Bird flu hard to detect until too late - studies
Pastor Dale Morgan
Bird flu hard to detect until too late - studies*
22 Nov 2006 22:00:09 GMT
Source: Reuters
By Maggie Fox, Health and Science Editor
WASHINGTON, Nov 22 (Reuters) - Quick tests that can tell if patients
have influenza do not detect bird flu, so despite heroic efforts, they
can die before anyone knows what killed them, doctors reported on Wednesday.
The H5N1 bird flu virus also causes a range of symptoms in people,
making it that much harder to diagnose, experts said in two separate
reports from Indonesia and Turkey.
In Turkey, repeated testing failed to diagnose H5N1 avian influenza in
eight patients, one team of doctors reported in the New England Journal
of Medicine.
In Turkey and in Indonesia, patients turned up with a wide variety of
symptoms, even in family clusters, making it hard to distinguish H5N1
from a range of other common infections, another team said.
Dr. Ahmet Faik Oner, Dr. Mehmet Ceyhan, and colleagues at Yuzuncu Yil
University Hospital in Van, Turkey said they hope their detailed
findings can help other experts battling avian influenza, which remains
largely a disease of birds but which occasionally infects humans.
Bird flu has infected 258 people in 10 countries and killed 153 of them.
Experts say the danger is that the virus will evolve and spark a
pandemic that could kill millions.
"There is no question that there will be another influenza pandemic
someday. We simply don't know when it will occur or whether it will be
caused by the H5N1 avian influenza virus," Dr. Robert Webster and Dr.
Elena Govorkova of the Memphis, Tennessee-based St. Jude Children's
Research Hospital wrote in a commentary on the two reports.
Dr. Anthony Fauci of the U.S. National Institute of Allergy and
Infectious Diseases, who was not involved in the studies, said they gave
useful details about the newer strain, called clade 2, of the virus.
"It's important that as these viruses evolve from one clade to another
that we get a good, clear description of the type of disease, the
transmission of the disease and ability of diagnostics to pick it up,"
Fauci said in a telephone interview.
TURKISH CHILDREN
Oner's team fought an outbreak of H5N1 in children in Turkey between
Dec. 31, 2005, and Jan. 10, 2006.
They said 32 separate tests failed to detect the virus -- not only quick
tests, but time-consuming polymerase chain reaction or PCR tests and
ELISA tests, which look for specific proteins from viruses or bacteria.
Eventually, eight patients were diagnosed using real-time PCR, the
researchers said. Four died.
"In our series, fever was a major symptom, and most of our patients had
pneumonia on admission," they wrote. Most had cough and sore throat, but
only half reported muscle aches and only one had a runny nose. About a
third had diarrhea.
Certain blood enzyme levels were elevated in most of the patients and
that may be an important clue, they said.
In a second report, a team of researchers from the World Health
Organization, the U.S. Centers for Disease Control and Prevention, the
Ministry of Health in Jakarta and elsewhere said rapid tests also failed
to detect the virus when they fought three family clusters of H5N1 in 2005.
The clusters "included mild, severe, and fatal cases among family
members," they wrote. Despite the use of multiple antibiotics, breathing
assistance and other care, half the patients died.
Last week, a team at the University of Colorado at Boulder and the CDC
reported they had developed an inexpensive and quick "gene chip" test
that might identify flu viruses, including H5N1. Fauci said that test
would have helped in Turkey and Indonesia.