Respiratory illness - adenovirus 14 -hits remote Alaska island - FluTrackers

[sharon sanders]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

.....

Unless we hear verifiable stories about transportation closures, communication blackouts, etc., I won't be convinced of any BF cases.

.

Yesterday I called the ferry service that serves the island and was told that the ferry is operating currently and would be operating today (Saturday).

Also, I called the state epidemiologist's office and was told that:

No tests back yet,

No diagnosis,

No deaths,

A couple of patients are very ill,

Some only coughing and sent home,

All adults,

No quarantine in the hospital,

No hemorrhagic features.


And I called a local pharmacy where an employee told me that there was no quarantine on the island but that there was an upper respiratory illness in a few adults.


There is no communication blackout. I was able to easily contact these offices.

 

[Giuseppe]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

What's the actual reason for these level of alarm at FT?

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Yesterday I called the ferry service that serves the island and was told that the ferry is operating currently and would be operating today (Saturday).

Also, I called the state epidemiologist's office and was told that:

No tests back yet,

No diagnosis,

No deaths,

A couple of patients are very ill,

Some only coughing and sent home,

All adults,

No quarantine in the hospital,

No hemorrhagic features.


And I called a local pharmacy where an employee told me that there was no quarantine on the island but that there was an upper respiratory illness in a few adults.


There is no communication blackout. I was able to easily contact these offices.

I would expect the communication blackout to be in the form of delaying or withholding the diagnosis on the "confirmed" cases.
A quarantine of the whole island would be reported by all major wire services in a heart beat (unless all phone and internet access were cut and I have firts hand knowledge that thepnones are working and internet access is normal).
I think the definition of a "communication blackout" needs a reality check.

 

[sharon sanders]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

What's the actual reason for these level of alarm at FT?

There is no level of alarm. I call many people on a daily basis. Yesterday a question was raised about this news report so I made a few phone calls. I daily exchange emails and phone calls with people from all over the world.

 

[Giuseppe]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

I modestly cast some doubts that an outbreak of avian influenza in humans is happening in this area of Alaska.

It may be the case, perhaps.

But what are the facts that are addressing this supposition?

The only fact that this Alaskan's island is on the path of migratory birds alone cannot be enough to draw a picture different from an usual outbreak of influenza-like illness sustained by common pathogens in cold weather region.

In other regions of norther hemisphere wild birds have started their migration. An increasing acute respiratory illness activity is currently ongoing even in Italy - where some rare wild birds were spotted some days ago (Ibis).

I need more informations for feel something strange in this case.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

What's the actual reason for these level of alarm at FT?

I think the delayed diagnosis is causing some concern by some. The original media report was dated Oct 1 and it described "confirmed" and "suspect" cases (and the involvement of the CDC). However, the reports from health regulatory agencies or the hospital indicates there is no diagnosis, which really makes little sense, because a diagnosis is required for a "confirmation" of a disease.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

I modestly cast some doubts that an outbreak of avian influenza in humans is happening in this area of Alaska.

It may be the case, perhaps.

But what are the facts that are addressing this supposition?

The only fact that this Alaskan's island is on the path of migratory birds alone cannot be enough to draw a picture different from an usual outbreak of influenza-like illness sustained by common pathogens in cold weather region.

In other regions of norther hemisphere wild birds have started their migration. An increasing acute respiratory illness activity is currently ongoing even in Italy - where some rare wild birds were spotted some days ago (Ibis).

I need more informations for feel something strange in this case.

The actual diagnosis remains open, but the failure to disclose a diagnosis while patients are being classified as "confirmed" or "suspect" is not common for a common pathogen.

 

[Giuseppe]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Confirmed cases of something... But something likes that kind of ailment?

Avian influenza?

There is the need of more clear picture for this thread.

Non-FT members' readers start to don't understand nothing.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Confirmed cases of something... But something likes that kind of ailment?

Avian influenza?

There is the need of more clear picture for this thread.

Non-FT members' readers start to don't understand nothing.

Yes, ProMED issued an RFI. I have e-mailed the reporter on the story twice, with no reply. I also have a contact on Prince of Wales Island, and am waiting for an update.

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Confirmed cases of something... But something likes that kind of ailment?

Avian influenza?

There is the need of more clear picture for this thread.

Non-FT members' readers start to don't understand nothing.

Speaking of clarification, I think it is worth a review what a communication blackout for a confirmed bird flu case would look like.

Some seem to think that calling the hospital or public health in the area and being told that there was no diagnosis on patients that have been characrerized as "confirmed" cases in a media report is an indication that there is no news blackout, but I think exactly the opposite is indicated.

The original story mentioned the word quarantine, which some interpreted as a quarantine of the entire island. Although the physical implementation would be relatively easy for an island, keeping an imposed quarantine out of the news would be virtually impossible if phone and internet communication were intact.

Those who were visiting the island for a day trip would be upset when they tried to return and were told they were under quarantine. This would also apply to many who were leaving the island for business or pleasure and would create considerable alarm. This alarm would be heightened by a lack of media coverage, and those impacted would try to get information from or give information to contacts not on the island, including media. A quarantine would be known to all (on or off the island) in minutes.

Clearly there has been no such quarantine, but a news blackout would be most effective if applied to the origin, which are the agencies claiming there has been no diagnosis. A "no diagnosis" would not create alarm and would buy time to confirm and more fully assess the situation and future actions.

Examples of this type of control with regard to human bird flu cases are not new. One of the best examples is the cluster in Pakistan, which now appears to involve at least 5 brothers, including 2 who died. Although the cluster represents the longest lab confirmed H5N1 transmisson chain reported to date, the asymptomatic case was just reported as confirmed this week, almost a year after the start of the outbreak, and WHO has yet to add the case, even though it meets their case definition. Similarly, the story broke in December, 2007, even though the index case was infected in October. No news leaked out until two brothers were dead and the H2H nature of the cluster was obvious.

Thus, news blackouts are controled at the source and not via a shutdown of communications to an entire island (in the United States no less).

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Commentary

http://www.recombinomics.com/News/10040802/PoW_Delay.html

 

[Snowy Owl]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Concerns On Diagnosis Delay On Prince of Wales Island Alaska
Recombinomics Commentary 12:37
October 4, 2008​

http://www.recombinomics.com/News/10040802/PoW_Delay.html​

How can there be confirmed cases when they don't know what the cause is?

The above remarks in a ProMED commentary requesting information on the respiratory disease on Prince of Wales Island in Alaska is telling.

The media report indicates there are ?confirmed? and ?suspect? cases, yet a patient cannot be confirmed without a diagnosis, but the Department of Health maintains that there is no diagnosis yet, even though the CDC is involved and the original media story was posted October 1.

The location of the island and the timing of the outbreak raise concerns of an H5N1 outbreak. In South Korea, a soldier/culler was PCR positive for H5 last spring, but South Korea denied an H5N1 infection because they failed to isolate the virus from the patient. Today, South Korea confirmed a suspected bird flu outbreak (see satellite map), and local media has indicated the bird flu is H5. Last spring, Japan implemented ?enhanced? surveillance, when South Korea confirmed H5N1 on duck farms, and Japan immediately identified H5N1 in dead whooper swans. The dead swans were found at multiple locations in northern Japan and the sequences were those of a Fujian reassortant with a clade 2.3.2 HA and 2.3.4 for the other seven genes. The same reassortant was found in Primorie, which was initially reported on a farm, but significant spread to migratory bird regions to the south and west of the commercial farm outbreak was subsequently acknowledged. Japan is currently expanding its surveillance / response programs for H5N1.

Last spring the H5N1 infected wild birds were migrating to the north, and excessive poultry deaths were reported on Kamchatka, but H5N1 was denied.

The whooper swans and other long range migratory birds in northern Japan would have summered in northern Siberia and Alaska, raising concerns of Fujian H5N1 spread to Alaska.

Consequently, the failure to disclose the diagnosis on the ?confirmed? respiratory cases is cause for concern. Release of test results on the ?confirmed? cases would be useful.​

Media Links

Recombinomics Presentations

Recombinomics Publications

Recombinomics Paper at Nature Precedings

 

[Giuseppe]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

I would like to send to dr Niman, Sally, Florida1, Alaska Denise and all the other FT members' my gratitude for these clear explications about this at least obscure incident in a isolated Alaskan's island.

I hope that in the near future further details will be available in order to definite the actual nature of this ailment that's hitting some people in an isolated outpost.

 

[Commonground]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Treyfish and I searched late into the night, and couldn't find any stories. We're still looking. Alaska did start the flu shots for everyone across the whole State.

 

[Thornton]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Definitions - from Pan American health Organization and WHO

bottom line is that diagnosis and case have two different meanings and usage.

http://www.paho.org/English/SHA/be991norms.htm

Norms and Standards in Epidemiology: Case Definitions
The use of case definitions is very important in epidemiology in order to standardize criteria for identification of cases. All case definition must include the three classical dimensions of epidemiological variables: time, place and person. It is of foremost importance to precisely define what will be considered as a case, in order to accurately monitor the trends of reported diseases, to detect their unusual occurrences and, consequently, to evaluate the effectiveness of intervention. Thus, the usefulness of public health surveillance data depends on its uniformity, simplicity and timeliness.
According to the Dictionary of Epidemiology, edited for the International Epidemiological Association by John M. Last, a case in epidemiology, is a person in the population or study group identified as having the particular disease, health disorder, or condition under investigation. A variety of criteria may be used to identify cases, e.g. individual physician?s diagnoses, registries and notifications, abstracts of clinical records, surveys of the general population, and population screening, among others. The epidemiological definition of a case is not necessarily the same as the ordinary clinical definition.
? The definition of terms used in this list for case classification is established as follows:
Clinically compatible case: a clinical syndrome generally compatible with the disease, as described in the clinical description.
Confirmed case: a case that is classified as confirmed for reporting purposes.
Epidemiologically linked case: a case in which (a) the patient has had contact with one or more persons who either have/had the disease or have been exposed to a point source of infection (i.e., a single source of infection, such as an event leading to a foodborne-disease outbreak, to which all confirmed case-patients were exposed) and (b) transmission of the agent by the usual modes of transmission is plausible. A case may be considered epidemiologically linked to a laboratory-confirmed case if at least one case in the chain of transmission is laboratory confirmed.
Laboratory-confirmed case: a case that is confirmed by one or more of the laboratory methods listed in the case definition under Laboratory Criteria for Diagnosis. Although other laboratory methods can be used in clinical diagnosis, only those listed are accepted as laboratory confirmation for national reporting purposes.
Probable case: a case that is classified as probable for reporting purposes.
Supportive or presumptive laboratory results: specified laboratory results that are consistent with the diagnosis, yet do not meet the criteria for laboratory confirmation.
Suspected case: a case that is classified as suspected for reporting purposes.
?..

 

[HenryN]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

Definitions - from Pan American health Organization and WHO

bottom line is that diagnosis and case have two different meanings and usage.

http://www.paho.org/English/SHA/be991norms.htm

I think that the public description (dry cough and temperature above 101) lacks the specificity to move a patient into the "confirmed" category, based on clinical presentation. It seems that some more would be required, like x-ray confirmed pneumonia.

For an epidemiological definition, it seems that all would be in the "suspect" category in the absence of a clearer clinical diagnosis.

I think there is more key detail that has not been made public (like influenza A positive). Of course a "case definition" would also be useful.

 

[Laidback Al]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

What's the actual reason for these level of alarm at FT?

Confirmed cases of something... But something likes that kind of ailment?

Avian influenza?

There is the need of more clear picture for this thread.

Non-FT members' readers start to don't understand nothing.
<!-- / message --><!-- sig -->

We don?t know when or where the next pandemic will start. But when it does, the news reports will look exactly like these from <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comffice:smarttags" /><st1:State w:st="on"><st1lace w:st="on">Alaska</st1lace></st1:State>. There will be rumors, misinformation, disinformation, and conflicting official responses.

It is a testament to the diligence and effort all of the news analyst and bird flu trackers that continually chase down these obscure reports. So far, they have all been false alarms, but one day, possibly not too far in the distant future, it won?t be a false alarm; it will be the start of the next pandemic.
<?xml:namespace prefix = o ns = "urn:schemas-microsoft-comfficeffice" /><o></o>

 

[Treyfish]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

:tiphat:I went thru many papers and made plenty of calls. So I found out this.
No papers have anything. From the calls.. I got hung up on 2 times.. from a hardware store. 1 guy said yes they heard some people were sick then he hangs up. The next call is answered by the manager and says no one is any sicker than in other places,anywhere else, then he hangs up. I called an EMS manager in Craig , no answer. From another call I found a nice lady to tell me this ..it is a regular flu and that people were gettin pnumonia. There is no quarintine on the island and she knew of both towns, but would not VERIFY it was 26 ill. She said the very ill, some which had prior respiratory problems, and any other serious cases, were moved to the Katchikan Hospital. I called the ferry service and it is running,the closest stop is 31 miles from the 2 towns. All the clinics are closed ,but say leave a message. I asked about any animal deaths or food poisoning, she said no. This is all i know from 19 hrs of lookin.

 

[AlaskaDenise]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

I combed through the Anchorage paper-edition news this morning - not a since word about the Craig/Klaowck illnesses.

.

 

[Dark Horse]

Re: Respiratory illness hits remote Alaska island

Re: Respiratory illness hits remote Alaska island

:tiphat:I went thru many papers and made plenty of calls. So I found out this.
No papers have anything. From the calls.. I got hung up on 2 times.. from a hardware store. 1 guy said yes they heard some people were sick then he hangs up. The next call is answered by the manager and says no one is any sicker than in other places,anywhere else, then he hangs up. I called an EMS manager in Craig , no answer. From another call I found a nice lady to tell me this ..it is a regular flu and that people were gettin pnumonia. There is no quarintine on the island and she knew of both towns, but would not VERIFY it was 26 ill. She said the very ill, some which had prior respiratory problems, and any other serious cases, were moved to the Katchikan Hospital. I called the ferry service and it is running,the closest stop is 31 miles from the 2 towns. All the clinics are closed ,but say leave a message. I asked about any animal deaths or food poisoning, she said no. This is all i know from 19 hrs of lookin.

I'm sure I speak for many of us when I sincerely thank you for all the efforts you have put in.