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Tsunami Driven Pneumonia and Influenza
January 7, 2005
>>But overcrowding at refugee camps has intensified the spread of pneumonia, and health officials fear that respiratory diseases may claim many lives in the already devastated region.<<
The crowded conditions and rainy weather with lack of shelter has led to an increase in respiratory diseases and spread on pneumonia. This situation is worrisome because human cases of H5N1 are appearing at an alarming frequency in the Mekong Delta region of Vietnam. In the past two weeks there have been five confirmed or suspected cases of H5N1 avian influenza and the H5N1 seems to be as virulent as last season. Two patients have died and the other three are in critical condition on ventilators. So far the cases seem to be linked to poultry outbreaks, but the concentration of H5N1 ducks in the Can Tho city area is alarmingly high, with almost half of all samples scoring as positive for H5N1. It is not clear if these ducks have symptoms, but WHO had issued an earlier warning about the ability of H5N1 from Vietnam and Thailand to cause fatal infections in humans, but merely grow to high titers in asymptomatic ducks.
The number or locations reporting H5N1 bird flu is growing rapidly, radiating out from the high concentration of infected ducks near Can Tho city. Although there is no evidence of human to human transmission, last season there were clusters in Vietnam and Thailand that appeared to involve transmission via close contact. Similarly, there appeared to be tiger to tiger transmission in a Sri Racha Tiger Zoo over the summer and laboratory tests showed that the virus could transmit from domestic cat to domestic cat..
Thus, although transmission from mammal to mammal appears to require close contact, an infection in overcrowded relief camps where displaced tsunami victims have lowered resistance, could provide conditions for human to human spread, even if H5N1 does not undergo further genetic change.
In addition, there was a fatal flu circulting in the southern portion, Matara, Padanangala and Embilipitiya, of Sri Lanka before the tsunami and in the northeastern region , Mullaittivu, after the tsunami and this flu was efficiently transmitted human to human.