Tuesday, February 07, 2006

Bird flu bloggers on the "sailor case"

The wires have been carrying the story of the Indian ship's cook who died shortly after leaving a UK port with a diagnosis of "rule out bird flu." We didn't post on it here in keeping with our practice of waiting a bit to let events settle. This has proved an effective screen in the past and we were adopting it again in this case. My purpose for writing about it now is to see how my flu blogger colleagues have handled it. I'm not sure I caught everything and I am not counting pure news filter sites (i.e., those that usually just a link to a newspaper story without any added commentary or perspective), but I was surprised to find little mention on other sites.

First, what little background we know or think we know. The Lithuanian Health Ministry is the apparent source for the idea this is a suspect case of bird flu. The 62 year old victim was removed from the ship M. V. Ocean Wind after falling ill on Saturday (February 4). He died fairly quickly (Monday) while being transported to medical help. Permission for autopsy was refused "on religious grounds."
Kazimieras Lukauskas, head of Lithuania's state veterinary and food service, said that raw poultry was among foods that were loaded onto the ship in Germany, but played down the possibility that it was the cause of the sailor's death.

"We do not think that poultry used for food on the ship could be the cause of death" Lukauskas said.

A special emergency team has been sent to Klaipeda to disinfect the ship, which had 30 crew -- 29 Indians and one Ukrainian -- on board, he said.

"Our emergency plan provides for crew members to undergo medical examinations," Lukauskas said. (Agence France Presse)
That's the story as most of us had it yesterday or today. The first to mention it was Crawford Killian at H5N1 (crofsblog) at 5:37 pm on Monday (the day of the sailor's death). His source was a story on Yahoo News, which noted that if verified it would be the first death in the EU proper.
This case is alarming for several reasons: The victim was far from any known sources of H5N1 infection. While raw poultry, loaded aboard in Germany, may have been the cause of the infection, the Lithuanians don't think so. (So what do they think the cause really was?) The victim was 62 years old, when most H5N1 deaths have occurred with very young or middle-aged persons.

Also ominous, the Indian captain of the ship refused permission for an autopsy, "on religious grounds."
This post was followed within hours by a comment on crofsblog from Dr. Bob Gleeson (who now has his own bird flu blog--welcome, BTW) who demurred:
Sorry, but this doctor does not buy this story. Nothing here fits the recognized pattern (close contact to sick chickens) and there are lots of reasons that a 62 year old career sailor can die suddenly. Today, several hundred people somewhere are sick with pneumonia and some will die--they have pneumonia, not bird flu. When you hear hoofbeats, think horses, not zebras. (in Comments to above post)
Next up was Silviu Docia this morning who just reported the case under the headline "First human case in EU?" but otherwise only quoted from the same YahooNews source as above.
Nothing at all on Henry Niman's Recombinomics site or (until now) here at Effect Measure. The CurEvent Forum has plenty (123 entries so far), but not (yet) the Discussion Forum section at The Flu Wiki.

I confess I thought there would be more made of this than there has been. While I would not have approached it in the way crofsblog did, I think his post is quite defensible and early on it brought to the attention of blog readers a potentially important development (although my take is more like Gleeson's). Avian Flu-What You Need to Know occupied a middle position, passing along the news account without comment in this instance. And while I am taking and defending a wait-and-see approach, I am glad we all don't do that. I'm satisfied to "see" on my colleagues' blogs and wait on mine.