How can they come to the decision that there is around a 50% chance of death in humans if it is aquired ? What if several million have already been infected unknowingly and have survived ?
A lot of suspected cases turn out to not be H5N1 i.e. they had H1, H2, the sniffles or something else.
To find out if you had lots of cases that had been exposed you could test a large sample of people and see if they show that they have been exposed.
They have discovered some of these cases e.g. those in S. Korea. Not in large numbers though, and pretty near the number of deaths that they suspect were from H5 but not verified. Such as the siblings that died with the same symptoms of verified cases but not verified in themselves e.g. Turkey and China.
This leaves for best estimates, only verified cases.
Mortality as of March 1st. by the WHO’s numbers are:
cases/deaths --- mortality (rounded to nearest percent)
Cambodia 4/4 --- 100% Iraq 2/2 --- 100% Indonesia 27/20 --- 74% Thailand 22/14 --- 64% China 8/14 ---- 57% Viet Nam 42/93 --- 45% Turkey 4/12 ---- 33%
Total 94/174 --- 54%
From a practical standpoint, because of the limited transmissability of the virus currently (B2H and not effectively H2H), to have millions infected you’d have to have millions and millions wallowing around in chicken coops (I know that’s an over-simplification, but in close contact none the less) that are ripe with the virus.IMO not very realistic.
Theoretically, you could have millions of people infected and surviving, based on a premise that H5N1 was not identified as their illness, but again, based on that premise you would have to allow that a similar percentage of DEATHS went unattributed to virus.
The simple fact is that on average, 50% of the people diagnosed with the virus die.
What are the current theories regarding susceptibility? Why is it seen to affect also only slightly or even said to go by symptomless? Has this to do also with overall virus-load?
Anam,
We don’t know. We are awaiting seroprevalence data from Turkey, and that will give us a better picture. Right now, that correct answer to most questions is “we don’t know.”
you may be interested in knowing that Feb 16, when Julie Gerberdine (with the CDC) spoke at the Floride Pandemic Summit, she pretty much validated the seroprevalence studies that I have seen. She spoke of the 50% mortality rate and said they had hoped that there might be “mild unreported cases” in the population that are being missed. And that there probably were some unreported cases…. but, there were not many. She said the studies that have been done do not show that this is occuring in the general population in the form of mild cases.
She did begin by saying that(the 50% mortality rate) was one of the CDC’s concerns….. that and the recent events over the last few weeks with the spread of the virus and the mutations they have seen in the virus since Turkey.
This validated the concerns I had. First, the virus really does have a high mortality rate. Second, the virus had not yet made the jump to efficient human to human… therfore may still retain that (or a relatively high %) virulence if it does. At least for the first waves.
BTW… Most of the seroprevalence studies tested people who had contact with known H5N1 patients… including HCW and family members. Those would be the most likely to contract the disease. If they show up negative…(and the Vast majority did) They did not have a mild unreported case.
Just FYI…
Those seroprevalence studies also included poultry handlers, the highest risk group of all by sheer numbers.
I’m “borrowing” this thread for a moment in order to say thank you to all who are contributing and sharing their knowledge, time and energy!
Anam
I would guess that it is because of the vast complications of this disease (auto-immune storm, liver, kidney and other vital organ complications) versus a victim dying of the flu itself. Most of us think of the flu as a week in bed feeling like we want to die …. but only the very elderly actually dying of it. This Avian Flu has so many complications and secondary infections. I think that is why we are seeing such a high mortality rate.
Anam – at 02:40
What are the current theories regarding susceptibility?
good questions. Theories include generic differences between people, receptor differences, viral differences, viral load, timing of infections vs diagnisis and treatment, unknown factors.
I had influenza one time, it lasted for a month..was very ill..I was pregnant at the time, no hospitals would take me ( back in 1987).. gave birth to a daughter..she was born with chronic kidney disease. It was attributed to the flu-doctors said. Influenza is nothing to mess around with. I was sicker than I have ever been in my life. Most people think it is like a bad cold or tummy bug..not so. It is deadly. More people should be educated about this.
Far as I recall the last time I saw someone do the math, the fatalities were 90% age 39 and under, age 25 and younger were 70% of the deaths, and under twenty were about 50% of the fatalities. Not good.
Janet with all those problems, people won’t be able to be getting the medical care they will need that the cases now are getting, too.
anonymous – at 01:04, that 50% mortality rate is with people getting, in some cases, international-level medical care and attention, ventialtors, antivirals, ect!
Even if the mortality rate (somehow!)goes down to 1% or less, people will be dying of H5N1 and other causes (including preventable causes like dehydration, neglect, accident victims we could normally treat, ect)
just because the already-full medical systems are not able to get ready for 1/3 the population in any area (including the medical workers) getting sick with influenza the same month. Burn though an area for a few months, then the virus could send other waves, just as infectious, later.
Lots of unknown factors, and many reasons for concern and action.
Yes, on fire, sorry for your ordeal.
Pregnant women and developing fetuses are at great risk, and the public should be being educated and prepared. If the authorities aren’t doing it, the non-authorities need to get the word to the public themselves. (At least we have the authorities outnumbered. But, the oblivious public outnumbers us. Oh, oh…)
any information/thoughts on percentage of patients who have died after early diagnosis and treatment?
I think you need to look at Turkey for that. After the initial deaths they quickly got on it and treated all suspected cases (at no charge) quickly.
If during a pandemic the cases would oblige themselves to just trickle in the mortality would be lower than what I expect to occur.
I expect the hospital to be overwhelmed and quickly run out of supplies. About 1/4 of health care workers will not show up for work (I make no judgements). It will become worse before it becomes better as doctors and nurses die.
Ky Jack, Wikipedia using WHO data has Turkey as “12 confirmed cases, 4 deaths = 33.3% mortality rate.
That was with a functioning society, infrstructure, and international assistance. And, only 12 H5N1 cases to deal with.
Indonesia, whether for the viral strain or the case handling, has a much higher than 50% mortality rate.
Indonesia (12 months) 2005: 17 cases, 11 deaths = 64.7%
2006 (2 months!): 10 cases, 9 deaths =90.0% [!]
Average over two years, which may be misleading if the virus is becoming worse: 27 cases, 20 deaths, 74.1% mortality rate.
Older thread, closing for speed purposes.
check dates