Maryn McKenna at CIDRAP has published a startling account of a 2007 case: Avian, human flu coinfection reported in Indonesian teen. Excerpt:
An Indonesian teenager has been brought forward as a case of simultaneous infection with seasonal and avian strains of influenza—a possibility that health planners have long warned could give rise to a pandemic flu strain.
In a paper presented today at the International Conference on Emerging Infectious Diseases, Vivi Setiawaty of Indonesia's Center for Biomedical and Pharmaceutical Research and Development described the case of a 16-year-old girl who was tested for flu in Jakarta in April 2007 under a flu-surveillance system established in 2005 by the Indonesian Ministry of Health.
The girl, who had been experiencing flu symptoms for several days, was only mildly ill, with a 100.5ºF fever, sore throat, cough, headache, and body aches, but no difficulty breathing and no signs of pneumonia. (Case reports of H5N1 patients in countries such as Thailand have described more dramatic clinical presentations.)
Throat and nasal-swab samples that were taken on the 6th day of her symptoms tested positive by reverse-transcriptase polymerase chain reaction (RT-PCR) for both avian influenza H5N1 and the seasonal flu strain H3N2 at the Indonesian National Institute of Health Research and Development. Serology test results were less clear. Antibody titers from serum samples taken the 6th day provided a weak indication of H5N1 infection (titer of 1:10) but were negative for H3N2; convalescent sera, on the other hand, gave a strong indication of H3N2 infection (titer of 1:640) but were negative for H5N1.
CIDRAP hopes to have more details on March 18.
This item is based on the abstract of the report, and the case raises a lot of questions: Was this an accurate diagnosis? Why did it take so long to be reported? What's the condition of the teenager now?
And if she tested positive for H5N1, why wasn't she reported? The only similar case I can find from April 2007 is this one, from April 10—a 15-year-old who died.