Stage 5 Pandemic Risk: If this doesn't scare you, nothing will!

Ok, folks, this one has me VERY worried.

The World Health Organization (WHO) has a scale it uses to describe infectious disease risk, much like the Saffir/Simpson scale we all know so well for tropical cyclones and hurricanes.

Stages of a Pandemic

Interpandemic period

Phase 1: No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

Pandemic alert period

Phase 3: Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.

Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).

Pandemic period

Phase 6: Pandemic: increased and sustained transmission in general population.

I've been following very closely the recent infections at Ragunan Zoo in Jakarta Indonesia.


On September 19, 2005, Recombinomics Commentary noted:

H5N1 Wild Bird Flu at Ragunan Zoo in Jakarta Indonesia?

The minister said that among the birds that had tested positive for bird flu were peacocks, mynahs, wild ducks, pigmy chickens, eagles and herons.

The H5N1 positive wild ducks raise the possibility that the outbreak at the Ragunan Zoo, south of Jakarta, may be linked to migratory birds. Migratory birds were involved in H5N1 transport and transmission in Qinghai and Xinjiang provinces in China as well as Russia, Kazakhstan, and Mongolia.

On the same day, September 19, 2005, Recombinomics Commentary noted:

Two Zoo Workers Test Positive for H5N1 in Jakarta Indonesia
Four pygmy chickens will be culled, but there are no plans for a mass culling exercise.

Titis Sari Muntorini, a Ragunan Zoo spokeswoman, said: "The other 15 infected birds, because they are endangered species, will for now be treated and isolated inside the surplus cages in the southern part of the zoo."

Health workers have also taken blood samples from zoo staff for testing as a precautionary measure.

On the same day, again, September 19, 2005, Recombinomics Commentary noted:

Asymptomatic H5N1 Positive Exotic Birds at Ragunan Zoo

The 19 were from a sample of 27 birds that were randomly tested earlier this month.

The above comment indcating that the 27 birds tested were randomly selected is cause for concern. This would indicate that the exotic birds were asymptomatically infected and the infections were widespread. In addition to the 19 that were H5N1 positive, 4 more were inconclusive, which is commonly found for low levels of infection. Thus, only 4 of the 27 tested were negative.

On September 20, 2005, Recombinomics Commentary noted:

Ten Hospitalized H5N1 Patients in Jakarta?

"Yes, there are two more people, with one suspected case an employee of Jakarta's Ragunan Zoo while the other is a vendor at the zoo," Siti said.

The minister said that as of Tuesday, there had been six people admitted to Sulianti Saroso Hospital in North Jakarta. Two of them earlier tested positive for the virus. Blood samples from the other patients have been sent to a Hong Kong laboratory.

The number of conflicting media reports and confusing quotes from officials continue to grow as does the list of patients hospitalized with bird flu conditions. Earlier reports indicated two zoo employees had tested positive for H5N1, but did not mention symptoms. The comment above indicates two people affiliated with the zoo are hospitalized with symptoms. One is an employee and another a vendor. Other media reports indicate the vendor is a street vendor, which would seem to indicate that transmission at the zoo was casual. Another media report describes a zoo trader as a 50 year-old male with a cough and breathing difficulties. It is not clear if this is the street vendor or a third person associated with the zoo with symptoms.

On the same day, September 20, 2005, Recombinomics Commentary noted:

Hospitalized H5N1 Zoo Workers Grow to Three

In Indonesia, a 28-year-old guide and a 39-year-old vendor at a popular zoo in the capital were hospitalized Tuesday with symptoms of bird flu, said I Nyoman Kandun, director general of Communicable Disease Control.

The above description of the two people affiliated with the Ragunan Zoo who tested positive for H5N1 raise concerns about transmission. Media reports also describe the hospitalization of a 50 year-old zoo trader with a cough and breathing difficulties. Other reports have indicated that the two described above also have bird flu symptoms.

On the same day, again, September 20, 2005, Recombinomics Commentary noted:

Increasing Human to Human Transmision of H5N1 in Jakarta

About the government`s decision on Monday to declare the outbreaks a National Extraordinary Happening (KLB), the minister said it was intended to make the public throughout the country alert to the disease.

"Besides, previously there was only one danger point, namely Pak Iwan Siswara but now there are two more danger points, namely RD and MG," she said.

The above "danger points" refer to three individuals who appear to be transmitting H5N1 to other people. The efficient human-to-human transmission is the major area of concern with regard to a catestrophic flu pandemic. H5N1 appears to be getting more and more efficient at such transmissions.

This transmission results in infections via casual contact and is becoming clearer at the Ragunan Zoo where three zoo employees have symptoms as well as in Tangang where the three human-to-human clusters are clustering.

The initial danger point was Pak Iwan Siswara who was a government auditor who died from H5N1. He is cited because he is the only member of his family listed as an official H5N1 case, but the index case was his 8 year old daughter, Sabrina Nurul Aisyah who developed bird flu symptoms on June 24. She is not listed as a confirmed case because there were only two serum samples collected and they were collected just 3 days apart so although both samples were positive and the antibody level was higher in the second collection, the increase was not 4 fold, which is the WHO standard, although that rise is expected in samples collected with longer time intervals between collections. Sabrina's 1 year old sister, Thalita Azizah, developed bird flu symptoms on June 29, but she died on July 9, so again she was not confirmed because of the lack of samples. Sabrina's father did not develop symptoms until July 2 and samples were collected at the appropriate time and he was PCR positive for H5N1. All three died within 5 days of each other, between July 9 and July 14 at Siloam Gleneagles Hospital in Tangerang. The onset dates strongly suggested that Sabrina infected her 1 year old sister and then one of the sisters infected their father.

On September 21, 2005, Recombinomics Commentary noted:

Casual Human Transmision of H5N1 in Jakarta Raises Phase 5 Flags

The reason for this, according to Minister of Health Siti Fadilah Supari, is that the number of victims is higher following the case of Iwan Iswara, an auditor at the Supreme Audit Agency (BPK), who died together with his two daughters a month ago.

"At that time, there was only one occurrence, that of Mr Iwan and his daughters. But now, there are two others, that of Rini Dina and Mutiara," said Supari during a meeting at her office in Jakarta on Monday (19/09).

Rina Dina died at Bintaro International Hospital on Saturday (10/09), while Mutiara is still being treated at Suliyanto Saroso hospital.

The above comments highlight the increase in human-to-human transmission, but the number of people developing symptoms is increasing steadily and most transmissions appear to be casual. These casual transmission are cause for major concern.

On September 21, 2005, Recombinomics Commentary noted:

Sixth H5N1 Fatality in Jakarta Causes Concerns

"The symptoms were heavy pneumonia, the same as bird flu symptoms. Her family confirmed to us that she had contact with dead chickens," Sardikin told Reuters.

The girl had been treated in a different hospital for five days before being brought to the Sulianti Saroso Hospital.

On the same day, September 21, 2005, Recombinomics Commentary noted:

9 Year Old Ragunan Zoo Visitor Hospitalized with H5N1

One of the 8 patients were expected terjangkit the virus of birds flu that was treated in the Infection Hospital (RSPI) Sulianti Saroso evidently had visited to the Ragunan Zoo.

This was revealed by Deputy Director RSPI Sulianti Saroso, Dr Sardikin Giriputro in RSPI Sulianti Saroso, Sunter, Jakarta, Wednesday (21/9/2005).

On the same day, again, September 21, 2005, Recombinomics Commentary noted:

Three More H5N1 Cases Admitted In Jakarta

...

The third patient, JM, had visited the Ragunan Zoo, where most randomly tested birds were H5N1 positive. Three or four zoo workers also developed H5N1 symptoms and two are also at the hospital.
...

The sudden jump in H5N1 cases this week is cause for concern. The case fatality rate for H5N1 confirmed and suspect acute cases in Indonesia remains at 100%.

On the same day, again, September 21, 2005, Recombinomics Commentary noted:

Another Child Hospitalized with H5N1 After Ragunan Zoo Visit

As noted in the above machine translation, 8 year-old Raka Datyo was transferred to Sulianti Saroso on Wednesday. Raka was the 4th admission with bird flu symptoms and the second child who had visited the Ragunan Zoo recently. In addition, 3 or 4 zoo workers have also showed signs of bird flu.

The zoo cluster has been growing almost hourly. The zoo was closed Monday after it was reported that only four of 27 randomly selected birds at the zoo were negative for H5N1. The birds were asymptomatic and it is unclear when they became infected, but the number of zoo visitors or workers with bird flu symptoms has grown steadily.

On September 22, 2005, Recombinomics Commentary noted:

Hospitalization of Four Zoo Visitors Raises H5N1 Pandemic Fears

The above machine translation indicates four more people were admitted to Sulianti Saroso Hospital on September 22. Media reports also describe a 15 year-old male who was also admitted with bird flu symptoms on September 22.

The two children who had visited the zoo brings the number of children to four. In addition three zoo employees have symptoms and two, Abdul Muntalib, a food vendor, and Ari Seytonini, a tour guide, are also at Sulianti Saroso.

On the same day, September 22, 2005, Recombinomics Commentary noted:

115 Symptomatic Zoo Visitors Seek H5N1 Treatment in Jakarta

The above machine translation indicates that 115 visitors of the Ragunan Zoo in Jakarta came to the Sulianti Saroso Infectious Disease Hospital for treatment, but because their symptoms were mild, they were not treated.

The hospital has already admitted two zoo workers and four young visitors. The two workers were a tour guide and a vendor, suggesting contact with the H5N1 infected birds was limited. Similarly the age range of the visitors, 1.5 to 10 years of age also suggests contact would be limited.

On the same day, again, September 22, 2005, Recombinomics Commentary noted:

Nine H5N1 Admissions Today Including Four Ragunan Zoo Visitors

The above machine translation describes 3 more patients admitted to Sulianti Saroso this evening, including two more children who had visited the Ragunan Zoo on 9/15 and "last Sunday". This morning two other children were admitted and yesterday there were two more who had visited the zoo. Thus, there are now 6 zoo vistors admitted and 115 zoo visitors with symptoms, who were turned away because they were not yet sick enough.

All I can say is [size=16]OMG!


Edit to reduce MASSIVE amounts of inappropriate copy-and-paste from other online sources.
(The previous enormous size of this post was causing system slow-downs.)

[edit on 26-9-2005 by SkepticOverlord]

This is scary, I to have been keeping track of the Avian Flu. I've gone to my doctor to get a perscription of Tamiflu just to keep in stock and make me feel better having it. I've also starting stocking up on can food. I believe to there will be a pandemic lets see what happens after "all" these birds return from there migration in the spring

Originally posted by Hobby
This is scary, I to have been keeping track of the Avian Flu. I've gone to my doctor to get a perscription of Tamiflu just to keep in stock and make me feel better having it. I've also starting stocking up on can food. I believe to there will be a pandemic lets see what happens after "all" these birds return from there migration in the spring

I've posted on the migration risk issue. You can read that here:

Death in a Cage: How the Illegal Bird Trade Might Doom America

This will likely seem off topic - but -

I know this could and probably will be devasting for humans, but what about the bird population in the world?

If H5n1 is so dangerous to humans I doubt most birds can survive the infection. So what potential danger does this have long term for the birds? The only reason I ask is because animals are dissapearing so quickly anyway nowadays, because of western civ - this would be a signifcant danger to their existence ya? or no?

Originally posted by Hobby
This is scary, I to have been keeping track of the Avian Flu. I've gone to my doctor to get a perscription of Tamiflu just to keep in stock and make me feel better having it. I've also starting stocking up on can food. I believe to there will be a pandemic lets see what happens after "all" these birds return from there migration in the spring

IF you can get your doctor to get you Tamiflu how long is the shelf life on it? I think a big question is if you can get your doctor to prescribe it or not at this point also. How many doctors will believe it is a big enough threat to listen to their patients who want to get this ahead.

I'm stocking up on stuff slowly too -- I figure I can use it even if it doesn't come about and I won't have to worry if it does. Plus right now the prices are lower than they will be after Rita hits and all prices of everything goes up again.

Originally posted by J_3
I know this could and probably will be devasting for humans, but what about the bird population in the world?

So far as we know, H5N1 and other influenza's all exists in the avian population. That is the flu's natural reservoir. This variant started out in ducks that were carriers only. Somewhere along the line H5N1 entered domestic polutry, which had no protection against it. It kills 100% of the chickens it infects while living and reproducing in wild ducks and now geese.

For now H5N1 seems to kill domesticated fowl. It has been reported that it is also asymptomatic in some species of migratory birds.

Most virus will not kill 100% of it's host's, since that would be an eveloutionary dead end.

Never fear, the birds will continue to populated our planet.

Looks like the WHO is confirming (almost) human to human transmission:

Indonesian avian flu case confirmed, could be human-to-human transmission

The World Health Organization confirmed an additional human case of avian influenza in Indonesia on Thursday.

A spokesperson for the Geneva-based agency confirmed the patient, an eight-year-old boy, may have caught the virus from another person.

The boy, who is recovering in hospital, is the nephew of a woman who died of H5N1 avian flu in Jakarta on Sept. 16. He had contact with his aunt after she became ill. Onset of his symptoms occurred four days after she became sick.

"It's possible that there's a common source (of infection). But . . . given the timing, we can't rule out human-to-human transmission," Maria Cheng, a WHO spokesperson, said in an interview from Geneva.

more...

On another note, does anybody find this strange?

Flu shots offered in hurricane shelters

To prevent a potentially catastrophic outbreak of influenza in crowded hurricane shelters, the state Office of Public Health is giving vaccines to occupants of about 80 shelters around Louisiana.

The shots aren't being offered to the general public at this time because they might not be effective when flu season peaks in January and February, said Dr. Frank Welch, the Office of Public Health's medical director for immunization programs.

Huh???

"But in shelters, where people are living in very close quarters in a very close environment, if flu were to get in there, it would spread like wildfire," he said.

About 10,000 shots have been given since the eight-day program started Friday, he said.

In addition to flu shots, people are administering hepatitis A and tetanus shots to ward off infections when people return to their homes, frequently by wading through foul water, and try to clean up.

Even though it is unlikely that people could contract hepatitis A from contaminated water, the vaccine is "a protective measure we can offer,"
Welch said.

Childhood vaccines also are available to shelter residents, he said.

Working with the Office of Public Health have been teams from other organizations, Welch said, including the federal Centers for Disease Control and Prevention, the U.S. Public Health Service, Louisiana State University and the Mayo Clinic.

[edit on 23-9-2005 by loam]

Meanwhile.....

USA Not to Issue Travel Warning


TEMPO Interactive, Jakarta:The US government will not issue a travel warning despite the bird flu disease in Indonesia.

The US Ambassador for Indonesia, Lynn Pascoe, has said that any such warning will not be issued.

“Such a warning will not be issued because there is yet to be any proof of spreading of the virus from human to human,” Pascoe told reporters after the signing of an agreement to send provide earthquake handling experts in Jakarta on Thursday afternoon (22/09).

Pascoe said that up to now, the disease had only spread from animals to humans, and a team of experts from the USA was already in Indonesia.

Again, I say, HUH???

Originally posted by justme1640

Originally posted by Hobby
This is scary, I to have been keeping track of the Avian Flu. I've gone to my doctor to get a perscription of Tamiflu just to keep in stock and make me feel better having it. I've also starting stocking up on can food. I believe to there will be a pandemic lets see what happens after "all" these birds return from there migration in the spring

IF you can get your doctor to get you Tamiflu how long is the shelf life on it? I think a big question is if you can get your doctor to prescribe it or not at this point also. How many doctors will believe it is a big enough threat to listen to their patients who want to get this ahead.

I'm stocking up on stuff slowly too -- I figure I can use it even if it doesn't come about and I won't have to worry if it does. Plus right now the prices are lower than they will be after Rita hits and all prices of everything goes up again.

Thats a good question I don't know how long the shelf life is I will ask. I told my doctor why I wanted it and there was no problem getting the perscription 75mg 5 days worth.

Originally posted by Hobby

Originally posted by justme1640

Originally posted by Hobby
This is scary, I to have been keeping track of the Avian Flu. I've gone to my doctor to get a perscription of Tamiflu just to keep in stock and make me feel better having it. I've also starting stocking up on can food. I believe to there will be a pandemic lets see what happens after "all" these birds return from there migration in the spring

IF you can get your doctor to get you Tamiflu how long is the shelf life on it? I think a big question is if you can get your doctor to prescribe it or not at this point also. How many doctors will believe it is a big enough threat to listen to their patients who want to get this ahead.

I'm stocking up on stuff slowly too -- I figure I can use it even if it doesn't come about and I won't have to worry if it does. Plus right now the prices are lower than they will be after Rita hits and all prices of everything goes up again.

Thats a good question I don't know how long the shelf life is I will ask. I told my doctor why I wanted it and there was no problem getting the perscription 75mg 5 days worth.

I think it was 2 or 3 years.

On September 24, 2005 Recombinomics Commentary reports:

The above comments indicate the number of patients admitted with bird flu symptoms continues to rise. The two additional zoo visitors brings that total to eight children in addition to two Ragunan Zoo workers who have been admitted to Suliant Saroso. Although the hospital is a referral hospital, it has limited admissions because of shortage of rooms and ventilators. Earlier in the week 115 zoo visitors with symptoms were denied admissions because the symptoms were not severe enough. Recently a class of 30 who visited the zoo had several members develop high fevers, and they also have not been admitted.

The zoo was closed on Monday, so many of the visitors from the weekend are just now developing symptoms or going to local hospitals, so the 8 admitted to Suliant Saroso reprsent only a small fraction of those visitors with symptoms.

The class of thirty was standing by the birds, where are heavily infected with H5N1, although the birds are asymptomatic. The large number of zoo visitors with symptoms repreaents a dramatic change in transmission, since media reports suggest the visitors were at the zoo on several different days and there have been no indication that those with symptoms had direct contact with the birds.

More data is required to understand the full extent of these transmissions, but the efficiency for human infections appears to have increased significantly.

Good stuff loam. Thanks.

...So-called 'bird flu' infects a variety of animals including cats, so I assume that's why the zoo was a center of infection. But I'm not hearing much chatter confirming the range of species it can hit. Also - research last year showed clearly that anti-virals do NOT work against H5N1 - and new reports say H5N1 is now 'developing immunities' to anti-virals.

Do you think anyone is going to tell the truth anytime soon?

Originally posted by soficrow

Good stuff loam. Thanks.

...So-called 'bird flu' infects a variety of animals including cats, so I assume that's why the zoo was a center of infection. But I'm not hearing much chatter confirming the range of species it can hit. Also - research last year showed clearly that anti-virals do NOT work against H5N1 - and new reports say H5N1 is now 'developing immunities' to anti-virals.

Do you think anyone is going to tell the truth anytime soon?

Well, hold onto your chair then, Soficrow.... H5N1 can infect flies!

See here:

www.abovetopsecret.com...

[edit on 24-9-2005 by loam]

Twelve H5N1 Bird Flu Patients Linked To Ragunan Zoo

...the number of patients at the Sulianti Saroso hospital with ties to the Rangunan Zoo is now up to 12. Three are zoo workers, including one, Karwati, who is in critical condition. She and tour guide, Aniek Setyonni, have both tested positive for H5N1 antibody.

The hospital also is treating food vendor, Abdul Muntalib. Test result announced indicated only 4 of 27 zoo birds tested were negative. The positive samples were collected September 5 and 6, so workers and visitors had been exposed to infected birds for some time before the zoo closed on September 19.

Although many of the patients had visited the zoo that weekend, Bilqis Widiawati had visited the zoo on September 11 and had been hospitalized at RS Medika Griya Sunter. Thus, like most of the suspected bird flu case, hospitalization was not reveal until transfer to Sulianti Saroso, which for Bilqis was September 24.

Thus, the number of zoo visitors with symptoms may be significantly higher than the 12 patients admitted. Indeed 115 visitors were turned away earlier this week and a high school class of 30 had visited the zoo on September 18, and students soon developed high fevers. These patients have also not been admitted.

The visit over an extended time period indicates that the infections were not due to an unusual event. It seems that multiple visitors where infected on several days and there had been little evidence of close contact.

The transmission of H5N1 to zoo visitors over an extended time period indicates that H5N1 is now transmitting via casual contact, a strong signal that the pandemic has moved to phase 5.

I can't believe they turned away those 30 students!

This is just the shot in the arm (pun intended) this virus needs to spread substantially. This is just terrible....

Originally posted by loam

The transmission of H5N1 to zoo visitors over an extended time period indicates that H5N1 is now transmitting via casual contact, a strong signal that the pandemic has moved to phase 5.

I can't believe they turned away those 30 students!

So we now have evidence of transmission via casual contact and they turn people away? This is exactly the time to be admitting them and keeping them quarantined.

I shudder to think where this may be in two weeks to a month, if the speculation is true.

Originally posted by loam

Well, hold onto your chair then, Soficrow.... H5N1 can infect flies!

See here:

www.abovetopsecret.com...

[edit on 24-9-2005 by loam]

I knew that - - but good find, loam.

Prions hitchhike on and/or infect microbes, like flu viruses - and "ectoparasites" like flies also 'harbor' prions.

FYI - it's been well known for some time in certain scientific circles that prions a) hitchhike on viruses, b) use the immune system to spread in the body, and c) multiply more rapidly when the immune system is actively fighting infection.

Also well known that prions also are spread in milk, urine, water, soil, food, vaccines, blood, and tissue products, and on medical devices.

Some background references:

"Animal prion infections, such as scrapie (sheep) and "mad cow disease" (cattle), have shown a pattern of horizontal transmission in farm conditions and several ectoparasites have been shown to harbor prion rods in laboratory experiments. Fly larvae and mites were exposed to brain-infected material and were readily able to transmit scrapie to hamsters. New lines of evidence have confirmed that adult flies are also able to express prion proteins. ...Several cell types found on the human skin, including keratinocytes, fibroblasts and lymphocytes, are susceptible to the abnormal infective isoform of the prion protein, which transforms the skin to produce a potential target for prion infection."
Int J Dermatol. 2003 Jun;42(6):425-9. Could ectoparasites act as vectors for prion diseases? Lupi O. Center for Vaccine Development, University of Texas Medical Branch at Galveston, Galveston, TX, USA. PMID: 12786866

This 1986 paper describes how "proteinaceous capsids" (prions) use viruses as vehicles of transmission...
* "Viral influences on aflatoxin formation by Aspergillus flavus." Appl Microbiol Biotechnol 24:248-252. Schmidt FR, Lemke PA, Esser K (1986)

"Epidemiological observations indicate that a microbial vector is responsible for the transmission of natural prion disease in sheep and goats … ...It is proposed that many microbial proteins may be capable of replicating themselves in mammalian cells eliciting and sustaining thereby degenerative and/or autoimmune reactions subsequent to infections with microorganisms."
* Med Hypotheses. 1999 Aug;53(2):91-102. Is the pathogen of prion disease a microbial protein? Fuzi M. Budapest Institute of National Public Health and Medical Officer Service, Hungary. PMID: 10532698

* Dangerous liaisons between a microbe and the prion protein. J Exp Med. 2003 Jul 7;198(1):1-4. Aguzzi A, Hardt WD. PMID: 12847133

Mad Cow and AIDS



relentless - quarantine will NOT work - pandora's box is already open. It's too late - the barn is totally contaminated, and the barn is planet earth.


.


[edit on 25-9-2005 by soficrow]

it seems as if it's only a matter of time until this becomes a problem. as soon as I get confirmation of human to human contact i am going to begin preparing. im only 16, i have my whole life ahead of me. i have a heart condition, i'm too young to die. this is going to change the world. i just hope the us deals with it better than these last 2 hurricanes.

loam - oops. Did I forget to mention that bird flu (and other Super Bugs) all result from mutations of a protein called "a-smooth muscle actin" (ASMA) - and that these mutations were predicted as early as 1950, when Linus Pauling first described the actin protein's a and b conformations? And that the mutation paths also have been tracked, and documented scientifically - not just predicted long ago?

Confirmed H5N1 Bird Flu Deaths In Jakarta Increase to Six

The most recent is Karwati a mother of two who has been described in media repots as being 27 or 30. One report indicates she has a connection with the Ragunan Zoo, but most reports link her exposure to 15 birds that died near her home, including one or more that was eaten.

The other case, Riska, died last week and was just confirmed to be H5N1 positive. She also had contact with dead birds, but also had a pet bird, which again focuses attention on pet birds. The first three H5N1 reported fatalities were in a family from Tangerang. The birdcage across the street from their residence was H5N1 positive.

...There is considerable concern over false negatives or misdiagnosis...

...misdiagnosis is common...

...serious questions about the monitoring of H5N1 in Indonesia and throughout the region...

And...

Dengue Fever Misdaignosis of Fatal H5N1Case Causes Concern

...The entire area is reporting unusually high number of cases of dengue fever. The Philippines has recorded 259 dengue fever deaths.

Last year the index case of human-to-human transmission in Thailand was diagnosed as dengue fever because she vomited blood and had a nose bleed. She fatally infected her mother, who was H5N1 positive. Her aunt was also H5N1 positive.

The confusion of pandemic influenza with dengue fever was also seen in the 1918 flu pandemic...led to mis-diagnosis of dengue fever, typhoid, and cholera.

The spread of H5N1 in Indonesia suggests monitoring efforts in the region are far from adequate. Indonesia now has 10 acknowledged H5N1 cases. Six have died and one has been discharged. Two are in South Sulaweto, indicating H5N1 in humans has spread far and wide....

The number of H5N1 cases in Indonesia and the area in general is unknown because of the lack of H5N1 testing combined with false negatives...

This is like waiting for the boogie-man to jump from behind the corner.


[edit on 26-9-2005 by loam]

THE POSITIVE SPIN:

Don't think of it as disease, think of it as adaptation and evolution in action.

...The horse got out of the barn long, long ago. Modern industry changed the world - completely - at the chemical and biological level. We - along with all the other life on earth - are now adapting to the changes. It really is too late to turn back the clock.

Do a quick search on super-organisms (or supra-organisms, I forget which), on Google and here at ATS. ...In a very real way, at the atomic level, we are one with our planet. We contain the bits and parts of things that exist around us - including elements, chemicals, proteins, microbes.

...And we have created new elements, chemicals, proteins, microbes, to be part of our world - whether we like it or not, they are part of us. "Disease" is the pain of assimilation, adaptation, and evolution. Nothing more, or less.


.

[edit on 27-9-2005 by soficrow]