Monday 4 May 2015

Hubei province listed its first H7N9 case in April...some rare detail

A new province was recently added to the list of those reporting cases of avian influenza A(H7N9) virus infection in humans. 

Of course reporting does not mean capturing. Reporting has been weak this season. The cases that have shown seem to be just those who were ill enough to visit a Doctor/hospital and get a laboratory test. This is the same story for most infectious agents. We see just the tip of the iceberg, the beginning, the head of the arrow, we only scratch the surface, the glycoprotein on the envelope of the virus as it leaves the...okay, you get the picture.

This year has seen a very disappointing effort by China to provide useful public data that could permit tracking of what has become the annual outbreak of human cases of avian influenza A(H7N9) virus infection.

The human H7N9 case hotzone, at least since we heard about the virus infecting a human in February of 2013, have been on the east coast of China. We currently stand at 659 reported human cases, and over 200 deaths. Very. Roughly.

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I remember fondly a time when there were scads of data on H7N9-related human cases and deaths. Okay, China did over-share on a number of occasions....

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Story to be found here.
Click on image to enlarge. 
Story to be found here.
Click on image to enlarge. 
Story to be found here.

..but things have changed. 

For a comparison take the Kingdom of Saudi Arabia's Ministry of Health and their efforts to provide public data on Middle East respiratory syndrome (MERS) and its coronavirus (MERS-CoV). While there are a few gaping holes in the data set (c'mon guys-fill these in!), there can be as many typos as on this blog (but I'm not a public health Ministry - in case you were wondering) and the data can be intermittent, it represents the best public source of detailed, yet deidentified, human data on an ongoing zoonotic viral emergence. And that's saying something. But congratulations nonetheless!

I'm not including Ebola virus disease data-gathering here - the fact that we have had so much data - despite the initial lack of infrastructure and people trained to collect, collate and report that detail - is a fantastic testament to the efforts of those on the ground in Guinea, Sierra Leone and Liberia.

But this season H7N9 data that have been reported by public health sources have been released in blocks and lack any consistent or useful detail, except the province. Some detail is available when harvested from media reports by the ever assembled FluTrackers team. I rely heavily on their line list (to be found here). 

One example of the poor data quality this season, take a look at this text from a recent Disease Outbreak News provided by BigBlue (that's the World Health Organization, or WHO, for those not accustomed to my street groove)... 

No-one will be reading that and feel overly informed.

One is left to assume that this is how these data are coming out of China - infrequently and without detail. We regularly see that when better data are provided - and again, I hold up MERS-CoV case descriptions here - they get publicly listed by BigBlue. 

And before you head to your keyboard to ask "Why should we have access to these data?"...I will first ask you - why shouldn't we? They are collected and collated internally. They are of interest to epidemiologists, model builders, public health planners and data tinkerers the world over. And it's not as though the details are subsequently released in peer-reviewed publications. They are not. 

It's just disappointing.

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