Canadians LIED About H5N1 Patient Not Having Respiratory Symptoms
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Much has been made of the report that the Canadian H5N1 bird flu victim had little to no respiratory involvement, ie no coughing etc. In birds, the bird flu is mostly intestinal; It appears that the case may be the same with both H5N1 and H7N9 bird flu in humans.
So far we have not seen any reports that the Canadian victim had diarrhea or vomiting, but we expect that she probably did have these symptoms. And given such intestinal symptoms, an aircraft toilet is the perfect place to spread the disease via both surface contamination and aerosolized flush related contamination.
In that regard, it would not surprise us if there were additional H5N1 cases related to the Canadian incident. However, we would expect those cases to be self limiting, and likely undetectable as no one is going to be looking for H5N1 as a cause of death in any case not directly tied to China.
But we will add one Caveat, there have been rumors of the Chinese engaging in Gain of Function (GOF) research with H5N1; that situation would change the ball game and the risk profile of this Canadian detection. Given, the woman's supposed lack of contact with poultry in Beijing, one might surmise something unusual is occurring, but she could just as easily come in contact with infected pigeon droppings.
In the mean time, the real take away from this case is that from an epidemiological perspective it is much easier for H7N9 to jump on board an aircraft than it is for H5N1. Given that the Canadian victim was infectious for 12 days before the authorities understood what was happening, and that the infection time is roughly 3 days from exposure; it is clear that North America has little chance of putting the Genie back in the bottle once it gets on the runs.
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