Thread: Thai scientist fears human-to-human cases of bird flu

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Thai scientist fears human-to-human cases of bird flu
By KATE WALKER
UPI Correspondent

WASHINGTON, Dec. 2 (UPI) -- Thai health officials have expressed concern that the country's two latest confirmed victims of avian influenza may be the beginning of the much feared human-to-human transmission.

Dr. Charoen Chuchottaworn, an avian-flu expert at the Public Health Ministry, said doctors reviewing the cases were alerted by the very mild symptoms present in both patients, neither of whom had had any recent contact with birds or poultry.

The doctors are unsure as to how either of the infected contracted the disease and have raised the possibility that the virus has traded its pathogenicity for ease of transmission.

Dr. Kamnuan Ungchusak, director of Thailand's Epidemiology Bureau, refuted these assertions, saying: "Chickens were dying near their homes and chicken droppings were everywhere around their neighborhood. They might have contracted the virus through contaminated soil."

Dr. Charoen, however, fears that these cases may be the tip of a previously unconsidered iceberg and that other people infected with a mild-symptom variant of avian influenza may have been around and undiagnosed for quite some time.

It must be stressed that these cases do not signal the beginning of a human-to-human transmissible pandemic of bird flu, merely that an isolated group of scientists is suggesting that the virus may already have become more transmissible by becoming less virulent.

Meanwhile:

-- Three more villages in eastern Romania have been quarantined following the discovery of an H5 strain of avian influenza in poultry in one of the villages.

The Romanian Ministry of Agriculture suspects the presence of bird flu in the other villages but is awaiting confirmation of test results from the United Kingdom.

Culling has begun in the area, and authorities estimate that 9,500 birds will be killed.

-- Also in Romania, authorities have banned hunting in Braila county as a precautionary measure against the spread of bird flu.

-- A study conducted by the University of Oxford of the chest X-rays of 14 Vietnamese patients ill with avian influenza found shared abnormalities in the lungs.

While all the sets of lungs were found to be surrounded by fluid, afflicted with a variety of infections and full of pus, the scientists established that the severity of the symptoms as seen in the X-rays was a good indication of the likelihood of survival.

-- Ethiopia is conducting tests for avian influenza on dead pigeons found in the east of the African country.

There have been no outbreaks of avian influenza in Africa, and officials say that the tests are a precautionary measure. The undisclosed number of dead birds were found in a region of the country not on any migratory routes.

Seleshi Zewdie, director of the animal health department in the Ministry of Agriculture, said, "It is unlikely that the disease is bird flu. It could be a local disease strain."

-- A team from the World Health Organization investigating the deaths from avian influenza in China has said that the extent of the problem in the country -- and elsewhere -- may be worse than initially thought.

While there are no problems of transparency on the part of the Chinese government, it is feared that the systems in place for detection and prevention of the disease may not be as proficient as the WHO would like.

Dick Thompson, a WHO spokesman in Geneva, told the New York Times, "In some cases the surveillance system may not be there. We're not nosing around, but we may be able to provide (China with) some technical expertise."

http://english.people.com.cn/200512/02/ ... 25185.html

Latest bird-flu cases in Thailand raise concern over human-to-human transmission



The two latest confirmed cases of human bird flu in Thailand might be human-to-human transmissions, a senior health official has said.

Dr Charoen Chuchottaworn, a bird-flu expert at the Public Health Ministry's Department of Medical Services, said doctors concluded after reviewing the history of the past two cases that both victims presented very mild symptoms of avian influenza and neither had any physical contact with chickens or birds.

One of the victims was a boy in Bangkok and the other was an 18- year-old man from Nonthaburi province, The Nation newspaper reported Friday.

This left doctors no clues as to where the patients became infected with the H5N1 virus and showed that the avian influenza had moved from causing severe human infection to milder cases.

Charoen, who is also a member of the national committee issuing guidelines for the treatment of avian influenza, made the remarks Thursday at the Joint International Tropical Medicine Meeting 2005 in Bangkok.

Dr Kamnuan Ungchusak, director of the Epidemiology Bureau, challenged Charoen's assertion about human-to-human transmissions.

He told The Nation that while neither of the patients had direct contact with chickens, they lived in an environment where the virus was prevalent.

"Chickens were dying near their homes and chicken droppings were everywhere around their neighborhood," he said. "They might have contracted the virus through contaminated soil."

Dr Charoen said the milder the symptoms, the harder it is for doctors to diagnose. This means that a lot more advanced laboratory facilities are needed with a testing technique called RT-PCR to confirm cases and decide if patients should be treated with antiviral Tamiflu (oseltamivir phosphate).

He said this meant that avian influenza could become asymptomatic now.

The only tool available in Thailand to fight H5N1 infections at the moment is insufficient, he said. At present, Thailand has about one million capsules for 100,000 treatments of Tamiflu, but it is estimated that about 120 million capsules of the drug will be needed.

In the past, only severe cases of human bird flu have been detected in Thailand simply because patients went to hospital for treatment. But doctors believe that there have been many cases with mild symptoms of the disease.

"We believe that this is the tip of the iceberg," he said.

Signs of possible human-to-human transmission were closely observed in Vietnam, where 10 clusters of probable human transmissions were detected in which the victims had no contact with infected poultry, Charoen said.

Thailand and Indonesia had one official cluster, he said, but the Indonesian cluster showed clear-cut evidence because a child contracted H5N1 without going to an infected area, as her father had.