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AVIAN INFLUENZA, HUMAN (157): CHINA (JIANGSU)
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A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Mon 10 Dec 2007
Source: Singtaonet.com [in Chinese, trans. Rappt.DS, edited]
<http://www.singtaonet.com/society_focus/200712/t20071210_688120.html>
[The following report provides new information relating to the source
of the H5N1 virus responsible for the death on 2 Dec 2007 of a
24-year-old man in Jiangsu province and the concurrent illness of his
father, and explains the possible relevance of the dog-bite incident.
- Mod.CP]
To celebrate [the 24-year-old's] acceptance [to a school of continuing
education], his mother and father took him and his girlfriend to
Nanjing's most bustling Confucian temple for some fun. At the temple's
restaurant, the 4 of them ate Beggar's Chicken, which was surrounded
by thick mud on the outside. [Dan Silver, the translator, comments
that a 1990 article from the New York Times provides a useful
introduction to Beggar's Chicken:
<http://query.nytimes.com/gst/fullpage.html?res=9C0CEFD91638F93BA35757C0A966958260>.]
According to analyses, perhaps because the mud on the outside was too
thick the chicken inside was not thoroughly cooked. On the 2nd day
after eating the chicken, [the young man] began feeling feverish. His
body temperature rose quickly and he was taken for emergency treatment
to Jiangsu Provincial People's Hospital. In the end, he could not be
saved.
As to why [he] was 1st to fall ill, a relative revealed that his
girlfriend keeps 2 pet dogs. Because she is from another part of
China, Nanjing limits the number of dogs [she can keep]. To avoid
discovery, she sent one to be looked after by [her boyfriend]. 20 days
before eating chicken, he was bitten by this small dog. To prevent
rabies, he began vaccine shots. 5 injections are needed and at the
time [of his illness] he had already completed 4 shots. His body's
immunity was [therefore] at its lowest point. When [the man] was 1st
sent to the hospital, he was not treated for avian influenza. The
physicians suspected he might have contracted plague.
After their son's sudden death, his father and mother were devastated.
On the 6th day after eating chicken, when the father developed fever,
he did not have the heart to seek treatment. Only after others begged
him did he go to the hospital. A relative said that [his] family loves
to eat chicken and his refrigerator is full of butchered chicken.
Because of this, the relative began to wonder if it might be avian
influenza, so [the man] went to the Nanjing
Municipal Infectious Disease Hospital where the diagnosis of avian
influenza was made.
The odd thing is that although 4 people went to eat chicken [at the
temple], only the 2 men fell ill and the 2 women are well. Reports say
that [the] girlfriend ate a lot of chicken but is perfectly fine.
Sources say that [the 24-year-old's mother] also has no similar
symptoms but has been isolated for observation. Her cell phone is
turned off and there is no contact with the outside world.
--
Communicated by:
ProMED-mail Rapporteur Dan Silver
[This exposure of father and son to the same poultry product (and
possibly the storage of refrigerated chicken in the father's house)
identifies a potential common source of infection and virtually
negates the possibility of human-to-human transmission being
responsible for these 2 cases. - Mod.CP
The possible relevance of the dog-bite incident is that 4 rabies
vaccine shots might have adversely affected the patient's immune
system. The 2 women who also ate the chicken should be checked for
antibody in case of asymptomatic infection. Or perhaps the men ate the
legs and thighs and the women the breast, with different degrees of
undercooking and/or original virus titer? - Mod.JW]
[see also:
Avian influenza, human (156): China (Jiangsu) 20071208.3967
Avian influenza, human (155): China (Jiangsu) 20071207.3945
Avian influenza, human (154): China (Jiangsu) 20071205.3920
Avian influenza, human (153): China (Jiangsu) 20071202.3886
Avian influenza, human (90): China, WHO 20070604.1809
Avian influenza, human (85): China, WHO 20070530.1743
Avian influenza, human (84): China 20070527.1699
Avian influenza, human (62): China, Egypt, WHO 20070331.1103]
........................................cp/jw/mj/jw
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