Human H5N1 Cluster in Vietnam

Laidback Al · Apr 14, 2010

This cluster is now being monitor by major wire services . . .

Vietnam awaits more test results in suspected H5N1 cluster
Lisa Schnirring Staff Writer
Apr 13, 2010 (CIDRAP News) - Two patients who are part of a suspected H5N1 avian influenza case cluster in northern Vietnam's Bac Kan province are still hospitalized, with 11 others isolated for flu-like symptoms, health officials said today.
The two hospitalized patients include a 22-year-old man and a 27-month-old girl whose confirmed infections were previously reported by the Vietnamese media, the Associated Press (AP) reported today.
Hoang Van Linh, deputy director of northern Bac Kan's health department, told the news service that some of the isolated group includes relatives of the two hospitalized patients. Hoang said the 11 people in isolation recovered after treatment with oseltamivir (Tamiflu) and that he is awaiting test results to see if any were infected with the H5N1 virus.
The man was hospitalized on Apr 2 and remains under care, and the toddler, admitted Apr 4, is in stable condition, he told the AP.
FluTrackers, an Internet message board that translates foreign-language news reports on infectious disease events, has been following local coverage of the suspected cluster for the past several days. Though FluTrackers and other infectious disease blogs warn readers to interpret translated reports with caution, they have noted that most of the information coming out of Vietnam about the cluster has been consistent. . . .

indigo girl · Apr 14, 2010

http://www.scottmcpherson.net/journal/2010/4/13/vietnams-na-tao-hamlet-ground-zero-for-latest-bird-flu-clust.html

Commentary from Scott McPherson, the Chief Information Officer for the Florida House of Representatives:

...The Vietnamese government has acted quickly and decisively on the issue of Bak Kan. They have applied a Tamiflu blanket over an area comprising 700 villagers. They have eleven villagers in quarantine with clear symptoms of influenza, and three confirmed human cases.
The epicenter of the epicenter appears to be a commune within the hamlet. Now I suppose it is possible that people would have eaten diseased poultry at the same time. But the onset of symptoms is staggered by several day between the first and third cases. This would cause me to speculate that you cannot exclude human-to-human contact. And the simple fact that 700 surrounding villagers are currently on Tamiflu as a preventative would seem to support that hypothesis.
Hopefully, the reasonably transparent Vietnamese government will be very forthcoming with samples of this virus. In light of the fact that H1N1v, aka swine flu, is still traversing those same remote hamlets of Asia, and in light of the jarring re-emergence of H5N1 bird flu across eastern Europe and Asia, we need to know: Has bird flu mutated?

indigo girl · Apr 20, 2010

Why Na Tao matters, despite apparent lack of human bird flu transmission

H2H is human to human transmission. B2H is bird to human transmission.

As we now know, there are three suspected human cases, not two. But that is not material to our discussion. What is material is that two persons, living about a little more than a football field's distance apart, contracted H5N1 bird flu.
The report seems to conclude that distance alone, coupled with a lack of direct contact of one with another, eliminates the possibility of human-to-human (H2H) transmission. That sounds logical enough.
But the larger issue -- the proverbial elephant in the room -- is this: Has the virus itself changed enough in Na Tao, Vietnam, to allow for an easier method of transmission from avian to human respiratory cells? If so, that disclosure would prove to be almost as big (and ultimately more potentially troublesome) than another H2H cluster.

More at: Why Na Tao matters, despite apparent lack of human bird flutransmission - Journal - Scott McPherson's Web Presence

Scott McPherson is the Chief Information Officer for the Florida House of Representives.

Laidback Al · Apr 21, 2010

Today, WHO has officially announced these two new human H5N1 cases from Bac Kan province. While these cases represent a geographic cluster, there was no apparent contact between the two victims and both were presumed to be infected by contact with sick or dead poultry. Apparently, the "Tamiflu Blanket" worked, no other human cases were detected.

Avian influenza – situation in Viet Nam - update 11
21 April 2010 -- The Ministry of Health has reported two new confirmed human cases of A(H5N1) avian influenza infection on 6 and 9 April 2010. These cases were confirmed at the National Institute for Hygiene and Epidemiology.
The first case is a 22 year old male from Nhu Co commune, Bac Kan province. He developed symptoms on the 28 of March 2010 and was transferred to the National Hospital of Tropical Diseases in severe condition. Confirmatory test results for influenza A (H5) were obtained on 3 April.
The initial epidemiological investigations show that there were sick/dead poultry at the patient's home and in the surrounding areas.
The second case is a 2 year old girl residing in Cho Moi district, Bac Kan province. She developed symptoms on 2 April 2010. On 4 April, she was transferred to Cho Moi District Hospital for treatment where she is in a stable condition. Confirmatory test results for influenza A (H5) were obtained on 7 April.
The initial epidemiological investigations show that there were sick/dead poultry at the patient's home and in the surrounding areas. The patient's family slaughtered the sick poultry to eat.
There is no epidemiological link between these two cases that would indicate human-to-human transmission.
Of the 119 cases confirmed to date in Viet Nam, 59 have been fatal.

WHO | Avian influenza â€“ situation in Viet Nam - update 11