#16,530
Last week, on the heels belatedly reporting another 5 H5N6 cases from the Mainland, HK's CHP Reported 4 Human H9N2 Cases On The Mainland, all from either November or December 2021. Today they announce yet another H9N2 case, this time from mid-November of 2021.
H5N6 cases, on the other hand, are apt to be severe or even fatal, and should be more readily apparent. It seems likely, given the high number of H5N6 reported in China over the past 6 months, there are a number of cases in the queue we haven't heard about yet.Since they tend to be mild, H9N2 infections are often picked up by routine testing of samples collected by local hospitals, often delaying their discovery.
Novel flu infections undoubtedly occur more often than we know, since testing and reporting in much of the world is often sparse or non-existent. But China has a history of `strategically' releasing information, often belatedly and in batches, when it is politically convenient.
They aren't alone, of course.
Despite signing onto the 2005 IHR (International Health Regulations) - which requires member nations develop mandated surveillance and testing systems, and that they report certain disease outbreaks and public health events to WHO in a timely manner - many countries are slow to report outbreaks.
We get dribs and drabs of information, often coming weeks or months after the fact, but the truth is much of the infectious disease activity around the world remains hidden or ignored until it breaks out of control, as it did two years ago in Wuhan, China (see Flying Blind In the Age Of Pandemics & Emerging Infectious Diseases).
Our visibility of MERS-CoV in the Middle East is another example (see Saudi Arabia Announces 4 Additional MERS-CoV Cases To End 2021), with the last monthly WHO EMRO Report published in October of 2021 (see below), which stated: No new cases of MERS were reported to WHO during the month of October 2021 or in their September report, either.
This, despite the fact that the Saudi MOH website lists 5 cases between September and December. They've not updated their 2022 website since Epi Week 2, but we've previously seen KSA literally go months without updating their website, or the WHO (see WHO EMRO Updates A Year's Worth Of MERS-COV Reports From Saudi Arabia).
Of course many Middle Eastern countries haven't reported any MERS-COV cases in years, even though the virus is presumably endemic in their camels.
It is disconcerting that - while we can't really know what we aren't hearing about - surveillance and reporting of infectious disease outbreaks (in humans, animals, and plants) feels markedly worse today than it did 6 or 7 years ago.
Some of that is undoubtedly due to finite resources being diverted to deal with the pandemic. But whatever the reason, the next emerging infectious disease threat will use our inattention, or any lack of international cooperation, to its full advantage.
We need to do a lot better. In preparedness, in surveillance, and in reporting.
Otherwise, the past couple of years are likely just to be a glimpse of what is to come.
