One hundred and thirty-nine children examined at the Paediatrics Department of the Clinical Hospital in Tetovo in 48 hours. Twelve kept in for hospital treatment. The number reached the public, and the institutions will not explain it - they will explain why it does not mean what people think it means.

Hospital director Dr Erzen Elezi rejected claims that this is an epidemic or a case of mass poisoning. According to him the children presented with varied clinical pictures - some with respiratory, some with viral illnesses - and the number of patients does not deviate dramatically from the same period last year. The following day, between 07:00 and 14:00, 13 children were examined and none were kept in.

Paediatrician Dr Isa Osmani links the cases to seasonal summer infections. The most common symptoms were high temperature, vomiting and diarrhoea, and the factors he lists are the high temperatures, the way food is prepared and stored, insufficient hygiene when preparing formula milk, and contact between sick and healthy children.

The distinction that decides the story

139 examinations in two days is not the same thing as 139 children with the same illness. That is the crucial distinction and it is a fair one - nothing in the available information suggests all the cases share a common cause. Nor that this is a confirmed epidemic.

But the same logic works in reverse. If the number is normal for the summer period, then what is normal is that the Polog region has a paediatrics department taking in over a hundred and thirty children in two days - and that this surprises nobody.

The Alliance for Albanians responded with a question that is political but not inaccurate: "Where are the alarms today? Where are the press conferences? Where are the ministers, the directors and all those who in Gostivar counted every examination and every report as an argument for creating public panic?" The party accuses the authorities of double standards and institutional silence.

The silence of the institutions is information in itself

So far there is no official statement from the Health Ministry or the Institute of Public Health that an epidemic has been declared in Tetovo or that the cases share a common cause. Nor is there a statement that it has been checked and there is no cause for concern. Silence functions as an answer, just a bad one.

The Institute of Public Health previously warned that infants and small children regulate body temperature less easily and face a higher risk of dehydration in hot weather. In a week when Skopje-Petrovec is measuring 37.6 degrees, that warning is not theoretical.

The Clinical Hospital in Tetovo serves the whole Polog region. This year the Health Ministry announced a project worth around 4.56 billion denars for its complete reconstruction and modernisation. That is a number that impresses in a press release. Whether it will mean more paediatricians on duty in August - that is the question no press release answers.