Updated H5N1 Bird Flu Cases and Deaths in Humans Since 2003

The table at the end of this page shows the number of confirmed human cases of bird flu reported to the World Health Organization since 2003. The information from the WHO in this table was updated April 3, 2008, but there are usually a few cases reported in the news yet to be confirmed by the WHO. (see latest blogs for news links.) Egypt has reported 4 bird flu cases in humans and one death in 2008. Indonesia and Vietnam continue to report cases.

Many of Indonesia's 15 cases this year (more, if you count ones reported in the news) are from in and around Jakarta, the capital. WHO situation reports usually report the presence of chickens around the home of the victims. I live in a nice South Jakarta neighborhood and there are plenty chickens around me here. In fact many countries with epidemics of bird flu among birds do not have as many, if any human cases of the disease, so the presence of chickens alone cannot really justify the high case numbers of bird flu in Indonesia.

At this time the total number of cases reported to the WHO since 2003 is 378. Total deaths, 238. This represents a total mortality of 63%. Counting only cases from this year, 21 out of 27, or 77.8% of people who caught bird flu, died. Only counting cases in 2007, 59 out of 86 cases ended in death, or 68.6%. In 2006, there were 116 cases and 80 deaths, a mortality of 69%. Mortality is thought to depend upon on the rapidity of treatment with Tamiflu. Until now, drug resistance to Tamiflu has not been a major issue, but the effectiveness of Tamiflu has been called into question.

Indonesia

After a lull in cases in the latter part of 2006, bird flu came back strong in Indonesia in 2007 and continues marching right into 2008. Most cases this year have been around Jakarta, and some cases involving family members raise suspicions that human-to-human transmission has occurred there. Recent victims from Bali have caused concern both among tourists and the Balinese tourism industry. One victim was a 15 year-old live-in maid who lived and worked in the wealthy Jakarta neighborhood of Menteng and the most recent bird flu victim is from Jakarta as well. Some of the victims come from the Banten province, close to the capital of Jakarta, while others are from West Java, and the island of Sumatra -- where it has been confirmed by scientists from the University of Seattle and the Fred Hutchinson Cancer Research Center that there was human-to-human transmission of bird flu in 2006. The WHO is also reporting a possible case of human-to-human bird flu transmission in Pakistan. Until now, bird flu has mostly been transmitted to humans by infected birds.

Backyard poultry bans were put into effect in Jakarta beginning in February, 2007, and some other provinces in Indonesia. I live in Jakarta right now and I pass chickens on the street daily and I've never seen an official take action against free-range poultry in the city. On a visit to a village in the province of Central Java, I saw children picking up chicks. It appears unlikely that backyard poultry bans will be enforced.

I do not believe a backyard ban will help the fight against bird flu much. See more information about the backyard poultry ban controversy and top 10 reasons your backyard chickens won't give you or anyone else avian flu. What is needed is more public education, although perhaps a ban, being controversial, will spur leaders to raise awareness about the risk factors in contracting avian flu.

Indonesia continues to report a steady stream of bird flu victims, from the islands of Java, Sumatra and Bali. A great resource for flu trackers can be found in the Flu Wiki, an open-access avian flu site where everyone can contribute information. Here is the Flu Wiki site for Indonesian maps and case information. Here you can find Flu Wiki's maps and stats for Indonesian cases pinpointing regions where cases have been identified and listing new cases that are being reported before 2007.

Vietnam

Vietnam has reported 7 bird flu cases in 2007 and 4 deaths, the first cases reported in that country since 2003. After Indonesia, Vietnam has been hit hardest by avian flu and continues to be dogged by the virus in poultry throughout most of the country.

Tamiflu Resistance

Tamiflu resistance was reported in one case in Vietnam in 2005. Two people who died from H5N1 bird flu in Egypt in late 2006 also had a virus somewhat resistant to Tamiflu. This resistance represents a minority of strains of the H5N1 virus, the majority of which are susceptible to Tamiflu in laboratory studies. The WHO continues to recommend Tamiflu in their treatment recommendations (PDF from the WHO) for human cases of the H5N1 avian influenza virus.

_Source

World Health Organization. Updates of Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO http://www.who.int/csr/disease/avian_influenza/en/index.html. Retrieved September 10, 2007.

Yang Y, Halloran ME, Sugimoto J, Longini, Jr IM. Detecting human-to-human transmission of avian influenza A (H5N1). Emerg Infect Dis [serial on the Internet]. 2007 Sep 7.