Rising tide of H5N1 cases in Asia

There have been an increasing number of H5N1 cases in Asia within the last few weeks.

China :

A 37 year old man from Shenzhen, Guandong Province became ill on December 21, 2011 and died on December 31, 2011.

A 39 year old man from Guiyan City, Guizhou Province became ill on January 6, 2012 and died on January 22, 2012.

Vietnam:

A 18 year old man from Kien Gang Province became ill on January 10, 2012. He died on January 16, 2012.

Cambodia:

A 2 year old boy from Banteay Meanchey Province became ill on January 3, 2012. He died on January 18, 2012.

Indonesia:

A 23 year old man from Jakarta Province became ill on December 31, 2011. He died on January 7, 2012.

A 5 year old girl from Jakarta Province became ill on January 7, 2012. She died on January 16, 2012.

There have been a number of other reports in the Indonesian media of possible H5N1 cases. You can find a list of these compiled by dbg at PFI_Forum.

The confirmed recent cases in Asia are noteworthy because they have all died. In contrast, the recent death rate in Egypt from H5N1 has been approximately 50%. Although this could be due to differences in quality of medical care, many of the patients who died in Asia appear to have received Tamiflu and advanced medical treatment. This raises the possibility that the virus in Asia is different from the one in Egypt. In particular, there has been discussion of the possibility that there is a strain in Indonesia which is now Tamiflu-resistant. If so, one of the most effective treatments is no longer available which would likely increase the death rate.

The cases reported here are likely not the only cases which have occurred in Asia. Certainly in Indonesia there are indications that there may be many more. It is possible that the assays for identifying H5N1 are failing in Indonesia. This would also imply a change in the virus. The intense censorship of reports of H5N1 in China makes it impossible to know how many cases are occurring in that country.

If H5N1 in Asia has changed, there could hardly be a worse time for it. Hundreds of millions of people are traveling in crowded trains during the Lunar New Year celebrations. Special alertness for signs of H5N1, especially clusters, is warranted.

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