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Sunday, July 31, 2005

First Russian Human Bird Flu Case

This one is awaiting confirmation by testing, which may take a few weeks:
A 20-year-old man showing bird flu symptoms has been hospitalized in Kazakhstan's Pavlodar region, where 600 domestic geese died between July 20 and July 30 as a result of an outbreak of the disease in the area.

The patient, a poultry farm worker from the village of Golubovka, was later diagnosed with double pneumonia and taken to the intensive care unit of Pavlodar's regional infectious diseases hospital in a critical condition, sources in the region's emergency medicine center told Interfax.
The infection hasn't been in Kazakhstan for long and clearly got there from China. It is becoming increasingly improbable that China has experienced no human bird flu cases as it maintains. Russia has instituted a quarantine and a culling program for the area.

China has, however, sent out 50,000 health care workers and blockaded all the roads to Beijing. This, they insist, have nothing to do with bird flu but a bacterial infection in pigs that has broken out in Sichuan (Sechuan). Currently there are 181 cases and 34 deaths. According to news reports from China, you can only get it from close contact with an infected pig. According to reports from Hong Kong, 11 people there have gotten it and there is no evidence that all of them came in close contact with an infected pig or pork:
Two cases were reported in Hong Kong this week, raising the city's total infections to 11 since May 2004, the territory's Health Department reported Saturday night. But officials have said the cause of the infections was unknown and that the cases don't appear to be linked with the Sichuan outbreak because the patients had not recently travelled outside Hong Kong and had no exposure to pig farms.

The first Hong Kong case this week, reported Thursday, involved a 26-year-old man who fell ill on July 5, the Health Department said.

Hong Kong reported another infection Saturday night: an 84-year-old man who got sick on June 16 and was now in stable condition, a Health Department statement said. The man had helped prepare meals at home but didn't recall handling raw pork before his illness, the statement said.
Confusing - is it the same disease or not? Are they including the other cases because it looks the same? If so, it might explain another report of deaths in Taiwan, cautiously attributed to Whitemore's disease. There is a ring of odd diseases spreading out around China, and as one commenter on this thread notes, there are unusual factors:
They're going on symptoms (so they say) and Melioidosis is one of those diseases that can cause purple patches of skin, so it's possible this could be Bird Flu.

Notice the strange pattern of dispersion: 16 people in 4 different places (birds?).

And again, as with Sichuan, we have this strange story of bacteria being untreatable by anti-bacterials.
I don't think I have any good answers. But I doubt that both Strep. Suis and Burkholderia both becamse resistant at the same time in two different places. It's not impossible, but unlikely.

It's much more likely that both diseases and the woman who "turned black" in Singapore were all caused by a virus. A pathogenic virus (like H5N1) causes a collapse of the immune system and the body is susceptible to myriad bacteria. The bacteria eventually overwhelm the body and lead to septic shock. These are bacterial infections which are "secondary" to the virus.
One thing that appears good is that right now there is little evidence of efficient human-to-human transmission. However, if all of these occurrences are linked to the extremely infectious and pathogenic H5N1 strain that showed up in Qinghai, all bets are off. I'll tell you what - I'm not eating any chicken or pork any more.

The Sichuan disease could be something else entirely which is being spread by infected birds or another vector. For example, one of the ricksettial diseases like typhus or ehrlichiosis, which often cause bleeding and immune system disfunction. There have been heavy rains in this area from a storm, and mosquitos might be passing it. Ricksettia are sort of halfway between bacteria and viruses, and they often infect the lymph glands and then bone marrow, causing a low platelet count. Furthermore a lot of cases of ehrlichiosis can be chronic, thus reducing the body's ability to fight infection generally. This could well be a lethal convergence of two different infections in both animals and humans, which would account for the odd distribution and the difficulty in diagnosis.

There were no reports of this type of bleeding in the southern Asia bird flu cases as far as I know.

"There is a ring of odd diseases spreading out around China, and as one commenter on this thread notes, there are unusual factors:"

Isn't China battling some sort of pig flu as well?
Well, that is the "bacterial infection" in pigs I mentioned above. However, even the WHO seems quite skeptical that Streptococcus is the cause of the human deaths.
I thought there was some kind of bird flu type virus. I must have been mistaken.
Gindy - it is not you. It is them.

The Chinese have called it swine flu and called it a virus. But the official story still is that it is a bacterial infection.
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