A Definite Maybe
It’s early Monday Morning, May 22nd, and the only thing we know for certain about the Avian Flu cluster in Indonesia is that it has continued to expand, albeit slowly. There are now reportedly 10 members of this cluster (although reporting is vague and that number could be off a bit). What we haven’t seen is an explosion in the numbers of infected people, and that, for the moment, is reassuring.
Yesterday, a WHO spokesperson stated there was no evidence of H2H transmission. Today, I Nyoman Kandun, director for the health ministry's communicable disease control center, said H2H couldn’t be ruled out.
Both statements are probably true.
In the world of the WHO, proof of H2H requires irrefutable evidence. WHO officials are interested in containment. Of the virus, of course, but also of the news. They answer not to you or I, or the peoples of the world, but to 190 governments. And while there are reputable scientists and doctors working in the trenches of the WHO, the public relations end of the organization is highly political.
The Indonesian Health Ministers’ statement, that H2H couldn’t be ruled out, is a fairer assessment, although it pretty much says the same thing as the WHO. There is no proof of H2H, but there are suspicions.
The route of transmission of these cases remains unknown. Perhaps all of the victims were exposed to the same vector. But the range of onset dates of sickness (over a period of 20 days) seems to call that into question. Perhaps the virus is being spread via fecal-oral routes, as is the Norovirus. This is serious, but will not create a pandemic. Or perhaps there is an intermediary vector, a cat, or a pig, or a dog that is spreading the virus.
So this morning, all we know is this cluster continues to grow. There are reports of other small outbreaks in Indonesia, and we can only guess at the numbers of infected that simply die, and are quietly buried, and never reported.
And we should also bear in mind that there are other `suspected' cases, some apparently in quarantine, whose status has not been determined or publicly released. The potential certainly exists for a futher expansion of this Indonesian cluster.
The next week will tell the tale. If a large number of additional victims surface, then something truly ominous is happening in Indonesia. If not, then this turned out to be another brush fire, much like Turkey, and we have once again dodged a bullet.
How many more bullets are in this gun, and how long our luck will hold, remain to be seen.
