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New Bird Flu Outbreak in Southern Vietnam
June 18, 2005
"Seven hundred chickens on a farm in An Khanh commune in Ben Tre province were culled last Saturday after 6,000 of them had died within four days," said Mai Van Hiep, director of the province's veterinary department.
"Test samples of the fowls were positive for H5 virus," Hiep said from the province 150 kilometres south of Ho Chi Minh City.....
On Friday, a senior health official said a number of suspected human-to-human cases of H5N1 had been detected by the National Institute of Hygiene and Epidemiology.
"We have got a number of suspected cases of human-to-human transmission of bird flu, including a doctor from Bach Mai hospital," Nguyen Tran Hien, the director of the institute, told Deutsche Presse-Agentur dpa.
The above comments on the bird flu outbreak in southern Vietnam is cause for concern. It coincides with an outbreak of H5N1 in humans in central and northern Vietnam. Media reports suggest 23 patients have been hospitalized this month and 11 of the cases have been confirmed to be H5N1 positive. The others were admitted this week and results have not been reported yet. The human cases are from at least 6 different provinces.
New sequences have been found in northern Vietnam this year and these sequences have correlated with in more efficient transmission of a milder bird flu in humans. In contrast, the human cases in southern Vietnam and Cambodia have almost all been lethal.
The co-circulation of a lethal H5N1 in southern Vietnam with a more transmissible H5N1 in northern Vietnam raises the possibility of a the creation of a recombinant H5N1 having both lethality and transmissibility in humans.
Some reports have suggested that such a virus has caused human infections and death in western China. An unprecedented die-off of migratory birds in Qinghai Lake has been widely reported. Although China has denied any reported human cases, third party reports indicate the die-off has been extensive in birds and mammals in the area, including humans. Te reported case fatality rate has been high and the 121 deaths also would be without precedent.
Additional repors have described another outbreak in adjacent Xinjiang province. In Tacheng domestic geese were positive for H5N1 and all poultry in the area were culled. Again China has denied any human cases, but third party reports indicated there was a pneumonia cluster in Tacheng affecting patients and health care workers. These reports would again suggest efficient human-to-human transmission of H5N1 which has the unusual property of being lethal for ducks and geese. Tacheng is on the border of Kasakhstan and near the Russian border, which suggests more H5N1 infections bordering China.
The have also been reports of mysterious disease in Nepal in regions bordering Tibet. The bar headed geese at Qinghai Lake winter in northern India and fly over Nepal and Tibet when migrating in May and June.
WHO has requested permission for an on site vist to Qinghai Lake. There ahve been no reports indicating that permission has been granted.
Thus, the outbreaks of H5N1 in Vietnam, western China, and possible human cases in India, Nepal, Tibet, and Vietnam are cause for concern that H5N1 is being increasingly transmissible in humans and may have reached phase 6 in some areas.