Did Vietnamese Man Die
Of Recombined H5N1?
From Patricia Doyle, PhD
If this is found to be correct, and the Vietnamese man died of combination of bird flu H5N1 and H3N2, or N8, then the possibility for recombination of H5N1/H3N2 is real. This is worriesome and I hope more news on this case will be forthcoming.
Patricia Doyle
Peoples Daily Online
Xinhua News Agency
After world health experts and officials set out key steps to halt the spread of H5N1 bird flu virus at a Geneva meeting on Wednesday, a 43-year-old Vietnamese died of infection of bird flu virus H3N0 [? - see comment below] on Thu 10 Nov 2005.
Tests by the Vietnamese National Institute of Hygiene and Epidemiology showed that specimens from the man, from the northern city Hai Phong, who died on 2 Nov 2005 from respiratory failure, were positive to influenza A virus, subtype H3N0 [?], local newspaper Pioneer reported. The man was admitted to a hospital on 1 Nov 2005 after returning home from the southern city of Vung Tau. During his stay in the southern city, he ate poultry.
The hospital suspected that the patient was infected with [avian influenza] A virus, subtype H5N1. However, the tests concluded that he was infected with subtype H3N0 [?], which is less dangerous than the subtype H5N1. The new finding surfaced after the World Health Organisation (WHO) said on Wed 9 Nov 2005 that one more case of human infection with H5N1 virus had been confirmed in Viet Nam.
In Geneva, health experts unveiled a plan [costing] 1 billion US dollars on Wed 9 Nov 2005 to halt the spread of bird flu. The global action plan is aimed at rooting out bird flu among poultry and stopping it from spawning a human influenza pandemic. More than 600 delegates from over 100 countries agreed there is an urgent need for financial and other resources for countries which have been affected by bird flu and those which are most at risk, and to identify and respond to a human pandemic the moment it emerges. "The world recognizes that this is a major public health challenge," WHO Director-General Lee Jong-wook said in his conclusions to the 3-day meeting.
Experts and officials set out key steps that must be taken in response to the threat of the H5N1 flu virus, which is currently circulating in animals in Asia and has been identified in parts of Europe. The steps included control at source in birds, surveillance, rapid containment, pandemic preparedness, integrated country plans, and communications.
David Nabarro, Senior UN System Coordinator for Avian and Human Influenza, said: "We must use all our assets and skills to the best effect, avoid duplication, share expertise, learn from our experiences, and tune up our ways of working. We must focus on support for existing country mechanisms and provide integrated global joint plans, programs and monitoring," he added. The meeting was co-organized by the WHO, the Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE), and the World Bank. Participants also discussed key financing needs for countries in the short-, medium- and long-term.
According to an analysis presented by the World Bank, the needs of affected countries will potentially reach 1 billion US dollars over the next 3 years. This does not include financing for human or animal vaccine development, for antiviral medicines, or for compensating farmers for loss of income due to animals that have been culled.
The meeting supported an urgent resource request for 35 million dollars to fund high-priority actions by the WHO, FAO and OIE over the next 6 months. Additionally, surveillance, control, and preparedness work in countries requires urgent funding. "Based on our work here in Geneva over the past 3 days, we now have a strong business plan to take to the donors financial conference in Beijing in mid-January [2006]," said James Adams, vice-president of the World Bank for Operations and head of the Bank's Avian Flu Taskforce.
The urgency of fighting bird flu was underlined after Indonesia reported on Wednesday what it confirmed would be the 65th [human] death blamed on the H5N1 virus since late 2003. The victim lived in an East Jakarta suburb near a bird market and had chickens and pet birds in her house. However, no evidence of contact with an infected bird has been established.
Chinese Premier Wen Jiabao has called on the nation to intensify efforts to fight bird flu, as the country is facing a "very serious situation" in controlling the epidemic. Bird flu has not been totally controlled in China and the danger of its spread still exists in some areas, the premier said during an inspection tour of the bird flu-hit Heishan County in northeast China's Liaoning Province on Tuesday. He urged the local governments to pay great attention to the epidemic and focus on the prevention of the disease from jumping to humans, a task he said is "arduous."
(The identity of this virus is unclear. Currently 16 hemagglutinin (H1 to H16) subtypes and 9 neuraminidase (N1 to N9) subtypes of influenza A virus are recognised. Most combinations of H and N subtypes have been found in influenza viruses in the natural environment. There is no N0 subtype. Tests for H5N1 virus infection have been negative. The diagnosis of H3N0 is clearly erroneous: possibilities are that the patient has contracted H3N2 human influenza virus infection or even H3N8 avian virus infection (a combination of H and N antigens found previously in ducks). Alternatively the N0 designation may mean no more than that the subtype has not been identified. Clarification is requested urgently from any informed source. - Mod.CP - ProMed)
Patricia A. Doyle, PhD
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