Are there many mild cases of H5N1?

[Blue]

Here is a link to a few videos. Dr. Anna Thorsen is the second video.
Listen to what she has to say. This is very interesting. Too bad the sound quality is not so good. She seems to be talking about many cases of avian flu in people who survived with mild flu illness, if I am understanding her correctly. I have never heard this anywhere else.

http://www.new-fields.com/birdflu4/index.php

 

[Laidback Al]

Mild cases of H5N1?

Mild cases of H5N1?

Here is a link to a few videos. Dr. Anna Thorsen is the second video.
Listen to what she has to say. This is very interesting. Too bad the sound quality is not so good. She seems to be talking about many cases of avian flu in people who survived with mild flu illness, if I am understanding her correctly. I have never heard this anywhere else.

http://www.new-fields.com/birdflu4/index.php

I was unable to connect to the video by Thorsen but the idea that there are many unreported mild cases human H5N1 infections crops up from time to time in discussions on flu forums.

To my knowledge there is no published data to support this statement. I don't think that there has been any H5N1 antibody testing among individuals that presented with mild flu symptoms. Of course there may be some data somewhere that is not publicly available.

NAMRU-3 data indicated that only about 5% (26) of about 500 human samples tested for H5N1 were positive. That does not argue for a lot of mild cases. Of course, we don't know if any of these individuals were later retested because "false negatives" do occur.

 

[Blue]

Re: Are there many mild cases of H5N1?

I think that I had to use Real Player to access the videos. When you go to that page, the Turkish doc comes on first, but I just scrolled down on the right hand side of the page, and hit the button next to her picture. She is saying that her study indicates that 650 to 750 indivduals had mild flu like symptoms, but probably had H5N1. I think that if true, this is significant.

 

[HenryN]

Re: Are there many mild cases of H5N1?

Here is a link to a few videos. Dr. Anna Thorsen is the second video.
Listen to what she has to say. This is very interesting. Too bad the sound quality is not so good. She seems to be talking about many cases of avian flu in people who survived with mild flu illness, if I am understanding her correctly. I have never heard this anywhere else.

http://www.new-fields.com/birdflu4/index.php

I think she is talking about the "no data" study that assumed people with flu like illness in Vietnam had H5N1, but had no data to support the assumption.

 

[Blue]

Re: Are there many mild cases of H5N1?

I think she is talking aboutb the "no data" study that assumed people with flu like illness in Vietnam had H5N1, but had no data to support the assumption.

No data? That's too bad.

 

[Niko]

Re: Are there many mild cases of H5N1?

There is epidemiological "data" but no microbiological data to support the incidence of mild cases of human H5N1.

[FONT=verdana, arial, helvetica, sans-serif] Is Exposure to Sick or Dead Poultry Associated With Flulike Illness? [/FONT] [FONT=verdana, arial, helvetica, sans-serif] A Population-Based Study From a Rural Area in Vietnam With Outbreaks of Highly Pathogenic Avian Influenza [/FONT]
[FONT=verdana, arial, helvetica, sans-serif] <nobr>Anna Thorson, MD, PhD</nobr>; <nobr>Max Petzold, PhD</nobr>; <nobr>Nguyen Thi Kim Chuc, PhD</nobr>; <nobr>Karl Ekdahl, MD, PhD</nobr> [/FONT]

[FONT=verdana, arial, helvetica, sans-serif] Arch Intern Med. 2006;166:119-123. [/FONT]
[FONT=verdana, arial, helvetica, sans-serif] Background The verified human cases of highly pathogenicavian influenza in Vietnam may represent only a selection ofthe most severely ill patients. The study objective was to analyzethe association between flulike illness, defined as cough andfever, and exposure to sick or dead poultry.[/FONT]
[FONT=verdana, arial, helvetica, sans-serif]Methods A population-based study was performed from April1 to June 30, 2004, in FilaBavi, a rural Vietnamese demographicsurveillance site with confirmed outbreaks of highly pathogenicavian influenza among poultry. We included 45 478 randomlyselected (cluster sampling) inhabitants. Household representativeswere asked screening questions about exposure to poultry andflulike illness during the preceding months; individuals witha history of disease and/or exposure were interviewed in person.[/FONT]
[FONT=verdana, arial, helvetica, sans-serif]Results A total of 8149 individuals (17.9%) reported flulikeillness, 38 373 persons (84.4%) lived in households keepingpoultry, and 11 755 (25.9%) resided in households reportingsick or dead poultry. A dose-response relationship between poultryexposure and flulike illness was noted: poultry in the household(odds ratio, 1.04; 95% confidence interval, 0.96-1.12), sickor dead poultry in the household but with no direct contact(odds ratio, 1.14; 95% confidence interval, 1.06-1.23), anddirect contact with sick poultry (odds ratio, 1.73; 95% confidenceinterval, 1.58-1.89). The flulike illness attributed to directcontact with sick or dead poultry was estimated to be 650 to750 cases.[/FONT]
[FONT=verdana, arial, helvetica, sans-serif]Conclusions Our epidemiological data are consistent withtransmission of mild, highly pathogenic avian influenza to humansand suggest that transmission could be more common than anticipated,though close contact seems required. Further microbiologicalstudies are needed to validate these findings.[/FONT]

[FONT=verdana, arial, helvetica, sans-serif] Author Affiliations: Division of International Health, Departments of Public Health Sciences (Drs Thorson, Petzold, and Chuc) and Medical Epidemiology and Biostatistics, (Dr Ekdahl), Karolinska Institutet, and Clinic of Infectious Diseases, Karolinska University Hospital (Dr Thorson), Stockholm, Sweden; Nordic School of Public Health, G?teborg, Sweden (Dr Petzold); Hanoi Medical University, Hanoi, Vietnam (Dr Chuc); European Centre for Disease Prevention and Control, Solna, Sweden (Dr Ekdahl); and Stockholm Group of Epidemic Modeling, Stockholm (Dr Ekdahl).

[/FONT]http://archinte.ama-assn.org/cgi/content/abstract/166/1/119

 

[JJackson]

Re: Are there many mild cases of H5N1?

Without subsequent testing for antibodies in some of the likelier possibles this is not very compelling; the only thing it has going for it is the impressive sample size.

 

[sharon sanders]

Re: Are there many mild cases of H5N1?

The anti-pandemic threat group uses that study to further the idea that a pandemic with a high morbidity and mortality rate is not valid. One is Michael Fumento.


http://www.flutrackers.com/forum/showthread.php?t=14728

 

[Blue]

Re: Are there many mild cases of H5N1?

Without subsequent testing for antibodies in some of the likelier possibles this is not very compelling; the only thing it has going for it is the impressive sample size.

I agree. Why didn't anyone do the antibody testing?

 

[JohnW]

Re: Are there many mild cases of H5N1?

I seem to recall a good article on "seroprevalence" about a year ago. The article reviewed a number of studies including cases in Vietnam and Thailand where a human case of H5N1 had occured. Blood samples had been taken for the entire village. In every case, no person other than the victim showed H5N1 antibodies.

To the best of my recollection, I believe South Korea is the only country where this is not the case. There, H5N1 antibodies have shown up in poultry workers who were not symptomatic.

 

[Thornton]

Re: Are there many mild cases of H5N1?

JohnW's recall I believe is correct.

Dr. Thorson and colleagues conclude their abstract as follows:

Further microbiological studies are needed to validate these findings.

Agree.

In going to the linked Annals of Internal Medicine source we find a letter commenting on the article and a reply. May be an interesting exchange but I do not have access.
JT

 

[Shannon Bennett]

Re: Are there many mild cases of H5N1?

Dr. Julie Gerberding stated last spring that some testing of family members and others living close to bf patients had been done and, there were no antibodies to be found. She then stated there was no evidence of any mild cases.

 

[Laidback Al]

Re: Are there many mild cases of H5N1?

. . .
To the best of my recollection, I believe South Korea is the only country where this is not the case. There, H5N1 antibodies have shown up in poultry workers who were not symptomatic.

Yes, this is rather ironic since the CDC confirmed H5N1 human cases from South Korea, asymptomatic as they were, are not ever counted in the total number of world-wide human H5N1 cases. . . . .

I believe there have been only one or two WHO confirmed cases (from Vietnam?) that were asymptomatic.

 

[JohnW]

Re: Are there many mild cases of H5N1?

Below is a link to a series of articles on seroprevalence.

http://www.fluwikie.com/pmwiki.php?n=Science.Seroprevalence

 

[Blue]

Re: Are there many mild cases of H5N1?

Thanks for that link from Fluwiki. That answered my original question but, of course leaves me with the obvious problem that has always been there.

So we still do not know why small numbers of people are getting H5N1 amidst the great majority of their fellow humans that do not, despite the same surroundings. I know viral load is probably just part of the equation.
I am sure that this has been addressed many times elsewhere on more than one flu forum. It's a very intriguing mysery.

 

[DeadAhead]

Re: Are there many mild cases of H5N1?

Hi Blue -

As an RNA virus, H5N1 is constantly rewriting itself, putting forth new versions that might replicate better.

There is no question that it is extremely hard to catch H5N1 from a bird, though it happens.

Each human being that catches and survives now harbors a virus that is trying just as hard to cross over to other human beings. This is where H5N1 will either make or break itself as a huiman virus.

I see no reason why the WHO et al would try to overlook signs that numerous people have been infected. The more people infected, the bigger our problem, whether one subscribes to recombination or reassortment, or both.

It is why Nabarro et al are terrified that H5N1 will reach the giant pool of HIV/AIDS carriers in Africa, whose immune systems are considered likely to welcome the new flu.

It is very clear that H5N1 in mice grows monstrously in virulence as it passes though a generation and into another. H5N1 could use a generation of not terribly affected people as it winds up to spead better and more fatally.

Beware of the dedunkers who try to use unconfirmed and isolated papers to prove points that, on closer examination, wouldn't be in any way comforting!

I won't be relieved to see that more people have caught and survived H5N1. I would see that as a likely step toward the catastrophe we fear.

Stay well,
DA

 

[Blue]

Re: Are there many mild cases of H5N1?

I believe you DeadAhead. Could you explain a little more about why those with impaired immune systems would be more of an issue?

 

[DeadAhead]

Re: Are there many mild cases of H5N1?

Hi Blue -

People with impaired immune systems are more likely to catch anything (those with HIV-AIDS are at some risk from various American urban water systems).

A bird virus looking to expand its horizons couldn't find a better location than sub-Saharan Africa, where people are underfed, under daily attack from innumerable viruses and bacteria, and served by little public health outreach. In many places, the deaths of an entire family would merely ignite local conversation, IF the residents were aware of bird flu. Were some victims already known to have HIV/AIDs, it might not draw much attention.

H5N1 can look an awful lot like dengue fever and who-knows-how-many other killer viruses in Africa....

As for the chickens, I twice visited a very poor family in the Kenyan highlands. They had 2 or 3 chickens that fed themselves on their washed-out red clay hillside. When the mother cooked one in my honor on my second stay, I had to swallow the pieces whole because they were unchewable. The chickens and two mud shacks papered with pharmaceutical ads from slick American magazines were all they owned.

No one important would notice if they died unless it started consuming their village; after weeks and weeks the regional administrators might take notice.

I should add to the other comment that recent comments by some flu experts imply that they see no reason why H5N1 MUST moderate its killing power in order to spread. I think moderation for a pre-wave or two would help it spread, but they think it just might leap over and prosper full-blown in people.

Stay well,
DA

 

[Blue]

Re: Are there many mild cases of H5N1?

Interesting essay at Effect Measure about the need for seroprevalance studies.

http://scienceblogs.com/effectmeasure/2007/03/how_about_some_basic_descripti.php#more

 

[JJackson]

Re: Are there many mild cases of H5N1?

If you want a taste of what to expect when H5N1 meets HIV/AIDs read this paper. Mingus' post #1

Abstract Link: http://www.flutrackers.com/forum/showthread.php?p=48248#post48248