Father of Chinese H5N1 fatality has infection

Dec 7, 2007 (CIDRAP News) – Chinese officials said today that the father of a Chinese man who recently died of H5N1 avian influenza has been hospitalized with an H5N1 infection, raising the possibility of a new family cluster and sparking fears of human-to-human transmission.

China's health ministry said the 52-year-old man was admitted to the hospital after he came down with a fever on Dec 3, according to a statement today from Hong Kong's Centre for Health Protection. The man's samples were sent to the Chinese Centre for Disease Control and Prevention, where tests for the H5N1 virus were positive, the statement said.

If the man's illness is confirmed by the World Health Organization (WHO), he will be listed as China's 27th H5N1 case-patient.

The man is from Nanjing in Jiangsu province in the eastern part of the country, according to Xinhua, China's state news agency. He was hospitalized with lower lobe pneumonia, the report said.

Joanna Brent, a World Health Organization (WHO) spokeswoman based in Beijing, said the man's illness raises concern about the possibility of human-to-human H5N1 transmission, according to an Associated Press (AP) report today.

"We will be monitoring this case closely," Brent told the AP. "If it is found to be easily passed between humans, we would be concerned."

Media reports on the father's illness gave no indication of whether he had any exposure to sick or dead birds. Earlier reports, including one from the WHO, said his son had no known contact with infected birds.

The WHO confirmed the 24-year-old son's death on Dec 4. He got sick on Nov 24, was hospitalized 3 days later, and died on Nov 27, the WHO report said. His illness and death pushed the number of H5N1 cases in China to 26 and the fatality total to 17.

Some global health officials have been skeptical about China's claims that hardly any of the country's reported H5N1 patients had contact with infected birds. In June, after the WHO confirmed that a 19-year-old soldier who had been serving in Fujian province had died from an H5N1 infection, WHO spokesman Gregory Hartl told the AP that only one of China's H5N1 patients had reported contact with sick birds.

Hartl said the lack of reported links to infected birds raised questions about how effectively the Chinese government was monitoring the disease in birds.

Julian Tang Wei-tze, a virologist in Hong Kong, also voiced skepticism about whether China's latest fatality really had no contact with infected birds, The Standard, a Hong Kong business newspaper, reported Dec 4.

"It's about the accuracy of their contact history. With an incompatible history it's hard to exclude any contact with infected birds, their droppings, or people," he told The Standard.

Case clusters raise the possibility of human-to-human transmission of H5N1, which would increase the risk of a pandemic. A number of family clusters of infection have been reported, but human-to-human transmission has been proved by laboratory tests only once: in Sumatra, Indonesia in May 2006. The vast majority of human cases have been linked to contact with infected poultry.

See also:

Dec 7 Hong Kong Centre for Health Protection statement

Dec 4 WHO statement

Dec 3 CIDRAP News story "Chinese man dies from H5N1 infection"

Jun 4 CIDRAP News story "Vietnam reports H5N1 case; Chinese patient dies"

Jun 23, 2006, CIDRAP News story "H5N1 mutation showed human transmission in Indonesia"

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