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Suspect H5N1 Patient in Kien Giang Vietnam

Recombinomics Commentary

August 3, 2006

In Vietnam's Kien Giang province on the Cambodian border in the Mekong Delta, a man was hospitalized with damaged lungs and high fever about a week after eating duck, the Tuoi Tre newspaper reported, citing a local medical official.

``The patient is in critical condition, his lungs have been seriously damaged and we are using a respirator to support his breathing

The above comments suggest that there may be a re-emergence of reported H5N1 bird flu cases in patients in southeast Asia.  Recently a fatal case in Pichit in northern Thailand was H5N1 confirmed and a second patient, in Lon Buri has also tested positive.  Another patient in the same province has died with bird flu symptoms.  Both Thailand and Laos are reporting H5N1 in poultry.

These data suggest H5N1 is re-emerging throughout southeast Asia.  Surveillance and reporting remains poor.  Earlier this year H5N1 sequences from Laos and Malaysia were made public.  These sequences were closely related to Fujian strain detected in human cases throughout China in 2005 and 2006.  The presence of the Fujian strain in two countries in southeast Asia suggest the H5N1 was widespread, but neither country reported the H5N1, nor did neighboring countries.

Laos subsequently acknowledged the published sequence, but maintained that infections were limited to a single farm.  The lack of earlier reports raises serious credibility issues.  WHO/FAO's failure to report this data, even though the sequences were placed in their private data base by WHO affiliated labs sends signals of tolerance of these reporting failures.

Now the H5N1 outbreaks have been reported in sevearl regions in Laos and Tahiland.  Moreover, human fatalities are being reported.  The above case suggests the H5N1 has spread into Vietnam and neighboring Cambodia.

The Fujian strain is Clade 2 and is distance from the Clade 1 H5N1 that caused earlier human fatalities in Vietnam, Thailand, and Cambodia. 

Sequence data on the H5N1 being reported in Thailand and Laos would be useful.

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