Avian flu case reported in Vietnam

May 13, 2005 (CIDRAP News) – Initial testing has shown that a man in northern Vietnam has H5N1 avian influenza, marking the first human case in more than 3 weeks, according to news reports today.

Initial tests were positive for Cao The Hai, 55, from Vinh Phuc province, according to Dr. Nguyen Thi Tuong Van of the Institute of Tropical Diseases in Hanoi. The news was reported by Agence France-Presse (AFP) today.

In addition, a 20-year-old Cambodian woman has been hospitalized in Vietnam with a suspected H5N1 infection, AFP reported. She is from Kampot province, the home of four other people who died of H5N1 this year. A doctor at the provincial hospital told AFP she was in stable condition.

The new case comes after a 3-week period without any reported human or poultry cases. Such lulls have sometimes prompted authorities to declare victory over avian flu. This time the Vietnamese—having seen 41 previous human cases with 16 deaths as well as widespread culling of poultry since December 2004—were more circumspect.

"Given the practice of raising small poultry flocks, the bird flu epidemic is still well entrenched in the environment in Vietnam," AFP quoted Deputy Minister of Health Tran Chi Liem as saying.

The deputy minister made the comment at a ceremony earlier today at the Hanoi Institute of Tropical Diseases. The hospital was celebrating the departure of 21-year-old Nguyen Sy Tuan, who had been admitted in February, gravely ill with H5N1.

"We are very glad to be able to bring back Nguyen Sy Tuan to life," Dr. Van said.

That young man, from Thai Binh province, was part of a family cluster of H5N1 cases. His 14-year-old sister was hospitalized about the same time he was, although she apparently recovered faster. In addition, their 80-year-old grandfather was found to have antibodies to avian flu in follow-up testing, though he was never sick with the flu.

Cases such as that family cluster have heightened fears about possible changes in the H5N1 virus in Vietnam. Such worries are also growing in Indonesia, where authorities have found H5N1 infections in pigs and are testing to see whether infected poultry are putting poultry workers at risk.

The Indonesian Agriculture Ministry today said that scientists had found avian flu infections in pigs on several farms on the main island of Java, according to a Reuters story in the Jakarta Post.

Pigs have long been considered a melting pot for avian and human flu viruses, where the viruses can swap genetic material and possibly generate a human pandemic virus. Recently, however, people have been contracting the H5N1 strain directly from poultry with no biological intermediary.

Indonesia has sent human blood samples to Hong Kong to be tested for exposure to avian flu, according to another Jakarta Post story today. A half-dozen samples were from poultry workers in South Sulawesi, and another 77 samples had been sent earlier, the story said. It said that chickens in that region began dying of H5N1 infection in March.

One official quoted in the story described the testing as a surveillance procedure only, not prompted by suspected influenza in the workers.

Hariadi Wibisono, director for eradication of diseases in Indonesia's health ministry, told the newspaper that his office had boosted flu tracking in South Sulawesi by monitoring clinical symptoms in local healthcare outlets and pushing for improved safety procedures on farms.

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