Here’s a case that highlights the immense difficulties in tracking H5N1 down. The patient was negative for influenza in testing. Only after death could the diagnosis be confirmed.

WHO

The Ministry of Public Health in Thailand has confirmed the country’s 25th case of human infection with the H5N1 avian influenza virus. The case, which was fatal, was the third detected this year and the third fatality.

The case occurred in a 59-year-old farmer from Nong Bua Lam Phu Province in the north-eastern part of the country. He developed fever on 14 July, was hospitalized on 21 July, and died on 10 August. Possible H5N1 infection was suspected when relatives reported the sudden death, in the days prior to symptom onset, of several fighting cocks raised by the farmer. Local veterinary authorities noted a number of poultry outbreaks in the area.

Repeated tests on samples taken from his upper respiratory tract were negative by PCR for all influenza A viruses, including H5N1. He was treated with the antiviral drug, oseltamivir. Virus was eventually isolated from lung samples taken at autopsy.

Of the 25 cases confirmed to date in Thailand, 17 have been fatal.

Poultry outbreaks were confirmed in two provinces of Thailand in late July of this year following a lull in outbreaks dating back to 9 November 2005.

The drug treament was oseltamivir, Tamiflu. He lasted 20 days in the hospital.

UPDATE: Thank you to Hugh Hewitt for the link. Please check my category Avian Flu for other news and commentary.