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THAILAND -1st Confirmed Human Tests Positive Both Bird flu and Dengue Fever
Archive Number 20060726.2060
Published Date 26-JUL-2006
Subject PRO/AH/EDR> Avian influenza, human (102): Thailand, dengue exposure
AVIAN INFLUENZA, HUMAN (102): THAILAND, DENGUE EXPOSURE
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Wed 26 Jul 2006
From: Joe Dudley <jdudley@eaicorp.com>
Source: Bloomberg News Agency, Wed 26 Jul 2006 [edited]
<http://www.bloomberg.com/>
1st Confirmed Human Case Tests Positive for Both Bird flu and Dengue Fever
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Bird flu killed a teenage boy in northern Thailand yesterday [25 Jul
2006], the 1st reported case in 7 months in the world's 4th-biggest
poultry exporter. The 17-year-old tested positive for the H5N1 avian
flu strain, Prime Minister Thaksin Shinawatra told reporters in
Bangkok today [26 Jul 2006]. Fowl in the boy's northern province of
Phetchabun province, about 350 km (218 miles) north of the capital,
were infected with the lethal virus, Thaksin said. "He had been in
contact with fighting cocks, which were not declared for fear they
would be culled by authorities," Thaksin said. Thailand's fighting
roosters are prized for gambling bouts and fetch as much as 500 000
baht (USD 13 156).
Human H5N1 fatalities have almost tripled this year [2006] as the
virus spread in wild birds and domestic poultry to at least 38
countries. New cases create chances for the pathogen to mutate into a
pandemic form that may kill millions of people. The previous H5N1
outbreak in Thailand was in November 2005 and the last of the
country's 22 human cases was reported in December 2005.
Thailand's latest case has [now] been confirmed by the World Health
Organization. The youth died after being admitted to a Phichit
hospital on 20 Jul 2006, said Thawat Suntrajarn, director general of
the health ministry's disease control department, in a telephone
interview today [26 Jul 2006]. He tested positive for both dengue
hemorrhagic fever and H5N1 avian flu, Thawat said.
"He was a unique case" because of the dual infections, Thawat said,
adding that the youth "had a history of touching dead poultry."
--
Joe Dudley
Chief Scientist
EAI Corporation
<jdudley@eaicorp.com>
[Dr. Dudley has pointed out that a previous study by Thai research
workers identified dengue fever as a differential diagnosis factor in
children (See: Investigation of avian influenza (H5N1) outbreak in
humans--Thailand, 2004. By Areechokchai D. et al., in MMWR, 55 Suppl
1: 3-6. 2006
<http://www.cdc.gov/mmwr/preview/mmwrhtml/su5501a2.htm>).
During the period February to November 2004, at the onset of the
outbreak in Thailand, the Thai MPH's Bureau of Epidemiology and
provincial health offices worked together to investigate the
characteristics of H5N1 infection in humans. Two studies were
conducted: (1) a descriptive study to describe the clinical
manifestations and epidemiologic characteristics of the cases, and
(2) a matched case-control study to determine risk factors for
persons who might subsequently become ill with H5N1. Although only a
small number of patients (16) could be surveyed, the authors were
able to conclude that H5N1 avian influenza was more severe in
children. They recommended that children should avoid handling dead
poultry during epizootics.
Early avian influenza in children resembled the more common dengue
fever, but presence of cough and absence of hemoconcentration
distinguished avian influenza, which often progressed rapidly to
acute respiratory distress syndrome, requiring intensive care. The
incidence of concurrent or previous dengue virus infection is a
factor which should be taken into account in assessment of bird flu
outcomes in human patients. - Mod.CP]
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