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Paradigm Shift Intervention Monitoring | Commentary . Tsunami Related Spread of H5N1 Recombinomics Commentary December 29, 2004 >> It would be prudent for federal, state, and provincial public health departments to set up surveillance systems to monitor the health of individuals who traveled to help with the tsunami recovery efforts.<< It would be prudent for public health departments to set up surveillance systems in Thailand, Indonesia, and Sri Lanka. Prior to the Tsunami, there were school closings in Thailand because of H5N1 infected pigeons falling from the sky. The Tsunami displaced both humans and wildlife. The case fatality rate for H5N1 in Thailand has been in excess of 70%. Thus, the virus can clearly cause significant problems in the local population. Likewise the virus generated infections leading to the deaths of 147 Tigers in a Thai zoo. The case fatality rate for the tigers exposed to the virus may have been near 100%. There is no published data suggesting the H5N1 virus has spared a human sub-population in Thailand, and no data indicating tourists or aid workers are more susceptible. The situation in Indonessia is also cause for concern. Although there have been no reported human cases, H5N1 has already reappeared this season in Indonesia and has infected poultry in densely populated provinces. Although H%N1 infections were no reported until the beginning of this year in Indonesia, about half of the H5N1 isolates at GenBank are from 2003 indicating initial infections were well over a year ago in Indonesia. The situation In Sri Lanka is also unclear. Initial reports indicated that there was one influenza A and two influenza B cases. Later reports indicated that the 9 deaths and 75 hospitalizations were related to influenza B outbreaks. However, a case fatality rate in excess of 10% for human influenza infections is unusual and influenza B cases are usually milder than influenza A. Concerns were also heightened by the culling and dying of chickens in the area. Although the general population was told that the spread of infections was reduced, they were also advised to stay away from crowds. The death and destruction caused by the Tsunami has created an environment more conducive to spread of infectious diseases, and increased surveillance of all susceptible H5N1 hosts would be warranted (click on title below for assocciated media stories). Tsunami-related Spread of H5N1 Coverge in P R China |
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