H5N1 Confirmed Cluster in Hai Duang Vietnam Causes Concern
Recombinomics Commentary 16:16
February 15, 2008
Chuc said the man's wife cooked the dead chickens and shared them with a relative, then cremated the three sick birds.
No other members of the man's family have fallen ill, but health authorities were testing them and close neighbors for the virus, Chuc added.
The above comments describe contacts of the index case of a geographic cluster in Hai Duang in northern Vietnam (see satellite map). The index case (40F) was H5N1 confirmed and died on Wednesday. The update from the WHO described the case and noted that "close contacts" were being monitored. They were being treated with Tamiflu, but they had no symptoms. However it is not clear if “close contacts” extends to the relative described above.
Today a seven year old child from Hai Duang was H5N1 confirmed. The timing and location raise concerns about human to human transmission, or transmission via shared food if the seven year old is a family member of the index case or the relative who received some of the dead chickens.
Today’s media report on the seven year old added that more patients were hospitalized with bird flu symptoms, but lab confirmation had not been completed.
The sudden increase in H5N1 in the region is cause for concern. Two confirmed cases in the same small district in the same week is one cause, as are the additional confirmed and suspect hospitalized cases. Moreover, all confirmed patients, other than the recently confirmed seven year, have died.
In the past, clusters in northern Vietnam have caused concern. The most alarming series was three years ago, when clusters grew as the case fatality rate fell. In the current burst of activity, the number of cases is quickly rising but all outcomes have been fatal.
More information on the relationship of the confirmed seven year old to the index case would be useful, as would updates on the other hospitalized patients and sequence data on these news cases.
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