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Vietnam: Worries Over Changes In H5N1

 


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Over the past couple of weeks we’ve seen a series of news articles coming out of Vietnam – most  in the Vietnamese language – that seem to indicate that worrisome changes have been detected in the H5N1 bird flu virus. 


For the most part, the machine translations that I’ve seen have been vague, and difficult to decipher.   With the exception of one English language article I blogged on 10 days ago (see Variations On A Bird Flu Theme), I’ve not felt particularly comfortable posting these stories.

 

Today, we’ve another English language report from the Saigon Daily, and while it contains tantalizing tidbits of information, it also contains very little specific data.   

 

A hat tip to Carol@SC on the Flu WIki for posting this article.

 

First the article, then some discussion.

 

 

Concern grows over drug-resistant H5N1 mutations

Medical experts are growing increasingly worried that the bird flu virus (A/H5N1) is showing  signs of transforming into more lethal forms, since the number of cases in Vietnam since the beginning of the year is equal to all those of 2009.

Medical workers advise people to  wear protective clothing and wash their  hands  after coming into contact with poultry

The Department of Preventive Health and Environment, a sub-division of the Ministry of Health, has reported five H5N1 infections in the country since January 1 including two deaths. A 38-year-old woman from southern Tien Giang Province and a three-year-old from Binh Duong Province both succumbed to the illness.

 

Dr. Nguyen Huy Nga, head of the Department of Preventive Health and Environment, said the increase in infections highlights the complexity of the disease’s development.

 

Health workers are also concerned over the critical condition of a 25-year-old female in Hanoi’s Soc Son District who is currently being treated for bird flu at the National Tropical Disease Hospital. Unlike other cases, the woman reportedly had not had contact with diseased or dead waterfowl or eaten poultry before falling ill.

 

Dr. Nguyen Quynh Mai from the National Institute of Hygiene and Epidemiology, said research has revealed seven new A/H5N1 virus strains in Vietnam. Tests show the strains are drug-resistant and potentially lethal.

 

Dr. Nga said that low public awareness could lead to more lethal strains of both bird flu and swine flu (A/H1N1). He warned health agencies to strengthen supervision of flu outbreaks in communities to quickly isolate infected patients from coming into contact with other people.

 

Residents should report to local governments immediately when chickens die or show signs of disease for unclear reasons, he said. In addition, people should wear protective clothing and wash their hands after coming into contact with poultry.

 

Anyone suffering fever, cough or breathing problems is advised to seek immediate medical treatment.

 

 

Obviously, this article is written for a general audience, and is intended more to raise community awareness of their ongoing bird flu threat than it is to impart scientific information.   

 

The claim that they’ve detected `seven new A/H5N1 virus strains in Vietnam’ sounds ominous, but fails to tell us over what time period these variants appeared, and their exact nature.  

 

There are at least 10 well defined clades (and numerous sub-clades) of the virus in circulation around the world, with more expect to develop over time.

 

It would be helpful if we knew if these `seven new’ strains were actually new, or simply discovery of known clades circulating in Vietnam.

 

H5N1 clades

 

The statement that these new strains are drug-resistant is potentially worrying, but once again, details are lacking.  Presumably this refers to Tamiflu resistance (although Amantadine is also a possibility), and that would be of concern.

 

And lastly, we’ve this report of the 25-year-old from Soc Son District who reportedly had no contact with diseased or dead.  Of course, somewhere around 30% of cases in Indonesia and China over the past few years have reported no contact with birds as well.

 

Is something unusual going on with bird flu in Vietnam?

 

It’s possible.

 

But it is pretty hard to come to any conclusions based on these limited newspaper accounts.    Five cases this year isn’t exactly an avalanche of human infection, even if it equals their count for all of 2009.  

 

Obviously, we’ll keep a close eye on this situation.   Hopefully we’ll get a scientific paper, or letter to a journal, giving us better detail on this story in the coming days or weeks.

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Vietnam
Bird Flu

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