This report from Vietnam, published in Archives of Internal Medicine, suggests it may be much milder than popularly believed. The survey of cases of flu like illness linked to close contact with dead or diseased birds in a confirmed poultry outbreak suggests that the usual infection is mild. This is in marked contrast to high case fatality rates reported previously, on the order of 50%. The authors speculate that the high reported mortality rates reflect a bias toward sicker patients, since the data are based on patients referred to hospitals in metropolitan areas. There is likely a larger burden of mild disease in rural areas which goes unreported.
The principal weakness of this paper is the lack of serologic confirmation, which the authors imply is forthcoming. Although the identity of the disease is unproven the authors marshal strong epidemiologic evidence that it’s avian influenza.
Michael Fumento comments and reminds us that he told us so.