# 3235
Disease surveillance, even in developed countries, isn’t as sophisticated as many might believe.
We don’t know, for instance, how many people are infected with the West Nile Virus, or Lyme Disease, each year in the United States.
About the best we can do is make estimates.
During the recent Salmonella outbreak, fewer than 1,000 cases were laboratory confirmed, even though the assumption is that thousands more were affected.
As I pointed out this morning, we even have to `guesstimate’ the number of deaths that occur each year due to influenza. And during flu season, only a tiny fraction of suspected influenza cases in this country are tested and typed.
Now . . . imagine what it is like in other, less developed countries.
While certainly not `news’,this next story is a welcome official reminder that an absence of documented H1N1 cases in developing countries is certainly not proof that they don’t exist.
Most developing nations unable to track flu: WHO official
Agence France-Presse | 05/21/2009 10:15 PM
GENEVA - Most developing countries are not in a position to track seasonal flu, let alone a potentially pandemic strain of swine flu, a World Health Organisation official said Thursday.
"Obviously what we're worried about is that most of the developing countries don't have the systems in place that will even tell us whether H1N1 flu is there," said Ties Boerma, director of health statistics at WHO.
"In most countries there is no good cause of death reporting system, so we do not get any data on any cause of death," Boerma said. "So there is still a big gap in information there that we and our partners are working on but that's a huge undertaking."
The WHO annual health statistics report released on Thursday lists H5N1 bird flu among 18 selected infectious diseases.
But it points out that bird flu, as well as malaria or Japanese encephalitis, is difficult to identify without laboratory testing that is often not available in developing countries.
Mexico had to resort to Canadian testing to detect the swine flu virus. Even in middle income countries, flu cases are often listed as pneumonia.
