Pakistan: Suspected Human Cases December 10 - December 17, 2007

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

map

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Yeah -- and who's Tariq?:

http://www.flutrackers.com/forum/showpost.php?p=115297&postcount=5

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Yeah -- and who's Tariq?:
http://www.flutrackers.com/forum/sho...97&postcount=5

You've got me
add this to further muddy the mess...

After the blood samples of both the brothers were sent for formal testing in Laboratory, it was found that both brothers died due to Bird Flu virus (H5N1)

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother?s blood sample could not be collected, health experts talking to ?The News? said clinical evidence suggests that he too succumbed to the deadly virus. The blood samples of two of the three brothers were received by the National Institute of Health on October 28.

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

Reconstructed timeline
<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p></o:p>
Based on Post #20.
<o:p></o:p>
H5N1 poultry outbreak on October 21 at Abbottabad.
<o:p></o:p>
Dr. Ishtiaq Durrani is involved with culling of 3000 birds and gets infected and eventually tests positive.
<o:p></o:p>
A day laborer from Mansehra involved in the culling also gets infected and eventually tests positive. <o:p></o:p>
<o:p></o:p>
Dr. Ishtiaq Durrani becomes ill and is treated at Khyber Teaching Hospital. <o:p></o:p>
<o:p></o:p>
His two brothers Mohammad Ilyas Durrani and Mohammad Owais Durrani attend to him in the hospital. <o:p></o:p>
<o:p></o:p>
Both brothers become sick. Samples are collected from Dr. Ishtiaq and Ilyas and are sent to lab for processing on October 28th. (Both tested positive). No sample was apparently collected from Owais. <o:p></o:p>
<o:p></o:p>
Mohammad Ilyas Durrani dies on Monday, November 19th. He is the first H5N1 casuality in <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" /><st1:country-region w:st="on"><st1:place w:st="on">Pakistan</st1:place></st1:country-region>.<o:p></o:p>
<o:p></o:p>
Mohammad Owais Durrani dies on November 29th.

December 10, the news story breaks (see Post #1) about H2H transmission among three human cases, 2 died. The story notes that samples were collected ?3 weeks ago? which would place the sample collect date at least back to November 19th. This breaking news references the three brothers, Ishtiaq Durrani, Mohammad Ilyas Durrani, and Mohammad Owais Durrani. <o:p></o:p>
<o:p></o:p>
Post #3 implies that that both brothers died on Monday (December 10th), which is quoted in the Pro-Med post #17 above. This is most likely an error and the brothers died in mid to late November. The news on the human cases didn?t surface until December 10th and was initially presented as being immediate and current, which may have caused the confusion.
So far, thiere is no more information about the status of day laborer poultry worker who apparently tested positive.

Any suggestions about this sequence of events? <o:p></o:p>

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Samples are collected from Dr. Ishtiaq and Ilyas and are sent to lab for processing on October 28th. (Both tested positive). No sample was apparently collected from Owais.

Mohammad Ilyas Durrani dies on Monday, November 19th. He is the first H5N1 casuality in Pakistan.

I thought this could read as though Ilyas -- the first brother that died -- was actually the one tested...

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother's [Mohammad Owais'] blood sample could not be collected, health experts talking to 'The News' said clinical evidence suggests that he too succumbed to the deadly virus.

??

Maybe Mohammad Owais was reluctant to be tested or something?

Not convinced by my own argument here. I just think it's a possibility.

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Reconstructed timeline
<o:p></o:p>

Any suggestions about this sequence of events? <o:p></o:p>

Is Tariq a nickname for Mohammad Owais or is this reporter error?

Another error? post #4

After the blood samples of both the brothers were sent for formal testing in Laboratory, it was found that both brothers died due to Bird Flu virus (H5N1)

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

My opinions --

I think Niko is right that there are four "confirmed" and "reported" cases.
Dr. Ishtiaq Durrani, Mohammad Ilyas Durrani, and Mohammad Owais Durrani, and an unnamed poultry worker. Only three of which have been sampled and tested.

So Niman may be correct that there is at least one other individual who has tested postive. It may be one of the two indviduals that are under observation, the "labourer?s daughter" or "another male". If so that would make either a separate cluster of 2 individuals or all of these individuals are part of one big cluster.


I think that Tariq is probably Mohammad Owais Durrani, since the news report identifies him as a brother to Ilyas and as having died. Maybe a reporting error in one of the reports about whether or not Owais was actually sampled. If he was, then there is no mysterious fourth individual who has tested positive.

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Reporters repeating errors???

Bird flu claims first two lives in Pakistan
Friday December 14, 2007 (0923 PST)

PESHAWAR: The administration of Khyber Teaching Hospital on Thursday confirmed that two brothers Mohammad Ilyas and Tariq, who were brought to the hospital from Mansehra on suspicion of carrying H5N1, died of bird flu Monday last.


?The two brothers have been confirmed as bird flu victims and are the first human sufferers of the disease in our country,? Dr Siddiqur Rahman, Acting Chief Executive of KTH, told media on Thursday.


Mohammad Ilyas and Tariq were working at a poultry farm in Mansehra and were brought to KTH in a serious condition. They were suffering from pneumonia and were kept in the isolation ward, said Dr Rahman.


One of them was in critical condition at the time of arrival, Dr Rahman said. He added that the Ministry of Health after their expiry took blood samples and sent them to Islamabad to verify if they were carrying Bird Flu virus (H5N1). ?Then I don?t know what happened to the test,? he added.


Meanwhile, some reports on Thursday suggested that the laboratory test conducted in Islamabad confirmed Bird Flu influenza. A spokesman of Health Ministry in Islamabad said that they had died of bird flu, adding both the brothers were working in a poultry farm in Mansehra and had direct link with the chickens that resulted in the transfer of the virus (H5N1) into them.
End.

http://paktribune.com/news/index.shtml?195522

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

This news article states that "Bird flu claims first two lives in Pakistan" on Monday (December 10th). Yet, other posts indicate that the "first" H5N1 death in Pakistan was Mohammad Ilyas Durrani who died on November 19th. These news reports can't all be true.

Hopefully, a spokesperson from the Pakistan Ministry of Health will make a public announcement and clarify the situation on human cases of H5N1 in Pakistan.

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

This news article states that "Bird flu claims first two lives in Pakistan" on Monday (December 10th). Yet, other posts indicate that the "first" H5N1 death in Pakistan was Mohammad Ilyas Durrani who died on November 19th. These news reports can't all be true.

Hopefully, a spokesperson from the Pakistan Ministry of Health will make a public announcement and clarify the situation on human cases of H5N1 in Pakistan.

Hear! Hear! Until then, I'm done! Off to nurse my headache.....

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives

I think there could be as many as 8 patients. My guess is that the 40 samples collected were from contacts with the farm (owner, workers, cullers). These samples were collected and tested in October. There were four positives. One was the vet and another was the culler. The other two could be cullers not named. After that first wave, the two brothers of the vet were developed symtoms (H2H2H). One tested positive the other wan't tested (but both died from H5N1). Next the daughter of the positive culler developed symptoms, as did a male (possibly a contact) and both are still hospitalized.

All of the above link back to the small October cull of 3000 birds. Since then there have been more outbreaks and probably more suspect cases who have not been reported / tested, which led to the hospital alert.

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

I think there could be as many as 8 patients. My guess is that the 40 samples collected were from contacts with the farm (owner, workers, cullers). These samples were collected and tested in October. There were four positives. One was the vet and another was the culler. The other two could be cullers not named. After that first wave, the two brothers of the vet were developed symtoms (H2H2H). One tested positive the other wan't tested (but both died from H5N1). Next the daughter of the positive culler developed symptoms, as did a male (possibly a contact) and both are still hospitalized.

All of the above link back to the small October cull of 3000 birds. Since then there have been more outbreaks and probably more suspect cases who have not been reported / tested, which led to the hospital alert.

See post #3

...Pakistan has reported 76 outbreaks of Bird Flu in 2007, the latest being on November 22 at Mansehra. Of these, 56 outbreaks involved commercial and backyard poultry and 20 outbreaks were reported in wild birds, mostly crows....

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

Niman may be correct that there are more than 4 human cases from more than one outbreak in this area of Pakistan.

Thirty total poultry outbreaks are reported by OIE for 2007 in Pakistan. Post #1 notes that Dr Ishtiaq Durrani was tasked with culling the 3000 hens on the ?Ijaz Shah Poultry Farm in Abbotabad? from October 21 to 23. This outbreak, in Abbottabad District, has a start date of October 19, as posted by OIE.

The last reported poultry outbreak by OIE is on October 23, at Farm M/S Ahtasham, Batal, in Mansehra District, about 11 miles north of the outbreak in Abbottabad.

But as Niko points out above there has been at least one other poultry outbreak in Mansehra District on November 22 and many other outbreaks in Pakistan unreported to OIE.

The 40 human samples that have been processed in Pakistan were collected from individuals in ?Peshawar and Abbottabad? (Post #19). It seems that the four positive samples were from Abbottabad because there has been no reports of human cases from Peshawar District.

BUT, post #19 refers to positive results from a ?Mansehra-based poultry handler?, and post #4 states ?two brothers Muhammad Ilyas and Tariq working in a poultry farm in Mansera suffered flu?. This suggests that several of the infected individuals are from or worked in Mansehra District, where samples have yet to be processed or at least the results have not yet been made public.

As shown in the map below the two OIE reported outbreaks are in different districts. It may be that news reports are confusing cases between several separate areas from two separate Districts. Niman may be correct that there could be as many as 8 or more human cases of H5N1 in this area of Pakistan.

Official news releases from the Pakistan Ministry of Health would clear up a lot of this confusion.

[wetDirt]

Re: Pakistan: Bird Flu claims 2 lives

I think there could be as many as 8 patients. My guess is that the 40 samples collected were from contacts with the farm (owner, workers, cullers). These samples were collected and tested in October. There were four positives. One was the vet and another was the culler. The other two could be cullers not named. After that first wave, the two brothers of the vet were developed symtoms (H2H2H). One tested positive the other wan't tested (but both died from H5N1). Next the daughter of the positive culler developed symptoms, as did a male (possibly a contact) and both are still hospitalized.

All of the above link back to the small October cull of 3000 birds. Since then there have been more outbreaks and probably more suspect cases who have not been reported / tested, which led to the hospital alert.

And perhaps the vet was on tamiflu, but the cullers weren't

[Gert van der Hoek]

Re: Pakistan: Bird Flu claims 2 lives

Pakistani men suspected of being country's first bird flu victims

Fri, 14 Dec 2007


Islamabad - Two brothers who suddenly died after becoming ill at a chicken farm in north-west Pakistan are suspected of being the country's first bird-flu victims, health officials said Friday. The men died at least 10 days ago, but the Pakistani government did not disclose their deaths and has refused to confirm test results of whether they succumbed to the H5N1 avian influenza virus.

The victims, whose names were not released, were in the 20s and 30s and worked together on a chicken farm in Manshera, North-West Frontier Province, and had direct contact with birds, said Dr. Siddiqur Rahman, chief medical officer at the Khyber Teaching Hospital in Peshawar, the provincial capital.

He said the men were brought into the hospital in critical condition "about 10 days ago" suffering from pneumonia and died soon after.

"After having suspicions that the deaths were caused by bird flu, we informed the Health Ministry, which took blood samples and sent them to the (government) laboratory in Islamabad," Rahman told Deutsche Presse-Agentur dpa.

Dr. Mazhar Barjis, chief public health officer at the National Institute of Health in Islamabad, which houses the laboratory, said testing of the samples was underway.

"We will inform the public of the results in a couple of days," he said.

Health officials declined to say why the Islamabad government did not disclose the men's deaths, or why it was taking so long to analyze the blood samples for bird flu, a process that should only take a few days.

Pakistan does not have any recorded human cases of bird flu, according to the World Health Organization. However, there were two significant outbreaks among poultry populations on chicken farms in 2006 and in June of this year, prompting health officials to cull some 50,000 birds.

http://www.earthtimes.org/articles/show/158589.html