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Testing Meningococcemia-like Cases in Baguio City for Bird Flu

Recombinomics Commentary
January 12, 2005

>>Government officials have said some 28 are suspected to have died of the disease nationwide although the cause of death in many cases has not been confirmed.
"This is an exceptionally high fatality rate for meningococcal infection so we are treating the situation seriously," Olive said.
"But we need to know how many of these suspected cases are really due to meningococcal infection and not to other causes," said Olive.<<

Additional investigation of the meningococcal-like infections is important.  The case fatality rate for the combined group of meningococcemia confirmed and meningococcemia-like (meningo-like) cases is 58%, so the ratio for the menigo-like cases may be higher, and similar to last year's case fatality rate of about 70% for bird flu.  This year there are 15 confirmed or suspect avian influenza cases in Vietnam and none have recovered.

This week WHO had warned that the Baguio City area was in the flight path of migratory birds that might be H5N1 infected, so the practice (Ikik) of catching migratory birds with nets on Mt. Ampacao near Sagada should be discontinued. However, the warning was curious since the season runs from the beginning of September to the beginning of January.
The incidence of meningo-like cases has been increasing this year as have the number of bird flu cases in Vietnam. 

In the 1918 flu pandemic, many cases were misdiagnosed as cholera, Dengue Fever, and typhoid and more virulent H5N1 isolates are neurotropic in mice as was the pandemic flu virus in people.  Many of the patients infected with pandemic flu developed secondary bacterial infections and cyanosis.

Testing of meningo-like patients in The Philippines for avian flu should have been done, but there are few if any reports of such testing or test results.

Test results on meningo-like patients and contacts as well as screening of markets linked to the cases would be useful.

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