Published Date: 2008-10-01 17:03:55
Subject: PRO/MBDS> Acute resp. distress syndrome - Thailand: AI susp.
Archive Number: 20081001.3093

ACUTE RESPIRATORY DISTRESS SYNDROME - THAILAND: AVIAN INFLUENZA SUSPECTED
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: 1 Oct 2008
Source: Bangkok Post [edited]
<http://bangkokpost.com/011008_News/01Oct2008_news03.php>


A worker on a free-range duck farm died from bird flu-like symptoms
in Pho Prathap Chang district yesterday [30 Sep 2008], and health
authorities put his 12-year-old son under close observation for signs
of infection with the virus. The 48-year-old worker was taken to the
provincial hospital on Monday [29 Sep 2008] after he developed a high
fever, suffered from a cough, sore throat, chest pains and breathing
difficulties.

The man was treated in an isolated intensive care ward because he had
come into contact with fowl. He was a hired hand at a duck farm which
has more than 1600 birds. Doctors pronounced him dead due to kidney
and heart failure.

His 12-year-old son, who worked alongside his father, was taken to
Phichit hospital yesterday [30 Sep 2008]. He too was put in an
isolation ward for observation, and no visitors were allowed to see him.

Livestock officials have collected samples from the free-range ducks,
which have been dying in large numbers over the past week, for
testing for the bird flu virus.

Public health permanent-secretary Prat Boonyawongwirot said lab tests
were being made on samples collected from the dead man's body to see
whether he was infected with the deadly H5N1 virus as believed. The
results were expected to be released today [1 Oct 2008].

Dr Prat said leptospirosis could also not be ruled out as a possible
cause of death, as the area was affected by floods.

There were reports of poultry, particularly free-range ducks, dying
en masse in the district during the past week.

Although an avian flu outbreak has never occurred in the district,
Phichit was listed as an avian influenza epidemic zone, he said.

Kamnuan Ungchusak, director of the epidemiology bureau, said a team
of epidemiologists had been dispatched to the district for bird flu
surveillance.

Disinfectant would be sprayed at all poultry farms, slaughterhouses
and at-risk areas.

Thailand faced its 5th bird flu outbreak in early February [2008],
when the disease reemerged in Nakhon Sawan and Phichit.

The 1st outbreak struck the country in January 2004, when more than
60 million fowl were culled. A total of 25 people have been infected
by the virus since then, with 17 of them dying of the disease.

[Byline: Sitthipoj Kebui and Apiradee Treerutkuarkul]

--
Communicated by:
PRO/MBDS <promed-mbds@promedmail.org>

[Given the past occurrence of suspicion of avian influenza on the
part of the newswires and ultimate rapid ruling out of the diagnosis
of avian influenza, we queried the Director of Epidemiology of the
Thai Ministry of Public Health on the above case and received the
information below. - Mod.MPP]

******
[2]
Date: 1 Oct 2008
From: Kumnuan Ungchusak <kum@health.moph.go.th>


For our surveillance system, we classify cases as suspected, probable
and confirmed after the investigation ends. We do have several acute
respiratory distress syndrome (ARDS) cases reported in our avian
influenza surveillance, but once testing demonstrates a negative for
the H5 influenza virus, we rule it out.

In the above mentioned case, this 47-year-old man had a history of
fever 3 days ago and died yesterday [30 Sep 2008] from acute
respiratory distress syndrome. The primary diagnosis by the attending
physician is leptospirosis. Leptospirosis is endemic in Thailand and
is common at this time of year, when there are rainy months. There
have been 3 cases reported in the same province since beginning of
this year [2008].

As his family raises 1600 ducks, and 15 died during last 2 weeks, we
have to thoroughly test for the presence of H5 avian influenza virus.
This testing should be completed by tonight [1 Oct 2008]. We examined
his wife and son. His son has a mild fever and is now under treatment
and observation at the hospital. The veterinary team has taken
cloacal swabs from his duck flock to test as well. In summary, we
have to rule out avian influenza.

--
Kumnuan Ungchusak
Director,
Bureau of Epidemiology and International Health Regulation (IHR) Focal Point
Department of Diseases Control
Ministry of Public Health
Tivanonda Road, Nonthaburi 11000
Thailand
<kum@health.moph.go.th>

[PRO/MBDS would like to thank Dr. Kumnuan Ungchusak for his rapid
response to a query on the suspected case of avian influenza in
Thailand. As can be seen from the response, there is collaboration
with the animal health sector in Thailand so that the investigation
of the suspected case includes a veterinary investigation of the
avian flocks in the general area of the suspected human case as well
as the Bureau of Epidemiology investigation of the human case.

We look forward to final information on this case when it becomes available.

For a map of Thailand showing the geographic regions, see
<http://www.lib.utexas.edu/maps/middle_east_and_asia/thailand_admin_2005.jpg>.

For the interactive HealthMap/ProMED map with links to other
ProMED-mail postings in Thailand and neighboring countries, see
<http://healthmap.org/promed?v=15.1,101,5>.
- Mod.MPP]

See Also

Avian influenza, human - MBDS region (19): Thailand, NOT, MOPH 20080801.2358
Avian influenza, human - MBDS region (19): Thailand, NOT 20080731.2350
Avian influenza, human - MBDS region (18): Thailand, susp., RFI 20080730.2339
Avian influenza, human - MBDS region (05): Thailand, not 20080209.0531
Avian influenza, human - MBDS region (04): Thailand, RFI 20080208.0520
Avian influenza, human (03) - MBDS region: Thailand, surv. 20080127.0348
Avian influenza, human - MBDS region (17): vaccine trials 20080422.1425
Avian influenza, human - MBDS region (16): vaccine trials 20080328.1166
Avian influenza, human - MBDS region (15): Viet Nam, FAO, WHO 20080320.1069
Avian influenza, human - MBDS region (14): Viet Nam (Ha Nam) 20080318.1044
Avian influenza, human - MBDS region (13): Viet Nam, RFI 20080227.0796
Avian influenza, human - MBDS region (12): Viet Nam, RFI 20080226.0770
Avian influenza, human - MBDS region (09): Viet Nam, RFI 20080221.0703
Avian influenza, human - MBDS region (08): Viet Nam 20080216.0618
Avian influenza, human - MBDS region (07): Viet Nam (Nam Binh), RFI
20080214.0584
Avian influenza, human - MBDS region (06): Viet Nam (Hai Duong) 20080214.0581
Avian influenza, human - MBDS region (02): Viet Nam (Tuyen Quang) 20080124.0301
Avian influenza, human - MBDS region: Viet Nam, RFI 20080103.0034
Avian influenza, human - MBDS region (11): China (Guangxi), WHO 20080222.0726
Avian influenza, human - MBDS Region (10): China (Guangxi) 20080221.0705
Avian influenza, human - China (02): Guangdong, WHO 20080227.0797
Avian influenza, human - China: Guangdong 20080225.0764
Avian influenza, human: China (Jiangsu), Pakistan, WHO 20080110.0135
2007
----
Avian influenza, human - MBDS region (17): Thailand, NOT 20070716.2277
Avian influenza, human - MBDS region (16): Thailand, susp., RFI 20070716.2276
Avian influenza, human - MBDS region (07): Cambodia, WHO 20070410.1209
Avian influenza, human - MBDS region (06): Cambodia 20070406.1156
Avian influenza, human - MBDS region (05): Laos, conf. 20070316.0929
Avian influenza, human - MBDS region (04): Laos, fatal 20070308.0816
Avian influenza, human - MBDS region (03): Laos, susp. 20070304.0763
Avian influenza, human - MBDS region (02): Laos, conf. 20070227.0704
Avian influenza, human - MBDS region: Laos, susp, RFI 20070225.0686
Avian influenza, human - MBDS region (24): Myanmar, RFI 20071214.4022
Avian influenza, human - MBDS region (26): Viet Nam, WHO 20071228.4162
Avian influenza, human - MBDS region (25): Viet Nam, susp, RFI 20071226.4134
Avian influenza, human - MBDS region (23): Viet Nam, susp., RFI 20071108.3623
Avian influenza, human - MBDS region (22): Viet Nam 20070909.2970
Avian influenza, human - MBDS region (21): Viet Nam, WHO 20070831.2868
Avian influenza, human - MBDS region (20): Viet Nam, RFI 20070807.2574
Avian influenza, human - MBDS region (19): Viet Nam, susp., RFI 20070802.2501
Avian influenza, human - MBDS region (18): Viet Nam (Ha Tay) 20070731.2463
Avian influenza, human - MBDS region (15): Viet Nam 20070706.2153
Avian influenza, human - MBDS region (14): Viet Nam, WHO confirmation
20070629.2099
Avian influenza, human - MBDS region (13): Viet Nam, susp., RFI 20070626.2059
Avian influenza, human - MBDS region (12): Viet Nam, RFI 20070621.2005
Avian influenza, human - MBDS region (11): Viet Nam, RFI 20070616.1964
Avian influenza, human - MBDS region (10): Viet Nam, RFI 20070612.1916
Avian influenza, human - MBDS region (09): Viet Nam, RFI 20070601.1773
Avian influenza, human - MBDS region (08): Viet Nam 20070523.1649
Avian influenza, human (05): China (Fujian), WHO conf. 20070530.1749
Avian influenza, human (04): China, RFI 20070526.1683
Avian influenza, human (03): China (Anhui) 20070329.1077
Avian influenza, human: H9N2, China (Hong Kong SAR) 20070320.0980
Avian influenza, human (02): antiviral use 20070321.0999
Avian influenza, human: Pakistan, Egypt 20071227.4155
......................................................mpp/msp/mpp

*##########################################################*
************************************************************
ProMED-mail makes every effort to verify the reports that
are posted, but the accuracy and completeness of the
information, and of any statements or opinions based
thereon, are not guaranteed. The reader assumes all risks in
using information posted or archived by ProMED-mail. ISID
and its associated service providers shall not be held
responsible for errors or omissions or held liable for any
damages incurred as a result of use or reliance upon posted
or archived material.
************************************************************
Become a ProMED-mail Premium Subscriber at
<http://www.isid.org/ProMEDMail_Premium.shtml>
************************************************************
Send all items for posting on the PRO/MBDS list to:
<promed-mbds@promedmail.org> (NOT to an individual
moderator). If you do not give your full name and
affiliation, it may not be posted. If you are concerned
about repercussions if your name appears on a posting,
please advise us to withhold your identifying information
when you submit a piece for posting. Send commands to
subscribe / unsubscribe, get archives, help, etc. to:
majordomo@promedmail.org. For assistance from a human being
send mail to: owner-promed@promedmail.org>
############################################################
############################################################