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Bird Flu Causing Meningococcemia / Meningitis Cases in India?

Recombinomics Commentary
May 13, 2005

>> Two more people died of meningococcemia in the capital yesterday.

The disease is displaying characteristics never seen before.

It is supposed to occur among children aged between 1-5, but the worst hit are adult males in the 15-30 age group.....

There have been 260 suspected cases and 20 deaths in the space of one month. Though these figures have alarmed some people, the government maintains the situation is well under control. <<

The meningococcemia / meningitis outbreak in India has some striking parallels with the outbreak in the Philippines.  There have been no reports on bird flu tests on these patients, even though the infections are clustered, spreading rapidly, and affecting an unusual age group.  Previously, WHO had said that clusters of unusual deaths would be tested for H5N1.  There is little evidence for such tests, and there are significant concerns about the sensitivity of such tests.  Moreover, meningococcemia is a known secondary infection of influenza.

Recent reports of H5N1 antibodies in poultry workers in India raise a red flag on bird flu.  The sera were from 2002, but the monitoring of bird flu in India has been minimal, and there have been no attempts to isolate or sequence the virus.  Thus, the current bird flu situation in India is not well understood.

In Vietnam a high percentage of ducks are asymptomatically infected with H5N1, and an increasing percentage of chickens are also asymptomatically infected.  False negatives in humans are frequent in both northern and southern Vietnam, so the distribution of the virus in endemic areas is not monitored well, and the evolving virus is becoming increasingly difficult to detect with probes directed against earlier isolates.

Similarly, the probes being used to detect WSN/33 H1N1 in Korean pigs also yield false negatives, as the number of fatal swine infections increases and spreads. Bird flu appears to be spreading in greyhounds in the United States leading to unprecedented levels of fatal infections.  These are being diagnosed as an unusually aggressive form of kennel cough, although the descriptions match the fatal H3N8 infections in Florida last year.

Although WHO has complained about a lack of samples, they have indicated that they were too busy to verify the fatal swine infections in Korea.  Moreover, the WHO makes pronouncements about the absence of reassortment in Vietnam H5N1 isolates, although they have very limited data.  Likewise, there has been no announcement on the fatal infections in dogs in the United States.  Explanations for the meningitis outbreaks in the Philippines and India have also been lacking. 

The recent infections of people, birds, pigs, and dogs create striking parallels with the 1918 flu pandemic.  The fatal infections in the fall were preceded by mild but unusually widespread reports of atypical infections in the spring. 

Although it is 87 years later and the number of scientific and medical advances has been significant, simple monitoring of various influenzas, including H5N1 is scandalously poor.

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