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Misinformation Associated With Canadian Train Fatality

Recombinomics Commentary 18:25
May 11, 2008

OPP Const. Marc Depatie said he believed the woman who died had boarded the train in Jasper, Alta., as part of a tour group. Depatie said there were reports she had flu-like symptoms when she boarded.

Tests results on the sick woman taken off the quarantined train stuck in Foleyet, northern Ontario, show she is negative for influenza A and B and she and the other five patients seem to be getting better, said Dr. Donald Low.

The rapid antigen tests are negative for influenza and Respiratory Syncytial Virus (RSV).

"Now they are doing the molecular testing, a more sensitive test. I suspect they'll be negative," he said.

The above comments from media reports on Friday raise a number of transparency issues concerning the medical emergency on then train in Canada.  The fatal case was said to have had influenza symptoms prior to board the train in Jasper, Alberta and her death sparked a medical emergency, which was compounded the flu-like symptoms in other travelers belonging to the same tour group.

However, subsequent media reports indicating most of all of the six travel companions have tested positive for influenza A and the fatal case died of “natural” causes.  However, the deceased was initially described as being in her 60's, followed by 86, followed by an identity who was 43 and from South Africa.  The relatively young age of the deceased has increased concerns.

The official press release did not indicate the infectious disease was influenza A, and claimed there was no infectious outbreak on the train, apparently based on the fact that the ill passengers has symptoms prior to boarding the train, and contacts had not yet shown any symptoms.

However, since contact with the tour group had been only 2-3 days, the lack of symptoms did not indicate a lack of transmission.  Similarly, the false negatives linked to the initial rapid tests on the symptomatic tour group members indicated any influenza testing on the train would be unreliable.

The attribution of the death of the index case is similar to claims linked to the index H5N1 case in Iraq as well as the index case in Azerbaijan.  Both were said to have died from complications of a heart condition, and both where subsequently H5N1 confirmed when contacts began to die.

The travel history of this tour group remains unclear.  Earlier reports indicated they originated in Australia and traveled through Asia before arriving in Canada.  However, the index case is from South Africa, so the true travel history remains unclear.

Similarly, the serotype of the seasonal flu has not been released, and the timing of they lab confirmation of seasonal flu relative to the release of the other passengers remains unclear.

Detail on the influenza serotype, travel history,  and autopsy of the deceased patient would be useful.

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