China reports another H5N1 death

Jan 23, 2012 (CIDRAP News) – A 39-year-old man from southwestern China died yesterday from H5N1 avian influenza, the country's second death in less than a month from the disease, according to Xinhua, China's state news agency.

The man, from Guizhou province, got sick Jan 6 and died in a hospital in Guiyang after 3 days of intensive care treatment, according to the report yesterday.

China's health ministry said so far 71 people who were in close contact with the man have not shown any influenza symptoms, Xinhua reported.

Hong Kong's Center for Health Protection (CHP) had a few more details about the case in a statement it released yesterday. It said the man was hospitalized on the same day he became ill and did not have any obvious exposure to poultry before he started having symptoms.

Another man from China who recently died from an H5N1 infection also had no known exposure to poultry. The 39-year-old from Shenzhen in Guangdong province got sick on Dec 21 and died on Dec 31. If the World Health Organization (WHO) confirms China's latest H5N1 case, the man will be listed as the country's 42nd case and its 28th death since 2003.

In the past, some experts have raised concerns about a lack of reported poultry outbreaks in the face of human H5N1 cases. In 2009 when China reported a spike in human cases that lacked the hallmark of nearby poultry outbreaks, Dr York Chow, Hong Kong's secretary of food and health, said the pattern raises questions about a possible change in the virus or that asymptomatic chickens might be contributing to the spread of the H5N1 virus.

China has a rigid vaccination policy for poultry flocks, but backyard birds are common, especially in urban areas. Suboptimal vaccine strategies can mask symptoms without blocking virus shedding. Some veterinary experts have called for more intensive surveillance and monitoring to identify new outbreaks and better characterize viral circulation.

Other H5N1 developments
In related news, the WHO recently confirmed Vietnam's latest H5N1 death, in an 18-year-old man from Kien Giang province who died on Jan 16, according to a Jan 20 statement. The man had been exposed to ducks. The Pasteur Institute and local health officials are conducting an outbreak investigation, the WHO said.

The man's death from the disease pushes Vietnam's H5N1 toll since 2003 to 120 illnesses, 60 of them fatal.

So far this year the WHO has confirmed 8 H5N1 infections and 5 deaths, spanning five different countries. Four of the cases and 3 of the deaths are counted in the 2012 total; the rest are included in the total for 2011.

Also, the WHO recently announced the availability of a new recombinant H5N1 candidate vaccine virus, developed from A/Hubei/1/2010, a clade 2.3.2.1 virus, according to a Jan 16 statement.

The WHO said the cleavage motif of the wild virus hemagglutinin was modified to resemble low pathogenicity avian influenza viruses. It said the new virus-sharing framework adopted in May 2011 applies to shipments, use, and handling of the virus.

The WHO coordinates the development of H5N1 candidate vaccine viruses as part of its pandemic preparedness activities. As the virus evolves, new candidate strains are developed and announced when they become available.

See also:

Jan 22 Xinhua story

Jan 22 CHP statement

Jan 20 WHO statement

WHO global H5N1 case count

Jan 21, 2009, CIDRAP News story "China's recent H5N1 cases raise transmission questions"

Jan 16 WHO statement on candidate vaccine virus

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