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H5N1 Case Fatality Rate
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>>A few analysts have suggested that the death toll could be considerably higher. Henry L. Niman, a medical researcher in Pittsburgh, who tends toward gloomy predictions and is a strong critic of W.H.O. for being too conservative, said that with more than 70 percent of the human victims of the disease dying so far, the death toll could in theory exceed a billion people if the disease were to spread rapidly among people with little if any reduction in current mortality rates.
"That estimate is unscientific unjustified, and an inaccurate extrapolation from the current situation," Dr. Stöhr, the W.H.O. expert, said.<<
Under the current situation, there is no pandemic in people (less than 50 reported cases worldwide). However, WHO had estimated that a pandemic could lead to the infection of 1/3 to 1/4 of the world's population, which would be 1.5 to 2 billion infected people. With a case fatality rate of 70%, that would generate over 1 billion deaths.
Efficient human to human transmission is still the key event and recombination can place a human receptor binding sequence on an avian H5 background and achieve human to human transmission without changing the rest of the avian genes, which are producing the 70% case fatality rate.