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Wednesday, January 11th 2006

Bird Flu Bad?

Even as certainly more than fifteen people have become infected in Turkey there’s new research that H5N1 may have a lower mortality than expected.

Two brothers in Ankara, who both tested positive for H5N1, have shown no symptoms. The brothers have doctors questioning whether H5N1 infection may at times take a subclinical form…

This development follows a study by investigators at the Karolinska Institute in Stockholm, published Monday in the Archives of Internal Medicine, which found that H5N1 transmission may be more common than once believed, but with a lower mortality rate. A population-based study suggested that people who come into contact with infected or deceased birds may become mildly sick, but the sickness doesn’t always progress to more advanced stages.

Time Magazine asks,

Is it just that physicians are getting better at finding all folks with bird flu infections, including those that don’t normally wind up in the hospital?

I predicted this. I know almost nothing about modeling public health crisises, but you have to believe, that the numbers they use to try to estimate the mortality generally downplay those who contract the virus and don’t report it, and thus overstate the mortality figures. I know the estimates they create are very sophisticated, but trying to model the number of people who get the disease but display only mild symptoms and so are never diagnosed, must be very difficult.

How many bacterial diseases are there where there isn’t at least a small set of the population who contract it and have only subclinical signs of the infection? You had to assume such a population of H5N1 patients existed as well, and at least question how accurate the estimates of the numbers of such (in trying to determine the mortality of the avian flu) were, when the media started hitting the panic button.

I understand this data showing that some H5N1 victims do not show clinical symptoms, and maybe a good number of them, is in and of itself uncoaborrated and preliminary data. Certainly avian flu, even with a mortality rate projected downward could still be a major health threat.