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Is Common Flu Bird Flu or Pandemic Flu in Quang Binh?

Recombinomics Commentary
March 21, 2005

>>  A 13-year-old girl from Vietnam's central Quang Binh province, who died on March 9, has just been found to contract bird flu virus strain H5N1, local newspaper Young People reported Monday……

The young girl named Hoang Lan Huong from Chau Hoa commune of Tuyen Hoa district died in a provincial hospital 10 days after eating chicken in late February when her family slaughtered the chicken given by one of their relatives for meal. After the meal, the family's three children suffered sudden illness…….

Now, up to 195 residents of the Chau Hoa commune have a common flu. Bird flu outbreaks were spotted in the area in early February. <<

The above report does not clarify if "common flu" is human flu,  bird flu, or pandemic flu.  Since 195 people have this flu, it is common to the area.  However, it is unclear if they all have influenza A infections and if so, what the sub-type is.  It is also unclear if the index case was found to contract H5N1 because she had symptoms consistent with bird flu and is the sibling of a confirmed H5N1 case, or if tests showed that she was infected with H5N1.

The report also does not clarify the current status of the patients with "common" flu or the status of the third sibling.  It also does not give the status of a fourth patient from the adjacent Quang Trach district, who was admitted with bird flu symptoms to a local hospital on March 17.

108 of the 195 patients were from Kinh Chau village, while the remaining cases were from other villages in the Chau Hoa commune.

The lack of information on sub-types is similar to the description of initial bird flu cases in Hanoi in December, 2003.  The children's deaths were initially attributed to a mysterious illness.  Then the illness was described as influenza A. That was followed by H5 and finally H5N1.

Since birds have died and been eaten by Chau Hoa commune residents, additional testing is critical.  Even though only 20% of H5N1 infected patients were testing positive on the PCR test in Ho Chi Minh City, positive results on patients outside of the familial bimodal cluster would help clarify the status of the almost 200 ill residents.  It is also not clear how many of these people have been hospitalized or how severe their symptoms are.

More information would be useful.  It is not clear if the common flu is H5N1, a flu that gives reduced titers on sub-typing tests, or the aggressive California strain of H3N2, which has been spreading worldwide, including Hong Kong and Bangkok.  Right now the relationship between a common human flu such as H3N2, a lethal bird flu such as H5N1, and a pandemic recombinant flu remains unclear.

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