#970
The mantra, uttered by most health officials over the past 3 years, has been that you must have direct contact with an infected bird in order to contract avian flu.
Of course, we've seen cases where the link to birds has been pretty tenuous. We've seen cases where a victim visiting a bird market (where no birds were known to be ill) was accepted as a probable route of infection. And `he killed an ate a chicken a week before falling ill' has been used so often, they probably have a rubber stamp for that by now.
Still, despite their best efforts, officials in places like Indonesia and China have failed to link a small percentage of bird flu victims to contact with birds. Some say as many as 20% of cases have no such linkage.
And that poses a real problem.
First, anyone presenting with severe pneumonia symptoms is asked about contact with birds. If they answer `yes', then bird flu is suspected. If they say `no', then it isn't. As more cases appear without that linkage, the diagnostic value of that screening question drops.
Second, it opens a real can of worms when we start thinking about other possible vectors.
Today, we learn that the last fatality from Indonesia reportedly had no contact with birds. This from the Daily Telegraph.
'Bird flu victim had no poultry contact'
July 11, 2007 03:59pm
A SIX-YEAR-OLD Indonesian boy who died of bird flu last weekend had no apparent contact with poultry, an agriculture ministry official said.
The boy from Cilegon in Banten province, just west of the capital Jakarta, was Indonesia's 81st bird flu victim.
Contact with infected birds is the most common form of transmission of the deadly virus to humans, experts say.
Memed Zulkarnaen, director of the agriculture ministry's bird flu unit, said no infected poultry had been found within a radius of up to 300 metres (yards) from the boy's home.
"The Indonesian medical community is still puzzled and does not understand from which source the victim was infected with the bird flu virus,'' he said.
"We are puzzled because the H5N1 virus needs to 'stick' to an object such as poultry and cannot freely circulate in the air,'' he said.
Asked whether there was a possibility the boy had contracted the virus from another person, Mr Zulkarnaen said it was too premature to tell and investigations involving personnel from the UN's health and agriculture agencies were ongoing.
Sardikin Giriputro, deputy director of Jakarta's Sulianti Saroso hospital, where the boy died, said on Tuesday that the boy had visited relatives who lived near a zoo elsewhere in Banten province, four days before he fell sick.
