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Watchful Waiting for Suspect H5N1 Patients in West Bengal India
Recombinomics Commentary 08:58
January 21, 2008
Today, he is searching for a particular house. Finally, he finds it. The house belongs to Kalu Sheikh, a daily-wage labourer. Roychowdhury begins a round of questions. “I heard your children are ill?” he says. “For how many days have they had fever? How many birds in your house are dead?”
Kalu’s children—seven-year-old Anarul Sheikh and eight-year-old Tumpa Sheikh—have been running a fever for the past four days. Kalu tells Roychowdhury that they had seven hens. Four died last week and the rest fell ill. The family ate one of the birds a few days ago.
“When my four birds died, the children picked them up and threw them behind the house. The other three were ill, so we thought why not eat one. But why are you asking these questions?” Kalu says.
One of the health workers ventures to tell Kalu that there is a new disease in the area that could be fatal to humans. Roychowdhury interrupts him, asking him not to create panic. Don’t worry, he tells Kalu and his wife, putting his hand on the children’s foreheads. “Keep a watch on the family,” he tells his staff as he leaves.
The above description of two suspect cases in Birbhum, West Bengal suggests that those who have eaten dead chickens and develop fever are simply being watched. There is no indication of hospitalization or treatment.
Earlier reports described 700 patients with fevers who were given medicine and sent home. There has also been no suggestion that these patients are being tested or being given Tamiflu. Earlier reports indicated the patients had no chicken contact or lower respiratory disease.
However, H5N1 can produce mild symptoms as was seen in children in Egypt last year. Samples from those children yielded H5N1 sequences which were clearly the Qinghai strain of H5N1.
The number of suspect hospitalized patients remains unclear. There have been no confirmed cases, and one media report citing patients in an isolation ward have been followed with reports indicating the isolation ward did not meet standards, it had not yet received patients.
Many villagers in hard hit areas have engaged in risky behaviors, including cooking and eating dead birds, or collecting dead birds or feathers without PPE's.
The lack of hospitalized patients appears to be linked to the lack of testing.
More information on suspect patients and treatment would be useful..
Recombinomics Paper at Nature Precedings