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Equal Case Fatality Rates for Meningo-like Illness and Bird Flu
January 12, 2005
>>Philippine health authorities said only two of the 19 who died were confirmed as having the disease, whose symptoms include headache, vomiting, stiff neck, rashes and fever.<<
Yesterday WHO put out a report indicating that 19 of 33 meningococcemia cases had died to generate a case fatality rate of 58%. However, only 8 of the cases had been laboratory confirmed, Neisseria Meningitidus A positive.
The number announced today would indicate that the case fatality rate for the 8 confirmed cases was 25% (2/8), while the case fatality rate for the meningococcemia-like (meningo-like) cases was 68% (17/25). This raises the distinct possibility that the cases that were unconfirmed were misdiagnosed. The 68% case fatality rate is almost exactly the same as the case fatality rate for bird flu (unofficial and official) confirmed cases in Thailand and Vietnam last season.
The more virulent versions of H5N1 are neurotropic and the 1918 pandemic virus was frequently misdiagnosed as cholera, Dengue Fever, and typhoid. Patients also developed cyanosis, which is a symptom of meningococcemia.
Earlier this week WHO warned of potential bird flu transmission from migratory birds.
All patients with meningo-like symptoms or those who have recovered from meningo-like illness should be tested for avian influenza.