Influenza (flu): Viral respiratory infection. its Web site and others found in by air to another destination. Symptoms include headaches, dry the sidebars in this guide to assist Today many airlines are fighting cough, muscle aches and fatigue. collecting data. bankruptcy. Give students the How is information about health activity found on “What Do You Lethal: Fatal; causing death precautions (vaccinations, washing Think?” More information can be hands, diet) disseminated to the found at http://ad.doubleclick. Mutate: To change public? Give students “What Do net/clk;29842043;13115100;n? You Think? This activity sheet http://h10010.www1.hp.com/ Mutation: An alteration or change, as provides several options for student wwpc/us/en/sm/WF05a/18972- in nature, form or quality; the process response and exploration. 236251-236268-15077-f51-446153. by which a sudden structural change html?jumpid=ex_r295_link/ Compare the Costs kimIPGsmb/2Q06Colorinoffice/ occurs, either through an alteration in The common influenza virus is L2600n/banner1/ the nucleotide sequence of the DNA the cause of death of thousands WashingtonPostNewsweek. coding for a gene or through a change annually. More than 60 people have in the physical arrangement of a died in other countries from the Go Human-to-Human vs. Bird-to-Bird chromosome H5N1 strain. In addition to this How scared should we be about human toll, what other costs are the common flu and the avian Pathology: Scientific study of the nature involved in the spread of flu? The flu? Compare your area or state of disease and its causes, processes, Animal Welfare Institute reports to those in other countries where development and consequences that “nearly a quarter of a billion immunization does not take place. birds have been killed” to contain The H5N1 strain has been Virulent: Extremely noxious, damaging, the spread of the flu virus. What detected in 30 countries. Ask deleterious, disease-causing does this mean to farmers and students to conduct research to find (pathogenic). factory workers whose income is out how many birds and humans dependent on poultry? have been identified carrying H5N1. Virus: Ultramicroscopic infectious agent See Government’s Role below How might the avian flu influence for another perspective on the us? that replicates itself only within cells economics involved. Give students Mumps is a human-to-human of living hosts; many are pathogenic; “$1 Billion Awarded for Flu transmission. Why should a piece of nucleic acid (DNA or RNA) Vaccine” for a perspective on wrapped in a thin coat of protein the cost of developing vaccines. Considerations include: continued on page Virologist: One who studies viruses

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page Suffer, So Do We” for one perspective other countries. Write a persuasive on the need for proper care of animals. paper based upon their findings. children be immunized? How has this Ask students to examine the argument practice benefited American children? that Kelly Overton develops in this Government’s Role What do students propose as a commentary. You might consider: To what extent do individuals want means to stop the spread of influenza? • What is the controlling idea of the the government to be involved in Carefully monitoring flu cases and any lede? public safety and health issues? You deaths, vaccination, limiting travel • Which is her least effective might frame the request for passenger to certain areas, canceling school, argument? Why? information (See “What Do You concerts and other large gatherings • What are her two most effective Think?”) in terms of privacy rights vs. of individuals might be some of their arguments? Why? public safety. Where is the balance? suggestions. How practical are these to • Is the conclusion persuasive? Why or For further study, augment current implement? For what period of time? why not? Post articles with lessons from the Post Give students “Too Much, Too Little, The World Watch Institute document NIE online manual (www.washpost. Just Right.” com/nie) found in the Business section. On page State an Opinion Iowa Outbreak 133 E43, “Government’s Role Read “A Pandemic of in Health and Economic Fear.” You might ask the At least 515 people have contracted mumps during Decisions” begins with following questions: a recent outbreak in Iowa. 82 three lessons: When 74 • What credentials make New cases of 66 Health Concern Interrupts mumps in Iowa Siegel a reliable source? 41 * Supply and Demand, does not show 0 cases in which • Of whom is Siegel critical? the onset date is unknown. 23 25 When Market Economy vs. 12 Why does he dispute 0 2 2 4 8 3 Traditional Economy vs. this individual’s “broad Public Safety, and When FOR THE 7th 14th 21st 28th 4th 11th 18th 25th 4th 11th 18th 25th 1st 8th speculation”? WEEK Jan. Feb. March April Government and Public • Have any individuals ENDING: Health Face Disease. survived bird flu? Does Mumps basics Avian flu, SARS and mad his data correspond with cow disease are included that of the “Assessing Bird How it spreads The mumps virus spreads like the flu — primarily through the air in the concerns facing Flu” graphs? when infected people cough or sneeze. citizens, businesses and • Allusion or reference to Symptoms The most common symptoms are fever, sore throat, headache and governments. Articles from previous contagious health swollen glands under the jaw. 2004 will provide some concerns is made. What Treatment There is no way to treat the disease itself. Patients should drink lots background perspective of fluids and take aspirin and other painkillers to reduce the fever and can be learned from them? alleviate the aches until their bodies can fight off the infection. while the issues remain • Do students agree with his the same, included Complications Most people recover in about a week. but in rare cases, victims, definition of “pandemic”? particularly adults, can develop severe complications, such as deafness are “Fearing SARS, His thesis? or a dangerous swelling of the covering of the brain and spinal cord China Begins Mass • Does the author agree called meningitis. Pregnant women can have miscarriages. Men can Killing of Civet Cats” with President Roosevelt’s develop a painful swelling of the testicles that can lead to sterility. and ”Bird Flu Upends adage from his first Industry, Livelihoods in souRCe: Iowa department of Public Health *Preliminary data still under review Inaugural Address, “the THE WASHINGTON POST Thailand.” only thing we have to fear is fear itself”? Inform Other Students stated, “Crowded, inhumane and “What Do You Think?” provides several In addition to the prominent unhygienic conditions on factory farms activities from which students select one. monitoring of wild bird flyways, can sicken farm animals and create the These require students to get informed, some organizations are urging an perfect environment for the spread of using the articles in this guide and examination of man-made paths that diseases, including avian flu.” Have additional sources, and then share their may be causing contamination and students in teams conduct research on information and conclusions with others. spawning H5N1. Read “When Animals conditions that exist in the U.S. and

An Integrated Curriculum For The Washington Post Newspaper In Education Program Cause for Concern? Scientists Monitor Spread of Dangerous Virus Worldwide Scares

• Originally published May 11, 2006 Of the 206 people who have caught the Pandemics — severe illnesses When you think of the flu, you disease, at least 114 have died. that break out quickly in large probably think of feeling miserable populations — are a normal part and missing school for a few days. But Is it safe to have pet birds or to eat of world health cycles. there’s a kind of flu — called bird flu chicken and eggs? Thankfully, they don’t happen — that has been in the news a lot lately The flu virus is killed by heat, so it’s that often. There have been three and is a lot more dangerous. highly unlikely you could get bird flu pandemics in the past 100 years Bird flu is a disease that can kill birds from fully cooked chicken or eggs. — in 1918, 1957 and 1968. (The and, sometimes, people. Bird flu doesn’t Pet birds have a low risk of getting 1918 flu outbreak was by far the transfer easily from birds to humans, bird flu if they stay indoors. worst, killing 50 million people.) and it can’t be passed from person to Because it has been so long person. Bird flu has not been found in What happens if the virus starts since the last pandemic, some the United States. spreading among people, including experts think there will be But viruses can change, and scientists here? another one within the next few are worried that bird flu could start If the virus changes so that it can years. The good news: We know spreading easily from person to pass easily from person to person, a lot more about viruses and how person — with no birds involved. If through a sneeze or from germs left on they spread than we did during that happened, the virus could spread a doorknob, your daily routine might past pandemics. We know more all over the world. That would be a change for a while. You would avoid about how to limit the spread “pandemic,” a term for lots and lots of crowded places such as movie theaters of disease, and we have better people getting sick from just one illness and grocery stores, and you might wear science to help find a cure. in a short period of time. a doctor’s face mask in public. Some The U.S. government, hospitals and schools might close and offer classes Here is information on the most even some schools are preparing for a over the Internet so that children could recent pandemics: possible outbreak of bird flu. KidsPost’s learn at home. People would be told to Margaret Webb Pressler answers some wash their hands often — and that’s a 1918 — Spanish Flu: Worldwide, basic questions about the virus. good idea anyway! This could last a few affected 20 to 40 percent of the months, until the outbreak slows down. population. What is bird flu? What people are calling bird flu is an When will this happen? 1957 — Asian Flu: Started in especially harmful bird virus, known as No one knows if bird flu will ever Asia and spread worldwide. the H5N1 strain, discovered in China become more contagious. If it does, it Affected old people the worst. in 1996. It has spread around Asia and could be next month or five years from to birds in Europe, the Middle East and now. It’s also possible that the virus 1968 — Hong Kong Flu: Similar parts of Africa. could change to become less dangerous. to the 1957 strain, it was the mildest pandemic of the three. How do you catch it? Is there a vaccine for bird flu? It’s pretty difficult for humans to get There are two drugs that might bird flu. All of the people who have prevent an infection or make the virus caught the disease had been in very less severe. But it’s unclear if there close contact with sick birds, dead birds would be enough of the medicine to go or the droppings of sick birds. The around during an outbreak. Doctors are H5N1 strain kills most infected birds. developing new drugs.

An Integrated Curriculum For The Washington Post Newspaper In Education Program What Should We Call This?

More than 70,000 cases of mumps have been reported in the United Kingdom since 2004. The Centers for Disease Control and Prevention (CDC) in April 2006 reported an increase in mumps cases in Iowa and other states. All of these cases are genotype G mumps, the same strain that has been known globally for decades. Collectively these cases are officially called an outbreak. The normal number of cases per year per country and state is established. A sudden increase, a bursting away from the inside or the norm, is classified as an “outbreak.” Having a shared definition helps health officials to communicate their understanding of symptoms, number CUSTOM MEDICAL STOCK PHOTO of cases and the seriousness of the disease and health conditions that The swollen cheeks of this boy indicate he is suffering from mumps. are observed. Government officials, journalists and citizens need to know a sudden, severe outbreak within Algerian community facing a deadly these definitions to avoid unnecessary a region or a group, it is classified epidemic of the plague. concern and fear and also to know as an “epidemic.” AIDS in Africa, Terms such as “wide-spread,” “public when action is required. for example, has reached epidemic health concern,” “public health crisis,” An illness that is present in a proportions. “highly contagious” and “virulent” community at all times but in low An epidemic that becomes very might be used to describe different frequency is said to be endemic. The widespread and affects a whole region, stages of an outbreak. prefix “en-” means “in.” Its root word a continent, or the world is classified Virulent emphasizes the rapid and is the same Greek word that gives us as a pandemic. The word “pandemic” malignant course of disease. The “democracy.” “Demos” means “people comes from the Greek “pan-,” meaning “virulence” of a microorganism is a or population.” An endemic is in “all,” combined with “demos” so a measure of the severity of the disease the people or prevalent in an area. “pandemos” affects all (or nearly all) it causes. The Latin word “virus” Malaria in some parts of the world the people. means “poison.” Virology is the study of is an endemic. Neighborhoods that The Latin language also had a viruses have experienced sustained dealing in word for the threat of disease upon Epidemiologists study populations in illicit substances have an endemic drug a population — “pestis” Our word order to determine the frequency and problem. pestilence comes from this Latin distribution of disease and measure the When more than the expected word which means “plague” or “fatal risks to others. These are the public number of cases of disease occurs in disease.” The 14th-century English poet health officials who gather information a community or region during a given Geoffrey Chaucer wrote of “pestilence” to establish the expected and alert period of time an epidemic is in the in “The Pardoner’s Tale.” This was society when disease is taking an making. “Epi-” means “upon.” When the bubonic plague that devastated unexpected course. combined with the root “demos,” the populations on land and sea. Six Source of definitions: MedicineNet. concept of something being placed centuries later Albert Camus wrote La com, PandemicFlu.gov, and American upon people is conveyed. When disease Peste (The Plague), a novel set in an Heritage Dictionary of the English spreads rapidly and extensively, is Language

June 1, 2006 © 2006 THE WASHINGTON POST COMPANY Assessing Bird Flu An outbreak of highly contagious avian influenza that began in Southeast Asia three years ago has now reached Europe, the Middle East and West Africa. More than 200 million domestic birds have been killed to halt the advance of the virus, called H5N1. Ninety-eight people, who probably contracted the disease through contact with domestic fowl, have died. Many scientists believe the virus could evolve and acquire characteristics that would make it easily transmissible among humans, causing a global influenza epidemic. But they cannot predict when, or if, that will occur.

What is bird flu? Europe key Year HN1 first Bird flu is the popular name for the 1. SWITZERLAND detected by Arctic Ocean illness caused by the H5N1 virus, province or district: 2. AUSTRIA one of hundreds of types of avian 3. SLOVENIA influenza viruses. many wild birds 4. SLOVAKIA 2004* 5. HUNGARY P a c i f i c carry flu viruses that cause them 6. CROATIA O c e a n no illness. These viruses sometimes 2005 7. bOSNIA SWEDEN mix and exchange genes, creating 8. ALbANIA North a 2006 Sea e new strains. one group of viruses S ic lt rapidly kills domestic chickens and a some species of wild birds. H5N1 B GERMANY is in this group. Human Cases RUSSIA FRANCE POLAND Where did HN1 start? Human Deaths 1 2 It emerged in China in 1996 and 4 * south Korea and Thailand 3 5 caused an outbreak in Hong Kong in recorded bird flu outbreaks 6 UKRAINE in december 200; these 7 ROMANIA SOUTH 1997 that killed six people. outbreaks are included in M JAPAN edi ITALY KOREA the 200 color coding. ter MONGOLIA scientists believe genetic mutations ra n of H5N1 have allowed easier e 8 BULGARIA KAZAKHS TA N a C n Black Sea a infection of mammals. Nearly all s S GREECE p e i a a GEORGIA human victims of H5N1 had contact n with birds, and so far H5N1 does not TURKE Y AZERBAIJAN

TURKEY S e pass easily from person to person. 12 Cases a 4 Deaths CYPRUS CHINA CHINA How flu viruses work 15 Cases IRAQ each flu virus has 10 Deaths two proteins, known IRAN collectively as ANTIGENS EGYPT “antigens,” IRAQ RNA 2 Cases/ that stud its NIGER Deaths Hong Kong VIETNAM surface. They a e S d e R MYANMAR LAOS help the virus VIETNAM penetrate cells, INDIA 93 Cases initiating infection. THAILAND NIGERIA THAILAND 42 Deaths The proteins are what Human Toll 9 22 Cases the immune system 14 Deaths CAMBODIA recognizes when HN1 bird flu TOTAL CASES 4 Cases/Deaths it mounts a CAMEROON reemerged CASES RESULTING defense. Varia- among poultry IN DEATH tions in the in 00 in MALA Y SIA shape of the Thailand and 1 proteins, deter- South Korea. I n d i a n mined by the PROTEIN Since then, 98 O c e a n virus’s genes, of the 177 INDONESIA Infected cell A t l a n t i c INDONESIA give each flu people infected 29 Cases strain its O c e a n have died. DNA 2003 2004 2005 2006 22 Deaths particular identity. bY GENE THORP — THE WASHINGTON POST

BIRDFLU Desk: FOR Run Date: 03/18/06 Size: 71p10 x 16.25 inches How does bird flu spread? AMONG BIRDS T O H U M A N S East Asia/ Australia East AAtlantictlantic Some observed

ia symptoms in humans North n s a A EEuropeurope e A s i a l a America n r · Incubation period: raan t r n e e 2 to 8 days U.S. it d C e M a / i · Initially high fever a s Atlantic A M A e Pacific t S t l Ocean s is a k Ocean · Sometimes blood- s n c e i Pacific P s t la W a s ic / tinted diarrhea c i B a Ocean p A A f r i c a c if p m i East Asia/ ic i r A e f A m r A AAustraliaustralia · Almost always viral m ic t e e a s r s a pneumonia, not treatable ri ic Shorebird c a E a s flyway zones s with antibiotics. SSouthouth America · Respiratory distress, NOTE: No H5N1 Indian 4 to 13 days after onset infection has been Ocean Australia of symptoms. detected in the United States, but the U.S. · In the most severe government plans to cases, multiple organ A nurse attended to a bird step up testing of wild dysfunction, including flu patient on Feb. in kidneys and heart, birds this year, China’s Hunan province. primarily in Alaska. The boy recovered. leading to death.

No INdICATIoN oF RIsK FEED

MIGRATION LIVE POULTRY MARKETS FEED AND HUMAN HANDLING INFECTED BIRDS OTHER CONTACT EATING CHICKEN MEAT scientists fear that the spring migration The virus can spread in crowded, BEDDING MOVEMENT All evidence indicates that In some cases in Indonesia, The World Health Organization and could further spread H5N1. They believe often unsanitary live poultry The virus is People can spread close contact with infected children may have contracted the World Organization for Animal the outbreaks among poultry in France, markets, which are common in excreted in bird the virus beyond birds is the principal source of the disease while playing in Health say people are not likely to Germany and northern Europe were most Asia, or through trade among feces. It can be an infected area H5N1 in human infections. yards contaminated by bird contract bird flu from fully cooked likely caused by wild birds. Their droppings farms. Importation by Nigeria of spread by bedding on the soles of Risky activities include feces. Swimming in or drinking chicken meat or eggs. can contaminate farms or ponds, where live chicks from China probably straw, cages and their shoes or the slaughtering, plucking and contaminated water may also domestic fowl can pick up the virus. caused the first outbreak in Africa. feathers. tires of cars. preparing infected chickens. cause infection. Stopping the spread among birds Preventing or containing a human pandemic

Culling, or killing Keeping farm chickens Establishing quarantine Disinfecting cars and Vaccinating Scientists are Two drugs, Tamiflu The U. S. government is providing Congress has approved in large numbers, indoors and restricting zones around infected people and restricting domestic poultry, developing and Relenza, may guidance to states and cities on $3.8 billion. President bush infected or the movement of live farms and disinfecting movement in and out which remains experimental prevent infection, or how to help prevent or lessen the has requested an additional exposed birds. poultry. enclosures. of infected areas. controversial. vaccines. reduce its severity. effects of a pandemic. $2.3 billion for fiscal 2007. souRCes: Centers for disease Control and Prevention, National Institutes of Health, Food and Agriculture organization of the united Nations, World Health organization, World organization for Animal Health, International society for Infectious diseases

PHOTO bY XINHUA VIA ASSOCIATED PRESS; MAPS bY GENE THORP, GRAPHIC bY CRISTINA RIVERO, GRAPHICS REPORTING bY DITA SMITH — THE WASHINGTON POST Name ______Date ______Global Graphics Use the “Assessing Bird Flu” map, bar graph, key and other resources to answer the following questions.

1. In what part of the world did the avian flu first appear?

2. How many countries on each continent have reported cases of the avian flu? List them on the back of this sheet by continent.

3. On how many continents have no cases of bird flu been recorded?

4. What is the percentage of countries that have been affected in each continent? State your answer on the back next to the continent headings.

5. In how many countries have humans been infected with the H5N1 virus? In which year did most of these cases occur?

6. Note the countries that have confirmed the presence of the H5N1 strain of flu. On your own paper, create a bar graph that illustrates the countries that have had the most confirmed human cases of avian flu.

7. The most human deaths as a result of H5N1 virus have occurred in which country?

8. Which country has had the highest percent of death resulting from known cases of avian flu? State the country and the percent. If there is more than one, list all.

9. Given that this information is accurate and scientists believe that birds carry the H5N1 strain, study the bird flyways. If the avian flu is conveyed in this manner, where might the next cases appear? Which U.S. state is the closest to identified cases of avian flu?

10. Given the information that is provided, create a possible scenario and illustrate it with a bar graph on a topic of your own choice. For example, Turkey has had 12 human cases of the bird flu confirmed; of those, four have been fatal. What countries that border Turkey have already had avian flu detected and which bordering countries are likely to have cases? Volume 5, Issue 5

An Integrated Curriculum For The Washington Post Newspaper In Education Program Mumps Watch A Mumps To-Do List For Young Children Parents Are Urged To Verify Child Immunizations as Outbreak Spreads • Verify that your children aged 4 or older have had two MMR (measles, • Originally published May 9, 2006 CDC spokeswoman Lola Russell said mumps, rubella) vaccinations. If By Audrey Edwards that 35 patients had been hospitalized your child has not or there are no Washington Post staff writer so far for complications from mumps or records to verify it, discuss getting an conditions that may have been caused by immunization with your doctor. As an outbreak of mumps that began in mumps. • If your child is 6 months old or the Midwest spreads east, area parents CDC director Julie Gerberding said younger, he or she has not been have been asking pediatricians what they last week that the outbreak, which she immunized but may have antibody should do to protect their kids. described as the worst in the United protection from the mother. In this The basic advice is this, said Thomas States in 20 years, is expected to continue case, avoid sick people, especially if T. Rubio, professor of pediatrics in spreading. your baby is less than a month old. the infectious She said that the disease division best protection For Teens and Young Adults at Georgetown against the virus • Parents of young adults should University Hospital: was vaccination, review their immunization records. If Verify that children despite what the young adult has received only a have received two she said was “a single dose of MMR, ask your doctor MMR (measles, confusion” about about getting a booster. mumps, rubella) whether the vaccinations. He outbreak is related For Adults also said most to problems • People born after 1957 who have not adults who have with the vaccine. received both immunizations should not had both Gerberding receive at least one injection of MMR injections should said there was vaccine. Those born in 1957 or before consider getting no current are considered naturally immune due one now information to to wide circulation of mumps prior to One more thing: suggest a problem 1958. There is no danger (or benefit) Don’t panic. with the vaccine. to most people who receive a third As of Thursday, The District injection. the Centers for was free of Disease Control mumps cases Answers on Mumps and Prevention as of Thursday, What’s the proper mumps vaccination (CDC) reported according to the schedule? Should it change due to the 2,869 confirmed, city’s Department national outbreak? probable and of Health. Even if the disease continues to suspected cases Maryland, which spread, immunizations should proceed tied to the mumps normally has five under the schedule recommended by outbreak in 13 by Charlie Neibergall — ASSOCIATED PRESS to 10 cases of the Centers for Disease Control and states, including A nurse holds a vial of mumps vaccine mumps annually, Prevention (CDC) and the American 1,552 in Iowa. at Iowa State University. has had seven Academy of Pediatrics. The first dose Another 1,305 confirmed cases of MMR vaccine is given at 12 to 15 cases are in Nebraska, Kansas, Illinois, this year, according to John Hammond, months of age, the second at 4 to 6 Wisconsin, Missouri, Pennsylvania and a spokesman for the state’s Department years. For details, visit the CDC Web South Dakota. Twelve isolated, sporadic of Health and Mental Hygiene. He said site (http://www.cdc.gov/). cases related to travel to the eight states were reported from Colorado, Minnesota, Mississippi, Arkansas and New York. continued on page 12 continued on page 12

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page 11 continued from page 11 recommend restricting gatherings at college campuses, camps and other these cases appear unrelated to the What if I don’t know whether my group facilities. Mass immunization Midwest outbreak. children or I have had both shots? of adults is an option, but this would As of Friday, Virginia reported First, check with your doctor’s office. be a huge logistical — and political nine cases for the year. Department If that fails to produce proof, consider — challenge. of Health spokeswoman Shannon two options, in consultation with your N. Marshall said the cases were doctor: getting the vaccination or getting Suppose someone in my family gets sporadic and unrelated to the a blood test to determine immunity. the mumps. What’s best case, worst Midwest outbreak. case? Rubio said it was surprising I have three kids between 2 and Best case is something like a mild the outbreak had not yet reached 15. We live in a busy area and use case of flu lasting up to two weeks, Washington, considering the large public transportation. If the outbreak with minimal glandular swelling. number of people who travel to the spreads to Washington, should I Many cases involve more swelling, capital daily. He warned that mumps restrict their activities? fever and discomfort; in adult men, could reach the area by summer, Properly immunized children are well there can be swelling of the testes. In although spring is the most common protected from the virus and need rare cases, sterility in both men and time for the virus to spread. no restrictions on their activities. As women occurs. Deaths are possible but Gerberding said that about 10 for young adults living in dormitories extraordinarily rare. percent of individuals who get both and around college campuses, public MMR shots are still susceptible to health authorities may issue advisories If the outbreak reaches Washington, the mumps. Many of the Iowa cases because many in this age group what do I do? occurred in college students, some of may not have received both MMR Make sure your family’s vaccinations whom did not receive both doses of shots. People who are 49 or older are are up-to-date. Practice good hygiene: the vaccine. considered naturally immune because Wash your hands and avoid sick Mumps can spread through mumps was common prior to the people. Mumps is contagious for sneezing and coughing. Symptoms widespread availability of the vaccine several days before symptoms appear include fatigue, loss of appetite, starting in 1957. and up to more than a week afterward, fever, headache and muscle aches. so if a local outbreak is severe, it might These signs are followed by swollen What if the outbreak spreads among be prudent to avoid crowds. But if your and tender salivary glands under the adults? vaccinations are current, you have little ears. More severe effects are rare. A few adult cases are no cause for to worry about. Francis Palumbo, a District alarm, but a more extensive outbreak — Audrey Edwards pediatrician, said parents in his could lead public health officials to practice were mainly inquiring to determine whether their children had been given both MMR shots. Renee Green, a mother of three who lives in Southeast Washington, said she feared for her youngest son, Joshua, age 6, who has asthma. “He’s up-to-date with his immunization. So are my other children,” said the 36-year-old Green, a tax examiner. “But the problem is, I wouldn’t know if other children or parents are sick. And he is really vulnerable to catch infections.”

by Charlie Neibergall — ASSOCIATED PRESS

An Integrated Curriculum For The Washington Post Newspaper In Education Program Resurrecting 1918 Flu Virus Took Many Turns

• Originally published October 10, 2005 adviser that he try to recover the virus for By David Brown use in a vaccine. The idea was approved. Washington Post Staff Writer While the percentage of people who became ill and died of the 1918 flu — the It took a lot of digging to bring back to “case-fatality rate” — was 2 percent to 5 life the Spanish influenza virus of 1918. percent in the United States and Europe, Some was done with invisible molecular it was more than 50 percent in some primers in a PCR machine in Rockville. isolated native groups. In Alaska, some Some was done with pick and shovel in villages were virtually wiped out. the frozen ground of Alaska. Hultin had spent the summer of 1949 Either way, it was a huge amount in Alaska, helping a paleontologist named of work on a project whose chance of Otto Geist perform excavations. He had success at the start seemed very, very driven up on the newly opened Alaska slim. Now, it will go down as one of the Highway, which he said “was itself a most astonishing technical feats in the great adventure.” He figured there were history of science — the viral equivalent mass graves from the 1918 pandemic of bringing dinosaurs back in the fictional there. He wrote Geist and asked him to Jurassic Park. contact missionaries working in Inuit It may also prove to be unusually useful ARMED FORCES INSTITUTE OF PATHOLOGY villages. Specifically, he wanted to know — not an elaborate biological parlor trick, Scientists have reconstructed the 1918 whether there were records of epidemic but a vital service to global public health. flu virus, shown above, that killed some deaths in 1918 or 1919, and if so, what The Spanish flu killed at least 50 50 million people. the symptoms were. million people around the world in Hultin heard from seven or eight slightly more than a year — late winter With more work, scientists will missionaries. They sent him notes 1918 into the spring of 1919. Researchers probably be able to figure out why copied from mission record books, often have never figured out what made the the 1918 strain was so dangerous. in Norwegian, which he could read. He virus so lethal, in part because there were Experiments with the reborn virus began got a map that showed the extent of no samples to study. Although viruses in August at the Centers for Disease permafrost — land where the ground had been discovered by 1918, the flu Control and Prevention in Atlanta and never thaws. He chose three villages in virus was not isolated until 1933. have already answered some questions, the permafrost zone that had mass graves With the genome of 13,600 nucleotides which may lead to better vaccines and containing corpses from an epidemic that known and published in the journals drugs. sounded like influenza. Science and Nature, the 1918 virus is The story of how this feat came about The young graduate student surveyed already shedding light on its own history. has several beginnings. In hindsight, the sites, all on the Seward Peninsula, It was a bird virus that appears to have it is clear that perhaps the crucial one which stretches westward into the Bering become a human virus through the slow occurred 55 years ago with Johan Hultin. Sea. In one, a river had changed course, accumulation of mutations, not through disturbing the permafrost. In another, a the sudden trading of genes with another Searching in Permafrost beach had eroded, exposing the grave. flu strain. Hultin had taken a break from medical But the third, a place called Teller It is also illuminating the possible studies in his native Sweden to study Mission, looked good. future of viruses that are worrying flu for a doctorate in microbiology at the Seventy-two of 80 residents of Teller experts now. Some of the H5N1 “bird University of Iowa. At a departmental Mission died between Nov. 15 and 20, flu” strains seen recently in 10 Asian lunch in 1950, he heard a professor 1918. The Army buried the victims with countries carry a few of the mutations make a passing reference to the idea a steam-powered excavator used by seen in the 1918 virus, suggesting that that intact samples of the infamous 1918 miners. they, too, may be slowly adapting to strain might still exist in bodies frozen human hosts. in the Arctic. Hultin was looking for a dissertation project. He proposed to his continued on page 14

An Integrated Curriculum For The Washington Post Newspaper In Education Program

ARMED FORCES INSTITUTE OF PATHOLOGY

Glass slides of lung tissue taken from a soldier who died of the 1918 Spanish flu. continued from page 13 of permafrost. They wore masks. There contents, spurting from its nozzle, formed were no observers or reporters. They dry ice. With native help, the expedition Hultin went to the village, whose sampled four bodies; all had evidence of members detoured the hazardous bay name has since been changed to Brevig pulmonary hemorrhage, the hallmark of crossing, made their way overland to a Mission, and requested permission to rapid death from influenza alone. They narrow strip of the bay, and got back to excavate the grave. Through a translator, took blocks of tissue from various organs the town of Teller,” wrote the reporter, he emphasized the benefit of making and quickly put them into steel containers N.S. Haseltine. a vaccine. The villagers had been that were then sealed in steel boxes. Back in Iowa, Hultin thawed the vaccinated against smallpox, so they “Preserving the specimens and getting tissue and tried to recover the virus. He knew what he was talking about. And them safely and quickly to their medical exposed ferrets — the species whose at the meeting were three of the eight laboratories in Iowa City was now the response to influenza is most like people’s survivors from 1918. problem,” wrote a Washington Post — to tissue extracts. The animals did “They told us their terrible story about reporter three months later in a brief not get sick. None of his experiments all the other people in the village dying. account. succeeded. He concluded there was no That convinced the rest of them to let me “A wild storm whipped the bay to live virus in the Inuit corpses. help,” Hultin recalled recently. waves of almost impassable heights. Dry Hultin believes he could have gotten On June 25, 1951, he, two Iowa ice, brought from the States to refrigerate a doctoral dissertation out of this professors and the paleontologist went the specimens, had evaporated . . . In to work. They dug through three feet of the emergency, the scientists used a fire tundra and gravel, and then three feet extinguisher whose foamy carbon dioxide continued on page 15

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page 14 damaged or decayed tissue. In 1995, any still exist. Taubenberger said yes. Taubenberger wondered whether it Hultin set off two weeks later. meticulous but failed effort. But he might be possible to get the 1918 virus He returned to Brevig Mission and never got around to writing it. Soon out of dried and fixed tissue from the again sought permission from the after his many months of experiments Spanish flu pandemic. “I really wanted village council to dig. “I said that the had proved fruitless, he was invited to to see if there was some way we could virus was dead in 1951 and was even enter medical school at the University make use of this vast, wonderful deader now,” he recalled. of Iowa. He accepted the offer, became collection for this,” he recalled. The village leaders talked a long time a pathologist and spent much of his He and his colleagues reviewed slides in Inupiat, the local language. They career at a hospital in California. Now of lung tissue from 78 soldiers who had were worried about the release of evil retired, he turned 81 on [Oct. 7]. died in the pandemic. They narrowed spirits, not contagion, Hultin said. No scientific publications came out of the search to 10 slides in which the Then someone recalled that the victims Hultin’s project. But it was not entirely microscopic appearance showed that had received Christian burials, which lost to history. A historian named the men died only of viral pneumonia, were supposed to have chased away the Alfred Crosby mentioned it briefly in not of a secondary bacterial infection evil spirits. Permission was granted. his 1989 book, America’s Forgotten that was more often the cause of death. On Aug. 20, 1997, Hultin and a Pandemic: The Influenza of 1918. They tested preserved, leftover pieces local crew opened the grave. The four As it happened, Hultin was not the of lung tissue from all 10. Two came bodies he had sampled in 1951 were only person who attempted to get up positive for influenza A, the broad decomposed. But he found one that had the Spanish flu virus out of the ice. family that includes Spanish flu. One been missed the first time. It was of a The same year he tried, U.S. Army was from a 21-year-old private who woman in her thirties who was very fat. researchers did also. They excavated a died in South Carolina on Sept. 26, All that was left of her clothes was a mass grave near Nome, Alaska, finding 1918. The other was from a 30-year-old row of bone buttons lying on her chest. only skeletons. Hultin had been there private who died in Upstate New York But her body was intact and frozen, three weeks earlier and had rejected the on the same day. apparently insulated by the fat from site. Using polymerase chain reaction the occasional brief thaws. “I sat on an Four decades later, however, the (PCR) technology to amplify the upside-down pail and I looked at this, Army returned to the story. genetic material, and primers — short, and I got the flash in my mind,” Hultin important stretches of genetic material said. “Maybe this is where I can find A Key Institution — from human, animal and bird it.” One of Washington’s more obscure viruses, Taubenberger, Ann H. Reid With only gloves and a face shield for but important institutions is the and Thomas G. Fanning fished out protection, Hultin removed her lungs Armed Forces Institute of Pathology fragments of the 1918 microbe. There and sampled her spleen, liver and in Rockville. It provides pathology were multiple copies of the virus in heart. He cut the tissue into one-inch services for the military, including the sample, but they had broken into cubes and put them in a preservative autopsies of war dead. It also functions small pieces. Matching the overlapping solution. The grave was closed for a as a kind of Supreme Court for ends of the fragments, the researchers final time. difficult cases. Pathologists unsure of a reassembled the fragments in the right Hultin and Taubenberger hoped the diagnosis, for a small fee, can consult order. Alaska material would contain virus its experts and send them microscopic The first gene they recovered, called material that was more nearly intact slides or other samples for review. NS, was virtually identical in the two than the material from the soldiers. Part of the institute’s value lies in its cases. It did not. In fact, it was a bit more pathological specimens dating to 1862 Influenza A has eight gene segments. fragmented. The longest strands of — 3 million pieces of preserved human When Taubenberger published the RNA — flu’s genetic material — in tissue. report on the first one, Hultin read it. the institute’s slides were about 130 Jeffery K. Taubenberger is a civilian He realized, at long last, that there nucleotides, or letters, long. In pathologist who heads the institute’s might be value in dead Spanish flu virus Hultin’s material, the longest was 110. division of molecular pathology. His — and he thought he might still have Nevertheless, Hultin had provided laboratory is one of the few in the a source. He contacted Taubenberger Taubenberger with all the material he country with expertise in rescuing and asked if he would be interested in would need to reconstruct the 1918 and restoring genetic material from frozen organs of 1918 victims, should virus. Eight years later, it was done.

Write a PSA for your school’s PA Washington in Brief announcements, TV or radio station. Or you may write a PSA for The Washington Post’s radio station, WTWP, that you know will Government Ads convey information and catch the attention of listeners who are your age. The objective is to communicate information about the avian Aim To Calm Bird flu, the mumps outbreak or another health issue that will be of importance to your Flu Fears school’s students. Hoping to prevent a scare over the deadly bird flu, the government is distributing television and radio commercials assuring people that chicken is safe to eat. “Mmm, that chicken looks great. But what about bird flu?” a man asks in one of the ads. His wife says she read that bird flu is unlikely to reach Newspapers, radio and television dinner plates. broadcasts and Internet sites report An announcer lists four steps for food safety: Clean hands information about health. It might be the and cooking surfaces. Separate raw and cooked foods. Cook growing obesity in children, Bono visiting poultry to at least 165 degrees. Chill leftovers promptly. — From staff writer Bill Brubaker and news services Africa to promote AIDS/HIV awareness or an outbreak of mumps in the U.S. Write an article for your school newspaper to localize a health or hygiene issue. What do your students need to know?

The Post reported that federal health officials want airlines to Migratory birds flying over the U.S. are collect personal information about domestic and international not the only concern of government officials. passengers to help track potential epidemics. In 2003 airlines Smuggling of wild animals, pets and animal cooperated by helping to locate passengers who might have been parts into this country is increasing. Why exposed to SARS and then traveled by air to another destination. worry? A Thai passenger in 2004 tried to With many airlines fighting bankruptcy today, their spokespersons smuggle two Crested Hawk-Eagles into question the cost, technological difficulties, time expenditure and Belgium in his hand luggage. Both birds privacy issues. tested positive for the H5N1 strain. No This proposal presents an interesting intersecting of business, humans became ill. public health, privacy rights and government interests. Form groups to represent the following parties. What are the goals of Assignment each in this situation? What might they want to take place? Present It’s a billion dollar business. Find out more each perspective to your class. Discuss and then take a class vote about the global trade —legal and illegal on whether you would support airlines being required to report — in wildlife and animal parts. From which information on travelers to the CDC. countries has the U.S. banned imports of Center for disease Control and Prevention birds, bird parts and bird products? Write a Transportation security Administration report or pair with classmates to debate the Air Transport Association means to import healthy animals and to stop American Civil liberties union the illegal trade in animals. Individual who takes a vacation to Thailand Businessperson who travels often to China Name ______Date ______Too Much, Too Little or Just Right?

What is okay or what is not okay? A new strain of flu is traveling around the world, and the U.S. government is concerned about preventing an outbreak in the United States. Examine the following actions that the government might take. Decide if it is too much, too little or just right. Check the blank with your response and in the space below each proposed action, tell why you think this way.

A. Government sends out warning about possible epidemics of deadly flu in certain countries. Warns Americans to travel to these countries with caution.

_____ Too much _____ Too little _____ Just right

B. Government asks airlines for the names of all passengers flying on flights to affected countries. Government monitors these people via e-mail and telephone calls.

_____ Too much _____ Too little _____ Just right

C. Government obtains all medical information of passengers flying to and from these affected countries. Does not inform passengers that this is taking place.

_____ Too much _____ Too little _____ Just right

D. Government quarantines all passengers coming from the affected countries for 72 hours, the time of incubation of the deadly flu virus.

_____ Too much _____ Too little _____ Just right

E. Government prevents any travel to affected countries and prevents anyone traveling from these countries to enter the

United States.

_____ Too much _____ Too little _____ Just right Volume 5, Issue 5

An Integrated Curriculum For The Washington Post Newspaper In Education Program A Pandemic of Fear

• Originally published March 26, 2006 test-tube conditions, we humans are Even the word “pandemic” scares us By Marc Siegel a different matter. In 1997 in Hong unnecessarily. The word simply means Fear is a deeply rooted emotion — one Kong, for example, where there were 18 a new strain of a virus appearing in that can serve as a lifesaving response human cases of bird flu and six deaths, several areas of the world at one time and to imminent danger. But because we thousands of people were screened, causing illness. The last flu pandemic, in humans often magnify risk, fear can also and 16 percent developed antibodies 1968, killed 33,800 Americans — slightly cause us to overreact to remote threats, but never got sick. There appears to be less than the number who usually die such as bird flu. a spectrum of disease in humans, not here of the flu in an average year. We According to a significant study nearly as deadly as many media reports certainly don’t need to think in end-of-the published in the prestigious British have supposed. world terms for that kind of pandemic. journal Nature recently, the H5N1 bird flu Even if the H5N1 virus does mutate Cooking a chicken or turkey kills any virus is at least two large mutations and enough to spread easily among the influenza virus 100 percent of the time, two small mutations away from being the upper breathing tracts of humans, there yet the fear of H5N1 bird flu is already next human pandemic virus. This virus are multiple scenarios in which it would so rampant in Europe that poultry attaches deep in the lungs of birds but not cause the next massive pandemic. consumption is down 70 percent in Italy cannot adhere to the upper respiratory In fact, the Spanish flu of 1918 made and 20 percent in France. In Britain tract of humans. Since we can’t transmit the jump to humans before killing a people are giving away their parrots the virus to each other, it poses little large number of birds. Not only do we after a single parrot got the disease, immediate threat to us. have vaccinations, antibiotics, antiviral and in Germany a cat died of H5N1 So why did the “flu hunter,” world- drugs, public information networks, and the public was told to keep cats renowned Tennessee virologist Robert steroids and heart treatments that were indoors. Forty-six countries outside the Webster, say of bird flu on ABC that lacking in 1918 to treat victims of the European Union banned French poultry there are “about even odds at this time flu; in addition, the growing worldwide exports after a single flock of turkeys was for the virus to learn how to transmit immunity to H5N1 may lessen the found to be infected. France, fourth in human to human,” and that “society outbreak in humans even if the dreaded the world in poultry exports, is already just can’t accept the idea that 50 mutation does occur. hemorrhaging more than $40 million a percent of the population could die . . Even as the virus spreads in birds, the month. . I’m sorry if I’m making people a little chances of a mutation occurring over In this country I have heard from more frightened, but I feel it’s my role.” time appear to be less likely. For every than one farmer and several poultry I’m sorry, Dr. Webster, but your role doomsayer who declares that “it’s not a companies that the price of poultry has is to track influenza in the test tube, matter of if, but when,” there is a sober already dropped 50 percent in some not to enter into broad speculation scientist who says that H5N1 may well places. Imagine what will happen if a on national television. By your way dead-end in animals and not be the next bird in the United States gets H5N1 bird of thinking, we should all be either pandemic virus. flu. Our fear is growing at such a rate building an escape rocket ship or killing If H5N1 spreads in pigs (a soup of that our own poultry industry, No. 1 in every bird we see before it can kill us. viruses) and exchanges genetic material the world, is likely to be destroyed. We Fear causes the public to blur the with another human flu virus before are already petrified by fear of mad cow distinction between birds and people, passing to humans, the result is likely to disease, another case where a species and so, as the H5N1 virus infects flocks be far less deadly. The swine flu fiasco barrier protects us. of birds in Pakistan and Israel, nightly of 1976 is an example of the damage Flu changes its shape and size and is a news watchers track the path to the that can be done by fear of a mutated killer worthy of respect and attention. But United States. The poultry industry virus that never quite lives up to 1918 the most contagious virus among humans cringes as migratory birds that may be expectations. About 1,000 cases of is our fear. carrying H5N1 make their way closer to ascending paralysis occurred from a the northern shores of North America. rushed vaccine given to more than 40 The writer is an associate professor at the New But though this bird flu appears to be million people in response to a feared York University School of Medicine and the quite deadly in many species of birds, pandemic that never arrived. author of Bird Flu: Everything You Need to Know killing 10 out of 10 chick embryos in About the Next Pandemic

An Integrated Curriculum For The Washington Post Newspaper In Education Program When Animals Suffer, So Do We

• Originally published April 12, 2006 farms have become wastelands from spongiform encephalopathy (mad cow By Kelly Overton the constant flow of toxic emissions disease), can lie dormant for up to 40 Do the animal rights nuts know and waste polluting the air, ground years. Once discovered it is too late — something we don’t? and water. Inside the farms, safety and the disease has proved fatal in every As we observe the growing number human health also take a back seat to human case to date. The repercussions of avian flu cases worldwide, bide profit. Animals too sick or diseased to human health from factory farming time until the eventual large-scale to stand are dragged or bulldozed to and habitat destruction may not outbreak of mad cow disease in the slaughter and into our food supply. be known for decades, or they may United States and hope what the world Mad cow disease was born of such immediately fly into our daily lives via experienced in 2004 wasn’t just a dress recklessness and greed — a desire by an avian flu pandemic. rehearsal for SARS, the time has come corporations to minimize financial It is ironic that animal-borne to reconsider humanity’s treatment of losses by using the remains of diseased diseases may very well achieve what nonhuman animals — if only for the animals to feed the animals that enter human activism has failed to do repercussions to our own health. our food supply. — guarantee nonhuman animals more In past decades we have removed Animals raised on a diet high in humane lives by making animal welfare animals from pastures, sunshine and antibiotics ensure human consumption synonymous with human welfare. fresh air to stack them on top of each of antibiotics, decreasing their Regardless of how our society arrives other in petri-dish-like buildings. As effectiveness when we need them at the conclusion, it is time to end one wild animals lose more and more of to fight infection. The presence of of the most inhumane and shameful their habitats, they are forced to live antibiotics in our food and water chapters in our nation’s history. on the perimeters of cities and towns also encourages the emergence of We humans remain only one species and in a proximity to humans that drug-resistant illnesses. In fact, an in what has always been a global increasingly appears to be detrimental increasing number of public health ecosystem — an interlinked web of not only to their health but also to issues are linked to our mistreatment life where the health of one species ours. of nonhuman animals — including depends on the health of others. Our health is being put at risk by the growing human resistance to Whether through reckless factory our demand for low food prices. In the antibiotics and the many health farming, the pollution of waters and past decade consumers have chosen consequences of global warming. the poisoning of the species within low prices over quality in the products Meanwhile, the change from a them, or the continued rampant and services we purchase — but nation whose food was once supplied destruction of forests and nonhuman animals aren’t products that can be by thousands of small to medium- habitat, our blatant mistreatment endlessly manipulated for lower food size farms spread across the country of other species for the benefit of costs. As a society it is time to ask to a nation now dependent on our own is not inviting disaster, it’s ourselves if we are willing to trade our just a few factory farms in specific guaranteeing it. It is time to end the health and the health of our land, air areas is inviting disaster. This new treatment of God’s living creatures and water in return for cheap milk, concentration of meat and food as products and to begin treating all eggs and meat. production in specific geographic life forms with respect and reverence Because factory farms are legally corridors allows for one incident of before the health repercussions to the recognized as farms — not the accidental contamination, sabotage or human species are irreparable. industrial sites they are — they terrorist activity to cripple our food are exempt from many of our most supply. The writer is executive director of People important environmental laws. The Creutzfeldt-Jakob disease, or Protecting Animals and Their Habitats. communities surrounding most factory CJD, the human version of bovine

An Integrated Curriculum For The Washington Post Newspaper In Education Program $1 Billion Awarded For Flu Vaccine 5 Companies Get Federal Contract

• Originally published May 5, 2006 By David Brown Washington Post Staff Writer

The federal government yesterday awarded $1 billion in contracts to five pharmaceutical companies to help them develop modern methods of producing influenza vaccine that would replace the current slow, laborious and unpredictable technique. The awards mark a huge step forward in the Bush administration’s $7.1 billion effort to plan for an influenza pandemic, which many experts believe is likely in the next decade. “The capacity simply does not exist in the United States to produce vaccine of sufficient quantity to vaccinate everybody. But that’s about to change,” Michael O. Leavitt, secretary of health and human services, said at a signing ceremony. Two local companies won contracts: MedImmune Inc., a Gaithersburg biotech firm, was awarded $169 million; ASSOCIATED PRESS and DynPort Vaccine Co. of Frederick A MedImmune employee inspects FluMist. received $41 million. The rest of the funding will be split by companies in For MedImmune, the government’s MedImmune now grows its vaccine Belgium, Switzerland and Britain. contract is the latest bit of good news virus in Liverpool, England, and The companies each agreed to build for FluMist, a product that had a finishes the product in Philadelphia. or expand a vaccine plant in this disastrous launch. Unlike flu vaccines Its annual capacity is 90 million doses; country. Each will seek to grow flu that contain killed virus, MedImmune’s the new plant should be able to make vaccine virus in cell cultures rather than product is a live, weakened strain of 150 million doses in six months, said in fertilized chicken eggs and apply for influenza. It is squirted into the nose David M. Mott, chief executive of Food and Drug Administration approval and stimulates a more natural and MedImmune. for its vaccine. Each company is also broader immune response than the The huge U.S. investment does not investing large amounts of its own conventional flu shot. buy the government a single dose of money — some have done so already MedImmune plans to use the award vaccine or ensure that future purchases — although few executives yesterday money in part to convert to cell- will come at a favorable price. were willing to say how much. based vaccine production a factory Instead, it is an effort to induce the In five years, if all goes as planned, in Frederick. It now makes a drug to pharmaceutical industry to direct time, the companies together should be able treat a form of viral pneumonia seen to make about 300 million doses of in premature infants and people with vaccine in six months — enough to immune disorders. That drug will be immunize every U.S. resident. made in a new plant. continued on page 21

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page 20 manpower and money toward a goal it might not otherwise pursue. The executives said after the signing ceremony that they plan no price or other concessions in exchange for the government largesse. “The concession is that we are going to do this in the U.S. That is the big concession,” said David M. Stout, pharmaceutical operations president of GlaxoSmithKline PLC, which was awarded $275 million. The company’s headquarters is in Brentford, England, near London. The flu vaccine it sells in the United States is made in Dresden, Germany. ASSOCIATED PRESS Solvay Pharmaceuticals, based in Sitting on her mother’s lap, a 5-year-old gets a dose of FluMist Belgium, received $299 million, and the Swiss drugmaker Novartis AG was the flu in children ages 6 months to 59 To create “surge capacity” for flu awarded $221 million. months. vaccine, the Health and Human MedImmune’s Mott said the payback In the past 15 years, vaccine Services Department in 2004 paid for the U.S. taxpayer is more rapid companies have slowly dropped out of Sanofi $10 million to add more achievement of a high-priority goal the U.S. flu market. Most of the ones egg farmers to its supply chain. set of the president’s pandemic plan. that remain make their vaccine outside Maintenance of the enlarged egg supply “We have clearly sped up by years this the country. through 2008 may cost $41 million. conversion from egg-based to cell-based In addition to GSK and MedImmune, A chief goal of Bush’s pandemic plan manufacturing,” he said. “We would not the other companies that made flu is to increase the country’s baseline be able to do that without collaborating vaccine for the U.S. market this year capacity for making seasonal flu with the government.” were California-based Chiron, which vaccine. That could then be switched MedImmune’s FluMist never caught recently was bought by Novartis, and immediately to pandemic vaccine if a on in the market despite a $25 million Sanofi Aventis, with headquarters in new strain, such as the H5N1 bird flu ad campaign. Patients balked at the Paris. Chiron’s production plant was virus circulating in Asia and Europe, high price. Doctors did not like the in Liverpool, near MedImmune’s. Only started to spread easily in human requirement that FluMist be stored in Sanofi made flu vaccine in the United populations. a freezer instead of a refrigerator, as States — in Swiftwater, Pa. The amount of seasonal flu vaccine flu shots are stored. The product also The conversion to cell-culture gives in the United States increased to 88 was approved for only healthy people vaccine makers far more flexibility than million doses last year from 77 million ages 5 to 49, leaving out a key market they have now. doses in 1999. It could be as high as — infants and very young children. In cell culture, virus grows in large 120 million doses next season. But MedImmune stood by the tanks that contain cells floating in a Seasonal flu vaccine contains three product, confident that its novel nutrient broth. It is somewhat like virus strains, each grown separately mechanism made it better than the brewing beer, and capacity can be and then blended. During a pandemic, standard flu shot. It set to out to win added with relative ease. In the current factories would grow only the pandemic approval for a new refrigerated version method, virus is injected into the living strain. Consequently, their production and to show once and for all that it was tissue of fertilized eggs, where it grows capacity would be three times that of better than a flu shot. Earlier this year, and from which it must be harvested. the seasonal vaccine. MedImmune announced results from Adding capacity requires getting more a large study showing that the vaccine eggs, among other things. Staff writer Michael Rosenwald contributed to was 55 percent better at preventing this report.

An Integrated Curriculum For The Washington Post Newspaper In Education Program Can We Stop the Next Killer Flu?

• Originally published December 11, 2005 By Joel Achenbach Scientists like Jeffery Taubenberger aren’t just going to sit there waiting for a pandemic. They’re gearing up for the war between bugs and humans.

Jeffery Taubenberger, virus hunter, goes to work in a bland building overlooking I-270 in Rockville. It’s the Armed Forces Institute of Pathology, and it is scheduled to be “disestablished” as part of the broader plan to close military bases around the country. Taubenberger doesn’t know for sure what he’ll be doing in a year or so. For now, he’s still walking past the fluttering flags every day, down a flight of steps to a windowless office, where he’s trying to save the world from a mysterious germ. Doom and Gloom Talk Will Be ARMED FORCES INSTITUE OF PATHOLOGY Limited to 30 Minutes Daily, reads a Dr. Jeffery Taubenberger examines DNA from 1918 Spanish flu lung samples. sign on his bookshelf. I ask if that’s a reference to the avian flu. No, he says, common influenza virus that circulates infections,” he says. Taubenberger is that’s about the base closings. every winter. Avian flu is still just that something of an alpha nerd. Modest The office is small and cluttered, with — a bird flu, not a human flu. Every of stature, rather boyish at 44, quick multiple stacks of documents, suggesting article about this flu has a boilerplate of speech, he keeps on his desk a a man who is struggling to impose order paragraph, as if mandated by law, stating prop from his 10th-grade science fair on an overly busy life. His phone keeps that scientists fear the virus will mutate, project at Robert E. Lee High School ringing — everyone wants a piece of become highly contagious in humans, in Springfield, the one that merited the him. You can’t pick up a newspaper and create a pandemic that will rival the grand prize for Fairfax County. It’s a without seeing a story about the catastrophe of the Spanish influenza of homemade model of the double helix, possible plague of avian flu, also known 1918. the structure of the DNA molecule. as bird flu or, to be scientifically correct, Taubenberger is doing his part to When discussing the genome of the flu influenza A/H5N1. Millions could die, keep that from happening. He wants virus, he will touch parts of the double the stories say. Or tens of millions. to understand the various types of helix and give a quick lecture on how life Or hundreds of millions. Avian flu has flu viruses at the most essential level works: The adenine always binds to the reached a cultural and media tipping — tunneling deep into their genetic thymine, the guanine to the cytosine . . . point, a kind of celebrity as the premier mysteries. What kind of mutation could The only flu in the room, as far as biological menace to civilization. turn avian flu into a pandemic pathogen? anyone can tell, is on a shelf. It’s a Avian flu is certainly a frightening What genetic improvisations in these stuffed, fuzzy influenza virus with plastic virus. It kills birds, can infect human little nodules of RNA and protein eyeballs, a joke flu from a company beings and has been lethal in about — these things so small and spare they called Giant Microbes. It’s just a blob. half of the documented cases so far hardly deserve the grandiose label of That’s scientifically accurate, because flu in Asia and Indonesia. More than 60 “microbe” — can turn an ordinary flu virus has an unremarkable appearance. people have died already. But so far into a cold-blooded killer? it hasn’t become easily transmissible He’ll pause at some point to get a flu from one human to another, unlike the shot. “I’m susceptible to respiratory continued on page 23

An Integrated Curriculum For The Washington Post Newspaper In Education Program continued from page 22 A Long War of a lot of these pathogens, particularly Man vs. microbe is an old narrative. in the case of viruses like flu. It’s a race In an electron microscope, you see a The plot’s been twisting. A few decades between our society, our politics, our knobby little ball. ago, medical science sensed that it had societal will and the viruses.” The effects of flu are more dramatic. the germs in full retreat. Antibiotics No one knows how the race will turn Taubenberger keeps autopsy samples of saved lives once lost to the most routine out, but the advantage at the moment lung tissue from a soldier who died of infections. It’s hard to remember, but is not necessarily on the side of the the 1918 virus. These are thin sections people used to die of strep throat, a microbes. We’re on to their game. Or, to of lung, cut and stained, and preserved small cut, a hacking cough gone bad. use a more appropriate metaphor, we’re in paraffin on a glass slide. He puts a Vaccines turned the tide; germs stopped not a bunch of sitting ducks. slide under his microscope. First we look killing babies in their cribs; smallpox at healthy tissue: Clearly visible are the air disappeared outright. The Secret of Life sacs, ready to breathe, with a scattering of And then the tide turned back. Drug- Taubenberger became inspired in 1995 red blood cells. Then we look at diseased resistant bacteria began flourishing. by a story of human eyeballs floating tissue. They’re filled, completely choked, HIV became pandemic. Scientists began in a jar. They belonged to John Dalton, with little red circles. Blood cells. talking of “emerging” diseases. They the pioneering chemist. Dalton died in “You don’t see any open air sacs come from the rain forest, from the dark 1844, but his eyeballs stuck around. He anywhere. They’re all filled with blood. recesses of tropical caves, from foul duck was colorblind, and he saw his defective This person drowned in his own blood,” ponds and fetid chicken coops. They vision as an experiment waiting to Taubenberger says. “This is not good, to take advantage of a world of abundant happen. use a highly technical medical term.” human and animal meat. It would He hypothesized that a fluid in the eye The 1918 flu killed more people in appear from the unfolding concern over (the vitreous humor) would, upon close a short period of time than any other avian flu, and from recent outbreaks of examination, prove to be blue, filtering plague in human history. Taubenberger panic over other pathogens — SARS, out the normal hues. He instructed his and his scientific collaborators hope for example — that civilization is assistant to pluck out his eyes upon his that the virus will serve as a Rosetta increasingly vulnerable to pandemics, death. After the great man died, the stone for understanding avian flu. They and that the human face of the future assistant examined one of the eyes and have literally rebuilt the 1918 virus and will be covered with a mask. saw no blue fluid. He nicked the other brought it back to life. Taubenberger has By overcrowding the planet, by one in the rear and looked through it come to the conclusion that there was ravaging our environment, by jetting — literally looked at the world through something very weird about this germ. promiscuously around the world with John Dalton’s eye. The world appeared It was a bird flu that jumped to humans, all manner of microbes in tow, by normal. The colorblindness was thus but the fine print of its genetic code is overprescribing antibiotics and helping neurological, a problem rooted in noticeably different from that of other breed superbugs, we’ve set ourselves up Dalton’s brain. bird flus. for a plague. That’s the basic argument. In 1995, researchers reported that As he works on the mystery, one But here’s another possibility: That they had taken the Dalton case a step thing is clear: This is a scientific drama we’re at a turning point in the war further. Genetic testing — a relatively that involves not only disease but between people and germs. That we’ve new analytical tool unthinkable in the also evolution, the process by which learned, just in the past half-century or day of Dalton — showed that he had an organisms mutate and adapt to changing so, how to read the code of life. That inherited colorblindness gene. conditions. And it’s evolution in real we’ve developed techniques, just in Taubenberger loved that. How very time, at a frantic pace, happening as we the past two decades, to discern the cool, he thought, to solve an old mystery speak, here at the start of the flu season. complete genetic code of an organism. through some aging tissue sitting in There is much debate these days about That, just in the last few years, we’ve someone’s lab. “Everything about life is whether evolution explains life on Earth, started to figure out the innermost interesting, when you start to get into but in the real world, on the ground, secrets of microbes and what turns some the details of how things work,” he says. among living things, evolution is not of them into pathogens. Taubenberger, the head of the molecular only real — it’s dangerous. Jeffrey Gordon, who studies intestinal pathology department at his institute, bacteria at Washington University in St. wondered: What could I do that would Louis, says: “We have the tools in the year 2005 to define the genetic evolution continued on page 24

An Integrated Curriculum For The Washington Post Newspaper In Education Program be really nifty, but also of significance hurricane. It’s a sweeping plan, using all nucleotides, more commonly referred to the world? A mentor once told him, the hardware Taubenberger can round up. to as the “bases” or “letters” of the “Work on an important problem.” If you take a left out of his lab, go genome. Life uses a very short alphabet. He considered studying the yellow through another lab (more vials, bottles, There are only four bases used by living fever that killed so many people in the jars, tubes, refrigerators) and cross things: adenine, cytosine, guanine and 1800s. But then he seized upon the another hallway, you’ll reach the room thymine, or A, C, G and T. Spanish influenza of 1918. It was wildly with the automated sequencers. There’s DNA sequencing, the process of infectious, and virtually everyone on the a big one from Applied Biosystems, the finding the order of the letters, isn’t planet was exposed. About 2.5 percent 3132 Genetic Analyzer. Somehow, this terribly new. As far back as 1977, of those who became sick died, which thing can read the language of a genome, Fred Sanger and colleagues managed seems like a modest level of lethality letter by letter. to piece together all 5,386 letters of a until you realize that it added up to more Life on Earth operates on a genetic tiny organism called phi-X174. In the than 600,000 American deaths in just a system that, at its core, is remarkably mid-1980s, Kary Mullis developed a matter of months and something like 40 simple, considering that it gives rise technique still used in Taubenberger’s million deaths worldwide. Taubenberger to creatures as diverse as sea urchins, lab, called polymerase chain reaction, knew that the institute had millions of praying mantises and humans. The which amplifies pieces of DNA and autopsy specimens from soldiers dating genome is written out on a very, very makes them easier to study. to the Civil War. If he could retrieve long molecule called deoxyribonucleic Automated sequencing machines came even a few genetic scraps of that virus, acid — DNA. online only in the past decade or so. perhaps he could figure out why it was Molecular biology is to some extent They’re like reverse vending machines. so contagious and virulent. the study of architecture. It’s all about You open a door, place a tray of DNA Ten years later, his project is still structure. Proteins — which do most samples in a slot, watch it recede into going, centered in the rather ordinary of the heavy lifting in the body, such as the interior of the machine, and wait. laboratory directly next to his office building cells and tissues — have many Inside the machine, needles descend (he has collaborators in labs around ways of folding themselves in three into the DNA vials and pull the fluid the country). Taubenberger doesn’t do dimensions. Their structure determines through a tiny glass tube, known as a lot of bench work these days, what their function. They roam the body in a fiber-optic capillary. The machine with giving interviews, taking meetings, search of a correctly shaped receptor. examines the thin stream of fluid with trying to get things published, but he They just want to fit in somewhere. laser light; the nucleotides, the bases, has assistants busily at work, filling When Francis Crick and James Watson go slipping through the laser beam one tiny vials with fluids containing DNA, rocked the scientific world in 1953, it by one, guanines glowing differently sequencing genes, tapping on computers, wasn’t by discovering DNA. Rather, they from cytosines, and so on. Soon, the accessing databanks and doing all the found the structure of the molecule, and results flash on an adjacent computer highly detailed work of decoding the proved that it was the source of genetic screen: the letters. The code. The 1918 influenza virus. Taubenberger also information. “We’ve found the secret of process is hardly push-button simple has a new project in collaboration with life,” Crick exulted that winter day to — the machines can examine only the National Institutes of Health and a friends at the Eagle pub in Cambridge, short segments of genes at one time, nearby genomics institute, to find the England, and the secret, it turned out, and scientists are often working with genetic codes of many thousands of wasn’t some special juice, some exotic scraps to begin with. But it’s definitely a different strains of viruses harvested energy source, but just a well-framed, scientific marvel. from people and wild birds. two-stranded, ladderlike molecule with “There’s this kind of voodoo part,” The overarching goal for both projects rungs in all the right places and a nifty Taubenberger says. “Nothing you do is to learn how these viruses evolve ability to make copies of itself. can be seen. It’s all invisible. It’s all and which mutations might make them A gene is historically defined as a magic.” But, he adds, in homage to the more or less likely to become adapted segment of DNA with instructions for requirements of the scientific method, to humans and develop into potential making a single protein, though the one- “it’s reproducible magic.” killers. By removing from influenza some gene, one-protein rule is pretty loose. To complete reading of this Sunday of its element of surprise, we might be Humans have upwards of 30,000 genes. Magazine feature, visit http://www. able to forecast likely outbreaks, in the The flu virus has just 11. washingtonpost.com/wp-dyn/content/ same way that we can forecast which The code of a gene is written in article/2005/12/07/AR2005120702154_ tropical depression is going to turn into a the form of tiny chemicals called pf.html