Pakistan: Human H5N1 Cluster December 2007

[Niko]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

It's just odd that they both died on the same day. If in fact they died on the 10th, this would be after the "flurry of activity" regarding the brother who flew back to the USA.

One report indicated that the brother returned to the USA after attending the funeral(s) of his brothers.

Maybe someone more familiar with Pakistani culture could weigh in on this - are funerals usually held within 1-2 days? If so, it is conceivable that he attended the funeral on Tuesday, caught a flight back to the USA Tuesday or Wednesday and was cleared by the CDC today.

Added: None of this jives with " 6) The flurry of activity surrounding this event occurred last weekend." from F1's post #90

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

They have to stop referring to these two guys as Pakistan's first suspected fatalities. The brothers of the vet are the first suspected fatalities -- not these poultry farm workers.

Actually one of the vet's brother was a CONFIRMED H5N1 fatality, at least according to one media report.

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Actually one of the vet's brother was a CONFIRMED H5N1 fatality, at least according to one media report.

Oh, I see! -- so these poultry workers are the first suspected cases -- the brothers of the vet were never suspected cases -- they're 'just' confirmed cases.

What a mess of reporting! Thanks so much to everybody for sorting through it all (while I was happily away from the computer today -- that'll teach me!).

 

[sharon sanders]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

One report indicated that the brother returned to the USA after attending the funeral(s) of his brothers.

Maybe someone more familiar with Pakistani culture could weigh in on this - are funerals usually held within 1-2 days? If so, it is conceivable that he attended the funeral on Tuesday, caught a flight back to the USA Tuesday or Wednesday and was cleared by the CDC today.

Added: None of this jives with " 6) The flurry of activity surrounding this event occurred last weekend." from F1's post #90

It was clearly indicated to me that the activity revolving around this brother was last weekend.

A detailed press release would be nice.

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

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http://www.gulf-times.com/site/topi...=190077&version=1&template_id=41&parent_id=23

<TABLE class=RedTableBorder style="HEIGHT: 483px" cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR style="PADDING-LEFT: 10px" vAlign=top><TD class=articalTitle align=middle>Probe into human-to-human bird flu transmission

<TABLE cellSpacing=0 cellPadding=0 width=430 border=0><TBODY><TR><TD class=dates id=hDate height=27>Published: Saturday, 15 December, 2007, 02:44 AM Doha Time</TD></TR></TBODY></TABLE></TD></TR><TR style="PADDING-RIGHT: 12px; PADDING-LEFT: 10px"><TD class=articalBody id=artical1 vAlign=top height=345>ISLAMABAD: Health officials yesterday were investigating a possible human-to-human transmission of bird flu among four brothers in north-west Pakistan, two of whom later died.
Khushnood Akhtar, secretary in Pakistan's Ministry of Health, said the bird flu cases occurred last month in Manshera, North-West Frontier Province (NWFP), when a man contracted the H5N1 virus while working on a poultry farm and helping to cull sick birds.
Human-to-human transmissions are extremely rare, with only three previous cases in Indonesia, Cambodia and Vietnam.
The Pakistani man, who has not been identified, survived the virus, but may have infected three of his brothers, none of whom had ever been to the farm or were believed to have been in contact with sick birds, Akhtar said.
Two of the brothers died from pneumonia-like symptoms but were buried by family members before health officials could take blood samples to test for the virus.
A third brother who lives in the US but was visiting Manshera at the time also tested positive for bird flu, but survived and has since returned to the US, Akhtar said.
"The two brothers died and we suspect that they might have died because of the human transmission of the H5N1 virus," he said. "We have requested the World Health Organisation (WHO) send a team to the area so we can find out exactly what happened there."
WHO officials in Islamabad could not be reached for comment.
Globally, bird flu has killed at least 208 people worldwide out of 339 cases since 2003. Most human cases of H5N1 are linked to contact with infected birds, but experts fear the virus might mutate into a form that spreads easily among humans, potentially sparking a pandemic that could kill millions of people.
The two Pakistani brothers who survived are the first confirmed people in Pakistan to contract the virus, while health officials are not sure whether they will be able to confirm that the two who died succumbed to bird flu. - DPA </TD></TR><TR><TD>

</TD></TR></TBODY></TABLE>

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

I don't think this adds any new info, but the Arab press has picked up on the Pakistan story. This article is from a Kuwaiti paper....

Google-translated from Arabic:

Murder victim 93 in Indonesia, two brothers in Pakistan and closes protected in Hong Kong
The disease strikes bird wings of the state to another and leave behind victims
Dec 15, 2007

Capitals agencies:

Still disease jumper "bird flu" is a threat to food security and life together, moving from State to State.

(...)

Pakistan

In Asla Abad Pakistani health officials said yesterday, Friday, that the two brothers died suddenly after noon by severe fatigue in a poultry farm in northwestern Pakistan suspected they were the first victims of bird flu in the country.

Two men died and at least ten days earlier but the Pakistani government did not reveal their death and refused to confirm the results of tests on whether they had died due dynasty H5N1 of the avian influenza virus.

He said Chief Medical Officer hospital Khyber educational regional capital Peshawar great friend Rahman that the two victims who did not disclose their names in the twenties and thirties of age and were working together in a poultry farm in the Manchera North West Frontier Province and were Hikhaltan poultry directly.

He added that the two men who were taken to the hospital in critical condition "Ten days ago" were suffering from pneumonia and died shortly thereafter.

(...)

http://www.alwatan.com.kw/Default.aspx?MgDid=578068&pageId=69

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

The CIDRAP folks are confused, too....

Pakistan suspects first human H5N1 cases

Lisa Schnirring * Staff Writer

Dec 14, 2007 (CIDRAP News) ? Reports of suspected human H5N1 avian influenza cases among brothers in Pakistan are raising fresh fears in the global health community of human-to-human transmission of the virus, amid uncertainty about how a father-son pair in China contracted their H5N1 infections.

Media outlets in Pakistan have been reporting on a possible family cluster in the northwestern part of the country over the past few days, but the sources of the information were often murky, and the details of the cases were confusing and often contradictory. And even though today's news reports flesh out more details about the suspected cases, they still contain contradictory statements.

If the World Health Organization (WHO) confirms the Pakistani cases, they would represent the country's first reported appearance of the H5N1 virus in humans in Pakistan.

Confusion, concern in Pakistan

Today an anonymous source in Pakistan's health ministry told Kuwait News Agency (KUNA) that authorities are testing samples from two poultry farm workers who died in a hospital isolation ward from suspected H5N1 infections. The ministry official said the brothers are from Mansehra district and were admitted to a hospital in Peshawar, in northern Pakistan, KUNA reported.

"We have received their blood samples, and they have been sent to laboratory for clinical analysis," the ministry official told KUNA, adding that results are expected tomorrow.

The Mansehra district where the men are from has experienced H5N1 in poultry, and thousands of birds have been culled in the area, the KUNA report said.

Khushnood Akhtar, secretary of Pakistan's health ministry, said the cases occurred in November but said that four brothers are involved, Deutsche Presse-Argentur (DPA) reported today. One of the men, who worked on a poultry farm, may have contracted the H5N1 virus after he helped cull sick birds, Akhtar told DPA.

The man survived but may have infected three of his brothers, none of whom had been at the farm or in contact with sick birds, Akhtar said in the DPA report. The DPA report appears to contradict the KUNA story, which said the two men in its report were farm workers.

Akhtar told DPA that two of the brothers died of pneumonia-like symptoms but were buried before health officials could obtain blood samples, which appears to contradict what the anonymous health ministry official told KUNA.

A third brother who lives in the United States and was visiting Mansehra also tested positive for the H5N1 virus, but survived and returned to his US home, Akhtar told DPA.

"We have requested the WHO to send a team to the area so we can find out exactly what happened there," he said in the DPA report....

http://www.cidrap.umn.edu/cidrap/content/influenza/avianflu/news/dec1407pakistan-jw.html

 

[gjs47]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

but survived and returned to his US home

Excuse me..... US home??? Where in the US home? Does that concern anyone besides me?

 

[Snowy Owl]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Many are concern gjs47, read the previous pages of this thread you will see that we have contact 'boots on the ground'' and have been told that a media release will be done by the CDC.

It appears that this matter has been taken care of diligently around last week end.

For now we are in the wait and see mode, but we did have confirmation that the matter was taken care.

Snowy

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Five cases of bird flu confirmed



<CENTER>By Baqir Sajjad Syed</CENTER>
ISLAMABAD, Dec 14: The Health Ministry on Friday confirmed that five people had been affected by bird flu, but challenged the veracity of two reported deaths linked to the H5N1 infection.

Confirming the bird flu cases, federal health secretary Khushnood Lashri said the infected patients had been quarantined and precautionary steps were being taken in cooperation with the Ministry of Food, Agriculture and Livestock to check further spread of the disease.

Three of the patients are in a hospital in Mansehra and the other two cases have been reported from Peshawar. One of the patients had been discharged from the hospital after recovery, health authorities said.

The last confirmed case had been reported on Dec 5 and there had been no fresh case, a senior health official said.

Stocks of Tamiflu, an antiviral drug used for influenza virus, have been rushed to the affected districts to meet any eventuality.

The two brothers, who were reported to have died of bird flu, were poultry workers and related to two other patients. However, the authorities were still trying to determine if the recent cases involved human-to-human transmission.

Most human cases of H5N1 are linked to contact with infected birds, but experts fear the virus might mutate into a form that spreads easily among humans, potentially sparking a pandemic that could kill a large number of people.

Human-to-human transmissions are extremely rare, with only three previous cases in Indonesia, Cambodia and Vietnam.

Mr Lashari said there was not enough evidence that the two casualties in Peshawar were victims of bird flu.

?Two brothers died from pneumonia-like symptoms, but were buried by family members before health officials could take blood samples to test for the virus.?

The World Health Organisation, he said, had been taken on board about the situation.

Symptoms of bird flu in humans have ranged from typical human influenza-like symptoms ? fever, cough, sore throat, and muscle aches to eye infections, pneumonia, severe respiratory diseases and other life-threatening complications.

So far this year Pakistan has reported 79 outbreaks of bird flu, the latest on Nov 29 in Murree. Of these, 53 outbreaks involved commercial and backyard poultry.

http://www.dawn.com/2007/12/15/top14.htm

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Commentary at

http://www.recombinomics.com/News/12140706/H5N1_Pakistan_Confirmed_5.html

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Three of the patients are in a hospital in Mansehra....

So, are these (from commonground's list):

2nd Familial Cluster

Manshera - Laborer - Hospitalized. Tested Positive

Daughter of Manshera - Hospitalized.

Third Person Hospitalized - Relationship to 5 above people is
unknown.

??

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Commonground's list applause: ):

Pakistan - 12/14/07

Culling Operation - Oct. 21-23. At Ijaz Shah Poultry Farm in Abbotabad.

40 People Tested as a result of operation on Oct. 30th.
4 were positive. llyas or Owais and 2 unknown positives.

1st Familial Cluster

Ishtiaq Durrani - Hospitalized & recovering. Khyber Teaching Hosp.
Organized cullling of 3,000 birds.

Mahammad llyas Durrani - Cared for Ishtiaq in hospital. Died on
11/19. Not part of culling.

Mohammad Owais Durrani - Cared for Ishtiaq in hospital. Died
on 11/29.


2nd Familial Cluster

Manshera - Laborer - Hospitalized. Tested Positive

Daughter of Manshera - Hospitalized.

Third Person Hospitalized - Relationship to 5 above people is
unknown.


3rd Familial Cluster

4 Brothers

Index Case - Tested Positive - He was a culler.

Muhammad llyas - Adm to Khyber Teaching Hospital. From
Mansehra. Died: 12/10. Died shortly after admission.

Tariq/Farooq - Adm to Khyber Teaching Hospital. From Mansehra.
Died: 12/10. Died shortly after admission.

No Name - Returned to United States. May have returned
12/8 - 9th.

 

[sharon sanders]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Thanks Commonground for the list.

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

So, are these (from commonground's list):

2nd Familial Cluster

Manshera - Laborer - Hospitalized. Tested Positive

Daughter of Manshera - Hospitalized.

Third Person Hospitalized - Relationship to 5 above people is
unknown.

??

Or maybe Index Case from the 3rd cluster. ??

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Commonground's list applause: ):

Pakistan - 12/14/07

Culling Operation - Oct. 21-23. At Ijaz Shah Poultry Farm in Abbotabad.

40 People Tested as a result of operation on Oct. 30th.
4 were positive. llyas or Owais and 2 unknown positives.

1st Familial Cluster

Ishtiaq Durrani - Hospitalized & recovering. Khyber Teaching Hosp.
Organized cullling of 3,000 birds.

Mahammad llyas Durrani - Cared for Ishtiaq in hospital. Died on
11/19. Not part of culling.

Mohammad Owais Durrani - Cared for Ishtiaq in hospital. Died
on 11/19.


2nd Familial Cluster

Manshera - Laborer - Hospitalized. Tested Positive

Daughter of Manshera - Hospitalized.

Third Person Hospitalized - Relationship to 5 above people is
unknown.


3rd Familial Cluster

4 Brothers

Index Case - Tested Positive - He was a culler.

Muhammad llyas - Adm to Khyber Teaching Hospital. From
Mansehra. Died: 12/10. Died shortly after admission.

Tariq/Farooq - Adm to Khyber Teaching Hospital. From Mansehra.
Died: 12/10. Died shortly after admission.

No Name - Returned to United States. May have returned
12/8 - 9th.

One of the first cluster deaths was on November 29, the other was November 19.

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Five cases of bird flu confirmed




<CENTER>and the other two cases have been reported from Peshawar. </CENTER>http://www.dawn.com/2007/12/15/top14.htm

Peshawar is NOT close to the earlier clusters.

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Peshawar is NOT close to the earlier clusters.

But the two brothers in the four brother cluster were admitted to Peshawar.

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

But the two brothers in the four brother cluster were admitted to Peshawar.

Khyber Teaching Hospital is in Peshawar.

 

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Re: Pakistan: Bird Flu claims 2 lives; more suspects

Map of the districts in Pakistan being discussed.

View attachment 2121