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Re: Egypt - Human Confirmed/Suspected Bird Flu Cases, Feb 8, 2009+
Although the above comments are well into the nonsense category and ignore data that is well into the obvious category, it is worth reviewing the recent data in Egypt, since these developments may be among the most important to date with regard to a catastrophic H5N1 pandemic.
The recent cases (including those from the beginning of 2009) are described in detail here
These description are from the MOHP in Egypt and cover the confirmed cases. As of this morning, the two most recent cases (#61 and #62 from Beheira) have not been added, but media reports indicate both are toddlers, and their conditions suggest that like almost all cases in 2009, these two H5N1 cases are mild.
The toddler classification is straightforward because each description begins with age and gender and 10 of the 11 cases in 2009 are toddlers. This is far from the "normal" in Egypt or anywhere else, where most victims are teenagers or young adults. In Egypt, prior to 2009 there were 51 confirmed cases, and only 6 were toddlers. This rate of about 12% was the same in 2006, 2007, and 2008. Therefore, the jump to 10/11 or more than 90% in 2009 is rather glaring, and increasingly so. The February report at the above site noted that the first 4 patients in 2009 in Egypt were toddlers, and now that the number has grown to 10/11, the trend is obvious to even the most casual observer.
Similarly, the classification of these patients as "mild" is also straight forward. Of the 11 cases in 2009, only one patient was initially listed as "critical" and in need of a respirator. However, since that patient was admitted on April 1, and the last confirmed fatality was in 2008, it is almost certain that the one critical patient has recovered, and the number of H5N1 confirmed patients that are discharged will be 11, giving a case fatality rate of ZERO.
However, the "mild" classification goes well beyond recovery and discharge. Most of these patients develop symptoms on day 1, are hospitalized and started on Tamiflu on day 2, and are confirmed on day 4. An official announcement immediately follows and by day 4/5 it is already clear that the case is "mild". The only adult confirmed this year was actually symptom free by day four, while the others have been described as in "good" general health or "stable". These reports have not hinted that the patient developed pneumonia, was placed on a respirator, or was ever classified as "critical".
Thus, 10/11 patients in 2009 were toddlers, 10/11 had a "mild" infection, and 11/11 have or will recover from the infection.
This situation is also noteworthy, because there are zero children (age 3-10) infected, who made up the vast majority of cases in the spring of 2007, when 16/17 recovered, and zero female teenagers / young adults, who have made up the majority of cases, excluding cases for 2009 or the spring of 2007. This teenage/young adult group contains the vast majority of the 23 fatalities.
Thus, none of the two major groups infected prior to 2009 have been reported this year, while the frequency of toddler cases rose almost 10 fold.
This new demographic is not explained by a sudden increase in toddler exposure to H5N1, and is most easily explained by protective immunity (either against H5N1 or cross protective immunity due to exposure of H1N1).
Thus, the new demographic (mild H5N1 in toddlers) is well into the GLARING category, as well as a cause for concern, especially if the protection is from prior exposure to H5N1.
Originally posted by Drew
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The recent cases (including those from the beginning of 2009) are described in detail here
These description are from the MOHP in Egypt and cover the confirmed cases. As of this morning, the two most recent cases (#61 and #62 from Beheira) have not been added, but media reports indicate both are toddlers, and their conditions suggest that like almost all cases in 2009, these two H5N1 cases are mild.
The toddler classification is straightforward because each description begins with age and gender and 10 of the 11 cases in 2009 are toddlers. This is far from the "normal" in Egypt or anywhere else, where most victims are teenagers or young adults. In Egypt, prior to 2009 there were 51 confirmed cases, and only 6 were toddlers. This rate of about 12% was the same in 2006, 2007, and 2008. Therefore, the jump to 10/11 or more than 90% in 2009 is rather glaring, and increasingly so. The February report at the above site noted that the first 4 patients in 2009 in Egypt were toddlers, and now that the number has grown to 10/11, the trend is obvious to even the most casual observer.
Similarly, the classification of these patients as "mild" is also straight forward. Of the 11 cases in 2009, only one patient was initially listed as "critical" and in need of a respirator. However, since that patient was admitted on April 1, and the last confirmed fatality was in 2008, it is almost certain that the one critical patient has recovered, and the number of H5N1 confirmed patients that are discharged will be 11, giving a case fatality rate of ZERO.
However, the "mild" classification goes well beyond recovery and discharge. Most of these patients develop symptoms on day 1, are hospitalized and started on Tamiflu on day 2, and are confirmed on day 4. An official announcement immediately follows and by day 4/5 it is already clear that the case is "mild". The only adult confirmed this year was actually symptom free by day four, while the others have been described as in "good" general health or "stable". These reports have not hinted that the patient developed pneumonia, was placed on a respirator, or was ever classified as "critical".
Thus, 10/11 patients in 2009 were toddlers, 10/11 had a "mild" infection, and 11/11 have or will recover from the infection.
This situation is also noteworthy, because there are zero children (age 3-10) infected, who made up the vast majority of cases in the spring of 2007, when 16/17 recovered, and zero female teenagers / young adults, who have made up the majority of cases, excluding cases for 2009 or the spring of 2007. This teenage/young adult group contains the vast majority of the 23 fatalities.
Thus, none of the two major groups infected prior to 2009 have been reported this year, while the frequency of toddler cases rose almost 10 fold.
This new demographic is not explained by a sudden increase in toddler exposure to H5N1, and is most easily explained by protective immunity (either against H5N1 or cross protective immunity due to exposure of H1N1).
Thus, the new demographic (mild H5N1 in toddlers) is well into the GLARING category, as well as a cause for concern, especially if the protection is from prior exposure to H5N1.
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