China, Vietnam report new H5N1 cases

Jan 6, 2009 (CIDRAP News) – Public health officials in two countries today announced new human cases of H5N1 avian influenza, involving a 19-year-old Chinese woman who died of her infection and an 8-year-old Vietnamese girl who is recovering.

In Beijing, local health authorities said the woman died yesterday after getting sick on Dec 24 and being hospitalized 3 days later, Xinhua, China's state news agency, reported today. Tests at two labs revealed she was infected with the H5N1 virus.

If the World Health Organization (WHO) confirms the case, she will be listed as China's 31st H5N1 case-patient and 21st fatality. Her illness marks China's first human case since February 2008.

The Beijing Municipal Health Bureau told Xinhua that the woman bought nine ducks at a market in Langfang city in neighboring Hebei province on Dec 19. She removed the ducks' internal organs and then gave three of the birds away to family and a friend.

Zhao Qingchao, a Langfang City official, said investigators found that 13 people ate the ducks but only the woman got sick, Xinhua reported. He said the ducks were from Jixian county in northern China

Beijing's health bureau said 116 people had close contact with the woman and that 102 of them were medical workers, according to the Xinhua report. One nurse who had contact with the patient had a fever but has since recovered.

The WHO's office in China released a statement saying the woman's death from the H5N1 virus should not prompt alarm, Agence France-Presse (AFP) reported today. "We are concerned by any case of human H5N1 infection. However, this single case, which appears to have occurred during the slaughtering and preparation of poultry, does not change our risk assessment," the WHO said.

Meanwhile, an official from Vietnam's Preventative Medicine Department told AFP that the 8-year-old girl, from Thanh Hoa province in northern Vietnam, got sick with pneumonia on Dec 27 after eating poultry and was hospitalized on Jan 2. If her case is confirmed by the WHO, she will be listed at Vietnam's 107th case-patient.

Nguyen Huy Nga, who directs the department, said tests revealed the girl's H5N1 infection on Jan 3. Her case is Vietnam's first since March 2008.

An official with the provincial health department said he expected that the girl would be discharged from the hospital soon, according to the AFP report.

Nguyen Huu Dinh, an animal health official in Thanh Hoa, said infected poultry had been detected and culled in the province, AFP reported.

Jeff Gilbert, an avian influenza expert with the United Nations Food and Agriculture Organization (FAO), told AFP that Vietnam is entering a high-risk season because of cold weather that favors virus survival and the Tet (lunar new year) celebration, which often includes eating poultry dishes.

"China has the (lunar) new year coming up, so the situation would be the same," Gilbert said in the AFP report.

If the WHO confirms the new cases reported today, they will raise the global H5N1 total to 393 cases with 248 deaths.

The number of H5N1 cases and deaths in 2008 was the lowest since 2003, when the lethal H5N1 virus began causing outbreaks internationally, according to WHO figures. In 2008 there were 40 cases and 30 deaths, down from 88 and 59 in 2007, 115 and 79 in 2006, 98 and 43 in 2005, and 46 and 32 in 2004.

Although there were fewer cases in 2008, the 75% case-fatality rate for the year was the highest since 2003, a moderate increase from 2007's case-fatality rate of 67%.

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