If someone cautioned you not to read a particular website because you were “the type of person who would stay up all night worrying,” you might think, “That is precisely the sort of information that my overly-informed-and-paranoid mind needs to know.” Or at least I would. I do not subscribe to the blissful ignorance camp; I feel empowered by knowledge and I try not to let knowledge of risks, particularly death, interfere with my everyday life. For example, I lace up my running shoes, fully aware that I could drop dead of sudden cardiac arrest a few miles from my door. Unfortunately, the things that I fear the most are precisely the ones over which I have the least understanding and the least control.

Certain threats are probabilistically likely in my own lifetime, such as cancer or even terrorism. While these threats may represent a formidable challenge, they have become increasingly familiar. We also have some hope that our fears of dying can be allayed if not entirely resolved. Our relative confidence in the medical establishment will allow us to evaluate the calculated risk of trying innovative treatments for chronic diseases, or pursuing a more conventional path to mixed results. Likewise, depending on our appraisal of the work of our fine bureaucracy, we may feel relative degrees of confidence that we are safe from hostile infiltration or at least capable of responding to an attack with brute force. I am not at all optimistic that a panacea for cancer or terrorism exists on the visible horizon; but there is something about these risks, particularly their increasing presence in the media and our daily life, that makes them comprehensible.

There exists a more nefarious brand of threat: those threats that are entirely unfamiliar and likely cataclysmic on a global scale that we have the real possibility of confronting in our own lifetime. One such threat is H5N1, popularly known as Avian Influenza. I had heard vague snippets about Avian Flu before this summer but unfortunately relegated it to the sort of risk that SARS posed—an overblown infectious virus that severely affects countries with vast populations and limited universal healthcare resources. You may recall the media frenzy surrounding the SARS virus that has now all but fizzled: the impending threat of global infection never materialized. But to assume the same of Avian Flu may be entirely misguided.

Or so I learned during my summer internship at the Environmental Protection Agency. While I was working for the toxic site remediation branch, pretty much utterly uninvolved with deadly pandemics in its day to day operations, we did have one staff briefing on pandemic influenza, particularly Avian Flu, which I found unnerving. It was during this meeting that we were given the above speech about not visiting certain websites. The temptation, like Eve to the apple, was more than I could resist. Unfortunately, both the information I learned in the meeting and that available on the internet caused the sleepless nights of which I’d been warned.

I am not an epidemiologist, but here’s a little background. In essence, the virus has already spread among both commercial birds—food if you eat that sort of thing—and wild bird flocks in Asia, Europe and now North America. Really, this is pretty bad for birds because they die but not so bad for humans unless they are poultry farmers. It is particularly bad for those people who raise poultry in their homes, slaughter the birds, come in contact with diseased or dying birds, or, apparently, swim in waters with infected bird carcasses, according to The World Health Organization. Human mortality rates from contracting the influenza in these ways in the past few years have ranged from 43 to 73% of those with laboratory confirmed infections in any given year. The Center for Disease control explains that in sum “more than half of those people reported infected with the virus have died” and that “most cases have occurred in previously healthy children and young adults and have resulted from direct or close contact with H5N1-infected poultry.” The potentially good news is that there may be more cases of infection that went unreported because the sufferer had such mild symptoms that she did not seek medical treatment. Accordingly, the mortality rate may be inflated. The especially bad news is that bird-to-human transmission is not at all what concerns health officials.

Instead, the fear is that an infected human’s immune system will attack the virus in such as way as to mutate it into a pathogen that will spread from human to human contact. At this point, many of the available resources make an analogy to the Spanish Influenza epidemic of 1918, in which 20 to 100 million people were killed. The reason why the Avian pandemic would be so devastatingly similar is that it would also be a new viral strain to which no living human has immunity. Moreover, as David Shenk of Slate.com explains, “Both viruses seem to trick the healthiest immune systems into a response so strong that it kills the patient. A disease that kills the strongest among us.” The demographic expected to be hit most heavily is our own: adults aged 20-40. From a more optimistic perspective, the WHO rather succinctly explains in a doomsday list lovingly entitled “Ten things you need to know about pandemic influenza” that Avian Influenza has the potential to be a pandemic. When the virus mutates, “all countries will be affected,” “widespread illness” and “large numbers of deaths will occur,” and finally, “economic and social disruption will be great.”  Please read more online about the pathogenic nature of the virus if you want an explanation of how or why this will occur.

I will end with a crucial question: why am I so worried? I think it is because the government is taking the threat of this pandemic especially seriously. I know firsthand that the EPA, and thus the rest of the federal government, already has contingency plans for when the Avian Flu strikes. They truly believe that the Avian Flu will occur, “maybe tomorrow, maybe next year, maybe in ten years,” but that it is definitely going to take place. They are beginning to stock carbon masks so that their employees can come to work and not be infected by the virus. They are beginning to strategize for worst case scenarios, such as what will happen when no health care workers will risk coming to hospitals to care for the sick and dying because they do not want to infect themselves or their families. Then again, the government, and particularly the EPA, is charged with emergency response. After the quality-of-life disaster created by Hurricane Katrina, in which the world saw citizens of the most prosperous country living in conditions much worse than many poultry farmers half a world away, perhaps the government is beginning to take threats to human life (other than al-Qaeda) more seriously. Unfortunately, we have known about the risks of hurricanes and make calculated risk assessments every year; the risk-averse now choose to take their tropical vacations during the spring. We know very little about the Avian Flu—only that it is coming, that it will be devastating, and that we will not be able to anticipate how to treat it until it has proved fatal. In the pandemic scenario, assured inadequacies in response to an assured threat is the worst kind of assurance.

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For more about surviving Avian flu, you can read David Shenk’s “The Survivalist” series at http://www.slate.com/id/2148772/entry/0/?nav=tap3 . For the United States Center for Disease control’s take on the situation, check out http://www.cdc.gov/flu/avian . Or, if you are interested in insomnia, go ahead and visit the World Health Organizations resources: http://www.who.int/csr/outbreaknetwork/en/.