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June 27, 2007

Mild bird flu: no news is bad news

For a long time I (and many others) were of the opinion that the reported deaths from H5N1 and the extraordinaraily high Case Fatality Ratio (CFR; proportion of all infections that end fatally) was an over estimate due to underascertainment of infections that were mild, inapparent or just undiagnosed because they weren't severe enough to come to the attention of the medical care system. The reason for thinking this was that this is the pattern for most other infectious diseasesk, even serious ones like TB and cholera. Most of the infections are asymptomatic or at least undiagnosed. It is estimated that half of all seasonal flu infections are also asymptomatic. So this was expected to be true of H5N1 as well. But for some time there has been no or little evidence of the hypothesized "missing" cases. Every time we look hard for them we don't find them. The latest search was reported in the form of an abstract and oral presentation at the big flu meeting in Toronto. I'd like to say they have now been found. But I can't:

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Posted by dymaxion at June 27, 2007 10:16 PM

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