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New Bird Flu Cases Northern and Central Vietnam

Recombinomics Commentary
May 22, 2005

>> Nguyen Tien Cuu, 46, from Binh Kieu Commune in the Khoai Chau District of Hung Yen Province, about 40km west of Ha Noi, arrived in a very critical condition with lung inflammation and weak kidneys, says the Health Ministry.

He died on Thursday.

Two other patients undergoing treatment at the institute have tested positive for bird flu.

One is from central Thanh Hoa Province and the other from northern Vinh Phuc Province………

Cuu's family had a small flock of chickens and ducks but all the birds were still very strong.

There were no chickens or ducks with the virus in the district, said Luong. <<

The number of new H5N1 confirmed cases in northern or central Vietnam continue to increase. The most recent cases are males between 46-58 years old, which are distinctly different than the fatal cases in southern Vietnam and Cambodia.

These demographic differences correlate with genetic differences, which place isolates from northern Vietnam with 2005 isolates from Thailand and isolates from southern Vietnam with isolates from Cambodia.

An increasing number of cases from northern Vietnam have no clear link to infected birds, and Thailand has yet to report a human case this season.  These 2005 cases may be more difficult to detect with primers based on 2004 H5N1 sequences, since there has been several antigenic changes in HA and nucleotide changes have not been reported, but a expected to be significantly higher than antigenic change.  Nucleotide changes in regions coding for primers would diminish or abolish binding, which would generate weak positives or false negatives.

Milder cases in northern Vietnam and Thailand could also be missed because the milder cases of H5N1 are similar to more severe cases of H3N2, like those caused by the California/7 strains which swept across the United States in February and March and has now spread worldwide, including southeast Asia and China.

An aggressive screen of patients with flu-like conditions, including secondary infections such as meningitis and meningococcemia is long overdue.

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