2005 WHO Situation Updates - Avian Influenza Archive

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam - update

6 January 2005

WHO has received reports of laboratory tests conducted in Ho Chi Minh City, Viet Nam, indicating two new human cases of infection with avian influenza. Both patients have died.

Initial tests have identified the H5 subtype of avian influenza virus. Further testing is under way.

The first patient was a 6-year-old boy from the southern province of Dong Thap. He died on 30 December.

The second patient was a 9-year-old boy from Tra Vinh Province, also located in the southern part of the country. He was hospitalized on 2 January and died on 4 January.

The additional recent case in Viet Nam, reported in late December, remains hospitalized in critical condition.

All three of these most recent cases have occurred in the southern part of the country, where poultry outbreaks have been recurring since December of last year.

Close contacts of these cases are being monitored for any signs of illness. Health authorities in Viet Nam, supported by WHO staff, have undertaken several measures to strengthen case detection. Avian influenza viruses become more active when temperatures turn cooler. Activities associated with the approach of the Lunar New Year festivities in early February may also increase the risk of further human cases.

http://www.who.int/csr/don/2005_01_06a/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

7 January 2005

<table border="1" cellspacing="0" width="79%"> <tbody><tr> <td width="31%">

Country/Territory

</td> <td width="37%">

Total cases

</td> <td width="32%">

Deaths

</td> </tr> <tr> <td width="31%">Thailand</td> <td align="center" width="37%">17</td> <td align="center" width="32%">12</td> </tr> <tr> <td width="31%">Viet Nam</td> <td align="center" width="37%">30</td> <td align="center" width="32%">22</td> </tr> <tr> <td width="31%">Total</td> <td align="center" width="37%">47</td> <td align="center" width="32%">34</td> </tr> </tbody></table> Notes

Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_01_07/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam - update 2

13 January 2005

The Ministry of Health in Viet Nam has today confirmed the fourth case of H5N1 infection to occur in Viet Nam since December 2004. The patient is an 18-year-old woman from the southern province of Tien Giang. She developed symptoms on 1 January and was hospitalized on 5 January. She remains hospitalized in a critical condition. The three other H5N1 patients reported this year, who all resided in different provinces in southern Viet Nam, have died.

This latest case brings the total in Viet Nam, reported since January 2004, to 31 cases, of which 23 have been fatal.

The Vietnamese government today held a national meeting on avian influenza control to which prominent health and local government officials from all provinces of Viet Nam were invited, along with the representatives of WHO and FAO in Viet Nam. Participants were updated on the current avian influenza situation in animals and humans and provided with information and guidance on the intensified measures needed to control avian influenza in the run-up to the festivities of the Lunar New Year.

Tsunami in South-East Asia and the risk from avian influenza

Concerns have been raised about whether the recent tsunami in South-East Asia may have increased the risk of an influenza pandemic. The level of pandemic risk depends on how widespread H5N1 is in domestic poultry, how often the virus is transmitted to humans, and the concurrent circulation of human influenza viruses. Areas with the highest prevalence of avian influenza were not directly affected by the tsunami, thus there is no inherent increased risk of the emergence of the pandemic strain due to the tsunami itself. However, any activity that spreads avian influenza increases the possibility of the emergence of a pandemic virus. The risk of importing avian influenza into areas affected by the tsunami can be minimized by controlling the movement of poultry from areas where outbreaks of avian influenza have occurred. It is also important to ensure that infected poultry are kept out of the food chain, including emergency food relief activities.

http://www.who.int/csr/don/2005_01_13/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

13 January 2005

<table border="1" cellspacing="0" width="79%"> <tbody><tr> <td width="31%">

Country/Territory

</td> <td width="37%">

Total cases

</td> <td width="32%">

Deaths

</td> </tr> <tr> <td width="31%">Thailand</td> <td align="center" width="37%">17</td> <td align="center" width="32%">12</td> </tr> <tr> <td width="31%">Viet Nam</td> <td align="center" width="37%">31</td> <td align="center" width="32%">23</td> </tr> <tr> <td width="31%">Total</td> <td align="center" width="37%">48</td> <td align="center" width="32%">35</td> </tr> </tbody></table> Notes

Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_01_13/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam – update 3

14 January 2005

WHO has received informal reports of two additional cases of H5N1 infection in Viet Nam. The cases are an 18-year-old woman from Hau Giang Province and a 35-year-old woman from Tra Vinh Province.

The 18-year-old woman was hospitalized on 1 January and died on 10 January. The 35-year old woman was hospitalized on 9 January and remains in critical condition.

Both patients are from provinces in the southern part of the country, where poultry outbreaks have been reported since the beginning of December.

If confirmed, these latest human cases will bring the total in Viet Nam, since mid-December 2004, to six. Of these, four have died.

http://www.who.int/csr/don/2005_01_14/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

18 January 2005

<table border="1" cellspacing="0" width="79%"> <tbody><tr> <td width="31%">

Country/Territory

</td> <td width="37%">

Total cases

</td> <td width="32%">

Deaths

</td> </tr> <tr> <td width="31%">Thailand</td> <td align="center" width="37%">17</td> <td align="center" width="32%">12</td> </tr> <tr> <td width="31%">Viet Nam</td> <td align="center" width="37%">33</td> <td align="center" width="32%">25</td> </tr> <tr> <td width="31%">Total</td> <td align="center" width="37%">50</td> <td align="center" width="32%">37</td> </tr> </tbody></table> Notes

Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_01_18/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam – update 4

19 January 2005

WHO is aware of reports of a new laboratory-confirmed case of influenza A/H5 infection in a 42 year-old man from Hanoi. The patient is alive but his older brother, a 45 year-old man from Thai Binh province, fell ill in early January and subsequently died of a respiratory illness. Laboratory tests on the deceased man are reportedly negative for influenza A/H5. WHO is seeking confirmation from the Ministry of Health.

The Ministry of Health is conducting epidemiological investigations into these cases and WHO will keep in close contact with the Ministry of Health over the progress and findings of these investigations.

http://www.who.int/csr/don/2005_01_19b/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

19 January 2005

<table border="1" cellspacing="0" width="79%"> <tbody><tr> <td width="31%">

Country/Territory

</td> <td width="37%">

Total cases

</td> <td width="32%">

Deaths

</td> </tr> <tr> <td width="31%">Thailand</td> <td align="center" width="37%">17</td> <td align="center" width="32%">12</td> </tr> <tr> <td width="31%">Viet Nam</td> <td align="center" width="37%">34</td> <td align="center" width="32%">25</td> </tr> <tr> <td width="31%">Total</td> <td align="center" width="37%">51</td> <td align="center" width="32%">37</td> </tr> </tbody></table> Notes

Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_01_19/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam – update 5

21 January 2005

Laboratory results have confirmed avian influenza infection (H5 virus subtype) in two brothers in the northern part of Viet Nam. The first case, a 46-year-old resident of Thai Binh Province, developed symptoms on 1 January. He died on 9 January.

Avian influenza – situation in Viet Nam – update 4
His 42-year-old brother, a resident of Hanoi, developed symptoms on 10 January, nine days after his brother fell ill. He remains hospitalized in Hanoi and is recovering. He is known to have provided bedside care for his brother, who was treated at the same hospital in Hanoi. The investigation surrounding the new cases is considering two hypotheses.

The first one includes the possibility that the 42-year-old man may have acquired his infection directly from his brother. All evidence to date suggests that isolated instances of limited, unsustained human-to-human transmission can be expected from avian influenza viruses in humans.

Their occurrence does not call for any change in the present level of pandemic alert. Intensified surveillance for respiratory symptoms in close contacts of the two men has been initiated in both Thai Binh Province and Hanoi and it is reassuring that no cases of respiratory illness have so far been detected among these people.

Health authorities in Viet Nam have launched an immediate investigation of the source of infection in the two brothers. WHO staff in that country are being kept closely informed.

The second hypothesis is focusing on a possible direct source of poultry-to-human transmission. Preliminary findings point to a family meal in which a dish containing raw duck blood and raw organs was served.

Public health officials in Viet Nam have repeatedly advised against the consumption of dishes made with fresh duck blood or with raw or inadequately cooked poultry products. As a precautionary measure, similar culinary practices involving dishes containing raw poultry parts or organs should be avoided in all countries experiencing outbreaks of highly pathogenic H5N1 avian influenza in poultry.

To date, most human cases linked to contact with poultry are thought to have acquired their infection following exposure to dead or diseased birds around households. Evidence suggests that particularly risky exposure occurs during the slaughter, defeathering, and preparation of poultry for cooking.

Proper cooking destroys the H5N1 virus. In general, WHO recommends that poultry should be cooked until all parts reach an internal temperature of 70<sup>o</sup>C. No cases of H5N1 infection have been linked to the consumption of thoroughly cooked poultry and egg products.

Avian influenza: food safety issues
Media reports that a third 35-year-old brother has been hospitalized have not been confirmed.

These latest two cases bring the total in Viet Nam since mid-December 2004 to eight. Of these, seven have died. The 18-year-old woman from Tien Giang Province, announced previously, died on 19 January.

Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

http://www.who.int/csr/don/2005_01_21/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

21 January 2005

<table border="1" cellspacing="0" width="79%"> <tbody><tr> <td width="31%">

Country/Territory

</td> <td width="37%">

Total cases

</td> <td width="32%">

Deaths

</td> </tr> <tr> <td width="31%">Thailand</td> <td align="center" width="37%">17</td> <td align="center" width="32%">12</td> </tr> <tr> <td width="31%">Viet Nam</td> <td align="center" width="37%">35</td> <td align="center" width="32%">27</td> </tr> <tr> <td width="31%">Total</td> <td align="center" width="37%">52</td> <td align="center" width="32%">39</td> </tr> </tbody></table> Notes

Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_01_21/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam – update 6

26 January 2005

The Ministry of Health in Viet Nam has today reported two further laboratory confirmed cases of human infection with H5N1 avian influenza in Viet Nam.

The first newly reported case is a 35-year-old woman from the southern province of Dong Thap. She developed symptoms on 14 January, was admitted to hospital on 20 January, and died the following day.

The second newly reported case is a 17-year-old boy from the southern province of Bac Lieu. He was hospitalized on 10 January and died on 14 January.

These additional cases bring the total in Viet Nam since mid-December to ten. Nine of these cases were fatal.

The recent family cluster in northern Viet Nam

As announced previously, a family cluster in northern Viet Nam has been the focus of intense investigation. The cluster involves three brothers. Of these, Vietnamese authorities have identified influenza A H5 infection in two: a 46-year-old man and his 42-year old brother. The older brother developed symptoms on 26 December and died on 9 January. The younger brother was hospitalized with respiratory symptoms on 12 January and has now fully recovered. He is known to have provided bedside care for his older brother during a period of critical illness.

The source of infection for the two brothers remains undetermined and investigations are ongoing. The third brother, aged 36 years, was hospitalized for observation only, did not develop symptoms, and remains in good health. Results of tests, conducted as part of the investigation, are pending. Clinical specimens for the two confirmed cases are being sent to a WHO collaborating centre for further characterization.

Surveillance for further cases among health care workers, other family members, and residents in both communities where the brothers lived has so far found no evidence of additional cases. If limited human-to-human transmission has occurred, all evidence at this stage suggests that the chain of transmission ended after a single person was infected.

Preventing transmission during care by family members

Further sporadic human cases and occasional family clusters can be expected considering the current spread of outbreaks of highly pathogenic H5N1 avian influenza in poultry in some Asian countries. Experience to date indicates that possible human-to-human transmission has occurred mainly during prolonged close contact of a family member with a patient who was critically ill. WHO has issued guidance on the precautions that can be taken in health care facilities to minimize opportunities for transmission of H5N1 infection from patients to close contacts, including health care workers and family members.

Rapid detection and investigation of clusters of H5N1 cases, closely related in time and place, are key surveillance activities that can provide an early alert to possible changes in the transmissibility of the virus.

http://www.who.int/csr/don/2005_01_26/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A(H5N1) since 28 January 2004

26 January 2005

<table border="1" cellspacing="0" width="79%"> <tbody><tr> <td width="31%">

Country/Territory

</td> <td width="37%">

Total cases

</td> <td width="32%">

Deaths

</td> </tr> <tr> <td width="31%">Thailand</td> <td align="center" width="37%">17</td> <td align="center" width="32%">12</td> </tr> <tr> <td width="31%">Viet Nam</td> <td align="center" width="37%">37</td> <td align="center" width="32%">29</td> </tr> <tr> <td width="31%">Total</td> <td align="center" width="37%">54</td> <td align="center" width="32%">41</td> </tr> </tbody></table> Notes

Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_01_26/en/print.html

MHSC · Aug 15, 2006

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Avian influenza ? situation in Viet Nam ? update 7

28 January 2005

WHO has received reports that laboratory tests undertaken in Vietnam have confirmed two further cases of human infection with H5N1. WHO is seeking confirmation from the Ministry of Health.

The first newly detected case is a 10-year-old girl from the southern province of Long An. She developed symptoms on 13 January, was hospitalized on 20 January, and is presently in critical condition.

The second case is a 13-year-old girl from Dong Thap Province, also in the south. She developed symptoms on 20 January and was hospitalized on 22 January. She is also critically ill.

The child from Dong Thap Province is the daughter of a confirmed case announced previously. The 35-year-old mother developed symptoms on 14 January and died on 21 January.

WHO understands that Vietnamese authorities are launching investigations into this newly detected family cluster. The investigation will explore possible sources of exposure and look for signs of illness in family members, other close contacts, and the general community.

In view of the six-day interval between dates of symptom onset in the mother and her child, limited human-to-human transmission, as seen during similar events in the past, cannot be ruled out at this stage. All such clusters of cases, closely related in place and time, require urgent investigation to determine whether the epidemiological behaviour of the virus might be changing in ways that could favour the onset of a pandemic.

If confirmed by the Ministry of Health, these latest two cases will bring the total in Viet Nam reported since mid-December to twelve. To date, nine of these cases have been fatal.

WHO is again emphasizing the need for family members caring for H5N1 patients to follow recommended protective measures.

Since human cases of H5N1 were first reported in January 2004, no cases have been reported in health care workers or in professionals undertaking culling activities. Their continued adherence to recommended protective measures is equally important.

http://www.who.int/csr/don/2005_01_28b/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam and Cambodia - update 8

2 February 2005

First Cambodian human case of infection with A/H5 avian influenza

The Ministry of Health in Viet Nam has today reported one further laboratory confirmed case of human infection with H5 avian influenza. The 25-year-old woman was from Kampot Province in Cambodia, where she developed respiratory symptoms on 21 January 2005. She sought medical care in neighbouring Viet Nam on 27 January and died in Kien Giang Provincial hospital in Viet Nam on 30 January. Tests undertaken at the Pasteur Institute, Ho Chi Minh City, Viet Nam on 1 February were positive for influenza A/H5. She is the first human case of H5 infection reported from Cambodia.

A joint mission of the Cambodian Ministries of Health and of Agriculture and of WHO is in Kampot Province, investigating the circumstances surrounding this case.

Cases under investigation in Viet Nam

Three more people are reported to have died of H5N1 avian influenza in Viet Nam. Among them, figure the 13-year-old and 10-year-old girls announced previously. Both children resided in different southern provinces. The third death occurred on 27 January in a man in his 30's from the northern province of Phu Tho.

If confirmed by the Ministry of Health, these latest three cases will bring the total number of human H5N1 cases in Viet Nam, excluding the case from Cambodia reported above, identified since mid-December to thirteen. Twelve of these cases have been fatal.

http://www.who.int/csr/don/2005_02_02/en/print.html

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Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

2 February 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">1</td> <td align="center" width="36%">1</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">37</td> <td align="center" width="36%">29</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">55</td> <td align="center" width="36%">42</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_02_02/en/print.html

MHSC · Aug 15, 2006

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Avian influenza ? situation in Cambodia - update 9

9 February 2005
Please see the WHO press release:
Surveillance Stepped up in Province where Cambodia's First Human Avian Influenza Case Was Detected [pdf 59kb]

http://www.who.int/csr/don/2005_02_09/en/print.html

MHSC · Aug 15, 2006

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Avian influenza ? situation in Viet Nam - update 10

7 March 2005

The Ministry of Health in Viet Nam has confirmed an additional four cases of human infection with H5N1 avian influenza.
Details about these four cases are as follows:

- A 21-year-old man from Thai Binh Province. He developed symptoms on 14 February and was admitted to hospital on 20 February.
- His 14-year-old sister, also from Thai Binh Province. She developed symptoms on 21 February and was hospitalized the following day.
- A 69-year-old man, also from Thai Binh Province. He developed symptoms on 19 February, was admitted to hospital the same day, and died on 23 February.
- A 35-year-old woman from Hanoi. She developed symptoms on 18 February and was hospitalized on 24 February.

WHO continues to work closely with the Vietnamese Ministry of Health to further investigate additional cases which may have occurred since 2 February. WHO will update its cumulative list of confirmed cases accordingly.

Earlier this year, staff from WHO, Japan?s National Institute of Infectious Diseases in Tokyo, and Centers for Disease Control and Prevention, Atlanta, Georgia, USA, began working with health authorities in Viet Nam to improve the sensitivity and reliability of laboratory diagnostic tests. This activity, which aimed to upgrade laboratory capacity and included a training component, involved the retesting in Tokyo of specimens from several persons initially classified in Viet Nam in January as negative for H5N1 infection. Retesting detected H5N1 in specimens from seven persons. WHO is awaiting further details about these cases, including outcomes. Upon receipt of this information, WHO will also include these cases in the cumulative total for Viet Nam.

One additional case in Viet Nam, dating back to February 2004, has been identified retrospectively from specimens stored as part of a study of encephalitis (see the New England Journal of Medicine, 2005, 352:686-691). H5N1 infection, which was not considered in the diagnosis of this fatal case, was identified in November 2004 when specimens were submitted to a battery of tests. Specimens collected from other patients in this study are now being systematically tested for possible H5N1 infection.

Information on new cases is of greatest concern and WHO continues to gather as much data as possible on each new case. Such data are urgently needed at a time when many countries are intensifying their pandemic preparedness activities.

http://www.who.int/csr/don/2005_03_07/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam - update 11

11 March 2005

The Ministry of Health in Viet Nam has today confirmed an additional 10 cases of human infection with H5N1 avian influenza. Today’s report is an official notification to WHO of some recent cases, whose infection was detected in March, combined with retrospective notification of older cases, some of which date back to late January. Of these newly reported cases, three have been fatal.

This notification of cases follows new reporting procedures established within the Ministry of Health in collaboration with WHO staff in Hanoi.
Today’s official report brings the total number of laboratory-confirmed cases in Viet Nam, detected since mid-December 2004, to 24. Of these, 13 have been fatal.

Pending further information from the Ministry of Health, WHO will issue details showing dates of onset, outcome, and province for all 24 cases in tabular form.

Full information on new cases, including those that may be closely related in time and place, is critical to ongoing assessment of the pandemic risk posed by the H5N1 virus. Rapid field investigation of each new case is essential to ensure timely detection of clusters of cases occurring in family members or health care workers. Such cases can provide the first signal that the virus is altering its behaviour in human populations and thus alert authorities to the need to intervene quickly.

Total human cases (all countries) since January 2004

The first human cases of H5N1 infection, linked to poultry outbreaks in parts of Asia that have been ongoing since December 2003, were reported in January 2004 in Viet Nam and Thailand. Since then, altogether 69 cases have been reported, of which 46 were fatal.

Human cases have occurred in three phases: from January through March 2004 (35 cases, 24 deaths), from August through October 2004 (9 cases, 8 deaths), and from December 2004 to the present (25 cases, 14 deaths). In the present phase, the total includes a single case in Cambodia, which was fatal, in addition to those in Viet Nam.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

http://www.who.int/csr/don/2005_03_11/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

11 March 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">1</td> <td align="center" width="36%">1</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">51</td> <td align="center" width="36%">33</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">69</td> <td align="center" width="36%">46</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_03_11/en/print.html

MHSC · Aug 15, 2006

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Avian influenza ? situation in Viet Nam and Cambodia ? update 12

29 March 2005

Viet Nam

The Ministry of Health in Viet Nam has confirmed three additional cases of human infection with H5N1 avian influenza. The cases concern a 5-year-old boy from the central province of Quang Binh, a 17-year-old girl from the northern province of Nam Dinh, and a 40-year-old woman from the northern province of Quang Ninh. The 17-year-old girl has died.

An earlier case has also been confirmed. These recently confirmed cases bring the total in Viet Nam since mid-December to 28.

WHO is aware of reports of suspected H5 avian influenza infection in five members of a family who are presently hospitalized in the northern port city of Haiphong. These cases, which include the parents and their three young daughters, are undergoing further investigation following initial tests indicating infection with the H5 subtype of avian influenza. Reports indicate outbreaks of avian influenza in poultry in the vicinity. Field investigation of this family cluster is under way.

The current outbreak of human cases in Viet Nam has included several clusters, mostly in family members, of cases closely related in time and place. Thorough investigation of all such clusters is essential to determine possible changes in the behaviour of the virus and thus support assessment of the risk of an influenza pandemic.

There is currently no evidence that the H5N1 virus is spreading easily from person to person. Rapid sharing with WHO of viruses from recent clusters of cases has become increasingly important. Analysis can determine whether any significant changes in the virus have taken place and provide further support for risk assessment.

Several media reports have recently covered rumours of a large outbreak of influenza-like illness in Quang Binh Province. The outbreak is presently under investigation by provincial and central health authorities. Samples have been taken for testing, and WHO is awaiting the results. The number of cases with influenza-like illness appears much smaller than initially reported by the media.

Cambodia

The Ministry of Health in Cambodia has today confirmed the country?s second human case of avian influenza.

The 28-year-old man, from Kampot Province, developed symptoms on 17 March and was hospitalized in Phnom Penh on 21 March. He died on 22 March. The same day, laboratory tests by the Pasteur Institute in Phnom Penh confirmed that the man was infected with H5 avian influenza virus. The Cambodian government immediately launched an investigation to search for possible additional cases and identify possible sources of exposure to the virus. The investigation team, which is continuing its work in Kampot Province, includes Cambodian Ministry of Health and Ministry of Agricultural officials joined by staff from the WHO country office and the Pasteur Institute in Phnom Penh. FAO is assisting the investigation of animal disease. Numerous deaths among chickens in the area have been reported and samples taken from sick chickens have tested positive for avian influenza. The results from the investigation indicate the deceased man had contact with sick poultry. An 18 year-old boy initially identified as an additional suspected case has tested negative for the avian influenza virus. Samples taken from twenty seven other people, including family contacts of the confirmed case and Phnom Penh medical staff involved in his care, have all tested negative for H5 avian influenza infection. Results from a further six people from Kampot Province have also tested negative for H5 influenza virus.

Cambodia?s previous case, a 25-year-old woman who died in late January, was also from Kampot Province but lived in another district.

The majority of poultry in Cambodia are raised in small backyard flocks in rural areas, making surveillance for outbreaks especially challenging. A campaign to educate rural populations about the dangers of contact with dead or diseased poultry is being undertaken by the government, with support from WHO.

http://www.who.int/csr/don/2005_03_29b/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – outbreak in poultry in the Democratic People’s Republic of Korea – update 13

30 March 2005

On 27 March, state media in the Democratic People’s Republic of Korea officially reported the country’s first outbreak of avian influenza in poultry. To date, outbreaks involving large numbers of poultry have been reported at commercial poultry farms, including one in Pyongyang Province. Mass culling has been undertaken by the authorities in an effort to prevent further spread.

No human cases have been reported to date.

Government officials have assured WHO that all measures are being undertaken to prevent transmission to humans and to detect human cases, should they occur.

The WHO country office in Pyongyang has offered direct assistance to the Ministry of Public Health in strengthening surveillance and diagnostic capacity for the detection of possible human cases. WHO has offered to send oseltamivir, an antiviral drug that can be used prophylactically, to reduce the risk of human infection and disease, as well as therapeutically.
The WHO country office has further offered to supply personal protective equipment for poultry cullers.

WHO is this week despatching test kits to support laboratory diagnosis of H5-subtype avian influenza in humans. Further assistance has been offered in the form of training of local staff in laboratory diagnosis and surveillance.
In monitoring the outbreak, WHO staff in Pyongyang are working closely with the FAO local and regional offices, which are also offering specialized expertise.

http://www.who.int/csr/don/2005_03_30/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

31 March 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">2</td> <td align="center" width="36%">2</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">55</td> <td align="center" width="36%">35</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">74</td> <td align="center" width="36%">49</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_03_31/en/print.html

MHSC · Aug 15, 2006

Re: WHO Situation Updates - Avian Influenza Archive

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Avian influenza – situation in Viet Nam - update 14

4 April 2005

The Ministry of Health in Viet Nam has confirmed five additional cases of human infection with the H5 subtype of avian influenza virus ( see previous report). All five cases are in a family from the northern port city of Haiphong. The cluster includes the 35-year-old father, the 33-year-old mother, and their three daughters, aged 13 years, 10 years, and 4 months.

All cases in this family were hospitalized on 22 March and remain under care.

Since mid-December 2004, Viet Nam has reported 33 cases of H5N1 avian influenza. Of these cases, 15 have been fatal.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

http://www.who.int/csr/don/2005_04_04/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

4 April 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">2</td> <td align="center" width="36%">2</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">60</td> <td align="center" width="36%">35</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">79</td> <td align="center" width="36%">49</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_04_04/en/print.html

MHSC · Aug 15, 2006

Re: WHO Situation Updates - Avian Influenza Archive

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Avian influenza – situation in Cambodia - update 15

12 April 2005

The Ministry of Health in Cambodia confirmed that an 8-year-old girl from Kampot province who died on 7 April, was the country’s third case of avian influenza.

The girl became ill with a fever on the 29th March. Her condition deteriorated rapidly on 7 April, when she was taken to a district referral hospital and then transferred to Kuntha Bopha Hospital in Phnom Penh, where she died. Samples from the girl tested positive for avian influenza H5N1 virus at the Pasteur Institute, Phnom Penh.

A field investigation was conducted immediately, with team members from the Ministry of Health, Ministry of Agriculture, WHO, Pasteur Institute and FAO. Poultry deaths occurred in this village in February, but no poultry deaths occurred in the two weeks prior to the girl’s onset of symptoms. Human-to-human transmission as a source of the girl’s infection appears unlikely, as none of her known contacts were sick with similar symptoms before she became ill. Investigations as to the source of the girl’s infection are continuing.

Samples were collected from four close contacts who cared for her at the village and nine medical contacts from Kampot and Phnom Penh. All have tested negative for the H5N1 virus.

The public education campaign in Banteay Meas and neighbouring districts is continuing. The recent funding from international donors will be crucial in helping Cambodia control this disease.

Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

http://www.who.int/csr/don/2005_04_12/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

12 April 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">3</td> <td align="center" width="36%">3</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">60</td> <td align="center" width="36%">35</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">80</td> <td align="center" width="36%">50</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_04_12/en/print.html

MHSC · Aug 15, 2006

Re: WHO Situation Updates - Avian Influenza Archive

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Avian influenza – situation in Viet Nam - update 16

14 April 2005
The Ministry of Health in Viet Nam has provided WHO with official confirmation of an additional eight human cases of H5N1 avian influenza. Two of the cases were recently detected, between 2 and 8 April, in Hung Yen and Ha Tay Provinces, respectively. Both patients are alive. The other six cases are thought to have been detected prior to 2 April. WHO is seeking further details from the authorities on this six cases.

The Ministry of Health has reported to WHO that 41 cases from 18 cities and provinces have been detected in Viet Nam since mid-December 2004. Of these cases, 16 have died and six remain under treatment.

http://www.who.int/csr/don/2005_04_14/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

14 April 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">3</td> <td align="center" width="36%">3</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">68</td> <td align="center" width="36%">36</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">88</td> <td align="center" width="36%">51</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_04_14/en/print.html

MHSC · Aug 15, 2006

Re: WHO Situation Updates - Avian Influenza Archive

Re: WHO Situation Updates - Avian Influenza Archive

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Avian influenza – situation in Cambodia - update 17

4 May 2005

The Ministry of Health in Cambodia confirmed today that a 20-year-old woman from Kampot province who died on 19 April in a hospital in Viet Nam, was the country’s fourth reported case of avian influenza.

The woman, a secondary school student, was from Kompong Trach district in Kampot province, the same district as the first case reported from Cambodia in February. Samples taken from the woman tested positive for avian influenza A/H5 virus by the Pasteur Institute in Ho Chi Minh City, Viet Nam.

Staff from the Ministry of Health, Cambodia conducted active case finding in the village where the woman attended school and also provided education sessions to the students at the school. The Ministry of Agriculture are conducting an investigation into poultry deaths in the area of the school.

http://www.who.int/csr/don/2005_05_04/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) since 28 January 2004

4 May 2005

<table border="1" width="67%"> <tbody><tr> <td align="center" width="34%">Country/ Territory</td> <td align="center" width="30%">Total cases</td> <td align="center" width="36%">Deaths</td> </tr> <tr> <td width="34%">Cambodia</td> <td align="center" width="30%">4</td> <td align="center" width="36%">4</td> </tr> <tr> <td width="34%">Thailand</td> <td align="center" width="30%">17</td> <td align="center" width="36%">12</td> </tr> <tr> <td width="34%">Viet Nam</td> <td align="center" width="30%">68</td> <td align="center" width="36%">36</td> </tr> <tr> <td width="34%">Total</td> <td align="center" width="30%">89</td> <td align="center" width="36%">52</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_05_04/en/print.html

MHSC · Aug 15, 2006

Re: WHO Situation Updates - Avian Influenza Archive

Re: WHO Situation Updates - Avian Influenza Archive

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Avian influenza – cumulative number of cases – update 18

19 May 2005

WHO is updating its table showing cumulative numbers of human cases of H5N1 avian influenza broken down according to phases in the outbreak, which began in December 2003. [Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO]. Numbers for Viet Nam, where the vast majority of recent cases have occurred, have been amended in line with case counts provided by the Ministry of Health during late April and May. Since the third wave of infection began in Viet Nam in mid-December 2004, 49 cases have been reported. Of these cases, 17 were fatal. The most recent case was reported to the ministry on 17 April.

WHO has asked the Ministry of Health in Viet Nam to supplement the numbers with data on individual cases. Rapid field investigation of new cases, especially when these occur in clusters, remains essential to assess possible changes in transmission patterns that could indicate improved pandemic potential of the virus.

Since January 2004, when human cases of H5N1 avian influenza were first reported in the current outbreak, 97 cases and 53 deaths have been reported in Viet Nam, Thailand and Cambodia. Viet Nam, with 76 cases and 37 deaths, has been the most severely affected country, followed by Thailand, with 17 cases and 12 deaths, and Cambodia, with 4 cases and 4 deaths.

http://www.who.int/csr/don/2005_05_19/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO

19 May 2005

<table border="2" cellpadding="2" width="100%"> <tbody><tr> <td rowspan="2" width="11%">Date of onset</td> <td colspan="2" align="center" width="22%">

Viet Nam

</td> <td colspan="2" align="center" width="22%">Thailand</td> <td colspan="2" align="center" width="22%">Cambodia</td> <td colspan="2" align="center" width="23%">Total</td> </tr> <tr> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="12%">deaths</td> </tr> <tr> <td width="11%">26.12.03-10.03.04</td> <td align="center" width="11%">23</td> <td align="center" width="11%">16</td> <td align="center" width="11%">12</td> <td align="center" width="11%">8</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">35</td> <td align="center" width="12%">24</td> </tr> <tr> <td width="11%">19.07.04-08.10.04</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">5</td> <td align="center" width="11%">4</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">9</td> <td align="center" width="12%">8</td> </tr> <tr> <td width="11%">16.12.04-13.05.05</td> <td align="center" width="11%">49</td> <td align="center" width="11%">17</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">53</td> <td align="center" width="12%">21</td> </tr> <tr> <td width="11%">Total</td> <td align="center" width="11%">76</td> <td align="center" width="11%">37</td> <td align="center" width="11%">17</td> <td align="center" width="11%">12</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">97</td> <td align="center" width="12%">53</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_05_19/en/print.html

MHSC · Aug 15, 2006

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Avian influenza – situation in Viet Nam – update 19

8 June 2005

The Ministry of Health in Viet Nam has confirmed an additional 3 human cases of infection with H5N1 avian influenza. The most recently detected case was reported on 26 April. In the same communication, an additional death from the disease was confirmed. No further data about these cases have been provided.

The newly confirmed cases bring the total, in Viet Nam, since mid-December 2004 to 52 cases. Of these patients, 18 have died and two are currently being treated in hospital.

http://www.who.int/csr/don/2005_06_08a/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO

8 June 2005

<table border="2" cellpadding="2" width="100%"> <tbody><tr> <td rowspan="2" width="11%">Date of onset</td> <td colspan="2" align="center" width="22%">

Viet Nam

</td> <td colspan="2" align="center" width="22%">Thailand</td> <td colspan="2" align="center" width="22%">Cambodia</td> <td colspan="2" align="center" width="23%">Total</td> </tr> <tr> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="12%">deaths</td> </tr> <tr> <td width="11%">26.12.03-10.03.04</td> <td align="center" width="11%">23</td> <td align="center" width="11%">16</td> <td align="center" width="11%">12</td> <td align="center" width="11%">8</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">35</td> <td align="center" width="12%">24</td> </tr> <tr> <td width="11%">19.07.04-08.10.04</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">5</td> <td align="center" width="11%">4</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">9</td> <td align="center" width="12%">8</td> </tr> <tr> <td width="11%">16.12.04- to date</td> <td align="center" width="11%">52</td> <td align="center" width="11%">18</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">56</td> <td align="center" width="12%">22</td> </tr> <tr> <td width="11%">Total</td> <td align="center" width="11%">79</td> <td align="center" width="11%">38</td> <td align="center" width="11%">17</td> <td align="center" width="11%">12</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">100</td> <td align="center" width="12%">54</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_06_08/en/print.html

MHSC · Aug 15, 2006

Re: WHO Situation Updates - Avian Influenza Archive

Re: WHO Situation Updates - Avian Influenza Archive

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Avian influenza – situation in Viet Nam – update 20

14 June 2005
The Ministry of Health in Viet Nam has confirmed an additional 3 human cases of infection with H5N1 avian influenza. The cases were detected during the last two weeks of May. All three patients are from Hanoi and remain alive. No further data about these cases have been provided.

The newly confirmed cases bring the total, in Viet Nam, since mid-December 2004 to 55 cases. Of these patients, 18 have died and three are currently undergoing treatment at a hospital in Hanoi. 

http://www.who.int/csr/don/2005_06_14b/en/print.html

<hr style="border: 1px none ; height: 1px; background-color: rgb(0, 0, 0); width: 759px;" align="left">
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO

14 June 2005

<table border="2" cellpadding="2" width="100%"> <tbody><tr> <td rowspan="2" width="11%">Date of onset</td> <td colspan="2" align="center" width="22%">

Viet Nam

</td> <td colspan="2" align="center" width="22%">Thailand</td> <td colspan="2" align="center" width="22%">Cambodia</td> <td colspan="2" align="center" width="23%">Total</td> </tr> <tr> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="11%">deaths</td> <td align="center" width="11%">cases</td> <td align="center" width="12%">deaths</td> </tr> <tr> <td width="11%">26.12.03-10.03.04</td> <td align="center" width="11%">23</td> <td align="center" width="11%">16</td> <td align="center" width="11%">12</td> <td align="center" width="11%">8</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">35</td> <td align="center" width="12%">24</td> </tr> <tr> <td width="11%">19.07.04-08.10.04</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">5</td> <td align="center" width="11%">4</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">9</td> <td align="center" width="12%">8</td> </tr> <tr> <td width="11%">16.12.04- to date</td> <td align="center" width="11%">55</td> <td align="center" width="11%">18</td> <td align="center" width="11%">0</td> <td align="center" width="11%">0</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">59</td> <td align="center" width="12%">22</td> </tr> <tr> <td width="11%">Total</td> <td align="center" width="11%">82</td> <td align="center" width="11%">38</td> <td align="center" width="11%">17</td> <td align="center" width="11%">12</td> <td align="center" width="11%">4</td> <td align="center" width="11%">4</td> <td align="center" width="11%">103</td> <td align="center" width="12%">54</td> </tr> </tbody></table> Notes
Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2005_06_14/en/print.html

2005 WHO Situation Updates - Avian Influenza Archive

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