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Are Sagada Meningo Cases Secondary Bird Flu Infections

Recombinomics Commentary
January 10, 2005

>>Health Department records showed that almost 60 suspected cases of meningococcemia have been detected in the Philippines since last year with about 90 percent of the cases in Baguio.

However, due to the difficulty of testing for the disease, Health Secretary Manuel Dayrit said "only five actual cases have been confirmed with only three deaths."

Dr. Antonio Bautista, spokesperson of the Health Department's Meningo Task Force, said that the exact circumstances of the cases from Mountain Province could not be immediately ascertained and health officials are still awaiting the report from the Bauko Municipal Health Office.

But a daily tabloid in the city quoted doctors from the Bontoc General Hospital and the Luis Hora Hospital that the two patients were afflicted with typhoid fever and not meningococcemia.<<

The situation in Baguio is confusing at best.  Media reports carried comments by WHO warning of bird flu in Sagada, because of potential interactions with H5N1 infected migratory birds. However, the large number of unconfirmed and disputed diagnoses raises additional questions about the meningo cases in Baguio City, which is 100 kilometers south of Sagada.

Reports on the 1918 pandemic flu indicate the course of the disease varied and it was frequently misdiagnosed as cholera, Dengue Fever, and typhoid.  Recently 3000 ducks died in Vietnam.  They had signs of leg paralysis, but since the symptoms did not match those of last year's bird flu, the ducks were diagnosed as having cholera.  The index case of the most likely human to human H5N1 transmission in Thailand was initially diagnosed as having Dengue Fever.  However, she became a suspect bird flu case after her mother and aunt tested positive for H5N1.  Now the above "meningo" cases in the Philippines are diagnosed as typhoid according to the media report above, but the symptoms are similar to bird flu.

More information on testing for bird flu for "meningo" cases and contacts would be useful.

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