Flu Stories: Indonesia Simmers, H5N1 Continues To Spread

by DemFromCT

In a summer full of other news - from Iraq to Lebanon to political battles in Connecticut - bird flu has slipped off the front pages. This isn't because things have changed much, it's because other things rightly take precedent, and because editors are tired of the story (not just a guess, there's a survey). But in the background, things are still happening. For example:

 

Indonesia bird flu deaths reach new world high of 43
Tb. Arie Rukmantara, The Jakarta Post, Jakarta

Indonesia's mortality rate from bird flu surpassed Vietnam on Thursday, giving it the sobering distinction of the country with the highest number of human deaths from H5N1.

The World Health Organization-sanctioned laboratory in Hong Kong confirmed that a 44-year-old man who died last week was infected with the deadly virus, Health Ministry senior official Nyoman Kandun said.

The confirmation brought the country's total deaths to 43 of 56 verified patients, surpassing Vietnam with 42 of 93, according to figures from the Centers for Disease Control (CDC) in Atlanta, Georgia.

However, the WHO recognizes only 42 deaths of 54 patients.

Health Ministry official Joko Suyono said the discrepancy was because the CDC acknowledged one patient death and another infection not recognized by other health agencies.

In fact, WHO has issued their latest update on the morbidity and mortality numbers. Already in 2006 more have died than in 2005 (57 vs 41), and it's only August. The case fatality rate (CFR) remains high at 65%, and much of those numbers are driven by Indonesia.

Meanwhile, Bulgaria has a new case in domestic birds, not yet confirmed H5N1, and the Canadian goose infection on Prince Edward Island has never been confirmed as H5N1 due to a lab accident (but it is H5 and the four geese died... making a varient likely). That's less an alarm about high pathogenic H5N1 being in North America (not yet, though low path variants circulate)and more of one about our patchwork surveillance system (hit and miss). Transparency and simple explanations are not innate to government agencies - it has to be practiced to be perfected.

The bottom line is that this is a virus that mutates and changes with every infection. The problem, and the risk, have not gone away. Pandemic preparation continues in the US (here's a story on more money being released to the states) but isn't nearly sufficient at this time.

What will happen is that you'll start to hear more about the virus when it moves beyond it's simmer, likely in the fall. In the meantime this confirmed cases table will highlight that flu surveillance in the Mideast could easily be another casualty of war.

Comments

[emptywheel]

DemFrom,

Can you say more about what you mean by the flu suveillance in the ME comment? Should the table ALREADY have higher numbers?

[Meteor Blades]

Editors tired of the story? Not enough deaths to make it worth their while. Too much of that subject their readers/viewers don't want to hear about: science. Occurrences far away in foreign climes. When it happens here, get back to us.

I know you're not of a mind to say "I told you so," DemFromCT, but I suspect it will be mighty tempting when the virus makes its leap.

[DemFromCT]

emptywheel

Well, NAMRU-3 is in Egypt, and is the naval surveillance station used to check specimens.

We know there were cases (see table). Let's say there are 5 dead ckickens in Kirkuk or Fallujah. I don't know that getting those specimens to NAMRU is a priority for anyone. Does that mean there are no more Iraq cases? What about Lebanon? What about Iran?

Meteor Blades

That survey is a real eye opener. The reporters are very concerned, the editors have moved on. For example:

I don’t want to panic anyone, but I do want to prepare my audience. I have personally told my family to get 90 days’ worth of supplies together, in case they need to stay away from other people for a while. I don’t tell my readers that, because our editors think that may be ineffective and will cause panic. But the world is a scary place. People need to understand what could happen so that they can be ready.

[DemFromCT]

speaking of surveillance:

link

Senators on Friday criticized the Agriculture Department's planning for deadly bird flu, saying the voluntary nature of its testing program threatens the U.S. poultry industry.

At issue is a federal audit that found the government lacks a comprehensive plan for testing and monitoring bird flu in commercial poultry. The department says it will have a plan in place by October.

"It is surprising that USDA does not have a program that monitors and collects data on what testing is taking place," the senators wrote in a letter to Agriculture Secretary Mike Johanns.