Scientists worldwide are craving information on the H5N1 avian flu virus.

So three years into the outbreak of the H5N1 avian flu virus, two international teams of researchers scored major scientific credibility points Wednesday when the New England Journal of Medicine published their articles on the diagnosis and treatment of a mere 16 H5N1 patients.

With the official World Health Organization case count hovering near 260 human cases and 153 deaths from 10 countries, it might seem the problems Turkish doctors experienced diagnosing eight patients last January or the course of illness experienced by three clusters of eight Indonesian patients last year wouldn't rate publication in the world's most prestigious medical journal.

But, in fact, there is so little clinical information about H5N1 disease in the scientific literature that experts are eagerly welcoming the addition.

"Boy, it would just be nice to have more of this information out there," Dr. Keiji Fukuda, who heads the WHO's global influenza program, said in an interview from Geneva.

"It's tough. It's not easy getting this information."

A deputy editor of the journal agreed the information charting cases is sparse.

"The number of documented human cases of H5N1 and the number of deaths attributed to it — well characterized — is still a relatively small number," Dr. Lindsey Baden explained.

"So I think that it's important to characterize them so that we understand. Is there person-to-person [spread]? Is there not? What type of public health manoeuvres seem to correlate with control?"

The WHO is hoping to fill those gaps more efficiently in the future.

Scientists working with Fukuda are devising a checklist of basic information they hope to be able to get for each future case of H5N1 infection — recording what symptoms patients experienced, what blood testing showed, which drugs where given when, how patients responded and which survived.

"Because there's no place that's having — fortunately — large numbers of cases, the only way to try to do this in a meaningful way is to collect as many of the cases from the different countries as possible," Dr. Frederick Hayden, a WHO scientist involved in the project, explained in a recent interview.

A myriad of questions continue to puzzle scientists:

• How does a bird virus manage to infect people?
• With so many people exposed, why do so few get sick?
• Why do so many clusters of cases among blood relatives occur?
• Why do children make up such a disproportionate number of the total cases? 

But with cases occurring randomly in remote and varied parts of the globe, gathering information to accurately chart this disease will remain a challenge, Fukuda admitted. That's because dealing with human cases can place hospitals in crisis mode. And rigorous science is hard to do in a crisis.

"The bottom line … is just to say the collection of medical information on what remains an unusual disease — and particularly unusual for the individual clinician out there — is difficult."