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  • THAILAND - Use of illegal vaccines may mask flu symptoms

    Use of illegal vaccines may mask flu symptoms
    August 9, 2006

    The bird-flu virus might have changed in some ways given its ability to hide from even advanced testing techniques," worried officials at the Public Health Ministry said yesterday.

    "This could either be caused by some changes within the virus itself or some other factors, probably the illegal use of vaccine in poultry," said caretaker Public Health Minister Pinij Charusom-bat.

    This year, two confirmed bird-flu patients who have already succumbed to the disease. Initial lab tests showed they did not have the virus.

    "They had the symptoms, yet both the rapid test and PCR (Polymerase Chain Reaction) showed negative results," he said.


    Pinij insisted the virus was still H5N1, but he and his team observed that something irregular might have happened in those cases.

    The illegal use of vaccine could be to blame, he said, adding they had discovered there was a type of vaccine produced based on the H5N2 strain, which could have something to do with the observed changes of the H5N1 virus in some human cases.

    The ministry's Medical Sciences and Medical Services departments together will be monitoring and studying to find out more, the minister said.

    The ministry's concerns over possible changes in the virus suggested some changes in screening and treating patients with bird-flu like symptoms, Pinij said.

    "From now on, doctors should not base their decisions to give Tamiflu on the lab results as much as they did before," he said, adding that if any patient showed suspected symptoms and had a history of having been in contact with sick or dead poultry, then the doctor could consider giving the anti-viral drug to the patient.

    These recommendations were based on the experts' conclusion on Monday when they met at the ministry to review current situations concerning screening and treatment of patients with suspected symptoms.

    However, Pinij said, the decision to give the drug or not should be carried out on a case-by-case basis to prevent too much use which could lead to resistance.

    Yesterday, the Public Health Ministry called an urgent meeting of health officials from 29 provinces listed as areas to be closely monitored for bird flu epidemics in poultry and other concerned parties including the Ministry of Agriculture and Co-operatives.

    Dismissing the caretaker Agriculture and Co-operatives Minister Khunying Sudarat Keyuraphan's concerns, Pinij said he insisted the recent two confirmed cases of bird flu this year did contract the virus from poultry - and not other sources as speculated.

    Sudarat said on Monday that since the avian flu virus had not been detected in Uthai Thani, Public Health officials needed to find out why and how the Uthai Thani patient had the virus.

    Dr Charal Trinvudhipong, Sudarat's assistant, said that in the Uthai Thani case, the dead chickens were not tested because they had been buried already and the negative results came from a different batch of live chickens.

    The meeting also agreed to involve scientists studying the adverse effects of bird-flu vaccine on the accuracy of testing bird flu in human cases - as well as the genetics of the virus, Charal said.

    The outcome of the study should shed light on what the Public Health Ministry suspected about the virus, he said.

    The team will comprise virus and animal disease experts from Chulalongkorn, Kasetsart, and Mahidol Universities.

    Fighting cocks and ornamental birds are the most worrying group concerning the risk of illegal use of bird flu vaccine, Charal said, adding it had been discovered that about 50 per cent of the free-range ducks had antibodies to the bird flu virus.

    Meanwhile Suphan Buri Governor Songpol Timasart has ordered all cockfights in the province banned until the virus is fully under control.

    "Failure to abide by the ban will result in immediate legal action," Suphan Buri Deputy Governor Somsak Pureesrisak said yesterday.

    In Bangkok, four patients including a three-year-old boy were listed for bird flu observation yesterday.

    Arthit Khwankhom
    The Nation

    ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

  • #2
    Re: THAILAND - Use of illegal vaccines may mask flu symptoms

    This is not good. Not good at all.

    Comment


    • #3
      Re: THAILAND - Use of illegal vaccines may mask flu symptoms

      Originally posted by Jeremy
      This is not good. Not good at all.
      Nope. What kind of "changes" are they talking about...?
      ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

      Comment


      • #4
        Re: THAILAND - Use of illegal vaccines may mask flu symptoms

        I find the clinical reporting from Thailand extremely difficult to follow.

        This year, two confirmed bird-flu patients who have already succumbed to the disease. Initial lab tests showed they did not have the virus.

        "They had the symptoms, yet both the rapid test and PCR (Polymerase Chain Reaction) showed negative results," he said.

        Pinij insisted the virus was still H5N1, but he and his team observed that something irregular might have happened in those cases.

        The illegal use of vaccine could be to blame, he said, adding they had discovered there was a type of vaccine produced based on the H5N2 strain, which could have something to do with the observed changes of the H5N1 virus in some human cases.


        I do not know of any clinical example where a vaccine with similar antigenic properties for one disease would change the PCR results for that disease antigen. It would impact the results of serological (blood) tests for antibodies. It could also impact the clinical presentation of disease. The most common explanation on why a person with disease A tests negative on PCR for disease A is that the A antigens were not collected on the sample (ie if they took only nasal swabs and not bronchial lavage samples).

        Were the two patients they refer to the same two patients we know have died in Thailand this month, or do they represent newly discovered, as yet unreported cases?

        I am hopeful we will soon find a Thai clinician who can communicate with us directly on these issues.
        CR

        Comment


        • #5
          Re: THAILAND - Use of illegal vaccines may mask flu symptoms

          I am wondering what prompted this release of info. Is the ministry stating only the most recent human cases have been effected by a vaccine. Or, have tests been occurring regularly since November 2005- with all reports coming out with negative results. Why this information- at this time.

          Comment


          • #6
            Re: THAILAND - Use of illegal vaccines may mask flu symptoms

            I think this just confirms what most of us have suspected, there are alot of cases that are slipping under the wires. Probably getting diagnosed as the "normal flu" and sent home which would explain the sudden jump from .6% to the 5% mortality rate they are now seeing. They're playing with fire while standing in gasoline. If we don't see a major outbreak in the next year I'll be amazed.

            Edit: There has also been a big increase in Dengue, 500% increase in the northern philippines and Indonesia will soon surpass their total for all of last year.

            Just wanted to say thank you for all that you do Theresa42!
            Last edited by MHSC; August 9, 2006, 09:03 AM.
            "We are in this breathing space before it happens. We do not know how long that breathing space is going to be. But, if we are not all organizing ourselves to get ready and to take action to prepare for a pandemic, then we are squandering an opportunity for our human security"- Dr. David Nabarro

            Comment


            • #7
              Re: THAILAND - Use of illegal vaccines may mask flu symptoms

              Originally posted by Christian Rivers
              Were the two patients they refer to the same two patients we know have died in Thailand this month, or do they represent newly discovered, as yet unreported cases?
              I am very sure they are referring to the two patients that we know about.
              ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

              Comment


              • #8
                Re: THAILAND - Use of illegal vaccines may mask flu symptoms

                does this mean that the testing reported negative on the large number of cases over the last 10 days are h5n1?

                Comment


                • #9
                  Re: THAILAND - Use of illegal vaccines may mask flu symptoms

                  Originally posted by stormsailor1981
                  does this mean that the testing reported negative on the large number of cases over the last 10 days are h5n1?
                  Ah, the $20,000 question....
                  ...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes

                  Comment

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