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Thursday, January 12, 2006

18 Confirmed Human H5N1 Cases In Turkey

Eighteen is now the lower bound of the number of humans who have been contracted an H5N1 infection in Turkey. This number includes the third child who died and hadn't been confirmed yet. Again, this case tested positive on autopsy like the other two.

This points to the fact that severe cases are likely to test negative by the time they get to the hospital. They may be confirmed if an autopsy is done after death, or confirmed by antibody blood testing weeks later if they survive. Swab testing is very unreliable, and initial blood tests for antibodies are also unreliable. Would we do any better? I don't think so.

I don't think the strain of H5N1 showing up in Turkey is significantly different than the Indonesian variant. In two weeks Turkey has now identified more cases than Indonesia has since last July. The obvious difference is that Turkey is working a lot harder on identifying the disease, isolating possible cases and testing them.

Perhaps due to these efforts, Turkey has indentified 18 cases and only 3 of those have died to date. That's one out of six. Indonesia has about 12 with more than 50% dead. Obviously they aren't finding milder cases. China is up to about six, with more than 50% dead. In Turkey the world community is getting the first chance to see how this disease really behaves in humans. Turkey deserves some recognition for its openness and honesty.

You are right when say swab testing is unreliable.

The fact is, the window to determine if the virus is H5N1 is really very small, and there is not a really good test yet.

I also suspect that Turkey too, is ill equipped to properly monitor and report on the virus. The images that we have seen of how they are culling chickens in Turkey isn't encouraging.
No - I mean yes. We don't have anything better than Turkey. They are testing for H5, and then following up with lab tests.

As for the culling procedures, we do have equipment etc, for large operations. But smaller or household chickens are kept in some areas of the US, and I don't think we'd do any better.

I absolutely shudder when trying to imagine what this virus is going to do to some areas in SA when it arrives.
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