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Patient to Nurse Bird Flu Transmission in Thai Binh Vietnam

Recombinomics Commentary
March 7, 2005

``The reason concerning why this nurse contracted the virus has not yet been determined,'' said Diu. ``But according to the preliminary investigation, he has a girlfriend in a village where bird-flu is present, and he went to her house and had meals there during Tet,'' the Vietnamese New Year that was celebrated last month. <<

The media reports on admission dates point very strongly toward the two bird flu patients as sources for the H5N1 infection in the health care worker.  The Tet New Year was Feb 9, and most celebrations would have been through Feb 16.  On Feb 22 the 21 year old patient was transferred from the Thai Thuy District Health-Care Center in Thai Binh province to Hanoi.  On or about Feb 24 his 14 year old sister was admitted to the same regional center in Thai Binh.

The health care worker was admitted with a high fever and breathing difficulties on Feb 28 suggesting initial symptoms began around Feb 26.  Thus, exposure was probably between Feb 22 and Feb 24, when he was caring for the sibling with bird flu.

The bimodal familial clustering strongly suggests human-to-human transmission was common from patients to family members.  The geographical clustering in Thai Binh also suggests casual transmission.

The transmission from H5N1 positive patients to a health care worker would suggest efficient transmission of H5N1 avian influenza in Thai Binh province.

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