# 4513
The World Health Organization has posted an avian influenza update (#11) for Vietnam, citing two new cases in Bac Kan province. One is listed in critical condition, the other as stable.
These cases began in late March and early April, and were covered extensively in this blog (here, here, here, and here),on Crofsblog, on Scott McPherson’s blog, and on the flu forums.
Although the two victims lived in close proximity to one another, and came down with the infection within a few days of each other, authorities state they have been unable to establish any epidemiological link suggesting human-to-human (H-2-H)transmission.
The burden of proof for H-2-H transmission of H5N1 has always been high, particularly when other plausible explanations for multiple infections exist.
In this case, sick and dying birds had been reported in and around both homes, and both victims could have been exposed through that route.
The operative words here being `could have’. There is simply no way to know with absolute certainty.
No diagnosis or explanation has been offered for the two dozen others in the village who reported flu-like symptoms, and who reportedly received Tamiflu.
While false negative tests for H5N1 are pretty common, their mass recovery would seem to argue for them having had something other than bird flu, but questions remain.
For now, the good news is that whatever transpired in this village appears to have been brought under control. No new cases have been reported, and most of those treated have apparently recovered.
Here is the WHO update.
Avian influenza – situation in Viet Nam - update 11
21 April 2010 -- The Ministry of Health has reported two new confirmed human cases of A(H5N1) avian influenza infection on 6 and 9 April 2010. These cases were confirmed at the National Institute for Hygiene and Epidemiology.
The first case is a 22 year old male from Nhu Co commune, Bac Kan province. He developed symptoms on the 28 of March 2010 and was transferred to the National Hospital of Tropical Diseases in severe condition. Confirmatory test results for influenza A (H5) were obtained on 3 April.
The initial epidemiological investigations show that there were sick/dead poultry at the patient's home and in the surrounding areas.
The second case is a 2 year old girl residing in Cho Moi district, Bac Kan province. She developed symptoms on 2 April 2010. On 4 April, she was transferred to Cho Moi District Hospital for treatment where she is in a stable condition. Confirmatory test results for influenza A (H5) were obtained on 7 April.
The initial epidemiological investigations show that there were sick/dead poultry at the patient's home and in the surrounding areas. The patient's family slaughtered the sick poultry to eat.
There is no epidemiological link between these two cases that would indicate human-to-human transmission.
Of the 119 cases confirmed to date in Viet Nam, 59 have been fatal.
