Thailand - 08/02 - 08/15

[mordan]

Re: Thailand 8/02 -

They can also just test for H3 or H1 and if found go no further and issue a statement of Human flu only.

[Jeremy]

Re: Thailand 8/02 -

H5N1 in high doses and H1 or H3 viruses hanging out in the same neighborhood is not a good thing.

[tsalagiT]

Re: Thailand 8/02 -

Quoted from Post #19
Today (3 August) Mr. [name] act for minister administer Ministry of Public Health assign [name] director-general department control disease [name] go on a tour of inspection Ministry of Public Health regularly area region east 8 province [?] deputy director Dept of Medical Science together with doctor public health province Chachoengsao Province travel arrive check visit system readiness check assort filter patient location in scope watch/guard carefully bird flu of hospital Baan Poh [Bo Tree] district Baan Poh province Chachoengsao because basically place as before there is outbreak of bird flu in poultry in around 3 year arrive this.


Translation please: Is this saying that there is an outbreak in poultry currently after three years, or is he referring to an outbreak there three years ago? In statements made today, he's reporting no poultry have been or are sick in the entire province during this epidemic. At the time I read this statement yesterday, I took this to mean "there is outbreak of bf in poultry, basically in the same place there was three years ago".
Input from others, please.


[Name] say that from check/examine visit discover that hospital Baan Poh receive lay down measures assort filter question history patient that have a fever test cough in order that separate search for bird flu keep method cautious reserve medicine Tamiflu 70 capsule [?!] at the same time group test bird flu can use immediately today there is patient have a fever measure to be at in scope watch/guard carefully lie down treat in room separate specific of hospital 2 cases is man age 17 year and female age 42 year work in factory process poultry accept enter on time 18.00 o'clock yesterday this result check also group test find infected with influenza result first lung normal both 2 cases give a prescription Tamiflu and today get send phlegm check assure that Dept of Medical Science expect that will know result tomorrow (4 August).


I think it's important to note that out of their very small reserve of only 70 capsules, these suspected cases have been given tamiflu from the beginning of their illness, before bf lung symptoms present.

As a side note: nice to see that they reportedly are performing phlegm tests now,....not relying on blood samples.

[tsalagiT]

Re: Thailand 8/02 -

from post #12, july 30 thailand thread:

BANGKOK, July 30 (TNA) - Thailand's Public health Ministry has named 80 patients in 19 provinces nationwide as being under close monitoring for bird flu infection, ministry permanent secretary Prat Boonyawongvirot said on Sunday.

The patients, now under treatment at hospitals and public health care units throughout the country, include 18 in Phichit, 14 in Sukhothai, nine each in Phitsanulok and Suphanburi, seven in Nan, four in Nakhon
Sawan, three each in Phetchabun and Uttaradit, two each in Nakhon Phathom and Nonthaburi, and one each in Bangkok, Kanchanaburi, Kamphaeng Phet, Chacheongsao, Nakhon Nayok, Phathum Thani, Phrachin Buri, Lampun, and Uthai Thani.

All are awaiting the results of laboratory tests to find out whether they have caught the deadly virus or not after they developed flu-like symptoms including high fever and coughs and had records of contact with
poultry which died of unknown causes, Dr. Prat said.

I think I've just answered my own question.

[Theresa42]

9 yr-old & 2 poultry (duck) processors reportedly infected with H1

Yes it is. What they meant, though, is a normal human influenza A virus--H1N1 or H3N2. Those two strains can and do cause severe pneumonia, killing patients in the process. It is relatively unusual for them to kill a 9 year old girl however.

Machine-translated from Thai:

Ministry of Public Health confirm lack virus test bird
โดย ผู้จัดการรายวัน 4 สิงหาคม 2549 19:52 น.

Manager Daily - Ministry of Public Health confirm result prove 3 persons suspected that lose life be not infected with bird flu result indicate is influenza group [?] day but virus spread down lung when again 2 cases not find virus H5N1 field [name] call meeting livestock 22 provinces adjust measures after state weather risk measure bird flu spread.

Yesterday this (4 August) chief [name] in charge minister Ministry of Public Health [name] director-general dept. control disease and [name] director-general Dept. of Medical Science can accompany make a statement summary that cases girl 9 to be at place group number 8 district Yaang Maak district Kohk Jay Rin province Lop Buri lose life when date 3 August place hospital Lop Buri after sick there is symptoms fever since date 31 July not lose life from bird flu like that is information certain.

Chief [name] say that result check/examine confirm from Dept. of Medical Science that check/examine repeatedly to 2 times find that infected with virus type A of group H1 which is virus influenza in persons but virus this spread too much place lung cause lung inflame/swell severely result in lose life.

As for person suspected 2 cases that be treated place hospital Baan Poh province Chachoengsao result check/examine by laboratory find that is influenza group A type H1 also though will dare to that cut duck in order that pack can/tin export but duck factory bring is raw material pass be up to standard again all province Chachoengsao not find poultry die unusual so then assure that Thailand there is patient bird flu only 1 case place province Phichit be the same in year 2549 (2006) still not patient cases new increase anyway.

Field [name] say that because at this period there is much disease that there is symptoms fever resemble one another all 'fever blood go out' [dengue], influenza disease, hand foot and mouth at the time have a temperature advise eat medicine fall fever town [?] be safe most and quickly go find doctor not should eat medicine aspirin because if sick have dengue will cause dengue be easily increase be harmful against life because disease dengue rather there is dengue around organs to be at already.

When [name] say that at present entertainment spot Ministry of Public Health every province use measures watch/guard carefully patients cold, influenza location in scope watch/guard carefully bird flu ultimate all from village and place hospital all include clinic hospital private everywhere 24 hours because receive report there is patient watch/guard carefully bird flu total 191 cases from 25 provinces because report result already 152 cases wait for more 39 cases.

When chief [name] Thailand director-general Dept of Livestock say that in today (5 August) [name] minister farmland and cooperative will call meeting livestock province in areas risk occur bird flu 21 provinces and Bangkok again 1 province total is 22 provinces come meeting place ministry farmland time 10:00 in order that adjust measures control outbreak of virus bird flu after tend condition weather risk that will happen epidemic bird flu high.

http://www.manager.co.th/Daily/ViewNews.aspx?NewsID=9490000099615&Keyword=%e4%a2%e9%cb%c7%d1%b4%b9%a1

[Theresa42]

Latest figures from the Ministry of Health

Just the last paragraph from this article - to get the latest numbers....

Machine-translated from Thai:

Be relieved Ministry of Public Health summary to be no person [infected with bf] new
โดย ผู้จัดการออนไลน์ 4 สิงหาคม 2549 16:06 น.

(...)

[Name] say that at present entertainment spot (website?) Ministry of Public Health all provinces can use measures watch/guard carefully patients cold, influenza location in scope watch/guard carefully bird flu ultimate all from village and place hospitals all include clinics hospitals private through 24 hours thoroughly yesterday this is since time 6:00 a.m. 3 August to 6:00 a.m. 4 August receive reports there is patients watch/guard carefully bird flu total 191 cases from 25 provinces because report result leave/depart already 152 cases wait for more 39 cases receive for Lop Buri and Suphan Buri 8 cases, Phichit 5 cases, Chachoengsao Province 4 cases, Phitsanulok 3 cases, Trang and Nakhon Pathom province each 2 cases, Kamphaeng Phet, Nakhon Nayok, Pathum Thani, Buri Ram, Phetchabun, Nong Bua Lamphu and Uthai Thani province each 1 case.

http://www.manager.co.th/QOL/ViewNews.aspx?NewsID=9490000099528&Keyword=%e4%a2%e9%cb%c7%d1%b4%b9%a1

[Mingus]

Re: Thailand 8/02 -

Archive Number 20060804.2155
Published Date 04-AUG-2006
Subject PRO/AH/EDR> Avian influenza, human (109): Thailand, susp


AVIAN INFLUENZA, HUMAN (109): THAILAND, 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: Thu 3 Aug 2006
From: ProMED-mail <promed@promemail.org>
Source The People's Daily online, Xinhua News Agency, Thu 3 Aug 2006 [edited]
<http://english.people.com.cn/200608/03/eng20060803_289572.html>


The initial test of a 61 year old woman in central Thailand who fell ill
with bird-flu-like symptoms showed positive for avian influenza, Thai
officials and local media reported Thursday [3 Aug 2006]. The patient in
Lop Buri Province's Sa Bot district fell ill with bird-flu-like symptoms
soon after her backyard chickens all suddenly dropped dead, the Thai
newspaper the Nation said. She had initially tested positive for avian
influenza and was being treated in an isolation ward pending confirmation
from laboratory tests, said Dr Charn Tantiwa-raporn, director of Ban Mi
Hospital, where the victim was admitted on Tuesday [1 Aug 2006].

After being notified about the case, provincial livestock authorities
rushed to the woman's home to check for bird flu. District chief Somsak
Intra-watana said he had ordered an urgent cull of all poultry in the
province after being notified by the livestock authorities. This district
did not have many chicken farms and most of the poultry were fighting cocks
and native hens, he said. Although denying the existence of bird flu in Sa
Bot district, provincial livestock chief Jintana Danwiwatporn said experts
were coordinating with other agencies in dealing with hundred of thousands
of migratory birds. Along with warning against cooking and eating sick
poultry, the Public Health Ministry was distributing some 100 000 manuals
designed to educate the public about bird flu and ways to prevent
infections, said Dr Narongsak Ungkhasuwaphala, the Ministry's deputy
permanent secretary.

Meanwhile, Anutin Charnveerakul, caretaker deputy health minister, stated
that as of Wed 2 Aug 2006, 144 patients from 24 provinces, mostly in
northern Thailand, had been put on the watch-list for bird flu. Two more
suspected human cases were found in Phichit Province, where the 1st case of
human bird flu was recently confirmed. Phetchabun Province also reported 4
cases and Phitsanulok 3 cases.

******
[2]
Date: Thu 3 Aug 2006
From: ProMED-mail <promed@promedmail.org>
Source: ETNA MCOT News Agency, Thu 3 Aug 2006 [edited]
<http://etna.mcot.net/query.php?nid=23829>


A 9 year old girl, suspected of having bird flu, was pronounced dead on
Thursday [3 Aug 2006], one day after being admitted to a hospital in this
central province, according to a health official. The body of the girl was
kept at the hospital awaiting a lab test to determine if she was infected
with bird flu. The girl suffered from fever, sore throat, and severe cough
for 2 days. She was rushed to the hospital after having breathing
difficulties. Her family raises about 20 fighting cocks. Provincial health
officials had inspected her house and nearby areas although none of the
fighting cocks died of any unknown cause.

In the northern province of Nan, [another] 4 suspected bird flu cases were
reported and officials are waiting from their lab test results. Meanwhile,
agriculture and cooperatives minister Sudarat Keyuraphan said Thailand
would jointly discuss with officials of neighboring countries on measures
to control bird flu disease. The ministry will also hold a meeting of
livestock officials in 21 at-risk provinces on Saturday [5 Aug 2006] to
thrash out measures to prevent bird flu.

--
ProMED-mail
<promed@promedmail.org>

[The Thai Ministry of Health website regularly lists the number of people
under observation for possible avian influenza virus infection, together
with the number of suspected and confirmed cases. As of 29 Jul 2006, there
have been a single confirmed case and 80 cases "under observation." None
was assessed as "suspected"; see,
<http://thaigcd.ddc.moph.go.th/AI_case_report_060729.html>.

The 144 "suspected" cases referred to in the first report should be
considered as "under observation."

It is unclear whether the surviving 61 year old patient or the deceased 9
year old girl in Lop Buri province have been diagnosed as potential avian
influenza virus infection cases on the basis of laboratory testing or
merely on symptomology. Until further information becomes available,
neither case should be ranked yet as a "suspected" case.

[Theresa42]

Ministry dismisses reports of a second 'bird flu' death

Ministry dismisses reports of a second 'bird flu' death
August 5, 2006

The Public Health Ministry yesterday dismissed "wild speculation" in the media that Thailand had recorded its second fatal case of bird flu in humans this year, saying that test results from the nine-year-old girl from Lop Buri indicated she had died from human influenza, not bird flu.

Two adults in Chachoengsao who were reported in the press as being suspected bird-flu cases have also tested negative for the H5N1 virus, said Dr Thawat Suntharacharn, director-general of the Department of Disease Control.

He insisted that Thailand had had only one confirmed human case of bird flu in the current wave of the epidemic, the 17-year-old boy from Phichit who died late last month.

Yesterday alone a total of 191 patients' samples were sent to be tested for bird flu, said Dr Paijit Warachit, director-general of the Department of Medical Sciences, which carries out the tests.

As of noon yesterday, 152 of the samples had been excluded from the "under investigation" list and the remaining 39 were being tested, the doctor said.

Thawat said that in response to the public attention to the Lop Buri case, the department ran tests twice even though there were no supporting epidemiological factors, such as contact with dead chickens.

He said the girl's illness was so virulent because she might have some underlying factor that weakened her immune response to human influenza, which killed about 900 Thais last year.

"Some people may not even fall ill after contracting the influenza virus, whereas some get sick with severe symptoms and eventually die," Thawat said.

More than 140,000 human influenza cases were reported last year and more than 6,000 cases have been diagnosed this year, of which 300 were fatal, he said.

"Influenza, too, is worrying ? there has been a significant rise in the mortality rate from the disease over the years," Thawat said.

Due to a lack of funds, the influenza vaccine is only given to people at high risk, he said, adding that the Public Health Ministry provided vaccination to healthcare workers in the front line of the fight against influenza.

The ministry also has a collaborative programme with the Social Security Fund, which takes care of about eight million private-sector employees in the country, to inoculate workers at risk, such as those employed in poultry slaughterhouses.

Arthit Khwankhom

http://www.nationmultimedia.com/2006/08/05/headlines/headlines_30010432.php

[HenryN]

Re: Ministry dismisses reports of a second 'bird flu' death

Ministry dismisses reports of a second 'bird flu' death
August 5, 2006

More than 140,000 human influenza cases were reported last year and more than 6,000 cases have been diagnosed this year, of which 300 were fatal, he said.

"Influenza, too, is worrying … there has been a significant rise in the mortality rate from the disease over the years," Thawat said.

http://www.nationmultimedia.com/2006...s_30010432.php

A 5% case fatality rate for seasonal flu is VERY high (20 fold higher than many pandemic plans expect). It looks like MANY H5N1 cases are being misdiagnosed as seasonal flu in Thailand.

[Shannon Bennett]

Re: Thailand 8/02 -

A 5% mortality rate is twice that of the pandemic of 1918 here in the States. Not only is the flu being under-reported, it appears to be out of the bag! Even if it somehow turns out to be a flu other than H5N1 (which I don't believe for a minute) this is still horrible news. Where are the WHO, and what do they have to say re: these totals? I'd give a lot to find out if the totals were in referance to the 6,000 number or the 140,000 number?</IMG>

[Laidback Al]

Re: Thailand 8/02 -

From the article also --

He said the girl's illness was so virulent because she might have some underlying factor that weakened her immune response to human influenza, which killed about 900 Thais last year.

So 900 death from 140,000 flu victims last year is a CFR of 0.6%.

300 dead from 6,000 this year is a CFR of 5% (to date).

Anyone know when their "flu year" starts?


http://www.nationmultimedia.com/2006...s_30010432.php

[Shannon Bennett]

Re: Thailand 8/02 -

Al, thanks for the clarification, I missed it the first time through the article. And their flu season starts in the early fall just ahead of ours.

[HenryN]

Re: Thailand 8/02 -

Commentary at

http://www.recombinomics.com/News/08050601/H5N1_Thailand_Fatalities_2.html

[Theresa42]

Re: Thailand 8/02 -

From the article also --

So 900 death from 140,000 flu victims last year is a CFR of 0.6%.

300 dead from 6,000 this year is a CFR of 5% (to date).

Anyone know when their "flu year" starts?


http://www.nationmultimedia.com/2006...s_30010432.php

Trying to find confirmation for these figures somewhere -- not having much luck.

Been poking around on the Ministry of Public Health's epidemiology page: http://epid.moph.go.th/

Found one report - "Reported Cases of Priority by Diseases Under Surveillance, 30 th Week, July 23 - 29, 2006" which, unfortunately, doesn't give the number of deaths due to influenza (although there is a column for that - it's just blank). According to this report, so far this year there have been 7,821 influenza cases:

http://epid.moph.go.th/weekly/w_2549/wk49_30/wk49_30_5.pdf

[Theresa42]

Re: Thailand 8/02 -

Another report on influenza in Thailand which does compare numbers with last (and previous) years, although again no CFR unfortunately. (Interesting account of a flu outbreak in a boy's boarding school in Bangkok.)

Original report where you can see the tables/map here:

http://epid.moph.go.th/dssur/respir/Flu49.doc

Machine-translation of text:

Situation influenza Thailand Buddhist Era 2549 (2006)

(Data date 28 July 2549)

From the start of the year until month July 2549 institute epidemiology receive reports of patients influenza total accumulated 7,430 cases rate sick 11.90/population hundred thousand persons amount patients also lower median (average) and year B.E. 2548 (2005) all month except month April there is amount equal to year 2548 (Table 1) amount patients that must treat is patient in 868 cases (hundred each 11.68) also to not report dead persons the South and region center there is rate sick high more than rate sick include country and high more than region another very much (Table 2).

Table 1 - Amount patients influenza divided monthly Thailand B.E. 2549 (2006) compare with B.E. 2548 and value median 5 year retrospective (B.E. 2543-2547) (Data date 28 July 2549)

Table 2 - Rate sick influenza against population hundred thousand persons divide case region Thailand B.E. 2549 (data date 28 July 2549)

Province that there is rate sick more than rate sick all country there is 30 provinces because 10 level/rank first to Samut Sakhon [?] city, Chanthaburi, Kanchanaburi, Samut Songkhram, Ratchaburi, Nakhon Ratchasima(?), Nakhon Pathom, Phuket, Rayong province Samut Sakhon there is rate sick highest 93.36/population hundred thousand persons province Roi Et there is rate sick minimum 0.46/population hundred thousand persons (Table 3) province that there is report patients more than median (B.E. 2543-2547) month same of province in month June there is 3 province to publicise Chanthaburi, Khon Kaen portion month July there is 3 province can to Sukhothai, Chai Nat, Suphan Buri in order that may there is lateness of data in some provinces and some provinces may also send data come not completely age group less than 4 years there is rate sick 21.91/population hundred thousand persons which high more than age group another very much (Table 4).

In period month June 2549 there is report spread/outbreak of influenza place Baan [?] Dtaa Bangkok patients is youth male 58 cases (is foreigners 3 cases) and persons control/limit 2 cases enter receive treatment is patient in hospital 1 case result check 'rapid test' find flu A 2 cases as for month July there is patient symptoms resemble influenza amount 43 cases enter receive treatment place public health center district Si Laa Laeng and accept treatment place hospital His Majesty [name of hospital] 1 case most is student school community Laa Laeng and is student that reside stay in dormitory of school amount 22 cases patients majority there is symptoms fever cough headache nasal congestion [?] throat aches & pains trace headache cannot/did not there is collect samples patients send check.

From Thailand find patients confirmed bird flu 1 case in year this every province therefore should watch/guard carefully situation influenza, bird flu and pneumonia closely because is season that there is patients a large number of more than normal province that there is patients more than median should check clear that succeed sick is group in event time same or not if find sick is group/cluster should quickly investigage control/limit disease quickly in order that not permit occurance spread/outbreak large of influenza (Influenza Pandemic) that be liable that occur at the moment.