Patients Hospitalized in Calcutta Raise H5N1 Concerns
Recombinomics Commentary 11:25
February 4, 2008
Two members of a culling team in bird flu-hit South 24-Parganas district in West Bengal have been admitted to a hospital with symptoms of influenza, even as killing of diseased poultry continued in the affected districts of the state on Monday.
Both the patients were members of a team engaged in the culling at Budge Budge in the district.
Tarak Nath Haldar was admitted to M S Bangur hospital while Mohammad Azizul Rahman was admitted to Budge Budge Rural Hospital on Sunday, Chief Medical Officer Health, Sachidananda Sarkar told PTI.
While blood samples of Haldar had been given for testing, a team from Bangur hospital would go to Budge Budge to take blood samples of Rahman, he said.
He said Haldar was suffering from fever, headache and body ache. Doctors were monitoring his condition to ascertain whether he had developed any respiratory problem as the fever could take a turn towards pneumonia, Sarkar said.
He said as of now, there were no reports of human deaths from bird flu in the country.
The above comments provide additional detail on two patients hospitalized in Calcutta after culling birds in Budge Budge (see satellite maps here and here). The wording of the report has been carried in multiple media reports, but the comments raise additional questions.
Earlier reports described three patients admitted, so the status of the third patient is unclear. Earlier reports indicated Tarak Nath had not received a full course of prophylactic Tamiflu, but it remains unclear if the incomplete courses apply to the other patients.
Similarly, the media reports mention influenza, but it is unclear of the patients have already tested positive for influenza A, which usually involves a rapid test on a throat swab. However, it remains unclear if throat swabs are being taken or tested for these patients or other patients with influenza-like symptoms. Similarly, it is unclear if influenza cases are due to H5N1 or oseltamivir resistant H1N1 in patients on Tamiflu.
Testing of humans and wild birds in India remain suspect. There is little doubt that some or most of the dead wild birds found in association with H5N1 confirmed poultry are also H5N1 positive, but such cases have never been reported for resident or migratory wild birds.
Similarly, India has never reported H5N1 in a human case, including highly suspect cases linked to the 2006 outbreaks in western India.
However, the above media report does not deny H5N1 patients in West Bengal. The comments only state that there have been no fatalities. In Pakistan late last year most of the H5N1 confirmed cases were not fatal, so the media comments leave open the possibility of H5N1 confirmation in human cases in West Bengal.
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