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Southeast Asia
Unreported Bird Flu Cases and Deaths in Vietnam
2005-03-11
>> An additional 11 people have been infected with bird flu in Vietnam and about eight of them have died, though the cases have yet to be reported officially by local health authorities, according to a person familiar with the matter.

The cases add to the official death toll of 46 people, including 33 in Vietnam, the worst-hit nation, since the latest wave of cases of bird flu emerged in 2003.

The new cases also are fueling concern about the reliability of statistics regarding the extent of the flu -- especially data from Vietnam. In a separate bird-flu development, seven people who tested negative for H5N1 avian influenza in Ho Chi Minh City in January were later found to have the virus when their samples were retested. Some of them also died. <,

The above report identifies serious under-reporting of cases in Vietnam. The sudden halt of reports on human cases in Vietnam just before Tet was suspect. Many patients were hospitalized with symptoms, but not confirmed. The same was true of patients who died. It is not clear if these patients are included in the 11 unreported cases. SNIP
While its not clear if all of the new cases represent a real increase or just better identification, it's clear there has been a sharp increase in the number of cases over the last month or two - more in the last month than the whole of last year. Such an increase can only mean the virus is now transmitting person to person and the pandemic is on its way. It remains to be seen how severe it is. Current 50%+ fatality rates will certainly drop but even a 1% fatality rate will mean 80 million dead. Note that the MSM is parroting the WHO line that person to person transmission is not or only rarely occuring.
Posted by:phil_b

#7  The US is in the position of having no choice. Avian flu kills the chicken ebryos used to make vaccine for the 'swine' type of flu; this means that other animals, mostly horses, are used. But there are far fewer horses than chickens. This means that it would be almost impossible to produce and distribute the vaccine to enough of the population to make a difference. So the alternative is plain: interrupt the transmission at its biggest vector source, schoolchildren; and vigorously attack outbreaks. On the plus side, America is underpopulated, we have very good hygiene and public health services, and we also have the communication network to advise the public about conditions, what to do, and what to avoid. And these are potent tools. The Americans most likely to die are those that are concentrated, such as prisoners and in other institutions; those that insist on attending public gatherings; health care workers and then those who usually are at risk: the elderly, the sick, and very young infants. And just because we don't have enough vaccine at the outset does not mean we cannot continue to produce it once the flu has arrived. With vaccine production in surge mode, more and more of the population will be resistant, making it harder and harder for the disease to spread.
Posted by: Anonymoose   2005-03-11 7:04:53 PM  

#6  reverting to the old quarantine rules This worked in the case of SARS. Its unclear if it will work with flu which is more infectious. The problem is that if disease control can eliminate the disease completely then it must be the highest priority. However, it still leaves you with a population that has no immunity and hence susceptible to new outbreaks. That is, if you can not eliminate every outbreak then you will still eventually have the pandemic. It does buy you time which may allow development of an effective vaccine or more effective treatments.

BTW, this bird flu at this stage looks a lot like the 1918 version in that young healthy adults with good immune systems are the worst affected.
Posted by: phil_b   2005-03-11 3:24:38 PM  

#5  This change in tactics could mean the difference between 200,000 US dead and 2,000,000 US dead.

That having been said, is the U.S. approach sensible or not?
Posted by: Bomb-a-rama   2005-03-11 12:29:01 PM  

#4  It's less arrogance than a combination of less-capable technology and indifference to the problem. The Chinese had a major revelation with SARS when the light dawned that they had *no* infrastructure for physicians to communicate between themselves and health authorities--it was a splash of ice water in their face. In a pretty amazing reaction, the Chinese not only correctly identified the problem, but are starting on the long and difficult road to fixing it. Truthfully, the US needs a much more advanced version of the same thing, in that its system is early 1980s quality. However, the US has reached the conclusion that avian flu is so dangerous, and it is so far beyond our capabilities to treat like a normal flu, that they are reverting to the old quarantine rules. That is, instead of the standard "vaccine for the very old, infirm, and very young", they are changing to "vaccine for school-aged children who are most likely to spread the disease, and outbreak areas", figuring that it will save more lives just to stop the flu from getting to the US than to try and treat it once it is here. This change in tactics could mean the difference between 200,000 US dead and 2,000,000 US dead.
Posted by: Anonymoose   2005-03-11 11:07:13 AM  

#3  Pining for the fjords?
Posted by: .com   2005-03-11 10:40:36 AM  

#2  "They're only mostly dead"
Posted by: Frank G   2005-03-11 10:37:49 AM  

#1  This is exactly what China did with SARS. They fudged their case numbers until WHO got very serious with them, and they fudged their death rate.

Why, oh, why would you expect a Communist dictatorship to tell the truth? They never have.
Posted by: Chuck Simmins   2005-03-11 10:21:17 AM  

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