A "gut feeling" about H5N1 : Aetiology

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Tara C. Smith is an Associate Professor of Epidemiology. Her research involves a number of pathogens at the animal-human nexus. She also writes for The Panda's Thumb and previously for WIRED SCIENCE's Correlations. Please note the views expressed on this site are Dr. Smith's alone and may not be representative of the groups mentioned above.

"...a veritable expert on tawdry cosmetic procedures gone horribly awry..."--Kevin Beck

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A "gut feeling" about H5N1

Posted on: May 11, 2006 9:00 AM, by Tara C. Smith

As usual, EffectMeasure is one step ahead of me. A news report came out yesterday suggesting that influenza may infect people through the gut. At least 4 routes of evidence suggest this possibility. 1) In birds, influenza is an intestinal infection. 2) Several cases of H5N1 have presented with diarrhea, generally uncommon in human influenza infections. 3) H5N1 virus has been isolated from rectal swabs from humans. 4) Some people have no risk factors for infection besides drinking duck blood. Revere further elaborates on all the red flags this virus has raised.

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Comments

Tara - It's raining here in Chicago, so to cheer everyone up, I am enclosing another Lettermen Top 10 List relating to Bird Flue: They all make sense except for #2, which is just not believeable enough...

Top Ten Surprises In ABC's Bird Flu Movie
(Presented By Britney Spears)
10. Thanks to sponsorship deal, flu is cured by delicious taste of Dr. Pepper
9. Humans attacked by pigeons with tire irons
8. 20% of population comes down with less dangerous "bird hiccups"
7. Every time someone says, "chicken," all the characters chug a beer
6. Hilarious scene in which Leslie Nielsen confuses his Tamiflu with his Viagra
5. Every single person in the world ends up at General Hospital
4. The big villain? Larry Bird
3. Sad conclusion in which Charlie Brown puts a bullet in Woodstock
2. Hilarious scene where the guy playing President Bush actually solves the problem
1. Sole survivors Michael Jackson and Rosie O'Donnell are forced to repopulate the earth

Posted by: J-Dog | May 11, 2006 9:17 AM

My question is, how do we know we've seen all cases of Avian Influenza in humans? How do we know we've seen all severe cases of Avian Influenza in humans? Has anybody considered the possibility that the vast majority of Avian Influenza cases in humans have been mis-identified as another type of influenza? Even some strain of stomach flu.

I remember a news story that said that for most people West Nile Virus resulted in a mild infection with no complications. Could the same situation apply with Avian Influenza?

Posted by: Alan Kellogg | May 11, 2006 2:36 PM

Hi Alan,

There is indeed a possibility that we're missing sub-clinical or atypical infections. I mentioned this here and in other posts on the old blog (and Revere discusses here among other posts). There haven't been any large, population-based studies of seroprevalence to H5N1 in affected areas, so we can't really answer that question yet. A few small studies (examining, for example, spouses or close contacts of H5N1 cases) haven't found much evidence of asymptomatic infection in those examined, but that doesn't mean they're not out there. It's definitely an area in need of evidence.

Posted by: Tara C. Smith | May 11, 2006 3:00 PM

I think if we started calling it the Nigerian-Chicken Virus, we would greatly reduce stress and, perhaps, alter the course of this deadly disease that has felled 0 Americans.

Hank Barnes

Posted by: Hank Barnes | May 11, 2006 3:13 PM

Sure, call it the Little Rabbit Foo-Foo virus if it makes you feel better. A rose by any other name...

Posted by: Tara C. Smith | May 11, 2006 3:19 PM

The big cats and the small cats that have died from it ate infected fowl. Suggests at least a potential that it can be caught that way. WHO makes a big point of maintaining that cooking kills the virus and that you cannot get H5N1 from cooked poultry.

My commentaries and posts:
http://blog.simmins.org/index.php/category/medicine/avian-flu/

Posted by: Chuck Simmins | May 12, 2006 4:19 PM