# 559
Basically an update, with a few more details about when this worker was exposed, and perhaps, an alternate explanation for his symptoms.
Worker May Have Bird Flu, New Outbreak Detected
Public health officials are testing a quarantine worker who they believe may have contracted the deadly avian influenza virus while working to prevent the spread of the disease in Anseong, Gyeonggi Province.
An official with the Korea Center for Disease Control and Prevention (KCDC) said Thursday that tests of "Kim" done at Dankook University Hospital in Cheonan showed symptoms of meningitis, but because there is no sign of pneumonia they are not sure if he has bird flu. More tests are ongoing.
The highly-virulent H5N1 bird flu strain infects chickens, ducks and wild birds. In humans, it leads to high fevers, muscular pain and sometimes death.
According to Anseong officials, Kim helped some 300 fellow Anseong employees dispose of 218,950 chickens and ducks and 7,386 pigs that had been exposed to the virus on a farm outside of Anseong town. The job began on Feb. 13 and lasted four days.
The KCDC said patients with fevers of over 38 degrees Celsius, coughs, sore throats and other respiratory problems may be suspected of having avian influenza.
Kim received a bird flu vaccine while he was working and took tamiflu, an anti-flu drug, for seven days after the job.
KCDC workers took saliva, sputum and serum samples from 304 other employees who worked with Kim and are running tests. They said preliminary results should be available next week.
Meanwhile, a new outbreak of bird flu was found in Cheonan, South Chungcheong Province, making it Korea's seventh outbreak since November.
The National Veterinary Research and Quarantine Service detected the virus after a mass death of poultry at a farm that raised 13,000 ducks run by a company that processes chicken and ducks for meat. The government plans to cull 35,000 ducks from four farms inside a "danger zone" within 500 meters of the farm.
We've seen atypical presentations of bird flu before, so the lack of pneumonia symptoms isn't a slam dunk that this isn't H5N1. Additionally, we've seen infections of the brain with Avian flu, and so that doesn't rule it out either.
What is a bit curious is the timing. Kim was exposed, according to this article, for 4 days, begining the 13th of February. Earlier reports indicated he became symptomatic on March 5th, 16 days after his last exposure.
The assumed incubation time of this virus is 2 to 17 days, much longer than usually seen in influenza, and so this does fall within those parameters. The use of Tamiflu for 7 days might have suppressed viral replication during that time, but it is conceivable the patient still carried the virus, and when the antiviral treatment was stopped, it bloomed.
A lot of `if's' and `maybes' right now.
Meningitis, while fairly rare, is not unheard of, and so that may be a plausible explanation for his symptoms.
It appears the jury is still out on this one, and we will simply have to wait until tests come back either confirming, or ruling out H5N1.
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