ProMED-mail [The clinical symptoms of the patient, admitted to hospital several days after disease onset, included high fever (40C/104F), cough, headache, weakness, pneumonia and slight diarrhoea. When he later disclosed his involvement in feeding migratory birds it was apparent the case met the clinical and epidemiologic criteria for avian influenza.
Subsequently, the Ministry of Health's Guidelines for Isolation Precautions in Hospitals relating to avian influenza suspected cases were put into operation (for the 1st time in Israel) and samples were sent to the Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Tel-Hashomer. Real-time PCR and RT-PCR of pharyngeal swabs for H5 were applied with negative results; the testing of bronchoalveolar lavage, which requires invasive procedures, was considered but was found not justifiable in view of the improvement in the patient's condition.
When the serological test (HI) was later found positive, the decision was made to repeat the tests and to send serum samples to the UK-based influenza reference laboratory for serum neutralisation tests.
The Veterinary Services (Ministry of Agriculture) have been operating a field surveillance scheme for H5N1 since October 2005, covering both domestic as well as wild avians. The survey in wild birds includes sampling and testing of sick or dead birds; allegedly, several hundred samples have already been tested, all with negative results. It has been contemplated to include, in the near future, the testing of randomly sampled healthy wild birds as well. According to the plan, this survey, to be cooperatively applied with the Nature Reserve Authority, will be combined with the birds' ringing [banding].
Israel is a main flyway of migratory birds on their route from Europe to the Near East and Africa; it is estimated that around 500 million birds pass through Israel annually in each direction. - Mod.AS] [Blood tests for antibody will not identify virulent H5N1, only the sequencing of PCR-amplified genome will. Even a seroconversion between his early and late blood samples, or the finding of IgM antibody, would not prove conclusively that his illness was due to H5N1 virus; he might have had a mild infection and his pneumonia could have been due to a different cause. - Mod.CP/JW]
"When the serological test (HI) was later found positive, the decision was made to repeat the tests and to send serum samples to the UK-based influenza reference laboratory for serum neutralisation tests."
So he has some sort of flu and it maybe a crossover of an older avian variety that already has made the leap to human to human transmission...if he's lucky.
It's not a good year to go feed the ducks on the local pond.