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Re: New ladder to a pandemic alert
Yes, H2H is not new. Most cases involve 2 or 3 family members (or other close contacts), and there were also clear examples in Vietnam and Thailand in 2004.
WHO uses many techniques to exclude H2H clusters, but those methods really have lost credibility, so the new systen will allow WHO to admit that there are dozens of small H2H clusters, and still keep the level at 3.
Originally posted by Oracle
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Within the first batch of human infection cases reported between May and August 1997.
Isolation of Avian Influenza A(H5N1) Viruses From Humans—Hong Kong, May-December 1997. Vol. 279 No. 4, January 28, 1998.
"The other possible case-patient (of 2 discussed in this paper) is the 3-year-old sister of patient 7 and cousin of patient 6. She lived in the same apartment as patient 7 and had onset of fever on December 13 and was hospitalized in good condition. Preliminary laboratory results were positive for influenza A(H5N1) virus; confirmation of these results by virus isolation is pending.
Patient 6
On December 7, a 5-year-old girl developed fever, rhinitis, cough, sore throat, and vomiting. As of December 17, she remained hospitalized in satisfactory and stable condition. A nasopharyngeal aspirate collected on December 10 yielded influenza A(H5N1).
Patient 7
On December 12, a 2-year-old boy developed fever and was admitted to the hospital in good condition. The child is a cousin of patient 6, who frequently visited him and his family at their home. On December 16, a culture from the child was reported positive for influenza A(H5N1) virus."
Right from the get-go, we have probable family clusters reported in the initial 18 cases of avian H5N1 infection in humans. A telling comment in the paper:
" because influenza surveillance in Hong Kong has been conducted primarily in hospitals, milder cases may not have been recognized, and the severity of infections identified to date may not be representative of the spectrum of illness caused by A(H5N1) infection in humans."
Isolation of Avian Influenza A(H5N1) Viruses From Humans—Hong Kong, May-December 1997. Vol. 279 No. 4, January 28, 1998.
"The other possible case-patient (of 2 discussed in this paper) is the 3-year-old sister of patient 7 and cousin of patient 6. She lived in the same apartment as patient 7 and had onset of fever on December 13 and was hospitalized in good condition. Preliminary laboratory results were positive for influenza A(H5N1) virus; confirmation of these results by virus isolation is pending.
Patient 6
On December 7, a 5-year-old girl developed fever, rhinitis, cough, sore throat, and vomiting. As of December 17, she remained hospitalized in satisfactory and stable condition. A nasopharyngeal aspirate collected on December 10 yielded influenza A(H5N1).
Patient 7
On December 12, a 2-year-old boy developed fever and was admitted to the hospital in good condition. The child is a cousin of patient 6, who frequently visited him and his family at their home. On December 16, a culture from the child was reported positive for influenza A(H5N1) virus."
Right from the get-go, we have probable family clusters reported in the initial 18 cases of avian H5N1 infection in humans. A telling comment in the paper:
" because influenza surveillance in Hong Kong has been conducted primarily in hospitals, milder cases may not have been recognized, and the severity of infections identified to date may not be representative of the spectrum of illness caused by A(H5N1) infection in humans."
WHO uses many techniques to exclude H2H clusters, but those methods really have lost credibility, so the new systen will allow WHO to admit that there are dozens of small H2H clusters, and still keep the level at 3.
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