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Commentary

Fatal H5N1 Export By China Raises Surveillance Concerns
Recombinomics Commentary 13:45
January 9, 2014

The minister, Rona Ambrose, and several public health officials, insisted that the death was an isolated case and posed little or no risk to the general public. They said that the victim did not appear to have contracted the H5N1 virus from human contact during a trip to Beijing last month and was unlikely to have passed it along when returning to Alberta.

The above comment on H5N1 transmission in humans in general or the above case in particular is based on negative data from a country that has just exported H5N1 via a commercial airline passenger infection for the first time in recorded history.  These statements raise serious concerns about media reports functioning as propaganda machines.

The above case had an unusual presentation (encephalitis in the absence of significant respiratory symptoms) which apparently is not being effectively monitored in China, which has not reported any human H5N1 cases since February 2013 (in Guizhou Province in southern China).  The first reported export of H5N1 via airline passenger infection suggest human cases of H5N1 in the exporting county are common, and the failure to report any such cases in almost a year signals an unreliable surveillance system, which is being used to generate negative data to support the claim of little or known human transmission.

Examples of coronavirus export from Hong Kong in 2003 or Saudi Arabia in 2013 were associated with human to human transmission as well as nosocomial transmission associated with significant numbers of lab confirmed cases, which signaled a more significant transmission in milder cases which were not lab confirmed.

For influenza, export has preceded the declaration of a pandemic, for which the 2009 H1N1 pandemic is the most recent example.  Although there is no suggestion that H5N1 is transmitting at pandemic levels, claims of limited human transmission in an H5N1 exporting country does not have a scientific basis, and such claims are little more than propaganda.

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