M&M’s

No, not the candy covered treat.

In most hospitals, the M & M meeting is a weekly occurance. It stands for Morbidity and Mortality. And it is where doctors gather and review cases and their treatment and outcome. Particularly those cases where the outcome was not what was expected, or desired. This is where doctors review their mistakes, and learn from them.

To date, we’ve seen no publicly available M & M discussion on Avian Flu victims. In fact, except for the use of Tamiflu, we’ve precious little information on what has been tried in the treatment of these patients. Worse, almost no information has been released on the course of this illness, or what lingering medical problems the survivors have experienced.

Why have these patient’s charts (with names redacted) not been released to the appropriate medical authorities for review? With more than 230 victims, and roughly 100 survivors, we should be able to learn a great deal more about this disease, if only the data were available.

We hear there are religious and cultural impediments, particularly since most of these cases have occurred in Moslem and Asian countries. Autopsy’s are almost never done. But even without post mortem analysis, there is much that can be gleaned from these patient’s charts.

What percentage of H5 victims developed secondary pneumonia? What strain? What antibiotics were tried? Have steroids been tried? What dosage of Tamiflu? And we need this information on every patient. Not just one or two.

So far, the success rate in treating H5 infection has been dismal at best. More than 50% of known victims have died. And we have heard scattered reports of multi-organ involvement, something not normally seen in influenza.

Are these reports so disturbing that they are being hidden, so as not to alarm the world? Or is this simply a case of private interests overriding the public good? I honestly don’t know.

What I do know is, that if this virus does go pandemic, we are going to need all the data we can get about it, good or bad, in order to effectively treat it.

And right now, that information is buried in a deep black hole.

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