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Casual Contact Transmission of Bird Flu in Hanoi Vietnam?

Recombinomics Commentary
March 3, 2005

>>  Pham Thi Hoa, 35, was admitted to hospital with a high temperature and serious lung infection. Experts are investigating how she contracted the disease.

It is believed that she came into contact with a carrier of the virus at her place of employment in the Ba Dinh District, as her family has said that she did not directly touch or eat poultry before falling ill.

Experts have visited Ba Dinh District and Hoa's working place in an attempt to determine how she caught the virus………

The health of 21 year-old Nguyen Sy Tuan and 14 year-old Nguyen Thi Ngoan from Thai Binh Province, who have been treated for the H5N1 virus at the institute, is improving, although Tuan still relies on a respirator to breathe. Experts have determined that Tuan and Ngoan caught the virus after consuming an infected chicken.  <<

The lack of contact with poultry is frequently cited in initial media reports, and there are rarely any likely sources in subsequent reports.  Details on evidence showing that the siblings caught the virus from eating infected chicken would be useful.  Since their disease onset was bimodal, a common meal would be an unlikely source of infection.  Consumption of the meal by others who did not get sick would also decrease the likelihood of a meal being the common source for two relatives.  A more likely route in bimodal distributions is the transmission from the index case to the family member.

All 11 familial clusters of bird flu in Vietnam, Thailand, and Cambodia have been bimodal and several lacked a link to sick or infected poultry.  These cases also lack evidence to discount a human-to-human transmission and account for over one third of reported H5N1 avian influenza cases.

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