# 4824
For a variety of reasons, the true incidence of infectious diseases around the world really isn’t known.
Some countries lack a good surveillance and reporting system, testing may be unobtainable or unreliable, and in a lot of cases where the symptoms are mild, many people may not seek medical help.
Even in the United States, the CDC can’t tell us with precision how many people contract Lyme disease each year, or influenza, or even Dengue. Some of the reasons are illustrated in the pyramid chart below.
Which helps to explain why we really don’t know how many people died from the recent pandemic, or how many have succumbed to bird flu around the world.
Official numbers almost always only represent the `tip of the pyramid’. While imperfect, sometimes the best we can do are estimates.
But there is another way that rates of illness can be underestimated, and that comes from a willful attempt to suppress the numbers.
China, infamously, spent months covering up the SARS outbreak in late 2002 into 2003, going so far as to evacuate infected patients from a Beijing hospital in advance of a WHO (World Health Organization) visit.
While promises of more transparency were made in the wake of the SARS debacle, few observers doubt that China continues to suppress disease outbreak information, including H5N1.
Indonesia has been less than open about their bird flu problems, refusing to share virus samples, and delaying the announcement of cases sometimes for months.
Other countries, no doubt, either ignore or hide inconvenient disease surveillance data as well.
Today, we’ve a report in India Today, that asserts that the true number of Dengue cases in the Capital Delhi is being intentionally under reported by authorities.
Neetu Chandra
New Delhi, August 20, 2010
Dengue outbreak figures are being fudged to conceal details of the rapid spread of the disease in the Capital.
Officially, the city has reported 322 dengue cases so far. However, a spot check of 12 hospitals and nursing homes in Delhi showed 1,131 dengue cases at these hospitals alone.
This is merely indicative of the actual figures that could rise quickly in the coming days. There are 1,800 government and private hospitals in the Capital, of which 700 are registered.
This report goes on to claim that the Municipal Corporation of Delhi (MCD) – which is in charge of controlling Dengue in the City – has pressured hospitals to under-report cases.
Given the muckraking and sometimes hyperbolic nature of Indian Journalism, seeing these sorts of charges in print isn’t unusual.
As to their validity . . . I’ve no idea.
According to the report, some of the undercounting is apparently due to patients settling for a diagnosis based on a physical exam, rather than paying for the confirmatory lab test.
And so those cases are never `officially’ counted.
Whether intentionally withheld (as claimed in this article), or due to circumstances beyond their control, it should come as no surprise that the number of Dengue cases in Delhi far exceeds the official numbers being released by local officials.
Which is why I don’t tend to give case counts and fatality numbers bandied about in the press a whole lot of credence, regardless of their source.
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