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January 09, 2006

Nothing But Questions Emerging from Turkey

The news out of Turkey is discomforting. What's most troubling is that it is different from anything we've seen since we first started H5N1Drome back in the summer when it became clear to us that this major looming threat needed watching.  We are not medical experts but we do know how to gather information from around the world in a quite efficient way and how to pass that on to visitors to our site.

Over this rather brief period, much has happened in terms of raising awareness to the potential for a pandemic. Although a few wags around the mainstream media might have called the Avian Flu threat the biggest non-story of 2005, few were so dense as to think the threat was somehow little more than hype or that it had been put away.

For us, we can be thankful for the dedication of a few journalists and bloggers who have tirelessly worked on the story.  Their diligence has provided a baseline in what is an inherently a confusing story stretching across nations and continents.  One worrisome truth is that no one knows how many birds have died from this flu that is being incubated in the bird species but has crossed over to other species, including our own. More importantly, we don't know how many humans have contracted the disease nor how many of died.  For the record, the World Health Organization is keeping accurate track of proven cases.  Their latest available numbers indicate that there were 142 confirmed human cases with more than half, 74, proving fatal. It's not clear if this number counts the three deaths in Turkey and the one newly reported death in Indonesia.

What the latest news from Turkey underlines however, is that these numbers do not even represent a major percentage of cases and deaths that have been reported but not verified, something that still requires sophisticated technology missing from most of the target zones.  More significantly, we can see from the story emerging from Turkey, sickness and death can go unreported and under the radar for a number of economic and political reasons.  A Japanese scientist working for the WHO reported several months ago that he suspected that the numbers in China are significantly higher but information there was suppressed. In the case of the deaths in Van, Turkey that have burst on the scene in the last couple of days, the people involved, at least in Van are apparently members of a politically unpopular group, Turkish Kurds.

What is most strange about the Turkish outbreak of human cases, Reuters is now reporting 14 confirmed, is that there has been almost no news of sick birds in the stricken region in an eastern corner of Turkey near the Armenian and Iran borders. In Asia, the ratio of stricken and destroyed fowl to human cases has clearly been in the thousand to one range.  Here, we are suddenly --and it must be noted at a very early stage-- facing 14 confirmed cases, or 10% of all human cases confirmed to date. We find that highly problematic.

So far, WHO is reporting that the virus has not changed in any significant way and that all the human cases are B2H, or bird to human, if we can borrow the shorthand of our colleague to the North, Crof. But this is early on.  We are used to seeing reported cases long before we seen confirmed cases and we know that there are a number of people in hospital in Turkey, as far west as Ankara, who have come down with the symptoms of Avian Flu.

We've been told that as long as the virus doesn't mutate, it will not be lethal enough to pass easily from H2H. We have also seen lab tests confirm, disconfirm and then reconfirm findings.  Can we be sure the virus has not recombined in some very subtle but lethal way? How can we know that all of these people have come in contract with infected birds?  Is it possible that many Asians have developed some immunity to the virus that others have not? As of last week, we didn't even know there were many infected birds in Turkey. It just hadn't been reported.

This is a story that bears close watching.  You can be sure that we will be staying on top of it.

Posted by dymaxion at January 9, 2006 05:20 PM

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