Thursday, March 24, 2005

Bird flu recap

On Sunday Thanh Nien News reported 195 people had flu symptoms in the same commune in Quang Binh province where the care-giver aunt and 5 year old brother of a 13 year old girl who reportedly died of bird flu on March 9 were also reported ill. The brother had already been shown to have H5N1 infection. The aunt developed a fever after caring for the girl but now appears to be better. In addition, a 41 year old male was admitted to the Hue hospital on March 21 after suffering high fever during the previous week. However there are also reports that a 41 year old male from the same commune (Chau Hoa) walked out of the hospital and was being sought by authorities (Reuters). It is not clear if this is the same individual. Today Thanh Nien News reported a 16 month old from Quang Binh was admitted to Hue Central Hospital Tuesday. But the deputy director of the hospital is quoted as saying the toddler no longer has a fever and no symptoms of flu were evident (AFP). Finally, a woman from another commune was reported to have a light fever and breathing difficulty and was being monitored at home.

WHO and Vietnamese authorities despatched a team to Quang Binh to investigate. As yet we don't know the results. AFP reported today from Hanoi that
The first bird flu tests carried out on several inhabitants of a village where residents reported an epidemic were all negative, a doctor in central Vietnam said.

Chau Hoa commune in central Quang Binh province, 400 kilometres (248 miles) south of Hanoi, is under scrutiny after local people reported a flu epidemic. A five-year-old boy there tested positive for bird flu last week.

"All tests on samples sent from Quang Binh province are negative," said Bui Trong Chien, deputy director of Pasteur Institute in the coastal city of Nha Trang, 500 kilometres north of Ho Chi Minh City.

"We are still making other tests," he said Thursday. The exact number of tests was unclear but he said both sick patients and residents without symptoms were examined.


[O]n Thursday Peter Horby, a WHO epidemiologist in the capital, Hanoi, said there was "no serious information so far to substantiate media reports."
On the other hand, The Sun (UK) reports that nine people in Quang Binh have reported symptoms and a total of 30 samples were taken from villagers in the province. Yet Reuters reports that
In hardest-hit Vietnam, where 34 Vietnamese have died, health inspectors found 37 people with fever in Chau Hoa commune in the central province of Quang Binh, where the 5-year-old boy tested positive for bird flu nearly 2 weeks ago.

"We don't see anyone in serious condition and nobody shows clinical symptoms that need medical intervention," said senior provincial health official Truong Dinh Dinh, disputing state media reports that up to 200 people had flu-like symptoms.

He said samples taken from residents, chickens, flies and the water supply would be tested for bird flu.
Finally, today Thanh Nien reports:
Currently, over 190 residents of the commune have a common flu. Bird flu outbreaks were spotted in the area in early February.

To deal with the situation, Vietnam has sent more health and veterinary officials to probe into suspected cases and work out concrete preventive measures. Over 1,000 fowls in the commune have been culled.
Thus the reporting is confusing, if not contradictory. It is becoming even more difficult to keep all the cases (confirmed and unconfirmed) straight.

Meanwhile, the death of a 28 year old Cambodian man is being widely reported (see, for example, AFP via ABC [Australia]). He came from the same area, bordering Vietnam, as Cambodia's first victim, a woman who crossed the border and died in a Vietnamese hospital last month. The victim was a business man who traveled frequently to Vietnam. Recently 400 to 500 chickens and ducks had died in his village, although it was unknown if he had any contact with poultry in Cambodia or Vietnam. Eight contacts of the victim had been "tested" for bird flu and "cleared."

Thus, Quang Binh is still under investigation and there are contradictory reports as to the number of people affected there. Additional cases in Quang Binh are suspected. A Cambodian man has become the second reported death from that country.

Again, the bottom line is there is nothing particularly reassuring in the news. On the contrary, to use one of Henry Niman's stock phrases over at Recombinomics, there is still "cause for concern."