Perspective: Watchful Waiting

 

 

# 609

 

With news that some HCW's (Health Care Workers) in Indonesia might be infected with the H5N1 virus, and the weekend approaching, it's probably a good time to think about what this does, and doesn't mean.

 

First, and most importantly, we have absolutely no confirmation yet that any of these HCW's have contracted bird flu.   None

 

The isolation of these patients may be nothing more than the exercise of an abundance of caution.  

 

Let's face it, if any of us had been in contract with a bird flu patient we'd take notice of every cough, every sore throat, and every fever or chill we might experience.  We'd be looking for signs of infection, and might interpret a common cold, one that we might otherwise brush off as being insignificant, as something more ominous.

 

Until we have worsening symptoms consistent with H5N1, and laboratory confirmation, we really don't have much here beyond local media speculation.

 

While it's true that we watch for HCW's coming down with the virus as an indication of increased transmissibility, it is also expected that we'd see many other casual contacts also infected.  Family members, neighbors, friends.   These people would have had contact without the benefit of protective gear, and would be far more likely to contract the illness.

 

Is this report worrisome?    Yes, a bit.   But it may ultimately prove to be nothing serious.

 

Even if one or more of these HCW's turns out to be infected, that, in and of itself, isn't a sign that anything has begun.  We have, after all, seen H2H2H (human to human to human) transmission before.  

 

If, over the next week or so, we see a large (and increasing) number of H5N1 patients in this area that can be epidemiologically   linked to one another, then we have a serious problem at hand.  

 

Even if the worst happens, and we see a spike in patients, and evidence of H2H2H transmission, it is possible that an outbreak could still be contained.  It is only if that should fail that a pandemic would begin.

 

Old hands at watching these types of situations are obviously alert and paying attention, but not necessarily worried.   Last May, we saw patients dying in Indonesia at a rate of one every 60 hours.   And we saw a cluster of 7 family members in Karo.   We been down this bumpy road before.

 

This is simply a time for watchful waiting. 

 

Whenever we see an increase in cases, real or suspected, a few people on the Internet begin to worry.  You see posts that `it's begun', or `it's time to make last minute preps'.   And that is a natural reaction. But each time it has happened in the past, the `crisis'  has passed.  

 

One of these days we may see this virus take off and a major crisis ensue.  Maybe this is the spark that ignites it, maybe not.   But it is too soon to tell.

 

I've a long list of friends, relatives, and acquaintances that expect me to email them if my personal alert level goes up.  

 

It hasn't.  

 

For now I'll be watching the situation, and reporting on it as the news comes in.  Until we know more, this is just another bird flu story to follow.

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