Scott McPherson's Web Presence

This story appeared yesterday in the South China Morning Post.  The story serves as confirmation of what we already knew; namely, that many cluster cases of H5N1 have indeed been documented by the WHO.  Also, at least 20 per cent of the cases are believed to have involved limited human-to-human transmission, with the transmissibility ending with the third generation of transmission.  This also means, in large part, that H2H transmission ended with the last death -- the virus died with the last death.  The exception to this was the Sumatra cluster of May, 2006, where a male survived (photo at left) after spending nearly a full season in hospital and being continually pumped with Tamiflu.  He still suffers brain damage, as the virus went after his brain as well as his lungs (a classic sign of a severe strain of influenza and hallmark of the 1918 virus).

I want to point out that FluTrackers.com and other Websites were accurately predicting and documenting this dramatic upswing in cluster cases all along.  The collaboration contained within FluTrackers and other influenza-related Websites is hereby validated with this WHO report.  Nice work, gang!

Mary Ann Benitez

South China Morning Post
Jun 18, 2007
The World Health Organisation is investigating clusters of bird flu cases which have been occurring increasingly since late 2005, a visiting WHO official said.
Forty-two clusters involving 111 people have been identified, with a mortality rate of 65 per cent. Ten out of 12 countries with human cases of bird flu have had at least one cluster.
The WHO concluded that limited human-to-human transmission could not be ruled out in 20 per cent of the clusters.
"We have to rule out human transmission. For that reason, clustering is very important for us in terms of catching a possible pandemic at the early stage," said Nikki Shindo, medical officer with the WHO's global influenza programme in Geneva.
She said sporadic cases of bird flu were expected, given that there were ongoing poultry outbreaks. So far, those clusters investigated have not progressed beyond the third generation of victims.
Takeshi Kasai, regional adviser in communicable diseases surveillance and response at the WHO western Pacific regional headquarters, said the latest assessment was that the risk for a pandemic remained the same as it had been since 2003.
The WHO officials were interviewed on the fringes of a closed-door workshop on outbreak communications, which ended on Friday.
The WHO has tried to determine why clusters of cases occurred.
"There are several hypotheses. One of them is that the infected family member has a genetic characteristic to get the disease more easily than the others. The other hypothesis is perhaps they had a heavier exposure than anybody else," Dr Shindo said.
There could also be some environmental factors at play, she said.
Ninety-two per cent of the cases involved blood relatives and 89 per cent were aged under 40. The index cases involved contact with sick or dying poultry. Many clusters had seen parent-to-child or sibling-to-sibling infections, but spouses infecting each other had not been seen.
Clusters involve two or more people who are epidemiologically linked. The largest cluster found, involving eight people, was in North Sumatra in May last year.