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Pastimes : Let's Talk About Our Feelings!!!

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To: Henry Niman who wrote (95597)	2/4/2005 12:32:40 AM
From: Grainne	Read Replies (3) of 108807

Who is fighting here, Henry? This is all so scary and confusing! Commentary Visible Human to Human Bird Flu Transmission in Vietnam Recombinomics Commentary February 3, 2005 Recent statements from WHO scientists regarding human transmission are actively ignoring some rather obvious examples that have been covered extensively in the media. Each familial cluster contains at least one confirmed H5N1 case. The overall description of all six clusters is the same. One or two family members develop bird flu symptoms and die. After the death of the index case, one of more family members develop symptoms and at least one is positive for H5N1. This general description matches the case that was recently published in the New England Journal of Medicine. The NEJM paper covers a cluster of 3 in Thailand this past summer. Although the index case was initially diagnosed as dengue fever and no sample was tested for avian influenza, the daughter was considered the index case of the cluster because both her mother and aunt developed symptoms after the daughter died and both tested positive. Initial test on the aunt were negative. Had the group not formed a cluster, it seems likely that none would have been diagnosed as having H5N1. The cluster received significant attention because the mother was not present when the daughter first was infected, and then when she went to visit her daughter, there was limited exposure to any common source that might have been present. However, it was the time differential between the onset of symptoms that provided the strongest evidence for human to human transmission. The clusters listed below match the Thailand cluster except the caregiver that became infected did have some common source exposure. However, in all six clusters the time differential was at least 7 days and the secondary case(s) developed symptoms after the index case died. There is no data to indicate that all members of the clusters below are not H5N1 avian influenza cases. Those that are not confirmed either did not have samples collected or results have not yet been reported. The cases not in the official totals have all died from illness that looked like bird flu clinically and have a direct link to at least on H5N1 positive relative. The under reporting of cases extends beyond these clusters. Many cases in Thailand last season had a high index of suspicion due to poultry deaths and clinical presentation. In 21 cases H5N1 was laboratory confirmed. 14 of the 21 died, but none of the 21 laboratory confirmed cases are in the official tally. The active exclusion of these obvious cases diminishes the utility of the fatality tallies and now the deficient database is being used to make comments and comparisons that are simply not supported by the facts. The faulty database covers up the clear deficiencies in the monitoring of the disease and the artificially low numbers are faithfully cited in media reports on a daily basis. The monitoring and reporting of avian influenza in Asia remains scandalous and the H5N1 virus does not read press releases or media reports. recombinomics.com

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