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Two Vietnamese Families?
August 12, 2004
Media reports suggest that there have been six deaths in Vietnam, and three cases have been confirmed. Five of the six cases appear to be from two families. One family in the south involves a brother, sister, and cousin. At least one of these three was in high school. A second family is in the north, near Hanoi. This family includes two confirmed cases, sisters aged one and four. All six deaths were between July 30 and August 3, 2004. The sixth fatality was also in the south and from the same province as the other three fatalities in the south.
The media reports have not been confirmed. There have only been three confirmed cases, but that may be due to rapid death. Three patients in the south died before samples could be collected. Details of contacts between family members have not been revealed, but deaths of multiple family members raise concerns regarding human to human transmission.
Although there may be overlap in the above cases reported by the media, gender and age differences suggest that there are two distinct outbreaks involving two families, as well as a sixth individual, unrelated to the other five Six deaths over a relatively narrow time frame is cause for concern, and raises the issue of additional unreported cases. The involvement of two families would also raise more red flags regarding transmission. The H5N1 viruses in Vietnam and Thailand have been acquiring human and swine polymorphisms, which correlate with expanded host ranges and increased virulence. Thus far the recently reported H5 cases appear to have a 100% fatality rate.