Situation in Vietnam – December 14, 2009

As discussed previously, there have been recent outbreaks of both H5N1 and H1N1 in close proximity in Vietnam. Here are some additional details.

There have been poultry outbreaks of H5N1 in Dien Bien Province, which borders both Laos and China. On November 18, 2009, a 23 year old man from Dien Bien Phu City, Dien Bien Province, became ill. He died of H5N1 on November 28, 2009. There may be at least two additional recent deaths due to H5N1 in Vietnam.

Also in Dien Bien Province, at least 675 people have been reported to be infected with influenza A. 15 of these have been confirmed to be pandemic H1N1. Vietnamese officials continue to express strong concern about the possibility of patients becoming infected with both H5N1 and the new H1N1. Birds suspected of harboring H5N1 are being culled.

An outbreak of H5N1 in an area where pandemic flu is circulating is not surprising. Indeed, once the WHO and the nations of the world decided not to impose movement restrictions, this event became inevitable. Although Vietnamese officials appear to moving briskly to eliminate poultry with H5N1, the proximity of the Province with outbreaks (Dien Bien) to both Laos and China may make this difficult. The public health system in Laos barely functions. So, it is impossible to know whether similar outbreaks of H5N1 and H1N1 are occurring there. And the Chinese government has a well-documented track record of covering up both H5N1 and pandemic H1N1 outbreaks.

Vietnam has served as a sentinel country for both the SARS and H5N1,  even though these epidemics began in China. Given this history, we would be foolish to ignore the warnings of authorities in Vietnam about the possibility of a hybrid virus with genetic material from H5N1 and H1N1.

References

High Alert to the Risk of Combining Two Services Flu – machine translation from Vietnamese, hat-tip, treyfish and Commonground.

Bird flu kills 23-year-old man
SCGP, December 1, 2009

Avian Influenza – situation in Viet Nam – update 7
WHO, December 11, 2009

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