Start of Bird Flu?
Several sources (e.g., here) are reporting that a 69 year old man, recently returned from Viet Nam, was hospitalized yesterday in the northeastern French town of Nancy. He had been transferred from a less well-equipped hospital so had already been sick for at least a few days. Southeast Asia generally is an endemic area for influenza A H5N1 in birds and Viet Nam has had 20 human deaths over the last year from presumed poultry to human transmission. Twelve deaths have occurred in Thailand, one a possible human to human case, although as far as I know this has not been confirmed.
At this moment there is no information as to whether the patient has had influenza A H5N1 confirmed or if he had prolonged or close contact with poultry. This story has not made the major wire services as yet. I will update as more information becomes available.
Non-update: There has been no further news regarding the suspect case of avian flu in northeast France. I continue to query my sources within the infectious disease community but so far there are no further developments. There are two main issues here that need to be clarified:
Minor update: Bloomberg, quoting an AFP reporter, quoting a French doctor: "We are applying the principle of precaution because the patient had come back from Vietnam and showed symptoms that suggested bird flu.'' The patient is quarantined in an intensive care unit in Nancy.
The tenor of this report is that the French medical authorities have not confirmed the diagnosis of H5N1. If it turns out not to be, that is reassuring news for the rest of us but probably little comfort to the patient. The regular human strains of influenza are bad as well and in a "normal" year kill on average 36,000 Americans (12 World Trade Centers worth). If we would spend as much time, energy and resources on public health as we have on Yellow alerts, . . . oh hell, never mind.
More from Bloomberg (no link available): Blood and tissue samples are currently being tested by French health authorities to determine if the patient is suffering from H5N1 influenza ("bird flu"). Connections with poultry are also being evaluated. WHO officials expressed confidence that French medical authorities were handling matters properly.
It is likely we won't know the answer to this before tomorrow or the next day. When it comes, I will try to bring it to you along with some context.
ProMed Mail post now up: This is a good source, although they tend to lag breaking news. But opinions expressed are knowledgeable and very cautious, a wise attitude. Here's the general link for your use. It also contains the post regarding this case (under Avian Influenza).
Status in pm of 12/03/04: For those following this story, there is as yet no further information from French health authorities on the follow-up diagnostic tests of the suspect case being treated in Nancy. I will update as information comes to me.
Update in am of 12/04/04: A number of people are checking in to see the status of this, so here is how things stand. I have located little additional information (France's TV channel tf1 has some additional details here (in French). The report, dated Thursday, says the confirmatory test results were expected yesterday. I have queried ProMed contacts but they have no additional information. The tf1 report also quotes hospital sources as saying the patient was admitted to the intensive care unit as a precaution and for isolation, not on the basis of the gravity of his condition.
So this is a bit of a mixed message. This has been on the national news in France, so one would expect that if tests were negative we would have heard an announcement. However it may be that things are just taking longer than expected (not uncommon). The fact that the patient is not gravely ill is reassuring. More if and when I get it.
Update note (12/16/04): For those following this thread via this link, please see update post with final disposition from later in 12/04/04 here.
At this moment there is no information as to whether the patient has had influenza A H5N1 confirmed or if he had prolonged or close contact with poultry. This story has not made the major wire services as yet. I will update as more information becomes available.
Non-update: There has been no further news regarding the suspect case of avian flu in northeast France. I continue to query my sources within the infectious disease community but so far there are no further developments. There are two main issues here that need to be clarified:
- Is this a genuine human case of influenza A (H5N1)?
- If so, was the transmission plausibly explained by close or prolonged contact with infected fowl in an endemic area (the patient had recently returned from such an area, Viet Nam); if not, the possibility of a strain adapted to person-to-person transmission needs to be seriously considered
Minor update: Bloomberg, quoting an AFP reporter, quoting a French doctor: "We are applying the principle of precaution because the patient had come back from Vietnam and showed symptoms that suggested bird flu.'' The patient is quarantined in an intensive care unit in Nancy.
The tenor of this report is that the French medical authorities have not confirmed the diagnosis of H5N1. If it turns out not to be, that is reassuring news for the rest of us but probably little comfort to the patient. The regular human strains of influenza are bad as well and in a "normal" year kill on average 36,000 Americans (12 World Trade Centers worth). If we would spend as much time, energy and resources on public health as we have on Yellow alerts, . . . oh hell, never mind.
More from Bloomberg (no link available): Blood and tissue samples are currently being tested by French health authorities to determine if the patient is suffering from H5N1 influenza ("bird flu"). Connections with poultry are also being evaluated. WHO officials expressed confidence that French medical authorities were handling matters properly.
It is likely we won't know the answer to this before tomorrow or the next day. When it comes, I will try to bring it to you along with some context.
ProMed Mail post now up: This is a good source, although they tend to lag breaking news. But opinions expressed are knowledgeable and very cautious, a wise attitude. Here's the general link for your use. It also contains the post regarding this case (under Avian Influenza).
Status in pm of 12/03/04: For those following this story, there is as yet no further information from French health authorities on the follow-up diagnostic tests of the suspect case being treated in Nancy. I will update as information comes to me.
Update in am of 12/04/04: A number of people are checking in to see the status of this, so here is how things stand. I have located little additional information (France's TV channel tf1 has some additional details here (in French). The report, dated Thursday, says the confirmatory test results were expected yesterday. I have queried ProMed contacts but they have no additional information. The tf1 report also quotes hospital sources as saying the patient was admitted to the intensive care unit as a precaution and for isolation, not on the basis of the gravity of his condition.
So this is a bit of a mixed message. This has been on the national news in France, so one would expect that if tests were negative we would have heard an announcement. However it may be that things are just taking longer than expected (not uncommon). The fact that the patient is not gravely ill is reassuring. More if and when I get it.
Update note (12/16/04): For those following this thread via this link, please see update post with final disposition from later in 12/04/04 here.
posted by Revere at
12/02/2004 08:57:00 AM
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