Bird Flu Surveillance Shortfalls in Asia
Recombinomics Commentary
February 24, 2005
>> In the meantime, many remain critical of current monitoring efforts. Henry Niman is the founder of Recombinomics, a company in Pittsburgh, Pennsylvania, that traces the molecular evolution of infectious agents. He claims that many cases of possible human-to-human transmission are not followed up properly. And a lack of widespread testing means that H5N1 could be to blame for other outbreaks, Niman says, such as a bout of apparent meningococcal blood poisoning that is ongoing in the Philippines.
There are no plans to test for H5N1 in the Philippines as yet. But the WHO is discussing how to broaden its surveillance of the virus. <<
Broadening surveillance is long overdue, and WHO's reluctance to test cases in the Philippines raises serious questions about transparency,. demonstrating why bird flu monitoring is scandalous.
WHO has already acknowledged that the Philippines are in the flight path of migratory birds and the case fatality rates of meningococcemia cases has been unusually high. Moreover, the case clusters demonstrated unusually high transmission rates between adults. Meningococcemia is a known secondary infection of influenza infections. The sudden death of these patients has similarities with sudden deaths of pandemic flu cases. The recent case described in the New England Journal of Medicine highlighted the neurotropism of H5N1 which has been seen in birds, mice, and ferrets.
The new reports of false negatives in Vietnam and the lack of any human cases in Thailand this season further illustrate the poor surveillance of pandemic flu in Asia. The lack of plans by the WHO for testing in the Philippines, and the inability to confirm the WSN/33 sequences in Korean swine, further extends the dismal surveillance record for pandemic flu.
Control of pandemic flu requires extensive and accurate testing, which has been sorely lacking.
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