Wednesday, June 15, 2005

Bird flu signal in north vietnam?

A nurse at the Institute of Tropical Diseases in Hanoi is quoted in a local newspaper (the Tuoi Tre) to the effect that six people in northern Vietnam were admitted last week to the hospital with H5N1 infection. One is in critical condition, the others are showing good signs of recovery. More ominously, a doctor who was taking specimens from the patients is now running a fever, a possible sign of transmission to a health care worker, indicating the disease has adapted to easy transmission between people (reports in People's Daily and Reuters).

We have no information on the relationship of the six people. If they represent a temporal and spatial cluster this may be the long awaited definitive signal that a human to human outbreak is underway in Vietnam, but it won't hurt to wait a day or two to confirm or disconfirm these very early reports. "Facts" have a way of changing in situations such as this.

The salient features are these: milder cases characteristic of a changed virus in the north of Vietnam (as opposed to the virulent form seen in the south); possible large cluster in time (we don't know the sequence of events here) and space (we don't know the relationship of these cases to each other); possible spread to a health care worker (no diagnosis of H5N1 yet); most importantly, we don't yet know if some or any of these reports are accurate.

These media reports are based on an anonymous source (a nurse) at the hospital in Hanoi and should be treated cautiously until better information is available.

Addendum, 7:30 am, 6/15/05 (AP via The Star):

Vietnam has recorded six new cases of bird flu in the past week, state-controlled media and officials said Wednesday.

The six people, all from northern provinces, had been admitted to a hospital in Hanoi over the past week, the Pioneer newspaper said. Five of them were in stable condition, it added.

Officials at the Ministry of Health declined to comment Wednesday.

Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology said those who had contracted bird flu since the last outbreak in December last year showed less severe symptoms of high fever, coughing and breathing difficulties.

He said the institute was researching whether the virus had evolved to allow for faster transfer, while becoming less virulent.

Most of the bird flu patients have been traced back to contact with sick birds.

It is not clear if the last comment refers to these cases specifically or most cases to date. This AP report seems to indicate semi-official confirmation of the cases.