Pakistan: Human H5N1 Cluster December 2007

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Commentary at

http://www.recombinomics.com/News/12130705/H5N1_Pakistan_H2H.html

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

So the doctor (vet) contracts AI. His two brothers that are caring for him then contract AI, and both die, though ten days apart (I'm assuming one of them was able to fight off the disease longer than the other). And then in addition to those three brothers, there are 4 others (out of 40) that also tested positive for AI.
Does this sound right?
Sounds like enough news is starting to come out of Pakistan, that they won't be able to keep much of a lid on it now?

I think it's 4 totally: the vet, his two brothers and the poultry worker from Mansehra.

 

[Shannon Bennett]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

H2H does look likely here. Not the first time we have seen this happen. The veterinarian culls chickens in late October, his brothers care for him and die 10 days apart with the last one dying a few days ago.

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

I think it's 4 totally: the vet, his two brothers and the poultry worker from Mansehra.

I think there are at least five (four positives and one who died without testing), but there are six hospitalized (Vet and two dead brothers plus another culler, his daughter, and another male). Thus, there are six or seven who are positive, or dead with symptoms, or hospitalized - presumably with symptoms.

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

I think there are at least five (four positives and one who died without testing), but there are six hospitalized (Vet and two dead brothers plus another culler, his daughter, and another male). Thus, there are six or seven who are positive, or dead with symptoms, or hospitalized - presumably with symptoms.

I'm so confused. Lemme look at the article again!

 

[HenryN]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

I'm so confused. Lemme look at the article again!

I think the timeline is something like this

Oct 21-23 - 3000 birds culled
Oct 27 - 40 samples colected for testing
early November 4 of 40 are positive
culler hospitalized one positive
vet hospitalized - another positive
vet brother dies Nov 19 - no sample collected
vet brother dies - Nov 29 maybe one poistive
culler's duaghter hospitalized no result
male hospitalized - maybe the fourth positive

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

I think there are at least five (four positives and one who died without testing), but there are six hospitalized (Vet and two dead brothers plus another culler, his daughter, and another male). Thus, there are six or seven who are positive, or dead with symptoms, or hospitalized - presumably with symptoms.

I still think it is four - 3 confirmed with samples; 1 presumed confirmation based upon clinical and exposure. No mention of test results for daughter and "other male" in cluster with poultry culler.

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother?s blood sample could not be collected, health experts talking to ?The News? said clinical evidence suggests that he too succumbed to the deadly virus. The blood samples of two of the three brothers were received by the National Institute of Health on October 28.

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Yeah -- you guys are right -- I count 6, too (missed the daughter & the other male in my first, panic read...):

Dr. Ishtiaq Durrani - Abbottabad vet - positive - Oct 21 culling
Mohammad Ilyas Durrani - brother 1 - d. Nov 19 - positive
Mohammad Owais Durrani - brother 2 - d. Nov 29 - not tested

Manshera poultry handler - positive
Manshera poultry handler daughter - observation
Another male - observation

Who's the fourth pos, then?

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

I think the timeline is something like this

Oct 21-23 - 3000 birds culled
Oct 27 - 40 samples colected for testing
early November 4 of 40 are positive
culler hospitalized one positive
vet hospitalized - another positive
vet brother dies Nov 19 - no sample collected
vet brother dies - Nov 29 maybe one poistive
culler's duaghter hospitalized no result
male hospitalized - maybe the fourth positive

Weirdly, it sounds like it was the first brother that died that was tested and not the second.... ??

While Dr. Ishtiaq himself is on the path to recovery, his brothers Mohammad Ilyas Durrani and Mohammad Owais Durrani ? both of who were attending him at the Khyber Teaching Hospital during his illness ? died on November 19 and November 29, respectively. The symptoms of avian flu infection in humans include muscle aches, fatigue, fever, coughing, sneezing, sore throat and eye infections. In severe cases, infection may lead to fatal pneumonia, blood disorders and multiple organ failure.

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother?s blood sample could not be collected, health experts talking to ?The News? said clinical evidence suggests that he too succumbed to the deadly virus.

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Okay, now I'm confused :surrender:

I think my confusion stems from the names of towns/farms.

Are Abbotabad andMansera/Mansehra interchangable?

Ministry officials said on October 21, 2007, bird flu virus H5-N1 was confirmed at Ijaz Shah Poultry Farm in Abbotabad and a veterinarian, Dr Ishtiaq Durrani, from the NWFP Livestock Department was tasked with culling as many as 3,000 hens in Abbotabad from October 21 to 23.

The deaths of two brothers of a veterinarian, who acquired the deadly H5N1 Avian Influenza virus after coming into contact with infected poultry at a farm in Abbottabad late-October

According to a spokesman of the Health Ministry, 2 brothers working in
a poultry farm in Mansera

the poultry handler from Mansehra

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

map

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Yeah -- and who's Tariq?:
http://www.flutrackers.com/forum/showpost.php?p=115297&postcount=5

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Yeah -- and who's Tariq?:
http://www.flutrackers.com/forum/showpost.php?p=115297&postcount=5

You've got me
add this to further muddy the mess...

After the blood samples of both the brothers were sent for formal testing in Laboratory, it was found that both brothers died due to Bird Flu virus (H5N1)

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother?s blood sample could not be collected, health experts talking to ?The News? said clinical evidence suggests that he too succumbed to the deadly virus. The blood samples of two of the three brothers were received by the National Institute of Health on October 28.

 

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Reconstructed timeline
<?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>
Based on Post #20.
<o></o>
H5N1 poultry outbreak on October 21 at Abbottabad.
<o></o>
Dr. Ishtiaq Durrani is involved with culling of 3000 birds and gets infected and eventually tests positive.
<o></o>
A day laborer from Mansehra involved in the culling also gets infected and eventually tests positive. <o></o>
<o></o>
Dr. Ishtiaq Durrani becomes ill and is treated at Khyber Teaching Hospital. <o></o>
<o></o>
His two brothers Mohammad Ilyas Durrani and Mohammad Owais Durrani attend to him in the hospital. <o></o>
<o></o>
Both brothers become sick. Samples are collected from Dr. Ishtiaq and Ilyas and are sent to lab for processing on October 28th. (Both tested positive). No sample was apparently collected from Owais. <o></o>
<o></o>
Mohammad Ilyas Durrani dies on Monday, November 19th. He is the first H5N1 casuality in <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comffice:smarttags" /><st1:country-region w:st="on"><st1lace w:st="on">Pakistan</st1lace></st1:country-region>.<o></o>
<o></o>
Mohammad Owais Durrani dies on November 29th.

December 10, the news story breaks (see Post #1) about H2H transmission among three human cases, 2 died. The story notes that samples were collected ?3 weeks ago? which would place the sample collect date at least back to November 19th. This breaking news references the three brothers, Ishtiaq Durrani, Mohammad Ilyas Durrani, and Mohammad Owais Durrani. <o></o>
<o></o>
Post #3 implies that that both brothers died on Monday (December 10th), which is quoted in the Pro-Med post #17 above. This is most likely an error and the brothers died in mid to late November. The news on the human cases didn?t surface until December 10th and was initially presented as being immediate and current, which may have caused the confusion.
So far, thiere is no more information about the status of day laborer poultry worker who apparently tested positive.

Any suggestions about this sequence of events? <o></o>

 

[Theresa42]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Samples are collected from Dr. Ishtiaq and Ilyas and are sent to lab for processing on October 28th. (Both tested positive). No sample was apparently collected from Owais.

Mohammad Ilyas Durrani dies on Monday, November 19th. He is the first H5N1 casuality in Pakistan.

I thought this could read as though Ilyas -- the first brother that died -- was actually the one tested...

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother's [Mohammad Owais'] blood sample could not be collected, health experts talking to 'The News' said clinical evidence suggests that he too succumbed to the deadly virus.

??

Maybe Mohammad Owais was reluctant to be tested or something?

Not convinced by my own argument here. I just think it's a possibility.

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Reconstructed timeline
<o></o>

Any suggestions about this sequence of events? <o></o>

Is Tariq a nickname for Mohammad Owais or is this reporter error?

Another error? post #4

After the blood samples of both the brothers were sent for formal testing in Laboratory, it was found that both brothers died due to Bird Flu virus (H5N1)

 

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

My opinions --

I think Niko is right that there are four "confirmed" and "reported" cases.
Dr. Ishtiaq Durrani, Mohammad Ilyas Durrani, and Mohammad Owais Durrani, and an unnamed poultry worker. Only three of which have been sampled and tested.

So Niman may be correct that there is at least one other individual who has tested postive. It may be one of the two indviduals that are under observation, the "labourer?s daughter" or "another male". If so that would make either a separate cluster of 2 individuals or all of these individuals are part of one big cluster.


I think that Tariq is probably Mohammad Owais Durrani, since the news report identifies him as a brother to Ilyas and as having died. Maybe a reporting error in one of the reports about whether or not Owais was actually sampled. If he was, then there is no mysterious fourth individual who has tested positive.

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

Reporters repeating errors???

Bird flu claims first two lives in Pakistan
Friday December 14, 2007 (0923 PST)

PESHAWAR: The administration of Khyber Teaching Hospital on Thursday confirmed that two brothers Mohammad Ilyas and Tariq, who were brought to the hospital from Mansehra on suspicion of carrying H5N1, died of bird flu Monday last.


?The two brothers have been confirmed as bird flu victims and are the first human sufferers of the disease in our country,? Dr Siddiqur Rahman, Acting Chief Executive of KTH, told media on Thursday.


Mohammad Ilyas and Tariq were working at a poultry farm in Mansehra and were brought to KTH in a serious condition. They were suffering from pneumonia and were kept in the isolation ward, said Dr Rahman.


One of them was in critical condition at the time of arrival, Dr Rahman said. He added that the Ministry of Health after their expiry took blood samples and sent them to Islamabad to verify if they were carrying Bird Flu virus (H5N1). ?Then I don?t know what happened to the test,? he added.


Meanwhile, some reports on Thursday suggested that the laboratory test conducted in Islamabad confirmed Bird Flu influenza. A spokesman of Health Ministry in Islamabad said that they had died of bird flu, adding both the brothers were working in a poultry farm in Mansehra and had direct link with the chickens that resulted in the transfer of the virus (H5N1) into them.
End.

http://paktribune.com/news/index.shtml?195522

 

[Laidback Al]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

This news article states that "Bird flu claims first two lives in Pakistan" on Monday (December 10th). Yet, other posts indicate that the "first" H5N1 death in Pakistan was Mohammad Ilyas Durrani who died on November 19th. These news reports can't all be true.

Hopefully, a spokesperson from the Pakistan Ministry of Health will make a public announcement and clarify the situation on human cases of H5N1 in Pakistan.

 

[Niko]

Re: Pakistan: Bird Flu claims 2 lives

Re: Pakistan: Bird Flu claims 2 lives

This news article states that "Bird flu claims first two lives in Pakistan" on Monday (December 10th). Yet, other posts indicate that the "first" H5N1 death in Pakistan was Mohammad Ilyas Durrani who died on November 19th. These news reports can't all be true.

Hopefully, a spokesperson from the Pakistan Ministry of Health will make a public announcement and clarify the situation on human cases of H5N1 in Pakistan.

Hear! Hear! Until then, I'm done! Off to nurse my headache.....