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Bird Flu and Meningococcemia in the Philippines
July 7, 2005
>> "I can assure you there's no indication it's the H5N1," said Agriculture Secretary Arthur Yap, who resigned last week to fight accusations of tax fraud but has stayed on until his successor is in place.
"The situation is it's a low pathogen. It's not high. That's the only statement I can make so that people don't have to panic."
Health Secretary Francisco Duque said avian flu was detected at a duck farm in the town of Calumepit, in Bulacang province north of Manila.
"There is no cause for alarm," Duque told GMA television. "Even the ducks are not sick." <<
The detection of bird flu in the Philippines is not a surprise, since the Philippines lie in the flight path of migratory birds and the latest series of outbreaks in western China's Qinghai and Xinjiang provinces strongly implicate migratory birds in the three outbreaks that have killed geese.
Sequence data indicates that these bar headed geese in Qinghai Lake are infected with a rare form of H5N1 that has a mutation at position 627 of the PB2 protein. This change is a likely contributor to the deaths of the ducks and geese. In Vietnam however, many of the ducks are infected with H5N1 that produces not obvious ill effects in the waterfowl such as ducks and geese, yet the same H5N1 is highly lethal to humans.
Moreover, as WHO warned last fall, the ducks excrete high levels of unusually stable H5N1. Thus, the appearance of the ducks is certainly not an indication that the infection is not H5N1 nor does the appearance of the ducks predict the lethality f the H5N1 in humans.
Reports seem to indicate that labs in Australia will determine the subtype.
The Philippines has had continues outbreaks of meningo (menegococemia and meningitis), frequently associated with efficient transmission and a high case fatality rate. Meningitis / meingococemia is a common complication of influenza. There have been no indications that these patients have been tested for H5N1 even though WHO sent a team to investigate and WHO held there May emergency meeting on H5N1 in Manila, where WHO has a major presence. Remarkably, e-mails from WHO at the time of the meningococcemia outbreak indicated that the lack of poultry deaths indicated H5N1 was not present in the Philippines.
Proper testing with the appropriate primers is the way to prove or disprove H5N1 in ducks, humans, or any other unexplained outbreak in the Philippines and throughout Asia and beyond.