10 September 2004
Dear Doctors,
Human H5N1 avian influenza in Vietnam and Thailand
On 9 September 2004, the World Health Organization announced that Thailand's Ministry of Health reported one recent human death caused by influenza A (H5N1). The case was an 18-year-old male from Prachinburi Province in eastern Thailand who had been exposed to sick chickens. He was admitted to hospital on 5 September and died from acute respiratory distress on 8 September. The report at the World Organization of Animal Health (OIE) website on 3 September showed that 61 new outbreaks of avian influenza had occurred in various parts of Thailand since the previous report on 5 August 2004.
In Vietnam, a total of 4 fatal human cases of H5 infection have been reported since August 2004. Three of them have been confirmed to be caused by the H5N1 strain. These cases were reported after recurrence of H5 outbreaks in poultry in Vietnam since late June 2004.
Furthermore, two outbreaks of H5N1 avian influenza have been reported in Malaysia (Peninsular) since mid August 2004, and no human case has been reported so far.
Your assistance is sought to advise patients who plan to travel: (a) to avoid contact with live poultry/birds; (b) to wash hands thoroughly after contact with live poultry/birds, and (c) to consult a doctor if they develop symptoms of influenza during or after travelling.
Please take special notice of febrile patients with respiratory symptoms, who reported history of visiting countries with avian influenza outbreaks during the 7 days before symptom onset. History of exposure to poultry should be asked.
Influenza A(H5) has been a statutorily notifiable disease in Hong Kong since 30 January 2004. Suspected cases should be notified to the Central Notification Office of the Centre for Health Protection at Fax: 24772770 and Tel: 24772772.
We are closely monitoring the situation. We have a sensitive and comprehensive influenza surveillance system, and there has not been any influenza A(H5N1) isolate in our laboratory surveillance in 2004. Please visit our website www.chp.gov.hk for further information and situation updates.
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Yours faithfully,
(Dr Marina SUM)
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