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Human / Human Transmission Hau Giang?
August 13, 2004
The H5N1 cases in Hau Giang province are complicated and raise the possibility of human to human transmission. Initial reports on the first four fatalities were detailed, with patient's initials and date of deaths. All four eventually entered the Tuberculosis and Lung Disease Center in Can Tho. All four had similar symptoms and died between July 29 and August 2. Three of the four were related. The initial case was PDC, who initially was admitted to a general hospital in Long My and the transferred to the TB center. WHO indicated the first admission of confirmed and suspect cases was July 19. His elder sister, PTNT, developed symptoms later, was admitted to the general hospital and also transferred to the TB center where she died on August 2. A female cousin, PTKC, was also admitted to the center and died on July 29. A fourth admission, LVT, was a 24F and she died July 29. In Long My chickens had died during the last 2 weeks of July.
Initial reports indicated the positive patient was a 25F and she had a sister who had died. However, the date of admission and death matched the older sister of the index case, who was a brother of one of the victims. Subsequent reports indicated a 23F died on August 6. She was also reported to be H5N1 positive and to have had a 19M brother who died. Thus, it is not clear if the 25F who reportedly died on August 2 was the same as the 23F who reportedly died on August 6. There is at least one more suspect case at the hospital whose age has been reported as 19 or 20.
Although it is not clear if there were 4 or 5 deaths at the Can Tho center, it sounds like at least 3 of the fatalities were related, but developed symptoms over an extended time frame, raising the issue of human to human transmission.