Sunday, December 16, 2007

Pakistan : Two Brothers Attending H5N1 Infected Veterinarian In Hospital Caught Virus and Died

Amongst the conflicting reports coming out of Pakistan, comes this extraordinary story, which
claims that a veterinarian who fell ill with H5N1 then infected his two brothers with the virus, while in hospital, and both brothers died. The veterinarian, however, recovered.

There are many details in this story that are not reaching the wire reports from Reuters and Associated Press, including the claim that this is the first case of human transmission of the virus in Pakistan :
The deaths of two brothers of a veterinarian, who acquired the deadly H5N1 Avian Influenza virus after coming into contact with infected poultry at a farm in Abbottabad late-October, and the recent hospitalisation of a Mansehra-based poultry handler who has also tested positive for the disease, provide sufficient evidence for the government to institute concrete measures for interruption of human transmission of the disease from birds to poultry handlers and their close contacts.

Of the 40 suspected human samples collected from Peshawar and Abbottabad in the wake of the first-ever confirmed human transmission of H5N1 in Pakistan, 36 have tested negative, while four are positive, investigations conducted by ‘The News’ have revealed.

This is the first time that human cases have been reported in Pakistan, placing an onerous responsibility on the government and its partners to eradicate some of the dangerous trends in the poultry industry that could spell disaster for the country.

It is learnt that both the veterinarian, Dr. Ishtiaq Durrani, who is working as livestock production officer at the Department of Livestock and Dairy Development, NWFP, as well as the poultry handler from Mansehra, did not follow the recommended protective measures while handling infected birds. They may either have come into contact with the saliva, nasal excretions and faeces of the infected birds, or the feed and water that are given to them.

Dr. Ishtiaq was involved in culling of 3,000 birds following the October 21 outbreak of bird flu at a poultry farm in Abbottabad. The other victim from Mansehra happens to be a daily wage labourer who was commissioned for culling without being advised on how he should protect himself. The labourer’s daughter, along with another male, is also under observation at a hospital in Abbottabad.

While Dr. Ishtiaq himself is on the path to recovery, his brothers Mohammad Ilyas Durrani and Mohammad Owais Durrani — both of who were attending him at the Khyber Teaching Hospital during his illness — died on November 19 and November 29, respectively.

Ilyas has been confirmed as being the first casualty of H5N1 in Pakistan. Even though his brother’s blood sample could not be collected, health experts talking to ‘The News’ said clinical evidence suggests that he too succumbed to the deadly virus. The blood samples of two of the three brothers were received by the National Institute of Health on October 28.
This Bloomberg wire report is vastly different to the above story, claiming that no samples were collected from the two dead brothers and that the most recent outbreak of H5N1 occurred in late November, instead of October.

1 comment:

wilfriedsoddemann said...

H5N1 avian flu: Spread by drinking water into small clusters:

Human to human and contact transmission of influenza occur - but are overvalued immense. In the course of Influenza epidemics in Germany recognized clusters are rarely (9% of the cases in the season 2005).
In temperate climates the lethal H5N1 avian flu virus will be transferred to humans strong seasonal in the cold via cold drinking water, as with the birds feb/mar 2006.
Recent research must worry: So far the virus had to reach the bronchi and the lungs in order to infect humans. Now it infects the upper respiratory system (mucous membranes of the throat e.g. when drinking and mucous membranes of the nose and probably also the conjunctiva of the eyes as well as the eardrum e.g. at showering). In a few cases (Viet Nam, Thailand) stomach and intestine by the H5N1 virus were stricken but not the bronchi and the lungs. The virus might been orally taken up, e.g. when drinking contaminated water.
The performance to eliminate viruses of the drinking water processing plants in Germany regularly does not meet the requirements of the WHO and the USA/USEPA. Conventional disinfection procedures are poor, because microorganisms in the water are not in suspension, but embedded in particles. Even ground water used for drinking water is not free from viruses.
In temperate climates the strong seasonal waterborne infections like norovirus, rotavirus, salmonellae, campylobacter and - differing from the usual dogma - influenza are mainly triggered by drinking water dependent on the drinking water temperature (in Germany minimum feb/mar – maximum august). There is no evidence that influenza primary is transmitted by saliva droplets. In temperate climates the strong interdependence between influenza infections and environmental temperatures can’t be explained with the primary biotic transmission by saliva droplets from human to human with temperatures of 37.5°C. There must be an abiotic vehicle like cold drinking water. There is no other appropriate abiotic vehicle. In Germany about 98% of inhabitants have a central public water supply with older and better protected water. Therefore in Germany cold water is decisive to virulence of viruses.
In hot climates/tropics the flood-related influenza is typical after extreme weather and natural after floods. Virulence of Influenza virus depends on temperature and time. If young and fresh H5N1 contaminated water from low local wells, cisterns, tanks, rain barrels or rice fields is used for water supply water temperature for infection may be higher as in temperate climates.

Dipl.-Ing. Wilfried Soddemann
Epidemiological Analysis: