Reports of missed mild bird flu cases raise questions about scope of spread
Posted in: darrelrussell.com edit
08 Jan 2009
17:54:50 EDT Sep 17, 2006
Canadian Press: HELEN BRANSWELL
(CP) - Recent reports from South Korea and Indonesia of after-the-fact discovery of a handful of mild human cases of H5N1 avian flu have again raised questions about whether the disease's extraordinarily high death rate is being inflated because mild cases are being missed.
Experts say the evidence to date points away from that notion. But they add that it is important to continue to search for mild cases. Understanding the true number of human infections and the range of symptoms experienced could help scientists better assess the pandemic risk posed by the virus.
As well, tracking mild cases over time could provide an early warning if important changes to H5N1 occur, they suggest. Climbing rates of mild cases might signal the virus was adapting to become a human flu strain, moving closer to triggering a flu pandemic.
"We need to keep monitoring it," Dr. Michael Osterholm, director of the University of Minnesota's Center for Infectious Diseases Research and Policy, said Sunday.
"Because frankly, one of the indications that there may be a changing epidemiology (disease pattern) with this is in fact if we start seeing larger and larger percentages of individuals who are asymptomatic or only mildly ill that we can clearly confirm as having H5N1 infection."
The World Health Organization announced last week blood tests done on an Indonesian man showed he became infected, likely in May when he helped nurse his sister, a confirmed H5N1 case. The man reported having a cough and abdominal discomfort but his symptoms weren't diagnosed as H5N1-related at the time.
And South Korean officials revealed that testing of blood samples from more than 2,000 workers who culled diseased poultry in late 2003 and early 2004 showed five had developed antibodies to the virus - a sign they had been infected. An earlier round of testing in South Korea turned up four cullers with antibodies.
None of these people had serious illness at the time; none has yet been added to the WHO's official case list.
To the best of the scientific community's knowledge, the H5N1 virus is not adept at infecting people. But when it does, it appears to cause severe disease. Nearly 60 per cent of the 246 confirmed cases have died; many of the survivors battled for their lives.
But there has always been a suspicion in some quarters that a significant number of mild cases are being missed - a theory these new reports may fuel.
Many - though not all - diseases cause a spectrum of illness ranging from undetectable to life-threatening infection. With polio, for instance, it is estimated there are 200 inapparent infections for every person the virus paralyzes. On the other hand, rabies is almost 100 per cent fatal.
If the confirmed H5N1 cases were the proverbial tip of the iceberg, the death rate attributed to the virus would tumble. That in turn might ease worries about the threat posed by H5N1 - though a flu virus that killed even 10 or 20 per cent of its victims would still be a source of serious concern.
Dr. Angus Nicoll, an influenza expert with the European Centre for Disease Control, said these new asymptomatic cases don't change the fact that the bulk of evidence to date suggests such cases are rare.
A number of small studies have been done to test the blood of people who've been in contact with confirmed cases. They have turned up few or no cases that missed earlier detection.
The most recent study - published in the October issue of Emerging Infectious Diseases - looked at blood samples from 351 Cambodians who had been in contact with a man who died from the disease. None developed antibodies to the virus.
"It's still a plausible hypothesis but it's becoming a less likely one," Nicoll said of the notion that there may be a significant number of asymptomatic and mild cases of the disease.
"My bottom line would be: I'm sure we're going to find the occasional mild case. I'm sure we're going to find, eventually, an asymptomatic (case)," he said from Sweden.
"Even if you find just a few asymptomatic and mild cases, that's not going to change the our risk assessment."
http://www.cbc.ca/cp/health/060917/x091704.html
Older article, I think... Did we discuss it?
http://www.flutrackers.com/forum/showthread.php?t=10552
2) Weren't there some Chinese farmers that tested positive for antibodies to H5N1?
3) What countries would you be testing in for evidence of LPAI H5N1 in humans?
And, I agree that if there were even a low number of persons who did not die, but were infected, the risk assessment analysis should be different as the total number of cases confirmed by WHO is not a high number. It would not take, statistically, many cases of LPAI H5N1 to change the CFR, hence the risk assessment.
2) Weren't there some Chinese farmers that tested positive for antibodies to H5N1?
3) What countries would you be testing in for evidence of LPAI H5N1 in humans?
And, I agree that if there were even a low number of persons who did not die, but were infected, the risk assessment analysis should be different as the total number of cases confirmed by WHO is not a high number. It would not take, statistically, many cases of LPAI H5N1 to change the CFR, hence the risk assessment.
The reservoir is probably mammalian, and the mammal most contacted by humans is obvious.
H5N1 antibodies were found in Indian poultry workers.
Indonesia has many varieties of H5N1 in humans.
Wasn't it Karo where the WHO went in and claimed to test everything around the families house? So what did they test?
.
February 14, 2006
In an unpublished study carried out last year by the National Institute of Animal Health in Bangkok, researchers led by virologist Sudarat Damrongwatanapokin tested 629 village dogs and 111 cats in the Suphan Buri district of central Thailand. Out of these, 160 dogs and 8 cats had antibodies to H5N1, indicating that they were infected with the virus or had been infected in the past.
The above comments on H5N1 in dogs and cats are not a surprise. H5N1 has been isolated from fatal infections of leopards and tigers in Thai zoos. H5N1 has also been isolated from a domestic cat and has been experimentally transmitted in laboratory cats.
Similarly, although an earlier report of H5N1 detected in a dog in Thailand was denied, later media reports indicated the original report was accurate and the denial was part of a cover-up.
In Croatia dogs were being destroyed and media reports included pictures of dead dogs and cats. Other unconfirmed reports indicate dead hyenas litter the roadside in Nigeria.
H3N8 has been found in racing and companion dogs in the United States providing additional evidence for expanding hosts ranges for influenza.
The large number of wild birds infected with H5N1 may provide a mechanism for infection of a wide range of carnivores. The number of countries reporting dead swans has increased dramatically in the past several days, and reports of H5N1 in the East Atlantic Flyway suggests the global spread of H5N1 will continue.
The expanded geographical reach and host range of H5N1 is cause for concern. The spread of H5N1 allows for more dual infections, recombinations, and new sequences causing new problems. Moreover, these new sequences can increase the affinity for human receptors, such as S227N, and can be generated in avian hosts infected with H5N1 and H9N2 as predicted previously.
I just found a picture of one...
738
Actually, that was me taken this morning.:D
Some things learned by looking at past pandemics.
Patient prognosis during pandemic influenza
One thing that is different about a major pandemic is just how hard it hits patients and how rapidly it kills. Patients affected by the flu can be broadly categorized into 3 prognostic types. The first type has a poor prognosis no matter what is done for them. The second might survive if there was full access to high technology medical care and resources. The third type is highly likely to recover from the flu as long as they are provided with consistent low-technology supportive measures that can be administered in home settings.
Type 1 patients have the poorest prognosis and almost all will die within 2 or 3 days of the development of their first symptoms. The cause of death in these patients during the 1918 flu was massive respiratory failure from overwhelming lung-destroying viral pneumonia. There was no effective treatment for this in 1918, and there is none today despite all the advances in medicine that have occurred over the last 90 years. Signs and symptoms of type 1 patients include rapid onset of severe shortness of breath, cyanosis (bluish discoloration of the skin of the hands, feet, and around the mouth and spreading centrally), or bleeding from the lungs, stomach and rectum.
Type 2 patients are similar to type 1 patients except they do not die after 3 days. Some but not many of these patients would survive if they had access to an ICU, ventilators and expert medical care but if we have a severe pandemic, those resources will not be widely available. Even if they had access to these services, many of them would die anyway. Remember, no matter what you do, they are likely to pass away in a week to 10 days after becoming ill.
Type 3 patients make up the majority of those that become ill with influenza. Fortunately, these patients have a good prognosis if they receive timely and diligent supportive care that can be provided well in a non-medical setting such as the home. Most of these pandemic flu victims will be severely ill and weakened by the infection such that they will be too ill to get out of bed. Many type 3 patients will be completely dependent on others for care. Without simple care, some of these patients will die from preventable causes like dehydration but with simple care, most of these patients will recover. No matter how good the care provided, some type 3 patients will die. This is not your fault. This happens usually because they develop a serious secondary condition that actually becomes the cause of death. Examples of these secondary conditions include bacterial pneumonia, stroke, and heart attack. There is nothing you can do but keep doing the best you can and let nature take its course.
In my opinion, as a general rule, provide everyone with the same level of supportive care. This is a rational course because it is not always possible to predict who will survive and who will not, especially early in the course of the flu.
http://www.fluwikie.com/annex/WoodsonMonograph.htm
UPI Correspondent
LONDON, Sept. 20 (UPI) -- One of the major concerns inherent in the possible avian-influenza pandemic is the disease's extraordinarily high death rate, which is more than half of known cases. But officials are now questioning whether this is indeed the case.
Both South Korea and Indonesia have recently announced cases of avian-influenza infection in humans that were not identified until after the person in question had been infected by, and had recovered from, the disease.
At the moment, experts say, there has not been enough evidence of mild avian-influenza infection to drastically reduce the disease's mortality rate, nor even to revise it. But, they concur, the possibility merits further study.
Reduced virulence is a possible indicator that avian influenza is preparing itself to become more transmissible -- as this column has noted for the past 11 months, reduced virulence can lead to increased transmissibility, as diseases are less able to infect large swaths of people when they kill their host before the infection has been passed on -- and it is this fact that health officials wish to monitor more closely, especially as the rainy season in Southeast Asia and the autumnal bird migrations are likely to lead to increased reports of both avian and human infections.
Speaking over the weekend and cited by Canada's CBCNews, Dr. Michael Osterholm, avian-influenza expert and director of the University of Minnesota's Center for Infectious Diseases Research and Policy, said: "We need to keep monitoring it.
"Because, frankly, one of the indications that there may be a changing epidemiology with this is, in fact, if we start seeing larger and larger percentages of individuals who are asymptomatic or only mildly ill that we can clearly confirm as having H5N1 infection."
The Indonesian case, which was made public last week, involved a man who had blood tests for H5N1 performed. Although the man was not ill, the test results showed he had been infected with avian influenza, most likely earlier this year, when he cared for his sister, a confirmed bird-flu case.
While looking after his sister, the man had complained of abdominal pain and had suffered from a persistent cough, but his symptoms were so mild that he was not tested for signs of H5N1 infection.
In South Korea five workers who had culled infected poultry between 2003 and 2004 -- out of more than 2,000 who were submitted to blood tests -- were found to have H5N1 antibodies in their blood, a sure sign that they had been infected with the disease at some stage, although none displayed avian-flu symptoms at the time.
While these cases were no doubt lucky to have survived avian flu, and to have suffered from it so mildly, they may in turn be the key to finding a cure for the disease that -- using current rates of infection and mortality -- has killed nearly 60 percent of known cases.
What remains now is for more work to be done into investigating why these lucky few were not only capable of fighting the disease, but did so without even knowing they were infected.
--
The World Health Organization and Indonesia are at odds over what constitutes a human case of avian influenza. The disagreement follows an earlier redefining of human avian-influenza infection in humans by the WHO, which saw the number of confirmed Indonesian cases rise.
The Indonesian Health Ministry has so far abstained from adopting the new definition of bird-flu infection. This refusal will not change the global infection statistics, however, as the official figures are those released by the WHO.
Santoso Soeroso, head of the Health Ministry's avian-influenza verification team, explained that the WHO's definition has been altered so that it is less restrictive, meaning that cases of bird-flu infection can, in theory, be identified and treated earlier.
According to the new WHO standards, those suffering from acute lower respiratory infections -- difficulty breathing, shortness of breath, fever and cough -- should be treated as possible cases of avian influenza.
The Indonesian Health Ministry currently uses acute higher respiratory infection as a sign of possible bird flu.
Soeroso said: "It's like catching fish with big-holed nets. We may be able to identify possible cases when patients reach the stage that the flu is incurable."
--
According to a report in the Financial Times over the weekend, the current Thai political crisis that has resulted in the government being deposed in a bloodless military coup may have contributed to the spread of avian influenza in the country.
Thailand had been working hard to combat the spread of avian influenza in the country's poultry, and until earlier this year it appeared that their efforts had been effective. But an outbreak in poultry along the Mekong River on the Laotian border earlier this summer showed that the virus was still present in a country believed to have defeated it.
Dr. David Nabarro, the United Nations' senior coordinator for avian influenza, told the Financial Times that he thought the changing political face of Thailand -- whose parliament was dissolved earlier this year by former Prime Minister Thaksin Shinawatra, who was ousted this week in a bloodless coup -- may have contributed to the disease's re-emergence.
"You don't maintain control over this disease unless there is regular top-level direction from a committed senior political figure that wants to be sure that the necessary activities are being undertaken," Nabarro said.
http://www.upi.com/ConsumerHealthDaily/view.php?StoryID=20060920-123047-5547r
"His illness was mild and he fully recovered."
World Health Organization - Weekly Epidemiological Record e-mail
bulletin service
DISEASE OUTBREAK NEWS Item(s)published on the World Wide Web
http://www.who.int/csr/don (http://www.who.int/csr/don)
-------------------------
Avian influenza - situation in Iraq - update 5
19 September 2006
The Ministry of Health in Iraq has retrospectively confirmed the
country's third case of human infection with the H5N1 avian influenza
virus. The case, a 3-year-old boy, was hospitalized in Baghdad on 15
March 2006. His illness was mild and he fully recovered.
During its outbreak, which is now considered over, Iraq faced problems
in the shipment of specimens for external verification of diagnostic
tests. For the retrospectively confirmed case, initial test results were
inconclusive, possibly as a result of sample deterioration during
shipment. Repeated testing, using different methods, was needed for
diagnostic confirmation.
The two cases previously confirmed in Iraq occurred in January 2006.
Both cases were fatal.
10 March 2006
Since the beginning of March, the Ministry of Health in Azerbaijian has been investigating a cluster of 10 persons placed under observation for possible infection with the H5N1 avian influenza virus. All of these persons are from the Daikyand settlement in Salyan Rayon in the eastern part of the country.
The Salyan Rayon is located near wetlands frequented by migratory birds. Recent deaths of poultry have been reported in the Daikyand settlement, but the cause of these deaths has not yet been determined. The investigation was launched when two young women, who were neighbours, died within a week of each other. The first patient, a 17-year-old girl, died on 23 February. She was reported to have suffered for more than a year from respiratory symptoms associated with a neoplastic condition. Her death is now thought to have been caused by this pre-existing disease. As a precaution, samples have been taken and will be sent for H5N1 testing at a WHO collaborating laboratory in the United Kingdom.
The second death occurred on 3 March in a 20-year-old woman who died following rapidly progressive acute pneumonia, which is a characteristic feature in many cases of H5N1 infection.
Immediately following the second death, the Ministry of Health initiated daily house-to-house investigations, conducted by four teams of hospital staff, looking for persons in the settlement having respiratory symptoms or fever. As a result, an additional 8 persons were hospitalized for observation. Of these, six showed only mild symptoms. They have fully recovered and have now been discharged from hospital.
http://www.who.int/csr/don/2006_03_10a/en/index.html
One of the major concerns inherent in the possible avian-influenza pandemic is the disease's extraordinarily high death rate, which is more than half of known cases. But officials are now questioning whether this is indeed the case. Both South Korea and Indonesia have recently announced cases of avian-influenza infection in humans that were not identified until after the person in question had been infected by, and had recovered from, the disease.
At the moment, experts say, there has not been enough evidence of mild avian-influenza infection to drastically reduce the disease's mortality rate, nor even to revise it. But, they concur, the possibility merits further study.
Reduced virulence is a possible indicator that avian influenza is preparing itself to become more transmissible -- as this column has noted for the past 11 months, reduced virulence can lead to increased transmissibility, as diseases are less able to infect large swaths of people when they kill their host before the infection has been passed on -- and it is this fact that health officials wish to monitor more closely, especially as the rainy season in Southeast Asia and the autumnal bird migrations are likely to lead to increased reports of both avian and human infections.
Speaking over the weekend and cited by Canada's CBCNews, Dr. Michael Osterholm, avian-influenza expert and director of the University of Minnesota's Center for Infectious Diseases Research and Policy, said: "We need to keep monitoring it.
"Because, frankly, one of the indications that there may be a changing epidemiology with this is, in fact, if we start seeing larger and larger percentages of individuals who are asymptomatic or only mildly ill that we can clearly confirm as having H5N1 infection."
The Indonesian case, which was made public last week, involved a man who had blood tests for H5N1 performed. Although the man was not ill, the test results showed he had been infected with avian influenza, most likely earlier this year, when he cared for his sister, a confirmed bird-flu case.
While looking after his sister, the man had complained of abdominal pain and had suffered from a persistent cough, but his symptoms were so mild that he was not tested for signs of H5N1 infection.
In South Korea five workers who had culled infected poultry between 2003 and 2004 -- out of more than 2,000 who were submitted to blood tests -- were found to have H5N1 antibodies in their blood, a sure sign that they had been infected with the disease at some stage, although none displayed avian-flu symptoms at the time.
While these cases were no doubt lucky to have survived avian flu, and to have suffered from it so mildly, they may in turn be the key to finding a cure for the disease that -- using current rates of infection and mortality -- has killed nearly 60 percent of known cases.
What remains now is for more work to be done into investigating why these lucky few were not only capable of fighting the disease, but did so without even knowing they were infected.
--
The World Health Organization and Indonesia are at odds over what constitutes a human case of avian influenza. The disagreement follows an earlier redefining of human avian-influenza infection in humans by the WHO, which saw the number of confirmed Indonesian cases rise.
The Indonesian Health Ministry has so far abstained from adopting the new definition of bird-flu infection. This refusal will not change the global infection statistics, however, as the official figures are those released by the WHO.
Santoso Soeroso, head of the Health Ministry's avian-influenza verification team, explained that the WHO's definition has been altered so that it is less restrictive, meaning that cases of bird-flu infection can, in theory, be identified and treated earlier.
According to the new WHO standards, those suffering from acute lower respiratory infections -- difficulty breathing, shortness of breath, fever and cough -- should be treated as possible cases of avian influenza.
The Indonesian Health Ministry currently uses acute higher respiratory infection as a sign of possible bird flu.
Soeroso said: "It's like catching fish with big-holed nets. We may be able to identify possible cases when patients reach the stage that the flu is incurable."
--
According to a report in the Financial Times over the weekend, the current Thai political crisis that has resulted in the government being deposed in a bloodless military coup may have contributed to the spread of avian influenza in the country.
Thailand had been working hard to combat the spread of avian influenza in the country's poultry, and until earlier this year it appeared that their efforts had been effective. But an outbreak in poultry along the Mekong River on the Laotian border earlier this summer showed that the virus was still present in a country believed to have defeated it.
Dr. David Nabarro, the United Nations' senior coordinator for avian influenza, told the Financial Times that he thought the changing political face of Thailand -- whose parliament was dissolved earlier this year by former Prime Minister Thaksin Shinawatra, who was ousted this week in a bloodless coup -- may have contributed to the disease's re-emergence.
"You don't maintain control over this disease unless there is regular top-level direction from a committed senior political figure that wants to be sure that the necessary activities are being undertaken," Nabarro said.
Wednesday, 15 March 2006
Bird flu cases have been discovered along the Caspian Sea coast
A stray dog has died of bird flu in the Caspian nation of Azerbaijan, health officials have said - thought to be the first time the virus has killed a dog. Azerbaijan reported its first three human deaths from bird flu on Monday. The World Health Organization has yet to confirm bird flu caused the human deaths, but said the US Navy lab that carried out the tests was reliable.
The deaths of the three young Azeri women would take the WHO total for human deaths from bird flu to 101.
There have been no confirmed cases of one person passing the virus to another. Most people who have contracted it are thought to have been in close contact with domestic poultry.
But scientists fear the virus could mutate into a form that can pass from person to person.
Germany has reported at least three cat deaths from bird flu, which has been spreading from South-East Asia since 2003.
Quarantine
The deadly H5N1 strain of the virus was discovered in migratory bird flocks in Azerbaijan last month.
The government has taken measures to quarantine the two regions where the women died, with entry and exit to their villages being controlled.
Cars were being disinfected and domestic poultry was being confined, Reuters news agency reported.
The dog that died was found in the capital Baku on 9 March, health officials said.
http://news.bbc.co.uk/2/hi/europe/4811284.stm
Ditto, Goju, I couldn't have said it better!
Dr. Niman, I hope you've been taking notes from gsgs's posts :rolleyes: :rolleyes:
gsgs, please don't disappoint me and stop posting. :whistle: Honestly, your posts are so funny that when I read them the tears of laughter stream down my face and I can hardly keep from falling out of my chair!
14 February 2006
10 March 2006
15 March 2006
.
Also, now we have the sequences from Indonesia from humans
and some birds but not the data of the human contacts
and possible exposures which might include some of the tested birds.
So, are these finds with the chickens just random or did they
have some suspicion to test just these chickens ?
I would think that the poultry H5N1 sequences are from dead or dying birds. There have been no reports of asymptomatic H5N1 chickens in Indonesia and the surveillance of poultry remains poor, so it is doubtful that there is any H5N1 from healthy chickens.
......
;)
Of course not. They are avimammalantilians. They hatch from mucilaginous covered eggs. The young suckle until their fur transmorgrifies to feathers, and green/brown scales cover their heads which extend almost down to their beaks. They have strong hind legs for hopping (which taste like chicken when cooked), make deep reverberating throat noises, and are slimy to the touch. They have not yet been tested but their green blood is not thought to be conducive to harboring H5N1 strains. :D
In addition to the normal pets, there's always the mammalian food:
Monkey Toes - Deep fried monkey toes, eat it off the bone.
|
Are aliens mammalian?
If so, what is the probability
that they are the reservoir?
Have they been
tested?
;)
I think Mellie is on the right track. Quail are looking more and more suspicious.
some evidence now- why should it be mammalean ?
It could be ducks, ducks can be asymptomatic, ducks can fly,
H5N1 was already found in lots of ducks and H5N1 does evolve
in ducks, which could explain how the virus was formed in
Indonesia prior to the first human cases in 2005.
The problem with ducks is, however that other ducks also have the
Indonesian avian virus and how do we explain why these two strains
didn't mix ? It could be some group of ducks which doesn't come into
contact with the chicken-virus-ducks but does come into contact
with other RESRRKKR-ducks.
It could be pigs. But then the virus would have circulated and
evolved in pigs prior to 2005. But virus evolution in pigs is
often slower and pigs don't come so much around as ducks.
Most pigs are domestic and pigs with unusual disease would
have been noticed. The viruses found in Indonesian pigs were chicken-viruses
AFAIK. And how do the pigs infect the humans in Java ?
The source should have been not so hard to find, if it were pigs.
If all the human cases in Java would come from a pig-source,
how could they miss it ? Maybe uncooked pork ? But then others
eating the same pork or butchers should have been infected too.
It could be cats. One cat with the human RESRRKKR sequence
had been found. We know that cats can be infected and spread
the virus from cat to cat. But this has been examined and we
should have heard about it, if that suspicion had caused evidence.
They are probably tracing possible cat-contacts of the human cases.
It could be insects. That would explain why it's so hard to find
the vector. But it should be insects then, where the virus could
evolve in 2003,2004 to form the current strain which is different
from the chicken-strain. So there should be insect-to-insect
transmission while the insects only rarely get it from chickens or ducks,
else the strains would mix which we don't observe.
And how do the humans get it from the insects ? Through blood
with mosquitos ? Or saliva from flies sitting and eating from human
food ?
It could be ... something else.
The match of the human sequences in Java is with chicken sequences from Sumatra. There is a great deal of micing and matching, but the selection of isolates for sequencing is biased..
17:54:50 EDT Sep 17, 2006
Canadian Press: HELEN BRANSWELL
("It's still a plausible hypothesis but it's becoming a less likely one," Nicoll said of the notion that there may be a significant number of asymptomatic and mild cases of the disease.
"My bottom line would be: I'm sure we're going to find the occasional mild case. I'm sure we're going to find, eventually, an asymptomatic (case)," he said from Sweden.
"Even if you find just a few asymptomatic and mild cases, that's not going to change the our risk assessment."
http://www.cbc.ca/cp/health/060917/x091704.html
These guys really don't get it. Sequence analysis of H5N1 in Indonesia suggests the human H5N1 infections are NOT coming from birds. Those exposed to the hidden reservoir are not tested.
Testing people in Cambodia, where there are few cases of humnan H5N1 would not be the likely location of mild cases.
Also, now we have the sequences from Indonesia from humans
and some birds but not the data of the human contacts
and possible exposures which might include some of the tested birds.
So, are these finds with the chickens just random or did they
have some suspicion to test just these chickens ?
http://www.weird-food.com/weird-food-mammal.html
Another possibility for Thailand is RAT....
| Rat (Thailand) | Rat (Northern Thailand, Karen Hill Tribe) In the Karen Hill Tribe village in northern Thailand (near the Mayanmar border) breakfast was described as 'small animal' which was clearly a rat, cooked whole over an open fire, then served in a bowl of extremely hot chili stock with a bowl of glutinous sticky rice. The whole family shares this one dish. The Karen people do keep domestic farm animals like pigs, chickens and buffalo, but these are only slaughtered for food on very special occasions. Everyday food is sourced from hunting in the jungle, so consists of whatever small animals end up on the wrong end of a sling shot (and these guys are good with a sling shot!). Rat was quite a tasty way to start the day, the meat tastes a bit like rabbit (and those chilies are HOT!), but needless to say I didn't eat too much... . |
H5N1 antibodies were found in Indian poultry workers.
Indonesia has many varieties of H5N1 in humans.
Maybe not so obvious. I thought you meant human mammals. AD apparently thought of other vectors.
So if it's cats or dogs wouldn't you get more cats/dogs in the sequences? sorry if this is a dumb question, this is a bit above my level of education. I only noticed the one cat sequence.
17:54:50 EDT Sep 17, 2006
Canadian Press: HELEN BRANSWELL
I'm sure we're going to find, eventually, an asymptomatic (case)," he said from Sweden.
http://www.cbc.ca/cp/health/060917/x091704.html
Earth to Canada (or Sweden). Asymptomatic patients with H5N1 antibodies have been reported in Hong Kong (1997), India (2002), South Korea (2003), Japan (2204), and Vietnam (2005).
some evidence now- why should it be mammalean ?
It could be ducks, ducks can be asymptomatic, ducks can fly,
H5N1 was already found in lots of ducks and H5N1 does evolve
in ducks, which could explain how the virus was formed in
Indonesia prior to the first human cases in 2005.
The problem with ducks is, however that other ducks also have the
Indonesian avian virus and how do we explain why these two strains
didn't mix ? It could be some group of ducks which doesn't come into
contact with the chicken-virus-ducks but does come into contact
with other RESRRKKR-ducks.
It could be pigs. But then the virus would have circulated and
evolved in pigs prior to 2005. But virus evolution in pigs is
often slower and pigs don't come so much around as ducks.
Most pigs are domestic and pigs with unusual disease would
have been noticed. The viruses found in Indonesian pigs were chicken-viruses
AFAIK. And how do the pigs infect the humans in Java ?
The source should have been not so hard to find, if it were pigs.
If all the human cases in Java would come from a pig-source,
how could they miss it ? Maybe uncooked pork ? But then others
eating the same pork or butchers should have been infected too.
It could be cats. One cat with the human RESRRKKR sequence
had been found. We know that cats can be infected and spread
the virus from cat to cat. But this has been examined and we
should have heard about it, if that suspicion had caused evidence.
They are probably tracing possible cat-contacts of the human cases.
It could be insects. That would explain why it's so hard to find
the vector. But it should be insects then, where the virus could
evolve in 2003,2004 to form the current strain which is different
from the chicken-strain. So there should be insect-to-insect
transmission while the insects only rarely get it from chickens or ducks,
else the strains would mix which we don't observe.
And how do the humans get it from the insects ? Through blood
with mosquitos ? Or saliva from flies sitting and eating from human
food ?
It could be ... something else.
#If you have any other info about this subject , Please add it free.# |
