Published Date: 2005-12-30 23:50:00
Subject: PRO/AH/EDR> Avian influenza, human - East Asia (209): China
Archive Number: 20051230.3714

AVIAN INFLUENZA, HUMAN - EAST ASIA (209): CHINA
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[1]
Date: Fri 30 Dec 2005
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: World Health Organisation (WHO), CSR, Disease Outbreak News,
Fri 30 Dec 2005 [edited]
<http://www.who.int/csr/don/en/>

China: Avian Influenza Situation - WHO Update 51
------------------------------------------------
The Ministry of Health of China has confirmed an additional case of
human infection on the mainland with the H5N1 avian influenza virus.
The case is a 41-year-old woman from the southeastern province of
Fujian. She developed symptoms of fever followed by pneumonia on 6
Dec 2005, and was admitted to hospital 2 days later. The patient died
on 21 Dec 2005.
On 13 Dec 2005, initial laboratory tests on samples from the patient
tested negative for H5N1 virus. But further tests on 23 Dec 2005 --
including PCR tests carried out at the Chinese Center for Disease
Control in Beijing -- showed positive results. The virus was also
isolated from the patient.
Close contacts who have been placed under medical observation have
not displayed any symptoms, health authorities report.
Agricultural authorities so far have not been able to confirm the
presence of the H5 virus subtype in poultry in the vicinity of the
patient's residence or place of work. Investigators have not been
able to confirm any direct contact between the patient and poultry
prior to the onset of illness. The investigation, however, is
continuing and answers to these and other questions are still being
sought.
This is China's 7th laboratory-confirmed human case. Of these cases,
3 have been fatal (including this latest case). To date, China has
reported human cases in 6 provinces and regions: Hunan, Anhui,
Guangxi, Liaoning, Jiangxi and Fujian.
--
ProMED-mail
<promed@promedmail.org>
******
[2]
Date:
Date: Fri 30 Dec 2005
From: Joseph Dudley <josephpainedudley@yahoo.com>
Source: English.eastday.com, Fri 30 Dec 2005 [edited]
<http://english.eastday.com/eastday/englishedition/node20676/userobject1ai1757281.html>

The Ministry of Health on Thu 29 Dec 2005 announced the country's 7th
human case of H5N1 bird flu. The infected was a 41-year-old factory
worker in Sanming City, east China's Fujian Province. She showed
symptoms of fever and pneumonia on 6 Dec 2005 and was hospitalized 2
days later. She died on 21 Dec. 2005, according to a report released
by the Ministry.
The woman's samples tested negative for H5N1 virus at the Fujian
Provincial Center for Disease Control and Prevention (CDC) on 13 Dec
2005, but further tests by the state CDC and the Fujian provincial
CDC both showed positive results, said the Ministry. The woman has
been confirmed to be infected with avian influenza in accordance with
the standards of the World Health Organization (WHO) and the Chinese
government, the Ministry said. This is the 3rd human fatality from
avian influenza reported in China.
Local health authorities have taken measures to check the spread of
the virus, and those who had close contact with the patient are under
strict medical observation, with no abnormal clinical symptoms found
so far.
However, no H5N1 bird flu outbreak in animal was detected in the area
where the new case was reported, said the health ministry. The
Chinese Health Ministry has informed the WHO, the regions of Hong
Kong, Macao and Taiwan, as well as several other countries, about the
new human case.
Previously, the Ministry had reported 6 human cases of bird flu,
including 2 fatalities in east China's Anhui Province, [one]
recovered case [each] in central China's Hunan Province and northeast
China's Liaoning Province, one in the southern Guangxi Zhuang
Autonomous Region and one in the eastern province of Jiangxi. [As of
Fri 30 Dec 2005 the cumulative total of human cases of H5N1 avian
influenza in East Asia since December 2003 becomes 142, of which 74
have been fatal. - Mod.CP]
Also on Thu 29 Dec 2005, China's Foreign Ministry spokesman Qin Gang
pledged at a regular press briefing that China will continue to
strengthen its cooperation with the world community to deal with the
challenge of bird flu. A total of 141 laboratory-confirmed human
cases of avian influenza including 73 deaths had been reported now to
the WHO by 23 Dec 2005, according to the WHO website.
China has reported 31 bird flu outbreaks in poultry this year. As no
effective vaccine has been put into use on humans so far, scientists
fear the H5N1 strain of bird flu could mutate to a form that could
pass easily between people, triggering a global pandemic. China's
home-made human vaccine begun human trials on 21 Dec 2005 with 6
volunteers receiving the shots. The whole trials will need 9 months
of tests, but initial results are expected within the first 3.
Dr. Shigeru Omi, WHO regional director for the Western Pacific, told
Xinhua earlier in an interview that the WHO hopes China to share more
samples of bird flu collected from animals and human cases with the
international society, which would help develop anti-bird flu drugs
and vaccine and trace the mutation of the virus. He warned that it is
too early to tell if bird flu in China has been brought under
control, as more outbreaks may occur during winter months. He also
noted that surveillance and prevention efforts need to be
strengthened at grassroots level. Omi also suggested Chinese farmers
improve their farming practice, as China has 14.2 billion poultry and
most Chinese rural families keep chickens and ducks in their
backyards or even houses.
--
Joseph Dudley
EAI Corporation
<josephpainedudley@yahoo.com>
[Dr Joseph Dudley has drawn attention to the following situation: "
It should be remembered that Hong Kong health officials reported 2
confirmed cases of H5N1 (one of them fatal) from 2 members of a
family of Hong Kong residents following their return from a visit to
Fujian province in February 2003 (a 33-year-old man and his
9-year-old son; the father died). A possible additional fatal case
may have occurred in a 3rd family member (8-year-old daughter) who
reportedly died while the family was in Fujian on 4 Feb 2003 of
unidentified causes after exhibiting symptoms of "acute febrile
infection with cough."
A fuller account of this event is available at the Hong Kong
Government Public Health and Epidemiology Bulletin, News in Brief
Section <http://www.info.gov.hk/dh/diseases/ph&eb/v12n2.htm> as
follows. "2 Cases of Influenza A (H5N1) Infection in 2003: During
February 2003, the Department of Health (DH) confirmed 2 cases of
influenza A (H5N1) in Hong Kong affecting a 33-year-old man and his
9-year-old son. Both of them had good past health. The son travelled
to Fujian, China with his mother and 2 sisters (aged 8 and 10) during
25 Jan and 9 Feb 2003. The man departed from Hong Kong on 30 Jan to
join them and came back on 9 Feb 2003. The man and his son had onset
of influenza-like illness (ILI) on 7 and 9 Feb 2003 respectively.
They were admitted into hospital on 11 and 12 Feb respectively. The
man's condition deteriorated and he passed away on 17 Feb 2003. The
son recovered completely and was discharged from hospital. The
nasopharyngeal aspirates of both cases were positive for influenza A
(H5N1) virus by culture on 19 and 20 February. Genetic sequencing
revealed that the two viruses isolated were essentially similar, no
human influenza genes segments were present, and none of the internal
genes of these viruses were similar to those of the strains found in
1997. The 8-year-old daughter in the family developed an acute
febrile illness with cough on 28 Jan 2003. She died on 4 Feb 2003 and
the cause of death could not be confirmed. Further laboratory tests
are being conducted to determine whether the man's wife and
10-year-old daughter have also been exposed to the H5N1 virus. The
avian influenza virus A (H5N1) was first known to infect humans in
1997 when 18 cases (including 6 deaths) were identified in Hong Kong.
In-depth studies showed that the main mode of transmission of
influenza A (H5N1) was from bird to man, and man-to-man transmission
was very ineffective.
After that outbreak, there has not been any isolate of influenza A
(H5) virus in human specimens prior to the recent 2 cases. The
initial clinical presentation of influenza A (H5N1) infection was
similar to that of other influenza viruses, typically with high
fever, malaise, myalgia, sore throat, and cough. However, the disease
may be complicated by viral pneumonia, respiratory distress syndrome,
multi-organ failure, and even death."
ProMED-mail thanks Dr. Dudley for drawing attention to this
connection and for providing supporting information. It will be
relevant to establish in due course the phylogenetic relationship of
this 2005 Fujian isolate to that of the viruses isolated in Hong Kong
in 2003 from the visitors returning from Fujian province. - Mod.CP]

See Also

Avian influenza, human - East Asia (170): China, susp 20051114.3329
Avian influenza, human - East Asia (173): China 20051116.3349
Avian influenza, human - East Asia (174): China 20051117.3354
Avian influenza, human - East Asia (175): China 20051118.3358
Avian influenza, human - East Asia (180): China, RFI 20051123.3399
Avian influenza, human - East Asia (181): China 20051123.3400
Avian influenza, human - East Asia (182): China 20051124.3405
Avian influenza, human - East Asia (183): China, WHO 20051124.3412
Avian influenza, human - East Asia (184): China 20051125.3423
Avian influenza, human - East Asia (185): China 20051125.3424
Avian influenza, human - East Asia (193): China, I... 20051206.3516
Avian influenza, human - East Asia (194): China 20051207.3530
Avian influenza, human - East Asia (195): China 20051208.3538
Avian influenza, human - East Asia (196): China, T... 20051209.3553
vian influenza, human - East Asia (200) 20051216.3618
Avian influenza, human - East Asia (202): China 20051220.3643
Avian influenza, human - East Asia (205): China 20051223.3673
Avian influenza, human - East Asia (208): China 20051229.370
2003
----
Avian influenza - China (Hong Kong) 20030105.0036
Avian influenza - China (Hong Kong) (02) 20030107.0054
Avian influenza - China (Hong Kong) (03) 20030204.0300
...........................cp/pg/lm
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