Thailand's first avian flu case of 2006 confirmed

Jul 26, 2006 (CIDRAP News) – The World Health Organization (WHO) confirmed today that a 17-year-old boy who died on Jul 24 in the Phichit province of northern Thailand had H5N1 avian influenza, marking the country's first case this year.

The WHO statement said the case was confirmed by Thailand's Ministry of Health. The country had not recorded a human H5N1 case since December; its toll now stands at 23 cases with 15 deaths.

The boy lived in the Thap Khlo district, where he experienced symptoms on Jul 15 and was hospitalized Jul 20, the WHO said. The patient had buried dead chickens on Jul 10. His death comes amid several recent reports of mass poultry deaths in northern and central Thailand.

Bloomberg News reported today that the patient had been in contact with fighting cocks that had not been declared to authorities for fear of culling; the fighting roosters are reported to be worth as much as $13,000. Thailand's disease-control director said the boy also tested positive for dengue hemorrhagic fever, making his case unique, Bloomberg reported.

H5N1 was detected in 31 dead chickens in the Bang Mulnarg district of the Phichit province, according to a report that a Thai livestock official filed Jul 24 with the World Organization for Animal Health (OIE). Several media outlets have reported suspicious poultry deaths in other nearby provinces, including Phitsanulok and Uttaradit.

Thai health officials have placed several other people from Phichit province under quarantine, according to an article today in The Nation, a Thai newspaper. Four are members of a family whose chickens tested positive for the H5N1 virus. A veterinarian told The Nation that the family raised 268 fighting cocks, which started to die on Jul 15. Another patient is an 11-year-old girl who lived near the family and developed a flu-like illness after touching a dead chicken.

Officials in Chiang Mai, the largest city in northern Thailand, have suspended cockfighting until further notice, The Nation reported. The country's agriculture minister recently announced bans on poultry imports and the transport of birds.

According to the OIE, the Phichit Provincial Livestock Office declared the Bang Mulnarg district an avian flu–infected area, which allows officials to conduct full-scale disease control efforts, including culling, quarantine, screening, and disinfection of affected sites.

In other news, China has invited the United Nations to observe tests it will run to verify a June report by Chinese scientists that a man who died in 2003 had the H5N1 virus, according to a Reuters report today. The scientists' report has fueled speculation about how many human H5N1 cases might have been missed or not reported in China before 2005, when the country reported its first case. Following the scientists' report, Chinese officials said they would investigate the case.

Avian flu scare in US hospital
In the United States, a 207-bed hospital in Carrollton, Tex., had a real-life test of its avian flu preparedness when an elderly woman who had recently spent a month in an area of Vietnam where human cases had occurred stumbled through the doors. WFAA TV in Dallas-Ft. Worth reported yesterday that within seconds of noting the patient's recent travel history, the intake nurse rushed the woman to the emergency department, where she underwent a rapid flu test.

When the test came back positive, the hospital staff alerted its infection control staff and Texas health officials, the story said. The woman was placed in an infectious-disease room with ventilation controls, while a state trooper rushed her test samples to a lab in Ft. Worth.

Within 6 hours, the woman was diagnosed with ordinary flu. The hospital's infection control director, Eileen McClachlan, told WFAA that the hospital staff was pleased that they knew what to do quickly when a patient's symptoms and history suggested possible avian flu. "But they were also very nervous that this could be the beginning of avian influenza in the United States," she said.

Businesses urged to prepare
Meanwhile, a US government official urged businesses to prepare for a possible avian flu outbreak. According to an Agence France Presse report yesterday, Rajeev Vankayya, a White House biodefense policy advisor, warned those attending a US Chamber of Commerce meeting in Washington that an outbreak would affect their businesses.

At the conference, businesses were advised to improve hygiene measures, develop telecommuting plans, and determine how to keep key business units functioning in the event of a flu pandemic.

The story said Lynn Slepski, a Department of Homeland Security official, told those at the meeting, "We won't be able to stop the disease at the borders. We can't depend on that. So plan!"

See also:

Jul 26 WHO update on Thai situation
http://www.who.int/entity/csr/don/2006_07_26/en/index.html

Jul 24 CIDRAP News story "Thailand faces renewed avian flu fight"

Jul 24 OIE notice on H5N1 in poultry in Thailand
http://www.oie.int/downld/AVIAN%20INFLUENZA/A2006_AI.php

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