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Human to Human Bird Flu Transmission in Northern Vietnam?

Recombinomics Commentary
January 19, 2005

>> Vietnam has just found that a middle-aged person from its capital city of Hanoi was infected with bird flu virus H5N1, the Vietnam Central Television reported Wednesday.

    After having conducted many tests, the Tropical Disease Institute in Hanoi on Wednesday concluded that samples from its 43-year-old patient were tested positive to H5N1. Since being admitted to the institute on Jan. 13 with symptoms of high temperature and damaged lungs, the patient has felt better.

    The patient have not had contact with fowls or lives in bird flu-hit areas, the television said, noting that the patient took care of the patient's elder brother who died of pneumonia on Jan. 9.

    The patient's brother, who lived in northern Thai Binh province,had symptoms of bird flu infection. However, samples from the 45-year-old man were tested negative to H5N1.<<

The confirmation of bird flu in the 43 tear old brother of a suspect fatal bird flu case raises the possibility of human to human transmission in northern Vietnam.  The transmission may be similar to an earlier cluster in Vietnam as well as likely human to human transmission in Thailand,  In each cluster, the caregiver was a relative who subsequently died and was H5N1 positive.

This is the first confirmed H5N1 case in northern Vietnam this season and the negative test result on the older brother (45M previously reported as a 48M) probably reflects shortcomings of the testing procedure

In southern Vietnam there is a confirmed case in an older sister (18F), the only confirmed case in the south still alive.  Her sister (15F) is among the 10 suspect cases in the south.

There are two additional suspect cases in the north (62M and a 25 year old).  There have not been reports of contact with infected poultry for the fatal suspect case or the older suspect case (62M), raising the possibility that the first three suspect cases in the north represent a new demographic linked to transmission that does not involve killing or disposing of infected birds.

Questions on the safety of the food supply still remain.

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