Graph - Human versus Poultry Infections by Country

[Laidback Al]

Comparison of the number of poultry infections with the number of WHO confirmed human cases by country

Human case data through March 1, 2007: http://www.who.int/csr/disease/avian.../en/index.html
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Poultry outbreak data through January 26, 2007: http://www.oie.int/downld/AVIAN%20IN...26_01_2007.pdf
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[Laidback Al]

Re: Graph - Human versus Poultry Infections by Country

UPDATE

Comparison of the number of reported poultry infections with the number of WHO confirmed human cases by country through Feb 12, 2008

Human case data through Feb 12, 2008: http://www.who.int/csr/disease/avian.../en/index.html

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Poultry outbreak data through Feb 11, 2008: http://www.oie.int/eng/info_ev/en_AI_factoids_3.htm

[JohnW]

Re: Graph - Human versus Poultry Infections by Country

Does the number of poultry infections represent the number of separate incidents or the total number of birds found infected?

[Laidback Al]

Re: Graph - Human versus Poultry Infections by Country

Does the number of poultry infections represent the number of separate incidents or the total number of birds found infected?

It is not the total number of birds infected. I think the counting unit is an "outbreak", but I am not sure how it is determined. I don't know if a reporting event is counted only once until it is resolved or, if each flare up on a different farm, for example as in West Bengal, is treated as a separate "outbreak".

[Shannon Bennett]

Re: Graph - Human versus Poultry Infections by Country

Next question I am sure everyone is thinking. Why do three of these countries show no human cases despite quite high bird cases? Is there a strain in Myanmar, Pakistan and Nigeria, that is far different?

[Laidback Al]

Re: Graph - Human versus Poultry Infections by Country

Next question I am sure everyone is thinking. Why do three of these countries show no human cases despite quite high bird cases? Is there a strain in Myanmar, Pakistan and Nigeria, that is far different?

A point of clarification. The graph only shows the list of countries with WHO confirmed cases. Myanmar, Pakistan, Nigeria (as well as Djibouti) all have only reported one confirmed case each. But Shannon's question is still valid. What medical, social, or political factors could account for such a low frequency of human cases in these countries with high numbers of poultry outbreaks?

[kent nickell]

Re: Graph - Human versus Poultry Infections by Country

here are a few I would suggest...

medical - lack of resources for good testing, many other serious diseases in the area
social - stigmatization issues, loss of livlihood for yourself and neighbors
political - fear of panic, economic losses

[JohnW]

Re: Graph - Human versus Poultry Infections by Country

A point of clarification. The graph only shows the list of countries with WHO confirmed cases. Myanmar, Pakistan, Nigeria (as well as Djibouti) all have only reported one confirmed case each. But Shannon's question is still valid. What medical, social, or political factors could account for such a low frequency of human cases in these countries with high numbers of poultry outbreaks?

This was exactly the question I was trying to raise in my "H5N1 Puzzle". What is the possibility of getting a chart like the WHO yearly charts by country, but showing both human and avian events? Is there an onset of avian activity prior to the rise in human cases? Do the human cases then decline when the avian cases decline?

[Shannon Bennett]

Re: Graph - Human versus Poultry Infections by Country

Bird cases signal infection is present. Human cases, nearly always follow the death of poultry.

It would be highly unlikely for birds to die in significant numbers and not infect a human. The graph while interesting, is in my estimation flawed. As in all statistical analysis, outliers should always be examined closely. The number of bird outbreaks compared to the human infections is fairly steady except in those three countries. I know of no strain, protocol or, social behavior to account for the differences. More likely as Kent noted above, for political, economic, or social reasons, locals do not measure the actual number of human cases. They just aren't found or they aren't reported.

[Laidback Al]

Re: Graph - Human versus Poultry Infections by Country

There is always the possibility that in some countries information on human cases is repressed.