Chemoprophylaxis for H5N1 Confirmed Soldier in Korea
Recombinomics Commentary 12:22
April 23, 2008
Nearly 2,000 other South Korean soldiers have culled chickens and ducks since April 17. Those soldiers are being monitored every morning and evening for signs of H5N1, and are taking a 10-day course of Tamiflu, a flu treatment drug, the MND spokesman said.
The soldiers were given human influenza vaccinations before the culling, as well as protective uniforms, gloves and masks, which were destroyed after use.
The above comments from Stars and Stripes provide more detail on the military involvement in culling operations in South Korea. As expected, the cullers have PPE’s and are under chemoprophylaxis, minimizing the chances of infection. They are also vaccinated against seasonal flu to minimize co-infections.
However, in spite of these precautions, the Special Forces corporal developed an H5N1 infection. Although he (22M) developed a high temperature and lost consciousness, he responded well to antibiotic and Tamiflu treatment (concentrations are double the prophylactic dose).
However, although he developed bird flu symptoms and was H5 positive by PCR, media reports are raising alternative explanations for the symptoms, including bacterial pneumonia. However, a secondary infection does not negate the PCR positive result.
The media treatment of this lab confirmed case is cause for concern. Frequently Tamiflu treatment lowers viral load to a level that is below detection. Similarly, virus can be quickly cleared from the nose and throat, leading to false negatives. Since the soldier responded quickly to treatment, detection of similar cases may be difficult.
Media reports describe the hospitalization of 15-20 cases with similar symptoms, but these cases have tested negative. On a related note, the military has withdrawn all troops from culling operations, even though new confirmed cases in birds are being announced daily (see satellite map), and testing has expanded to asymptomatic ducks.
Thus, the media comments on a culler that has been PCR confirmed, coupled with comments on H5 confirmed poultry, raise concerns that the level of H5N1 infections in poultry and people will be significantly under-reported.
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