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
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International Society for Infectious Diseases
Date: 1 Oct 2008
Source: Bangkok Post [edited]
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
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
Disinfectant would be sprayed at all poultry farms, slaughterhouses
and at-risk areas.
Thailand faced its 5th bird flu outbreak in early February ,
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]
[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]
Date: 1 Oct 2008
From: Kumnuan Ungchusak <firstname.lastname@example.org>
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 .
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.
Bureau of Epidemiology and International Health Regulation (IHR) Focal Point
Department of Diseases Control
Ministry of Public Health
Tivanonda Road, Nonthaburi 11000
[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.
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