The Triangle of Doom - The Monster at Our Door: The Global Threat of Avian Flu - page 39

and Eurasian lineages of waterfowl: this was considered to be a warning that previously separate genetic
hemispheres had now been bridged and that East Asia viruses have arrived in the United States. 151 In its
early stages the new virus caused very few clinical symptoms, but it quickly evolved more lethal geno-
types. By January 2002 a particularly virulent strain appeared on a San Diego farm and spread to other
local poultry ranches; infected hens from Southern California were then shipped to Turlock in the Central
Valley. A major poultry processing center, Turlock became the hub of an explosive epidemic. As a study
published by the Institute of Medicine explains: “Millions of birds shedding viruses traveling in trucks
easily spread the infection to farms along the route. That is when the Turlock region, which is bound by
three major roads, became known as the Triangle of Doom: a bird couldn't enter the region without be-
coming infected with H6N2. Tens of millions of birds in California became infected with this H6N2 virus
during a four-month period beginning in March 2002.” 152
This massive epidemic—in contrast to the HPAI outbreak in Holland—was largely invisible. From the
very beginning, growers used only their own veterinarians and did not release the diagnoses, “not to the
state or to other potentially affected states, not to the OIE, not even to neighboring farms, who might have
better protected their flocks from infection had they known about it.” The emergence of this so-called
“Triangle of Doom” was also kept quiet “by corporate decision-makers who feared that consumer demand
would plummet if the public knew they were buying infected meat and eggs.” 153 As with the SARS out-
break in China the following year, economic interests trumped any concern for public health.
But what, exactly, is the human risk from H6N2? Carol Cardona, a University of California veterinary
scientist, emphasizes that LPAI viruses all have the “potential to donate genetic material to potential pan-
demic strains. The interaction of animal agriculture and the public is complex and dynamic and we do
not fully understand the risks associated with various types of contacts between humans and birds.” 154
Indeed, many researchers feel that the official distinction between LPAI and HPAI outbreaks is scientific-
ally unsustainable and should not be allowed to dictate different levels of surveillance and response. 155 It
is also imperative that agribusiness's bottom line not be allowed to supersede the global priorities of pan-
demic surveillance and human biosecurity. Amongst the influenzas increasingly seen in the North Amer-
ican poultry industry are H5 and H7 subtypes that display a disturbing tendency to rapidly evolve from
LPAIs to HPAIs ( Table 7.2 ). The full danger of not taking LPAIs seriously as human health threats was
demonstrated in British Columbia's Fraser Valley in February to May 2004.

Table 7.2.
H5 and H7 (LPAI) Outbreaks in the USA Since 1997 156

1997 H7N3 Utah

1997-98 H7N2 Pennsylvania

2000 H7N2 Florida

2001 H7N2 Pennsylvania, Maryland, Connecticut

2002 H7N2 Shenandoah Valley, New York, New Jersey

2002 H5N3 Texas

2002 H5N2 New York, Maine, California

2002 H5N8 New York

2002 H5N1 Michigan

2003 H7N2 Connecticut, Rhode Island

2003 H7N2 Human infection in New York