H5N1 flu confirmed in three Vietnamese deaths against backdrop of more suspected cases

Aug 17, 2004 (CIDRAP News) – The cases of three people who died recently in Vietnam have now been confirmed by that country as being caused by the H5N1 strain, and two other patients are suspected of having the disease, according to news sources yesterday and today.

One of the latest victims is a 2-year-old boy from Hau Giang province in the southern Mekong Delta. He was admitted to the hospital Saturday but is, according to an Associated Press (AP) story, in stable condition. Samples from the child are being tested at the Pasteur Institute in Ho Chi Minh City. Poultry owned by the boy's family had died mysteriously, the story says. The other patient, a 19-year-old woman also from Hau Giang, was admitted with serious respiratory problems late last week but is also reported to be in stable condition, says an AsiaNews story. The director of the hospital admitting her is quoted as saying she has H5N1 avian influenza.

As for the earlier victims, a 25-year-old woman from Hau Giang province who died Aug 6 was confirmed late last week by Vietnamese officials as having H5N1. Two children, a 4-year-old boy from northern Ha Tay province who died Aug 2 and an 11-month-old girl from the same region who died Aug 4, were confirmed as having H5N1 yesterday. The H5 subtype for all three cases had been determined last week but further testing had not been completed. The boy's family had eaten meat from ill chickens, according to AP, and the girl's family raised geese. These three recent deaths bring the number of fatal H5N1 cases since the beginning of the year to 27, 19 in Vietnam and 8 in Thailand.

Although the World Health Organization (WHO) is in close communication with the Ministry of Health in Vietnam, the Vietnamese has not to this point allowed international experts to investigate the recent resurgence of avian flu or allowed the sending of specimens to WHO reference laboratories outside the country for further confirmation and analysis. However, Hans Troedsson, WHO representative in Vietnam, met with the Health Ministry yesterday and received tentative approval for a small group of laboratory and epidemiology specialists to participate, says an Agence France-Presse (AFP) story today. Getting samples to WHO laboratories is "vitally important," Troedsson was quoted as saying in an AFP story yesterday. "This is not only standard practice in cases like this throughout the world but we need to know if there has been any change in the structure of the virus," he said.

No new outbreaks of avian influenza in birds have occurred in the past 15 days in Vietnam, according to a Vietnam News Agency story. The last outbreak was detected Aug 2 in quail in the Hau Giang province, says the report. About 34,000 poultry have died or been put to death since Jul 9 in Vietnam. Controlling the disease in the country is a special challenge because about 80% of the population live in the countryside, and most farmers raise poultry for food, a Reuters report says. WHO experts have stated that it will take years to eradicate H5N1 flu from the area.

On other fronts, the outbreak of H5N2 avian flu in ostriches reported last week on two farms in the Eastern Cape province of South Africa is suspected to have spread to five more nearby farms, according to an AFP story today. An official of the South African Ostrich Business Chamber, which represents 600 ostrich farmers in the country, told AFP that culling of 4,000 birds on the additional farms will begin today as a precaution. Results of testing on the birds are awaited. About 6,000 ostriches from the first two farms were killed last week. H5N2 flu is not known to be harmful to humans.

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