WHO confirms Egyptian H5N1 death, Vietnam probes possible cluster

Apr 9, 2010 (CIDRAP News) – The World Health Organization (WHO) today confirmed Egypt's latest human H5N1 case and death, as speculation grew about a possible geographic cluster of illnesses in Vietnam's Bac Kan province.

The WHO's confirmation involves an 18-year-old woman from Fayoum governorate whose illness and death were reported by Egyptian sources earlier this week. The woman was hospitalized on Mar 31, where she was treated with oseltamivir (Tamiflu). She died on Apr 4. Her case raises the number of Egyptian H5N1 cases to 109 and the number of deaths to 34.

An investigation into the source of the woman's illness suggests she had been exposed to sick and dead poultry, the WHO report said. The WHO's confirmation pushes the global H5N1 count to 493 cases, including 292 deaths.

In other developments, influenza Internet message boards and blogs today are citing new media reports, some of them from local Vietnamese language sources, that appear to confirm and provide fresh details about an earlier report on a potential geographic H5N1 cluster. The affected area is Bac Kan province in northeastern Vietnam, home to the country's latest confirmed H5N1 case-patient.

On Apr 5 Voice of Vietnam, a news outlet that publishes English-language reports, said provincial health authorities confirmed the H5N1 virus in a 22-year-old man who was hospitalized in critical condition. The same report said four other people from the man's commune in Cho Moi district had similar symptoms and were being treated and quarantined at the Bac Kan regional hospital.

Today Voice of Vietnam reported that H5N1 has been confirmed in another patient from Cho Moi district, a 27-year-old man who visited the area 4 or 5 days before he got sick.

A Bac Kan media report from today, obtained, translated, and reported on the FluTrackers internet message board, said the H5N1 virus has also been confirmed in a 27-month-old toddler and that medical authorities are tracking 21 other suspected cases, of which 7 have reportedly been hospitalized.

The report said their symptoms include fever, cough, and shortness of breath. Some of the patients are reportedly the child's family members, and the local media report suggested that they may have shared exposure to infected poultry or contaminated meat.

The news report also mentioned control measures such as disinfection of affected areas and that the area has received a supply of oseltamivir, personal protective equipment, and medical supplies, according to FluTracker translations of the story. Media reports have also noted that checkpoints have been posted on roads leading to the affected area.

Mike Coston, a former paramedic who covers and analyzes breaking flu news on his Avian Flu Diary blog, noted today that machine translations of foreign-language news reports are valuable, but can sometimes contain glitches and lack key nuances. "Still, the stories coming out of Vietnam appear to be reasonably consistent, and have persisted now for several days. They are worthy of our notice," he wrote.

Sharon Sanders, editor-in-chief of FluTrackers, told CIDRAP News that if health authorities confirm the findings, it will be Vietnam's first geographic H5N1 cluster since late 2008 and early 2009, when two sisters were infected.

See also:

Apr 9 WHO statement

FluTrackers thread on possible Vietnam cluster

Apr 9 Avian Flu Diary blog entry on possible cluster

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