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Commentary

Bird Flu New Demographic and Genes in Northern Vietnam?

Recombinomics Commentary
January 17, 2005

>> Tests were being conducted to determine whether the two patients being treated at Hanoi's Hospital of Tropical Medicine for Tropical Diseases contracted bird flu, said hospital director Nguyen Duc Hien.

Tests on a 48-year-old man from the northern province of Thai Binh who died on Saturday were negative for bird flu, Hien said. The man was initially suspected of having contracted the disease.

The People's Army newspaper identified the two suspected cases as the younger brother of the 48-year-old man and a 62-year-old man from Hanoi.<<

Details on why the fatal case was initially thought to be bird flu would be useful.  The demographics of the first three suspect cases in northern Vietnam were quite distinct from the younger victims of avian influenza in southern Vietnam.

Warnings on potential contamination of Vietnam's food supply by H5N1 were issued by Vietnam and WHO recently.  These concerns may be driven by the detection of asymptomatic ducks, which make detection more difficult and increase the likelihood of these ducks entering the food chain.

However, these ducks also increase the likelihood of more recombination in H5N1, because it increases the number of hosts for dual infections.

Swapping of pieces of H5, could not only change the ability of the virus to spread human to human, but also affect the ability of screening assays to detect the altered gene.  The brother of the "negative" fatal case is being tested.

Altered genes can also be generated by the H1N1 and H9N2 infected swine in Korea. These pigs have 1933 human genes from WSN/33, but are still being "investigated", even though the amount of reassortment and recombination has been extensive.

More information on the brothers would be useful including symptoms and exposures.  It would seem that transmissible acute pneumonia would be a concern, regardless of etiology.

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