Indonesia suspects more avian flu as outbreaks spread in China

Nov 14, 2005 (CIDRAP News) – A new suspected case of H5N1 avian influenza was reported in Indonesia today, while still another poultry outbreak was reported in China, its ninth in the past month.

In addition, the World Health Organization (WHO) confirmed the avian flu case reported in an 18-month-old boy in Thailand last week, while Thai officials said the boy's grandmother has tested negative for the virus.

A 20-year-old Indonesian woman died in a Jakarta hospital Nov 12 after suffering from a high fever and respiratory problems, prompting tests for avian flu, according to an Associated Press report today.

A neighbor of the woman had 10 chickens that died recently, and other members of her family kept birds as pets, according to an Agence France-Presse (AFP) report.

Ilham Patu of Jakarta's Sulianti Saroso Hospital said an Indonesian lab would test samples from the woman today, and samples also were being sent to a Hong Kong lab for testing.

The WHO today confirmed H5N1 avian flu in the 18-month-old boy from a suburb of Bangkok, saying he remained in good condition. His case, reported in the media Nov 11, is the fourth in Thailand this year and the 21st since early 2004.

The boy's 65-year-old grandmother had been suspected of having avian flu, but Thailand's health ministry said she has twice tested negative for H5N1, according to an AFP report today. A third test result was still awaited. The ministry said her condition was improving.

China reported an H5N1 outbreak that killed 800 poultry in the eastern part of Anhui province, the ninth outbreak in about a month, according to an AFP story today. The outbreak was discovered Nov 6 and the cause was confirmed as H5N1 today.

Local officials ordered the culling of all poultry within 3 kilometers of the affected farm, and more than 126,000 birds have been killed so far, the story said. The agriculture ministry said another 279,000 birds in the area have been vaccinated.

Also, a group of WHO experts arrived in Changsha, capital of Hunan province, to investigate three pneumonia cases, including one death, suspected of being caused by avian flu, AFP reported.

In Romania, the veterinary authority said four dead hens in a village in the Danube delta had tested positive for an H5 flu virus, according to a Reuters report. Samples from the hens, found in the village of Caraorman, were to be sent to Britain to test for H5N1, officials said. H5N1 was found in poultry in two villages in the Danube delta last month.

In Vietnam, researchers reported that the H5N1 virus had mutated in ways that enable it reproduce more effectively in mammals, but two health officials described the findings as neither new nor particularly alarming.

An online report by the Pasteur Institute in Ho Chi Minh City said, "The H5N1 type noticed among people and poultry in early 2005 has undergone some changes, facilitating its reproduction in cells of mammals and making it more dangerous," according to an AFP report today.

Reuters reported that the findings were based on an analysis of 24 H5N1 isolates from poultry and humans. The information came from the online newspaper Vnexpress, which quoted Cao Bao Van of the Pasteur Institute. In one human isolate from southern Vietnam, he said, researchers had found a mutation in the PB2 gene that "allows more effective breeding of the virus in mammals."

The researchers offered no conclusions about the virus's ability to spread from person to person, Reuters reported.

An AFP story today quoted the director of the Pasteur Institute, Nguyen Thi Kim Tien, as saying that the new findings were "not of any surprise" and that the "changes in the virus are not that significant."

In addition, a WHO spokeswoman in Hanoi, Dida Connor, said mutations in the virus were not unusual. "It is sometimes difficult to directly link specific changes in the genetic sequence to changes in virus behavior, including its ability to infect humans," Connor said.

The Pasteur Institute report said the virus had developed resistance to the antiviral drugs amantadine and rimantadine, but that finding has been reported before.

Avian flu has broken out in poultry in 10 of Vietnam's 64 provinces since early October, the AFP report said.

In Taiwan, meanwhile, an H7N3 avian flu virus was found in droppings form a migratory bird, according to another AFP report today. The virus was found in one of 20 samples of bird droppings gathered from a swamp near the southern city of Tainan.

No dead birds were found in the area, and authorities were unsure of the virus's virulence, the story said. An official said a mild strain of H7N3 was found last April in bird droppings near Taipei.

Taiwan has had no H5N1 outbreaks, but eight pet birds smuggled from China tested positive for the virus last month, the story noted.

See also:

Nov 14 WHO news release
http://www.who.int/csr/don/2005_11_14/en/index.html

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