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Is Ebola-like Illness in Angola Really Bird Flu?

Recombinomics Commentary
March 18, 2005

>>  But unlike Ebola, which tends to predominantly affect the adult population, four out of five cases of this new ailment have been children, Thompson said.

"With Ebola, the age distribution is generally quite different than what we are seeing here," he said. "But we are not ruling Ebola out. We are not ruling anything out." The symptoms of the virus - including vomiting, bloody discharge and high fever - are similar to those for Ebola and dengue fever, according to the World Health Organisation. <<

Although WHO is not ruling anything out, it would be reassuring if they had indicated that the children were influenza A negative.  An infectious disease targeted age group with dengue fever symptoms and a high case fatality rate clearly is a red flag for influenza A testing.

In the 1918 pandemic, the flu was frequently misdiagnosed as dengue fever.  Moreover, the often cited human-to-human transmission of H5N1 in Thailand began with an index case that was misdiagnosed as having dengue hemorrhagic fever.

The overlapping regions with bird flu and dengue fever outbreaks in Indonesia are also cause for concern.

Dick Thompson's comments after the New England Journal of Medicine article on varied clinical presentations for H5N1 infections indicated that the WHO was going to expand the range of illness tested for H5N1 infections.  This broadening would be consistent with the researchers' recommendation of testing for H5N1 in clusters of unexplained deaths.

A large cluster of young people dying with dengue fever symptoms would surely meet that definition.

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