DiseaseIllness

ADD is often accompanied by a coexisting condition. On the other hand
often ADD and these other conditions have similar symptoms and
therefore
are easily misdiagnosed. Of course
this creates a plethora of problems as these disorders
when separate
must be treated differently. A misdiagnosis will lead to ineffective treatment. As coexisting conditions
these are especially of concern
because they increase the severity of many of the symptoms of ADD
as well as the negative impact on those that suffer them.

One such condition is Oppositional Defiant Disorder or Conduct Disorder. Children with this disorder tend to be very aggressive and defiant. They usually lose their tempers very easily and challenge authority figures. This is the most easily diagnosable behaviors
as teachers and parents become aware of this conduct quickly and seek treatment almost immediately. This particular disorder is common in children that are the hyperactive/impulsive type of ADD and occurs in 35% of children with ADD. This coexisting condition makes it much more likely that these sufferers will get in legal trouble as they age due to their authoritative defiance.

Many children that have ADD also suffer from mood disorders and/or depression. The complication associated with this coexisting condition is the increased likelihood of suicide common during teen years. 18% of ADD children also suffer from some type of mood disorder
and is it more likely to occur within the inattentive type of ADD. This is often not as easily diagnosed as compared to other conditions. Children with mood disorders as a coexisting condition must be treated with different medication than typical ADD treatment; therefore
such therapy may be more difficult.

Also a concern is anxiety disorders among ADD sufferers
which constitutes roughly 25% of those with ADD. Traits common of Anxiety Disorders are fear
panic
and worry
which may necessitate medication and/or counseling. As with mood disorders
combined treatment make therapy more complex and arduous.

Learning Disabilities are also conditions common with children that have ADD. While ADD
in itself
is not a learning disability
it can make it extremely difficult for children to perform well in school. If coupled with a learning disability
it makes it considerably more challenging for children to grasp academic concepts and utilize such knowledge.

For the most part
coexisting conditions make treatment more difficult and the side effects of both disorders more severe. The typical signs and symptoms of ADD are difficult enough to deal with
but with more intense severity
it often makes side effects deadly or incredibly negatively life altering.

Bird flu is a disease caused by a specific type of avian (bird) influenza virus
the so-called H5N1 virus. This virus was first discovered in birds in China in 1997 and since then has infected 125 people in Vietnam
Cambodia
Thailand
and Indonesia
killing 64 of them. It is spread by infected migratory birds (including wild ducks and geese) to domestic poultry (primarily chickens
ducks
and turkeys)
and then to humans.

Since 1997
and especially since the beginning of 2004
approximately 150 million birds have either died from the disease or been killed to prevent further spread. Nevertheless
this very infectious and deadly virus has spread relentlessly to China
Thailand
Cambodia
Vietnam
South Korea
Japan
Taiwan
Laos
Russia
Indonesia
Mongolia
Kazakhstan
Malaysia
Turkey
Romania
England
Croatia
Macedonia
and other countries. This ongoing geographic extension of the virus is of great concern around the world. It is feared that it will continue to spread to all continents
including the Western Hemisphere—and it no doubt will.

Normally
different types of viruses infect just one
or a limited number
of species specific to the particular virus type. The bird-flu virus
however
has infected a large number of birds and animals
including ducks
chickens
turkeys
tree sparrows
peregrine falcons
great black-headed gulls
brown-headed gulls
gray herons
Canada geese
bar-headed geese
little egrets
pigs
clouded leopards
white tigers
mice
domestic cats
crows
magpies
peacocks
blue pheasants
rare eagles
turtledoves
swans
terns
and others. This is another sign of the virulence or destructiveness of the virus.

Researchers
historians
and infectious-disease experts have determined that influenza pandemics (global epidemics) occur approximately once every 30 years. The most deadly pandemic ever recorded occurred in 1918-19
killing more than 100 million people across the globe in less than two years. Two other much less severe pandemics occurred
one in 1957
when approximately two million people died
and one in 1968
when about one million people died. Because we have already had three pandemics in less than 100 years
we are “overdue” for another one.

And so this disease-causing virus continues to infect more and more species in more and more countries. In laboratory experiments
it has been shown to be one of the most lethal influenza viruses ever known. In addition
just recently and after 10 years of work
researchers determined that the H5N1 bird-flu virus is genetically more similar to the deadly 1918-19 influenza pandemic virus than to the viruses which caused the much less severe pandemics of 1957-58 and 1968-69.



To summarize the important points so far: The bird-flu virus is a very deadly strain of avian influenza called H5N1 that has killed millions of birds; 2) the virus is spreading relentlessly around the world; 3) the virus has infected many species
which is uncharacteristic of most viruses; 4) the virus has been shown to be similar to the most deadly virus ever known
which caused the 1918-19 pandemic; 5) the virus has been shown to be much more deadly in laboratory experiments than regular influenza viruses; and 6) the virus is known to have infected at least 125 humans and killed 64 of them so far
yielding a fatality rate of approximately 50 percent.

The virus continues to kill humans
but at a slow rate—it has not yet acquired the capacity to be easily transmissible between humans; humans become infected primarily from sick birds. Because humans alive today have no natural immunity to the H5N1 virus
once it becomes easily transmissible between humans a pandemic or global epidemic will occur. The central question is
when will it exchange enough genetic material with the usual seasonal human influenza-viruses to become more like a human-influenza virus—and thus become easily transmissible between people?

Many people believe that the virus will continue to spread around the world until it is present in most or all countries—before it will “go human” (become easily transmissible between people). And that may be the case. The pandemic of 1918-19 is thought to have started in Kansas (of all places). So it is certainly possible that the coming pandemic could start somewhere else than in Asia—although most experts believe it will
in fact
start there. It could start in a country which has not yet been host to the virus.

However
it is most certainly not necessary for the virus to march all the way around the world before a pandemic can begin. The fact that the virus already has spread to more than 15 countries
and to many different bird and animal species
provides the opportunity for it to commingle with a human-influenza virus and create the dreaded human contagion. There is no known reason why this could not happen tomorrow. While it is true that the probability of the switch increases with time
the probability of its happening tomorrow is far from zero.

The flip side to the possibility that the crossover could happen at any time is the fact that the virus has been around at least since 1997 and
as a matter of record
has not yet switched to a deadly human-to-human form. At least a few scientists believe that the virus can’t and won’t make the switch to a deadly form
possibly ever.

And so we are left with these two very different possibilities—at any time
and as soon as tomorrow
the virus could mutate into a deadly form
readily transmissible between people—or it might never transform itself into such a form. There appears to be much more evidence for the former and
presumably
that is why the vast majority of scientists and governments are scrambling to prepare for the worst.

This situation is analogous to living on the Gulf Coast during the beginning of hurricane season. Residents there have been through it before
but most of the time the storms are not too severe and the people can get by without too much hassle. However
there have been rare severe storms that have been devastating. Some day another hurricane is coming
and it appears that it might well be a Category IV or even V by the time it strikes land. However
that’s not certain—no one can say for sure
and no one knows exactly when it will strike land. So what should the residents do? What should the residents have done before hurricane Katrina?

The coming bird-flu pandemic might be mild and it might not come for years. On the other hand
it might be severe and it might start tomorrow. The U.S. Government Accountability Office (GAO) has said
“While the severity of the next pandemic cannot be predicted
modeling studies suggest that its effect in the United States could be severe.” We should also be mindful that the pandemic could come at any time
even before the virus methodically marches around the globe. No matter how advanced science has become
we still can not predict when the switch will occur; it is currently unknowable—and that does not mean it will come later
in a predictable fashion. As Miguel de Cervantes admonished
“Forewarned
forearmed.”

Bradford Frank
M.D.
M.P.H.
M.B.A.
The Frank Group
P.O. Box 138
Lakewood
NY 14750
http://www.AvoidBirdFlu.com