Herman Kosasih of NAMRU reporting on clinical and lab comparison of dengue, human flu, or avian flu in Indonesia:
H5N1 epidemiology in Indoesnia June 2005–2006
- 532 cases: 56 confirmed + probable, 42 deaths, CFR 75%, 7 clusters
- Median age 19, range 1.5–43 years
- Male: Female= 1.5:1
- 44% rural, 30% semi-rural, 26% urban
- Most cases with poultry exposure
- Onset to hospitalization 4.8 days
- From hospitalization to avian influenza being suspected was 3.1 days
- The initial diagnosis were dengue, pneumonia, typoid, and other respiratory tract infections.
- The onset to hospitalization for dengue was 4 days, human influenza was 3.4 days, ie very similar.
- For distinction between avian and human influenza, it was difficult until shortness of breathe happened on day 5.
- Dengue and avian flu had similar respiratory symptoms, as well as spontaneous bleeding, so it was difficult to make a clinical distinction.
- Complete blood count (CBC): avian flu significantly lower leukocyte, lymphocyte, and platelet than human flu, but compared to dengue, lymphocyte was lower, but platelet count was higher
- Of the 3, H5N1 had the lowest lymphocyte count
Summary: it is difficult to distinguish AI from other endemic infections during acute illness, causing delay in diagnosis and treatment. Poultry contact, shortness of breath, serial blood counts to track leucopenia, lymphopenia, and thrombocytopenia may be useful.
<hr> Notice it took an average of 7.9 days from onset of symptoms to H5N1 infection being suspected.
