Aug 14, 2006 (CIDRAP News) – A World Health Organization (WHO) reference laboratory confirmed today that a 62-year-old Chinese man from the far northwestern province of Xinjiang who died Jul 12 had H5N1 avian influenza. The WHO also confirmed another H5N1 case in Indonesia.
The Chinese man developed symptoms Jun 19, according to a WHO update today, and initial tests were negative. Tests repeated in July and August, however, produced positive results.
Investigators did not find that the patient had a history of exposure to dead or diseased birds or a history of travel the month before he became sick. No recent poultry outbreaks had been reported near the man's home, and Xinjiang province has not recorded any previous human cases.
However, the Chinese news agency Xinhua reported today that an outbreak of avian influenza occurred in Aksu City, in west central Xinjiang, Jul 14. The Chinese Ministry of Health told Xinhua News that 3,045 chickens died from the disease and that 356,976 chickens were culled when the outbreak was confirmed.
"There was no confirmed link to poultry, but that doesn't mean there wasn't any contact," Roy Wadia, Beijing-based WHO spokesperson, told Agence France-Presse (AFP) today.
"Most of the cases on the Chinese mainland have not had any confirmed link to poultry," he said in today's AFP story, adding, "Migratory birds fly across much of China, including Xinjiang. Everything is possible."
The WHO announcement brings China's official human H5N1 total to 21 cases, which includes 14 fatalities.
Last week the WHO and China confirmed the country's 20th case and its 13th death when it retroactively confirmed the death of a 24-year-old Beijing man who was found to have died of H5N1 in 2003. The cause of his death was reported by Chinese researchers in the Jun 22 issue of the New England Journal of Medicine.
Meanwhile, in Indonesia a 17-year-old boy has tested positive for H5N1 avian influenza, which represents the country's 57th case, according to another WHO update today.
The boy, from a remote village in the Garut district in West Java province, developed symptoms Jul 26 and was referred to a hospital on Aug 9 where he was tested because the staff determined he had respiratory symptoms and a history of exposure to dead chickens. A positive result came back Aug 12, and the patient is recovering, according to the WHO update.
Bloomberg News reported today that the boy has not been hospitalized for his illness because health authorities haven't been able to reach him to tell him about his test results. A health ministry official said there is no telephone connection in the boy's village and that a team had been sent to locate him.
The AFP, Associated Press, and Reuters, however, reported today that the boy refused hospitalization. An AFP report today said that he remains under 24-hour medical surveillance at home.
Investigators found that chicken and duck deaths had occurred in the patient's household and neighborhood a week before he became ill. The patient reportedly had contact with diseased chickens during the disposal of their carcasses.
Also, investigators collected information on the death of a 20-year-old man who was the boy's neighbor. The man became ill on Jul 26 and sought medical care at the local health center on Aug 5. He died of respiratory disease on Aug 6 before he could be transferred to a hospital and before samples could be taken for testing. The cause of his illness and death remains undetermined.
The boy's illness brings Indonesia's confirmed human H5N1 count to 57 cases and 44 deaths. Indonesia had two other avian flu cases in August, and both were fatal: one in a 16-year-old boy and one in a 17-year-old girl.
Worldwide, human cases of H5N1 avian flu have reached 238, including 139 deaths.
Aug 14 WHO update on China situation
Aug 14 WHO update on Indonesia situation