6 March 2007
Laos reports first patient with H5N1 influenza infection while Egypt and China report their 23rd patient
On February 27 the Lao People’s Democratic Republic reported to the WHO (www.who.int) that a 15 year-old female had been hospitalized in Vientiane with an influenza-like illness that was subsequently confirmed to be due to H5N1 avian flu infection by the National Institute of Health laboratory in Thailand. Close collaboration has been ongoing between Lao and Thai health ministries in terms of the outbreak investigation, including the search for H5N1 virus poultry infections and clinical evaluations.
In addition, the World Health Organization (WHO) reported that oseltamivir prophylaxis was provided to adult close contacts of this first lab-diagnosed patient with H5N1 influenza virus infection in Laos. Notably, she is reported to be clinically stable.
On March 4th a second person was hospitalized in Laos with an influenza-like illness. Preliminary tests were positive for H5 influenza, but confirmation is still pending from a WHO reference laboratory. This patient was a 42 year-old woman who died on Sunday, March 4, in a hospital in Vientiane.
On March 1st, both Egypt and China reported their 23rd patient with laboratory-confirmed H5N1 infection in their respective nations. The patient in Egypt is a 4-year-old girl exposed to sick birds in the Dakahlea Governate. She is clinically stable. Thirteen of the 23 patients in Egypt have died of H5N1 infection. Egypt recently hosted a multinational-WHO conference on risk communication regarding avian and pandemic influenza and is expanding its preparedness efforts that already featured several major conferences in March and June 2006 in Cairo at the Ministry of Health and Population (MOHP). The June conference included fit-testing of N-95 respirators for all meeting participants (primarily physicians, nurses, and administrators).
China reported a 44 year-old woman from Fujian province who was admitted to hospital in critical condition and found to have laboratory-confirmed H5N1 influenza infection. The source of her infection is still under investigation. Fourteen of the 23 lab-confirmed patients in China have died due to H5N1 virus infection.
According to the WHO, the 12 nations with laboratory-confirmed H5N1 patients (total number) include: Azerbaijan (8), Cambodia (6), China (23), Djibouti (1), Egypt (23), Indonesia (81), Iraq (3), Lao People’s Democratic Republic (1), Nigeria (1), Thailand (25), Turkey (12), and Viet Nam (93). Of these 277 lab-confirmed infections, 167 (60 %) have been fatal.
Daniel R. Lucey, MD, MPH
Director, Center for Biologic Counterterrorism and Emerging Diseases
EROne Institutes, Dept. of Emergency Medicine, Washington Hospital Center
Co-Director, M.S. Program in Biohazardous Threat Agents and Emerging Diseases, Department of Microbiology and Immunology,
Georgetown University Medical Center, Washington, DC
E-mail: Daniel.R. Lucey@Medstar.net