# 429
Although I’ve said it often enough, it probably bears repeating, suspected cases of human H5N1 infection will, most of the time, turn out to be something else. At least for now. If the virus should ever develop the ability to transmit easily from person-to-person, all bets will be off.
There are literally dozens of ailments that can produce ILI’s, or influenza-like illnesses. Garden-variety influenzas (H3 and H1), which are running rampant this time of year, are but two of the more common ones. There are also other, less common pathogens, like Dengue fever, chikungunya, and malaria which can present with similar symptoms. Differentiating between avian flu, and something more mundane (or sometimes exotic), can often be difficult.
Complicating matters is the problem of testing.
Frankly, it isn’t very good. No, strike that. Testing is lousy. Many labs are simply not equipped to test for the virus, and even the ones that are frequently must conduct multiple tests to rule out infection. There have been cases where patients have tested negative 3, 4, or even 5 times or more, and only have been proven positive after death.
Others have died, and their cause of death was never ascertained.
In Indonesia, the standard seems to be 3 negative tests in a row to rule out avian flu. While not perfect, it probably catches most of the cases.
All of this brings us to the subject of `suspected cases’, of which we’ve seen a lot over the past six weeks. Hundreds in Indonesia alone. Thailand has tested hundreds, also; all negative. And in Egypt, the media continues to report new suspected cases entering hospitals on a daily basis.
I don’t blog on every suspected case mentioned in the news. If I did, I’d have room for nothing else. Most of these cases will turn out to be something other than bird flu, and I know that. But I watch these cases, as do the newshounds on the net, and for good reason.
If a mutated virus strain develops, our first indication will likely be an up tick in patient admissions for suspected bird flu. It may happen in Indonesia, or Turkey, or Nigeria, or someplace else on the planet. It could happen today, tomorrow, or a year from now.
By tracking cases now, we not only will know when something unusual happens, we are also developing a baseline to compare it with.
The newshounds on the flu forums do an incredible job tracking all of this. Contributors to this effort can be found on the Wiki, Flutrackers, CE, PFP, PFI and other forums. They share their sources, swap lists, and keep all of us informed as to what is happening on the ground all around the world.
While most of these cases will turn out to be non-bird flu related, their efforts are not in vain. We know more about where this disease is occurring because of their efforts, and hopefully will get an early heads-up if a change occurs in the virus.
In the meantime, readers should understand that we are likely to see many suspected cases over the next few months. Some will likely turn out to be H5N1, many others will not. In each case, we need to withhold judgment on early reports, and accept that the `fog of war’ often clouds the facts.
I will continue to update `suspected cases’ when they appear relevant. At the risk of repetition, I’ll remind my readers that they are only suspected cases until proven otherwise. But it is also important that we don’t become mired in watching every speculative news report.
I’ve no doubt, if this virus ever acquires the ability to efficiently go human-to-human, we’ll notice.
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