Wednesday, January 11, 2006

What's up with Turkey?

So what's up with Turkey? On the one hand the WHO spokesthing Dr. Maria Cheng implies, "nothing":
"Based on the epidemiological information we have so far, we haven't seen any change in the way that the virus is being transmitted," said Dr. Maria Cheng of WHO in Geneva. (CBC)
On the other hand:
In Turkey, with the 14 confirmed cases [NB: now 15], officials are concerned about how and why the country is being hit so hard across four broad regions.

By comparison, Indonesia has faced 16 cases and 11 deaths since its first human infection last June. In East Asia, human cases are more sporadic, although millions of birds are infected. It's also possible human cases have been missed.

The high number of human and animal cases in Turkey could mean a new strain is circulating that is picked up by humans more easily, the strain may have circulated for some time undetected, or it is simply a coincidence, health officials say.

"Can this virus now recognize human cells more effectively than bird cells?" asked Dr. Todd Hatchette, a virologist at Dalhousie University in Halifax. "That will be one of the key things they'll be looking at."
Good questions. Epidemiological questions. Of course the explanation for the different epidemiology in Turkey might not be because of a change in the virus (we set out some of the other possibilities in a recent post), but it certainly cannot be said, as Dr. Cheng implies, that there is no change in the apparent epidemiology. The majority of the cases and all three deaths have been in children. Why that is isn't known. But the evidence is worrisome, Dr. Cheng's "see no evil, speak no evil" statement notwithstanding.

WHO apparently does not wish to change the pandemic staging from Phase 3 to Phase 4. Fair enough, if that's their honest judgment. But WHO spokespeople should be saying something like this, if they do not wish to change the pandemic staging:
WHO is concerned about developing events in Turkey and is making every effort to determine if there has been a change requiring modification of their current judgment we are at Pandemic Phase 3. At the moment there is insufficient information to to allow a modification with any confidence. We therefore continue to maintain the Pandemic stage at Phase 3. We will notify the public immediately should results of current investigations indicate otherwise. NB: This is not a WHO statement, but my version of what an honest statement would look like