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H5N1 in France?
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>>The patient was admitted to the Nancy hospital on Wednesday, after being transferred from a less well-equipped hospital in the town of Bar-le-Duc.<<
The transfer of the 69 year old Frenchman to a better equiped hospital about 40 miles away is a sign of a serious illness or an over-abundance of caution. The number of travelers returning from Vietnam with bird flu symptoms will certainly be much higher than the number returning with bird flu and at this point there has been no confirmation, which is expected within 48 hours. The patient does have pneumonia and his wife shows no symptoms.
However, on a historical note, the first reports of H5N1 in humans last season came out of Hanoi when latge numbers of children with a musterious disease were dying at a Hanoi hospital. Flu does follow a seasonal pattern, and flu season in Asia is beginning.
In addition there have been several recent warnings, including H5N1 infected pigeons fall from the sky in Thailand, Laotians and Cambodians streaming across the Thai border for flu treatments, and several thousand ducks dying in Vietnam with leg paralysis and cholera symptoms (H5N1 can produce hind leg paralysis in lab mice and 1918 pandemic flu was misdiagnosed as cholera and dengue fever).
As flu season begins Vietnam and Thailand are the two most likely spots for a re-emergence of human cases. The 2004 isolates from Vietnam and Thailand have unique mammaliam polymorphisms not found in other H5N1 isolates and recent reports of high titers of H5N1 in asymptomatic ducks offers a provocative setting for further recombination.