Avian influenza – situation in Azerbaijan - update 2 (5 dead)

http://www.who.int/csr/don/2006_03_21a/en/
Samples from 11 patients under investigation in Azerbaijan for possible H5N1 infection have now been tested at a WHO collaborating laboratory in the United Kingdom. Positive H5N1 results were obtained for seven of these patients. Five cases were fatal.
snip

A 17-year-old girl died on 23 February. Her first cousin, a 20-year-old woman, died on 3 March. The 16-year-old brother of this woman died on 10 March. A 17-year-old girl, a close friend of the family, died on 8 March. All four of these cases lived together or near each other. The source of their infection is presently under investigation.

The additional two cases in Salyan involve a 10-year-old boy, who has recovered, and a 15-year-old girl, who is hospitalized in critical condition.

The seventh case occurred in a 21-year-old woman from the western rayon of Tarter. She died on 9 March.

Two additional patients, from Salyan and the adjacent rayon of Neftchela, have been hospitalized with symptoms of bilateral pneumonia. Testing of these patients is presently under way.
snip

Excellent collaboration between the Ministry of Health and the WHO team continues. WHO is confident that ongoing house-to-house surveillance for cases of influenza-like illness, undertaken by more than 90 local medical teams in Salyan and Tarter, will detect patients requiring further investigation. On-site diagnostic capacity continues to be provided by the US Naval Medical Research Unit 3 (NAMRU-3). A better understanding of the situation in animals is, however, urgently needed.



Looks like one cluster plus a few cases in another part of the country.

they are not the very young or the very old. damn.

have been in children and young adults. I hope it does not go pandemic or we could lose a whole generation of youngsters.
What makes me mad is "experts" who are saying to only have two weeks food in the house. If we did have a pandemic that would send people out looking to buy food in the middle of a wave and up their chances of coming home infected. Some good honest preparadness info needs to be put out to people for a just in case scenario.

Meanwhile
Egypt reports fourth human case of deadly bird flu virus
(AP)

21 March 2006


CAIRO - A 17-year-old Egyptian has been infected with the deadly bird flu virus, the fourth case of human infection reported in Egypt in less than a week, the health minister said on Tuesday.
..........

in North America, I'll let you all know how it goes.

is the WHO sometimes. This is not the only time the family of victims deny any poultry or bird contact but WHO insists there must have been some.

http://www.bakutoday.net/view.php?d=18325
Some 90 medical teams in Azerbaijan, including WHO and local experts, were investigating the source of the outbreak and carrying out house-to-house searches for possible cases.

The investigation was focusing on the possibility that local residents may have collected feathers from the carcasses of dead swans, the organization said in a statement. Swan hunting is illegal but thought to be common.

"Interviews with surviving family members have failed to uncover a history of direct exposure to dead or diseased poultry for several of the cases," the WHO added.

The WHO warned that a "better understanding of the situation in animals" was "urgently needed" in Azerbaijan.

The six cases around Salyan had come close to matching the first epidemiological signs of the possible emergence of a pandemic strain of flu under guidelines currently being compiled by a team of international health experts.

@@@@@
The spacing of the cases does suggest limited human to human as has been seen before.

"The investigation was focusing on the possibility that local residents may have collected feathers from the carcasses of dead swans"

Feb 23, Mar 03, Mar 08, Mar 10

It looks like maybe the feb 23rd victim was infected by collecting feathers from a dead swan and then went on to infect one or more of the other three.

to me too...

"Small cluster(s) with limited human-to human transmission but spread is
highly localised, suggesting that the virus is not well adapted to humans"

See, e.g. p. 25 http://www.hpa.org.uk/infections/topics_az/influenza/pandemic/pdfs/HPAPandemicplan.pdf

we can still hope that every time H5N1 transmutes into a deadly form that is transmissable between humans, it will be stopped in its tracks and not infect the whole world.

And if that is done successfully, the people who don't believe that such a pandemic is possible and blame it onto paranoia will feel vindicated. ;-)