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Alarming Increase in Bird Flu Cases in Northern Vietnam

Recombinomics Commentary
June 17, 2005

>>  [There are discrepancies between these reports which appear to confuse confirmed and suspected cases. As of 17 Jun 2005, the most recent WHO Update recognizes 4 new human cases of avian influenza, bringing the total of confirmed cases since Dec 2004 to 59 (18 of whom have died).

It is evident from the other reports that there are additional cases under
investigation and that a few people are still contracting avian influenza
in northern Viet Nam. It has been widely reported in the media that one of
the doctors treating avian influenza virus patients in Hanoi has himself
contracted avian influenza. However, the 3rd report above states that a 2nd test has proved negative and it is unlikely that the doctor is suffering
from avian influenza. - Mod.CP] <<

The above comments by one of the moderators at ProMed fails to note the sudden alarming increase in cases from northern and central Vietnam.  Although official notifications to WHO are lagging, WHO has indicated that they believe the media reports are accurate.  Two separate reports indicated that the total number of confirmed and suspect cases totaled 23.  One report broke the cases down into 11 H5N1 confirmed cases, most of which were admitted last week, and an additional 12 suspect cases admitted this week.

Admission of over 20 cases in less than two weeks is cause for concern.  There was some detail provided for the confirmed cases.  The two that were admitted at the beginning of the month were female and named, Cao Thi Hang from the central province of Nghe An and Dinh Thu Hien from the northern province of Thai Binh.  In addition there were two patients from Ha Noi and one each from Vinh Phuc and Hai Duong.  In addition there were two more listed from the central provinces of Thanh Hoa and Nghe An.  Thus, there would be seven or eight (the two listed in separate reports from Nghe An could be a duplicate of the same patient) in addition to the physician collecting blood from these patients.

The sudden jump in confirmed and suspect patients from at least six separate provinces in northern and central Vietnam in the past two weeks is without precedent.

The characterization of the alarming jump as "a few people" is yet another example of wishful thinking on the part of the ProMed commentator. 

The reports do not suggest that the sudden influx of patients has ceased.  Indeed it seems that there were two patients in the first week of this month, 9 in the second, and 12 so far in the third.  Since the cases are relatively mild, it is likely that the number of unreported cases in these six provinces is large and the jump in cases suggests more efficient human-to-human transmission.

The alarming jump in cases is clearly more than a few, and is cause for concern.

The jump may be signaling progress of the flu pandemic in northern Vietnam into phase 6.

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