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New H5N1 Clinical Presentation in Northern Vietnam

Recombinomics Commentary
June 21, 2005

>>  Two more Vietnamese have contracted bird flu in the country's north, a state-run newspaper reported on Monday, as more than 6,000 chickens were slaughtered in the southern Mekong Delta following a fresh outbreak.

The two were among five people admitted to a hospital in Hanoi with sore throat or bronchitis, the Saigon Giai Phong daily quoted hospital officials as saying. <<

The above description may signal a new clinical presentation signaling efficient transmission of bird flu.  A sore throat and bronchitis were not among the symptoms reported for 10 cases from last years outbreak, as reported in the New England Journal of Medicine.  Similarly, a recent report on the autopsy of a patient who died of bird flu in Thailand last year also noted the absence of virus in the upper respiratory system.

The H5N1 from last season had a high case fatality rate, but was poorly transmitted.  Sore throat and bronchitis are symptoms of human flu, which is efficiently passed from human to human.   The alarming increase of human cases in northern Vietnam has suggested the pandemic may be evolving into phase 6.

The sore throat and bronchitis in bird flu patients in northern Vietnam may reflect an improved ability of H5N1 to grow in the upper respiratory tract, leading to more efficient spread of the virus including human to human transmission.

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