This makes 2006 the deadliest year since the H5N1 virus started spreading rapidly amongst the world's bird population. And it brings this year's worldwide human death toll to 66, out of the 100 reported cases (66%). This death rate far exceeds that of the most deadly pandemic of the century, the 1918 Spanish flu, which had a death rate approximated at 2.5%. Even with this much lower death rate, the 1918 pandemic took a large toll on the worlds population with somewhere between 50-100 million deaths.



The H5N1 bird flu numbers however, are only for confirmed cases. The actual death toll and extent of illness are likely to be higher. The World Health Organization's situation reports indicate that other likely cases have remained unconfirmed, due to the inability to collect samples prior to death and disposal of the remains.

An example of this is surrounds the 44th confirmed bird flu death in Indonesia. The neighbor also fell ill with similar symptoms and then died prior to samples being obtained. Another neighbor has also died and confirmation of bird flu as cause of death is pending laboratory results.

So far most people who have become ill have had close contact with poultry. Indonesia has some 2 billion chickens and the virus is endemic in these birds in 27 of the 33 provinces.

Culling this many birds would require massive compensation to farmers and chicken owners. Indonesia has been criticized for not carrying out such an effort. Its neighbor Vietnam has carried out an aggressive culling campaign and has not had a confirmed case of the bird flu in 2006.

In July and August Thailand officials also conducted large-scale culling of chickens in an attempt to curb the spread of the disease. The aggressive action seems to have paid off with a government official declaring Thailand "bird flu free" for over a month.

This victory does not obviate the current worldwide risk. The battle ground is currently set in Asia and possibly Africa against this tiny viral enemy. Poverty and the lack of adequate healthcare feed the opportunities for the virus to mutate. The more opportunities H5N1 has to mix with the typical human seasonal flu, the greater the likelihood it will acquire the mutations that allow it to spread easily amongst humans. Experts agree that if this happens within 6 weeks the worldwide population will be fighting a pandemic battle that will be one for the history books.