BANGKOK, Thailand, January 31, 2005 (ENS):
The first documented case of human-to-human transmission
of bird flu occurred in Thailand last September, Thai,
U.S. and international health officials are saying.
The confirmation, which came last week in the form
of a report in the "New England Journal of Medicine,"
prompted the Influenza Foundation of Thailand (IFT)
to call for more information from the Thai government
on the possibility that the bird flu virus could mutate
and spread quickly from human to human, setting off
a global pandemic.
IFT president Dr. Prasert Thongcharoen said, "The
government should not shrink from the message that bird
flu can mutate and change into a form that may transmit
to humans so everyone will realize the gravity of the
situation and come up with better ways to protect themselves
In late 2003 and early 2004, a strain of avian flu
known as H5N1 infected birds across 11 southeast Asian
countries. Approximately 100 million birds died or were
destroyed after becoming infected or exposed to the
At least 44 people in eight countries sickened with
the H5N1 bird flu, and 32 of them died. One of those
who lost her life was an 11 year old Thai girl, Sakuntala
Health scientists say she most likely picked up the
virus from exposure to infected chickens.
But the girl's mother, who came from another province
to care for her sick daughter in the hospital, had no
exposure to chickens. The mother spent less than 24
hours with Prepasee, but became ill herself four days
later and died 12 days after her daughter.
Prepasee's aunt, with whom she lived, sickened after
handling infected chickens with plastic bags on her
hands, but did not become ill until a week after the
incubation period for the disease had passed. During
that week, she touched no chickens, but cared for her
sick niece in the hospital.
Researchers say she probably contracted the flu from
her niece. She survived the illness.
Writing in the current issue of the "New England
Journal of Medicine," the team from Thai Ministry
of Public Health in Nonthaburi, led by Dr. Kumnuan Ungchusak,
said, "We believe that the most likely explanation
for the family clustering of these three cases of avian
influenza is that the virus was transmitted directly
from the infected patient to her mother and to her aunt."
"Autopsy tissue from the mother and nasopharyngeal
and throat swabs from the aunt were positive for influenza
A H5N1," wrote Dr. Ungchusak.
"Disease in the mother and aunt probably resulted
from person-to-person transmission," the team found.
"It was reassuring that no further transmission
of the virus has been detected."
When these deaths were first reported, the U.S. Centers
for Disease Control and Prevention called the Thai family
cluster "one isolated instance of probable limited
human-to-human transmission occurring in Thailand in
World Heath Organization (WHO) officials downplayed
the human-to-human risk, calling them one of a very
few "inefficient, unsustained, dead-end-street"
transmissions between humans.
But a few months later, the WHO assessment was different.
In November 2004 the UN health organization stated,
"Although the number of human cases of H5N1 is
so far comparatively few, there is a sustained threat
that the outbreak in poultry will evolve into an influenza
pandemic, with considerable loss of human life."
At a meeting in Bangkok, Thailand in November called
by the World Health Organization, health ministers and
senior health officials from the 10 Southeast Asian
countries plus China, Japan and the Republic of Korea
were told that the threat of a pandemic was now greater
than at any time in recent years
"We believe a pandemic is highly likely - unless
intensified international efforts are made to take control
of the situation," said Dr. Shigeru Omi, Regional
Director of WHO's Western Pacific Region, which has
taken the brunt of the outbreak.
Dr. Klaus Stohr, head of WHO's Geneva based Global
Influenza Programme, has warned that up to about seven
million people may die in an influenza pandemic.
"There is no doubt there will be another pandemic,"
Stohr said in December. "Even with the most optimistic
scenario, the pandemic will cause a public health emergency
with estimates which will put the number of deaths in
the range of two and seven million.”
The H5N1 strain of avian flu is spreading across Asia
once again this winter.
A 13 year old girl has died from bird flu, becoming
Vietnam's eleventh victim of the disease in the past
month, a doctor said Saturday after concerned Thai and
UN experts met in the country for talks on the outbreak.
During the period January 1 to 28, avian influenza
has been confirmed in 30 Vietnamese provinces and cities
and more than 897,000 birds have died or have been culled.
On January 17, Vietnamese Prime Minister Phan Van Khai
sent an urgent message to concerned ministries, sectors
and provinces calling for "drastic" measures.
In his message, the Prime Minister says that bird flu
is returning, particularly in the Mekong Delta and southern
provinces, and tends to spread quickly; ministries must
consider the fight against the outbreak as their "key
and immediate mission" to ensure the health and
safety of the public and food supplies during Lunar
Imports of poultry and poultry products from neighboring
countries are temporarily suspended, with any detected
consignments to be seized at the border and destroyed.
The owners will not receive any compensation but will
be requested to pay for the cost of culling birds.
The Ho Chi Minh City Police Department has deployed
its forces to cooperate with the animal health bureau
and market monitoring staff to check the trading at
markets and, especially, the transport of fowl at gateways
to the city. In Danang City, trade in live fowl at major
markets is banned.
Up to December 29, 2004, the World Health Organization
reported 27 human cases of bird flu in Vietnam, with
20 fatalities. This number increased by January 26,
2005, when a further 10 patients were confirmed as infected.
Of these, nine have died.
Having lunar New Year on February 9, movement of poultry
and poultry products will increase in the region, UN
The need for biosecurity of domestic poultry to prevent
infection and enhanced early warning in order to detect
every additional case are highest during this season
to avoid new cases of highly pathogenic avian influenza
in poultry and to minimize the risk to humans.
Copyright Environment News Service (ENS) 2004. All