Fever in Cullers in Pakistan
Recombinomics Commentary 00:23
February 8, 2008
He said that, on the first day, they were suffering from fever but now they were absolutely normal. However, they would stay at the hospital for another eight-to-ten days as a precautionary measure.
The three were working on the poultry farm in Gadap Town where laboratory tests confirmed the existence of H5N1 strain of bird flu on February 1.
The above comments give the reason for the isolation of three cullers in Pakistan. Media reports indicated they did not have bird flu symptoms, but failed to give reasons for the isolation. The were said to be negative but media reports suggested the negative data was based on blood tests, which have a low sensitivity for detecting H5N1.
WHO sent a team to Pakistan, and they requested nose and throat swabs, which have a much greater sensitivity. Those results are expected this weekend, but the collection of samples after the start of Tamiflu may also generate false negatives.
The above comments suggest the cullers will recover, but the question about H5N1 infections in the cullers remains unanswered.
These testing issues remain a problem in the area. India has also reported H5N1 infections in West Bengal, but testing issues remain on wild birds and humans. Earlier Pakistan reported human H5N1 infections, and most did not involve pneumonia or death. These milder cases are easy to miss, especially if patients without low respiratory tract symptoms are not tested, which appears to be the case in India (see satellite map here and here).
The failure to detect H5N1 in wild birds in India and in patients in Pakistan, India, and Bangladesh, remain causes of concern.
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