Nearly Current overview from AP / WHO / CDC
Latest news about avian influenza (bird flu)
Bird flu leaps from human to human
A teenage girl has become the 11th victim of bird flu to die in Vietnam inside a month while a Cambodian woman with symptoms of the disease was last night admitted to hospital in a critical condition. It has raised fears that bird flu may be starting to appear as a human pathogen and escalated concerns over the extent of the threat posed by the disease.
The 13-year-old, from a southern province of Vietnam, died on Friday night in Ho Chi Minh City. Her 35-year-old mother died from the infection nine days ago, after the two of them had slaughtered a duck.
The World Health Organisation said human-to-human transmission is being investigated and cases must be closely followed 'to determine whether the epidemiological behaviour of the virus might be changing in ways that could favour the onset of a pandemic.'
Last week a study published in the New England Journal of Medicine revealed that the first confirmed case of avian flu being spread between people had occurred in Thailand earlier this month, when a woman contracted it from her daughter.
Most cases so far have been linked to infected poultry. Isolated cases of the virus being spread among humans in close contact have been reported. But urging caution yesterday, Hans Troedsson, WHO representative in Vietnam, said: 'It's too early to make any conclusions. [Human-to-human transmission] is something that needs to be ruled out.'
The Cambodian woman was admitted on Friday to a hospital in Kien Giang province with a high fever and cough and by last night the 26-year-old was critical.
The woman's relatives said there was dead poultry in her village in Cambodia's Kampot province about a month ago. If the virus is confirmed, it would be the first known human case outside Vietnam since the latest outbreak began in December.
Three more people confirmed to have contracted bird flu in Vietnam remained in hospital this weekend including a critically ill 10-year-old girl. Health officials fear the disease could spread faster during next month's Lunar New Year festival, or Tet, when thousands of people are on the move. Chicken is traditionally served during the feasts.
Last year, a similar outbreak in Vietnam forced officials to ban the sale and transport of poultry nationwide during the holiday. However, no restrictions have been put in place so far this year.
Last year's outbreak spread to 10 Asian countries, killing or forcing the slaughter of more than 100 million birds, but no person-to-person case was seen. Singapore authorities now say they are stepping up inspections of farms and poultry imports at border checkpoints. Officials plan to cull all two million chickens in the city-state's poultry farms and ban imports if a single case is detected.
One leading British expert, Professor John Oxford, commenting on the new research, said the virus had broken down the 'final door' which prevented it being spread between people. 'This is a very important step towards the conclusion that we all wanted to avoid,' he said.
In 2004, avian flu infected at last 44 people in eight south Asian countries, killing 32. Until the late 1990s, it had not been thought that the virus strain - H5N1 - could spread to humans but there is now a worldwide effort to combat the disease before it spreads to many other countries.
The Sars outbreak has convinced governments they have to work quickly in order to prevent travellers from spreading it. The emphasis is now largely on containing the virus within the country of origin. A flu drug, Tamiflu, works as a preventive measure, but the UK has not yet decide how much of this drug to stockpile. The Thai case - the first confirmed case of human-to-human transmission - began with an 11-year-old girl who lived with her aunt and went to the doctors with a fever, cough and sore throat in September last year.
Chickens in the household had died from avian flu in the preceding weeks. The girl slept and played among the chickens under the elevated house. Her mother, who lived in Bangkok, went to visit when she heard her daughter was sick, and cared for her in hospital for two days before the child died. Three days later, she too began to experience fever and severe shortness of breath. Within a week she too was dead.
The child's aunt also fell ill but survived. A probe led by Dr Kumnuan Ungchusak concluded: 'We believe that the most likely explanation for the family clustering of these three cases of avian influenza is that the virus was transmitted directly from the infected patient to her mother and to her aunt.'
Bird flu 'passed between humans'
Scientists have said a woman who died of bird flu probably contracted the disease from her daughter.
The researchers from the Thai Ministry of Public Health warn it is likely there will be more cases where the virus is passed from human to human.
Professor John Oxford, a leading UK expert, said the virus had broken down the "final door" which prevented it being spread between people.
The study is published in the New England Journal of Medicine.
In 2004, avian flu infected at least 44 people in eight south Asian countries, killing 32.
Until the late 1990s, it had not been thought that the virus strain - H5N1 - could spread to humans.
Once it did, scientists began to fear it could then be spread between people.
In a "worst-case scenario", they suggested the virus could combine with a human flu virus if people were simultaneously infected with both.
If the viruses then exchanged genes, a new, highly infective virus could be created and be passed from person to person.
It is not thought that this happened in the Thai case, but experts say the fact that the evidence strongly suggests human-to-human transmission of the basic virus is worrying.
The case began with an 11-year-old girl who lived with her aunt and went to the doctors with a fever, cough and sore throat in September last year.
Chickens in the household had all died from avian flu in the preceding weeks. The girl slept and played in the area under the elevated house where the chickens were also present.
The girl's mother lived in Bangkok, but went to visit her daughter when she heard she was sick, and cared for her in hospital for two days before the child died.
Three days later, she too began to experience fever and severe shortness of breath. About a week later, she also died.
The child's aunt, who also nursed her, showed symptoms of the virus, and was hospitalised. However, she survived her illness.
The research team interviewed surviving members of the family and carried out laboratory tests on the aunt and the body of the mother to test for the presence of the virus.
The child's body had been cremated so could not be tested.
'Shiver down the spine'
Writing in NEJM, the team, led by Dr Kumnuan Ungchusak, said: "We believe that the most likely explanation for the family clustering of these three cases of avian influenza is that the virus was transmitted directly from the infected patient to her mother and to her aunt.
"Person-to-person spread of avian influenza A (H5N1) strains has been the focus of intense concern.
"If H5N1 remains endemic for months to years in the eight countries that contain more than 30% of the world's population, it is likely that such clusters will appear again."
However, they add, "it is reassuring that no further transmission of the virus has been detected" after the Thai case.
The researchers said human-to-human transmission of avian flu had probably occurred before, but that this case was unique because secondary infection - of the mother - had resulted in her death.
Professor John Oxford, a virologist at Queen Mary's School of Medicine in London, said: "This is a very important step towards the conclusion that we all wanted to avoid - the spread of this virus from human to human.
"It sends a cold shiver down the spine.
He added: "In this case, it didn't spread, but I think we have to be careful not to be over-optimistic."29-01-05
Malaysia has network to monitor bird flu
Malaysia has a reliable network of clinics and hospitals to monitor cases of influenza and avian flu, said Health Minister Datuk Dr Chua Soi Lek.
He said the network comprised 135 hospitals and almost 4,000 clinics.
“If the increase (in flu cases) is dramatic, they would report to the state-level disease control division, and then to the national level,” he told reporters after presenting Hazard Analysis and Critical Control Points and Halal certifications to Sime Oleander Sdn Bhd here yesterday.
Dr Chua said Malaysia was on high alert for avian flu following fears that the country would be exposed to the disease after nine deaths were reported in Vietnam since Dec 30.
“When a place has an increase of influenza-like symptoms, we will send a public health team to investigate,” he said.
Dr Chua added that surveillance, which had two parts, would be carried out.
He said passive surveillance was compulsory reporting of cases while active monitoring would include examining everyone within a 1km radius.
“Each state has the facilities to make visits, and workers who are exposed to the disease are advised to wear gloves and face masks,” Dr Chua said, adding that his ministry was working closely with the Agriculture Ministry on the matter.
Strange disease kills poultry in Melphey
It may not be the avian flu, but more than 35 poultry birds in lower Melphay, Trashigang, have died in the past week. And more are dying every day.
D. B. Rai’s neighbour who also rears poultry lost all her birds to the disease. “Within a week’s time, seven small chicks and three hens died,” said the neighbour.
Some old timers like 60-year old Sonam from upper Melphay who has a small poultry farm with more than 60 chickens said the disease was not new.
“The same disease killed most of my chickens about nine years ago,” said Sonam. “Once the chickens get infected there is no cure. Three to four chickens die every night.”
According to him, chickens infected with the disease show similar symptoms; they lose appetite, frequently discharge watery feces, and the crest turns black.
“The disease usually hits when winter nears its end or before the summer heat breaks in,” said Sonam who added that 12 of the 15 chickens in his son’s house had also died.
Until now the disease had been under control with the poultry receiving inoculation from the livestock department once every three months. According to the village folks, the injection had finished this time and they were given some powdered medicine instead to feed the birds.
But the powder, it seems, has proved ineffective. “The disease has now spread to upper Melphay and three of my chickens in my farm have died,” said Sonam. “I gave the medicine to my chickens but it has not prevented the disease.”
Some villagers have tried to seek their own remedies. They fed their chickens with a strong concoction of ginger and garlic in water. That has not worked either.
“Years ago when there were no medicines we used to give the chickens rum,” said Sonam. “It helps to some extent but it couldn’t keep the disease away for long.”
Sonam has buried the carcasses of the dead chickens in his farm, concerned that if not disposed of properly it might spread elsewhere.
“If other animals eat the carcasses and go to other villages, it will carry the disease along and spread it there,” he said.
Animal husbandry officials in Trashigang feel the disease could have come from the border towns near Samdrup Jongkhar from where people normally import chicken for consumption.
“Like the foot and mouth disease in cattle, poultry diseases can also be transmitted through livestock movement,” said Dorji Wangchuk of animal husbandry.
The Trashigang veterinary hospital has taken the carcasses of chickens killed by the disease to the regional laboratory in Khaling for examination. “At the moment we don’t know what the disease is,” Dorji Wangchuk told Kuensel.
Vietnam deploys bird flu riot police, another dies
Vietnam has deployed riot police at bird flu checkpoints around the sprawling metropolis of Ho Chi Minh City, officials said on Friday, as the killer virus claimed another victim, raising the country’s recent death toll to 10.
Following an order from the city’s People’s Committee, the gun-toting riot officers are backing up traffic police and market monitors manning 24-hour checkpoints thrown up to stop infected or uncertified birds entering the southern city, officials said.
As Vietnam’s third wave of the killer H5N1 virus spreads unchecked, city authorities have started destroying any chickens and ducks whose origins cannot be pinned down, a policy that has raised the rare threat of civil unrest.
Most of the victims are believed to have caught the virus from infected poultry but doctors fear it could mutate into a form that is easily passed between people, unleashing a global human flu pandemic that could kill millions.
The Saigon Giai Phong daily said travel agents in Vietnam’s southern commercial hub had also been told not to take tourists to areas with a high risk of the H5N1 virus, which has now killed at least 42 people since first erupting in Asia at the end of 2003.
Vietnam’s latest victim was a 32-year-old man from Phu Tho province, 210 km (130 miles) northwest of Hanoi, who died on Thursday afternoon, according to a doctor at Hanoi’s National Institute for Clinical Research of Tropical Medicine.
Two other men were being treated there after laboratory tests confirmed they had bird flu, the doctor said.
A researcher at Ho Chi Minh City’s Pasteur Institute said tests had also confirmed the virus had infected two girls, a 10-year-old from Long An province and a 13-year-old from Dong Thap province.
“We tested the 13-year-old girl three times and found the H5 component in her samples,” said the laboratory researcher. Her mother died on Jan. 21, also from the H5N1 virus, doctors said.
The new cases bring Vietnam’s total number of human infections to 16 in the latest wave of the virus, which started in late 2004.
Of these infections, 10 have died in recent weeks.
Asia’s total death toll from this outbreak now stands at 42, including 12 who died of bird flu in Thailand last year as well as victims in the previous recent Vietnamese outbreaks.
Bird flu spreads to Vietnam's northern region
Bird flu has just been detected in Hanoi capital city and northern Ha Nam province, raising the total number of localities hit by the disease to 16, local newspaper Youth on Saturday quoted the country's Animal Health Department assaying.
The bird flu was spotted in a flock of 400 ducks, a flock of 600 chickens in Hanoi's Long Bien urban district, and a flock of 100 ducks in Ha Nam's Ly Nhan district.
Since last December, Vietnam has detected 84 outbreaks in 16 cities and provinces, namely Hanoi, Ha Nam, Nam Dinh, Lam Dong, Ben Tre, Ca Mau, Kien Giang, Tien Giang, Can Tho, Binh Phuoc, An Giang, Dong Thap, Long An, Tra Vinh, Bac Lieu and Hau Giang, which have killed and led to the forced killing of nearly 168,000 fowls.
Also, the country has recently discovered six human cases of bird flu infections, at least four of them died.
To curb the spread of bird flu among poultry and persons, Vietnam is considering the possibility of vaccinating fowls and researching into vaccines for humans.
"With the permission of the Ministry of Health, we are probing into vaccines to prevent people from bird flu. We hope that there will be vaccines for experiment in the coming time," said Pham Ngoc Dinh, deputy director of the National Institute for Hygiene and Epidemiology.
Prime Minister Phan Van Khai, on Friday, asked People's Committees in cities and provinces and some ministries to mobilizeall forces to isolate and then contain new bird flu outbreaks, andmonitor the transport and trade of fowls more closely to prevent potential spread of the disease.
After facing bird flu outbreaks from December 2003, Vietnam, inlate March 2004, declared an end to the bird flu that killed 17 percent of its poultry population, causing a total loss of 1.3 trillion Vietnamese dong (82.8 million dollars) to the local poultry industry. Since December, the disease has killed at least 24 people in the country.
Thailand not yet free from bird flu
The Thai government is still closely monitoring the bird flu virus in four of the country's provinces in the central plain.
The government does not plan to make any imminent announcement that the country is free from the disease, according to senior government officials.
“Thailand wants to play it safe and not jump to the conclusion that there is no more bird flu,” Director-General of the Department of Livestock Department Yukol Limlamthong told TNA on Friday.
Thailand has set a 21-day-deadline for the monitoring of the disease. No single new case has been reported in bird flu-hit provinces throughout the country as yet.
The deadline for surveillance is 25 January in the central province of Suphanburi, and the northern provinces of Phitsanulok, Pichit, and Uthai Thani, where officials believe the disease still continues.
''In these provinces, outbreaks are still found in 18 areas, the department plans to continue its strict surveillance programme to prevent it from spreading to other towns, despite the challenge, as people are still raising local breeds of fowls and field ducks,'' said Mr. Yukol.
Unlike Malaysia, Thailand will not announce that it is free from bird flu because the last time the government announced the country was free of the avian flu virus, it then returned, he noted.
''I, however, am confident that our strict measures against the virus will prevent it from spreading across the nation,'' said Mr. Yukol
Another death reported from avian flu in Vietnam
Avian flu claimed another life in Vietnam, the fifth death from the virus in two weeks, a doctor said Friday.
A 35-year-old woman from southern Mekong Delta province Tra Vinh died Wednesday, a day after being admitted to the Hospital for Tropical Diseases in Ho Chi Minh City with high fever and breathing difficulties, said Le Hai Au, director of Tra Vinh provincial Preventive Medicine Centre.
Au said the woman was hired by a neighbour to bury dead ducks and pluck sick ducks' feathers for sale four days before she developed fever.
Vietnam earlier reported four avian flu deaths, all of them in the country's south.
More affected by bird flu
Four more other spots of avian flu were discovered in three districts of the southern Tien Giang, Bac Lieu and Dong Thap provinces on Monday, according to Veterinary Department and Ministry of Agriculture and Rural Development.
In Tien Giang, avian flu appeared in two chicken farms in Go Cong Tay and Cho Gao districts.
In Bac Lieu, the flu appeared in a duck farm in Gia Rai District, and in Dong Thap, the flu happened in a farm raising quails in Chau Thanh town.
So far, 26,239 chickens, 34,634 ducks and 43,000 quails have been culled.
The National Steering Committee for Avian Flu Prevention and Control yesterday asked people’s committees of provinces and cities, as well as relevant ministries, to implement urgent measures to prevent and fight the flu.
The committee asked local officials to inspect each farm and household and clean every poultry farm three times a week.
It also urged local governments to strengthen their controls on transporting and international chicken smuggling.
Hong Kong to Test Dead Heron for H5N1 Bird Flu Virus
A heron found dead near Hong Kong's border with mainland China was carrying a bird flu virus, but further tests are needed to determine if it is the strain that has killed people, health officials said on Wednesday.
Health experts have warned that the H5N1 virus may unleash the next flu pandemic as soon as this winter and could kill up to 50 million people around the world. Humans have no immunity to H5N1, which can kill up to two-thirds of the people it infects.
The bird was found dead in Lok Ma Chau in northern Hong Kong on Tuesday and initial tests showed it was infected with a virus from the H5 family of bird flu viruses.
"We need to narrow it down to see if it was infected with H5N1," a government spokesman said told Reuters on Wednesday.
The government would inspect all poultry farms within three miles of where the bird was found as a precaution, he added.
H5N1 is found in wild birds, some species of which migrate to nature reserves and wetlands in Hong Kong each year to escape the cold northern winter.
They have long been seen as the source of the disease, which was first recorded in humans in Hong Kong in 1997, when it killed six people.
But the virus has since been sporadically found in domestic poultry in the city and is now believed by experts to be endemic in chicken and duck populations in many parts of Asia - which means that wild birds may not necessarily spark any future outbreak.
Concerns over the virus re-emerged after a 16-year-old girl in Vietnam died on Saturday of the disease.
Hanoi is now testing samples from two more suspected bird flu cases, one of whom has died. If confirmed, they would bring the human death toll in Vietnam from H5N1 to 24 since December 2003.
Entire poultry flocks in many places of Asia have either died of the disease or been slaughtered in the past year to control the spread of the virus.
New centre to handle bird flu outbreak
The (Thai) government is planning a new centre to handle bird flu emergencies in response to the World Health Organisation's concern about a possible major outbreak in Asia made deadlier by human-to-human transmissions.
The planned centre will monitor the flu's spread, devise strict quarantine protocols, designate separate treatment areas for bird flu patients, said Deputy Prime Minister Chaturon Chaisaeng, adding that patients will be examined on a case-by-case basis.
Mr Chaturon said a panel has been assigned to work out prevention and counter strategies and present him a draft plan in two weeks.
A system will be put in place to prepare the country in the event of mutation enabling the flu virus to jump from one person to another, he said.
A full action plan to fight the flu will be finalised in three months. It will come with a situational analysis and specific methods of dealing with the virus.
An early preparation is in order, he said. ``We can't afford to be complacent.''
Mr Chaturon said the feared outbreak, if it really occurs, could prove much more catastrophic than the Dec 26 tsunami disaster.
Thailand could be hit by a major bird flu outbreak in the next year or the next three to five years, he said, adding that his warning was based on credible scientific data.
The country still harboured remnants of the bird flu virus which could re-emerge at any time, he said. The WHO and international experts agreed the virus which killed and sickened scores of people across the region in the past years could not be eradicated in a short time.
Mr Chaturon said the cost of damage from such a major outbreak could far exceed that caused by the tsunami disaster.
In Vietnam, a 16-year-old Vietnamese girl who battled bird flu for more than two weeks has died, the country's third casualty in 10 days from the disease that killed dozens and devastated Southeast Asia's poultry industry last year.
With Asia's death toll from the H5N1 bird flu strain now at 35, an official said yesterday another patient has been infected by the virus.
Le Truong Giang, deputy director of Ho Chi Minh City's health department, told Reuters the girl from the southern province of Tay Ninh died on Saturday in the city's hospital after fighting the virus since late last month. Tests last week confirmed that an 18-year-old girl who was transferred to the same hospital from the Mekong delta on Jan. 6 had also contracted the H5N1 strain, he said.
``The Health Ministry will have the final say on the case but tests have shown positive bird flu results,'' he said.
Bird flu killed 12 people in Thailand last year but no new cases have been reported in the country since November. Malaysia, which has had no human cases, declared itself free of the virus last week.
The WHO also warned Vietnam it may face new bird flu cases this month as poultry is transported ahead of the mid-February Lunar New Year celebrations. The virus also becomes more active when temperatures cool, the WHO said.
A WHO official said in November that H5N1 was far more lethal than the Sars virus that struck Asia in 2003 and could unleash a pandemic that could kill as many as 50 million people. Sars, or Severe Acute Respiratory Syndrome, killed about 800 people around the world before being brought under control.
With the bird flu now endemic on poultry farms, experts fear it will only be a matter of time before the disease mutates into a form that can leap between humans and sweep through populations with no immunity. Pigs are seen as a likely next step.
Hospital denies child’s death caused by bird flu
Doctors at HCM City’s Hospital for Tropical Diseases have rejected initial fears that a 9-year-old boy who died in the hospital yesterday had contracted bird flu.
The hospital’s deputy director Dr Trinh Tinh Hien said he had died of hepatitis.
The patient, Thach Phung of Tra Vinh Province’s Cau Ke District, had been transferred to the HCM City facility from his province’s general hospital on Monday after suspicions he had been infected by the lethal H5N1 virus.
Director of the Tra Vinh Province hospital, Mai Khac Chon, said another 14-year-old boy had been sent to the HCM City hospital but that tests for the disease proved negative.
Dr Hien said that a 16-year-old girl was the only patient being treated at the hospital for avian flu. The girl, from the southern Tay Ninh Province, had been admitted in late-December and remained in critical condition, he said.
Director of the Ministry for Agriculture and Rural Development’s Animal Health Department, Bui Quang Anh, said yesterday that avian flu had spread to eight provinces and cities in Viet Nam, mostly in the south.
Truc Thai Commune in Nam Dinh Province was the only area in the north to have sick poultry, Anh said.
About 17,000 birds have died or been culled in the country since December 19.
The number, he said, was much higher than previous months because of the chilly weather and higher demand for poultry before Tet (lunar new year), which comes in mid-February.
"Prevention must be extremely prompt and drastic," he warned, pointing out that the period from now to Tet was the most critical in the spread of the disease.
Anh urged local authorities to bolster preventive measures against outbreaks and scrupulously follow instructions from government agencies.
In response to the new outbreak, HCM City has enlisted the police to join in supervising poultry transportation.
Ha Noi has also stopped entry of poultry from dubious sources, increased inspection at markets and disinfected live poultry trading areas.
Ha Tay Province has, besides similar preventive measures, announced rewards of VND50,000-100,000 for anybody raising the alarm about infected poultry.
Guangdong urges flu prevention for residents
Guangdong Province's health authorities are urging people to get vaccinated against flu before the coming spring.
An official surnamed Chen from the Guangdong Provincial Health Bureau said the illness was most prevalent for the first three months of the year.
"Injecting the flu vaccine is a simple and efficient way to prevent flu," said Chen.
Seven groups of people have been identified as at high risk of contracting the disease - including old people, young children, chronic patients, medical staff, kindergarten staff or people in the service industry.
The Guangdong plan recommends people be vaccinated between March and October. The department was careful to issue warnings to pregnant women, infants and people who are allergic to eggs, not to receive the vaccine.
Some people are still waiting to see what happens with the vaccine before they take it.
One worker, Du Ping, said her company had organized all employees to take injections once a year. "I hope the tradition continues this year," she said.
Provincial health authorities ordered 13 cities in Guangdong to enhance communication with bird farms, monitor the information about bird flu.
Guangdong cities are being asked to follow strict procedures to monitor flu outbreaks to try and avoid an epidemic.
Two groups have been organized to give advice to the public on flu control and prevention, and to organize ambulances.
Boy dies of bird flu in Vietnam
A nine-year-old boy in Vietnam has died of bird flu, bringing the number of people in the country killed by the virus to 21, a doctor said today.
The boy from the southern Mekong Delta province of Tra Vinh was admitted to the Hospital for Tropical Diseases in Ho Chi Minh City early yesterday morning and died later that day, hospital deputy director Tran Tinh Hien said.
"He was tested positive for H5N1 virus," Hien said, referring to the strain of the virus that is deadly to humans.
World health experts fear that bird flu might mutate and create the next influenza pandemic. So far, there has been no concrete evidence of human-to-human transmission of bird flu.
Only Vietnam and Thailand have recorded human deaths from the virus.
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