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Forgotten, But Not Gone

 

 

# 4733

 

 

While I’ve been offline dealing with a computer upgrade this weekend (still in progress), Crof at Crofsblog picked up a story from Antara News (Indonesia: A teenager dies of bird flu) of another bird flu fatality: this time a 14 year-old girl from Sukoharjo.

 

image

 

Ida at BFIC has another report of this story as well (Sukoharjo, Central Java ::: A 14-year-old girl dies of bird flu H5N1).

 

Sporadic human infections have been occurring for years in places like Egypt, China, Vietnam, and Indonesia. The official count is 500 infected with 296 fatalities.


The actual number of cases worldwide is unknown, but likely higher.   Below is the WHO’s accounting of human infections as of July 5th.

 

image    (Click to Enlarge)

 

As you can see, in recent years the number of reported cases has slowed.  Whether that is due to to fewer actual cases – or in some places, a reluctance or inability to report them, is impossible to say.

 

But given the vagaries of testing, surveillance, and reporting there remains considerable doubt as to the completeness of these official numbers.

 

Admittedly, the same could be said about any country with practically any disease.

 

We don’t know how many people get West Nile Virus in this country, or Influenza, Dengue, or any other illness for that matter.

 

Most of the time, the best we can get are estimates.  Actual cases reported are generally just the tip of the pyramid.

 

surveillance

 

The problem becomes much more difficult to define in countries with poor public health infrastructures. 

 

Quite frankly, there are places in the world where the bird flu virus circulates but human  (or animal) surveillance and testing for H5N1 is non-existent.

 

 

Indonesia has long been reticent to discuss their bird flu problem , and stopped reporting them in `real-time’ (see Indonesia To Stop Announcing Bird Flu Deaths) two years ago after deciding that discussing the problem publicly was `counterproductive’.

 

In recent months, we’ve seen some glimmers of more openness, but it is too soon to know how forthcoming they really are.

 

China - widely regarded as the `cradle of bird flu’ – since the virus appears to have emerged from their southern provinces, rarely reports cases in birds, or in humans.

 

Last month the first human bird flu case was reported out that nation since January of 2009, when 7 cases (4 fatal) made headlines in just one month.

 

Abruptly, as if turning off a spigot, the coverage of bird flu cases in China stopped in February of 2009. For the next 16 months, we heard almost nothing.

 

Given the large expanse and population of China, their limited surveillance, a state run press, and a historical reluctance to disclose internal matters – particularly when it comes to disease outbreaks – there remains a good deal of  skepticism that we are hearing about all of the bird flu cases in that country.

 

There are regular denials in the the state run press that bird flu is circulating in poultry, while at the same time, running admonishments not to touch or consume dead or sick chickens. 

 

Sharon Sanders at FluTrackers spends a good deal of time translating articles from the Chinese and dissident press.  One example from last month may be found here.

 

And while anecdotal, I’ve received word from a trusted source who has strong ties to China that the price of chickens in some places in China has gone up dramatically in recent weeks.

 

Additionally, there are reportedly some restrictions on the sale, export and consumption of ducks due to `health concerns’.

 

None of which appears to have been picked up by the State run media.

 

Bird flu?     Well . . . it’s certainly possible, perhaps even likely.  Although it may never be officially confirmed.

 

The situation in places like Myanmar, Cambodia, Laos, North Korea, Nepal, and much of the African continent is similarly vague.

 

While scarce, here are a few bird flu reports from the past two months.

 

Bird Flu Rumblings From China
Indonesia: MOH Confirms Bird Flu Fatality
WAHID Notification Of Russian H5N1
H5N1 Bird Deaths In Tibet
Avian Flu Reported In Palestinian Authority

 

So, while bird flu may have been forgotten, it is hardly gone.  And as long as it circulates, it has the potential to mutate into a human-adapted pathogen.


Which is why we continue to watch, even though the level of reported cases remains low.

Related Post:

Bird Flu
China
H5N1

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