Thailand: Avian Influenza surveillance in human, as at September 8, 2006

Thailand: Avian Influenza surveillance in human, as at September 8, 2006
submited by kickingbird at Sep, 10, 2006 9:53 AM from MOPH,Thailand

I. Avian Influenza in human situation 2006

Since January 1, 2006 to September 8, 2006, the Bureau of Epidemiology has received reports of influenza or pneumonia cases in Avian Influenza Surveillance Network from the Provincial Health Offices and Disease Prevention and Control Regional Offices. The investigation and analysis were summarized as follows:

Cumulative number of patients under surveillance are 4,721 cases 71 provinces. Today reports are 18 cases; Six cases from Sukhothai, 2 each from Nonthaburi, Kanchanaburi and Kampaengphet, and 1 each from Bangkok metropolis, Lopburi, Nakhonnayok, Chiangmai, Phetchabun and Sakonnakhon.
Confirmed human case of avian influenza 2006 = 2 cases, with 2 death cases.
· The first death case, reported from Phichit province, Tabklo district is 17 years old male. He had onset on July 15, 2006 and died on July 24, 2006.
· The second death case, reported from Uthai Thani province, Sawang Arom district is 27 years old male. He had onset on July 24, 2006 and died on August 3, 2006.
There are 37 cases under investigate reported, of which waiting for laboratory result.

Conclusion:

· In 2005, there are 5 confirmed human cases of avian influenza, with 2 death cases.

· In 2006, there are 2 confirmed human dead cases of avian influenza.

II. Avian Influenza International Situation, www.who.int

Avian Influenza update in Indonesia : 8 September 2006

http://www.who.int/csr/don/2006_09_08a/en/index.html

The Ministry of Health in Indonesia has confirmed a new case of human infection with the H5N1 avian influenza virus. Inclusion of these two cases now aligns figures given for Indonesia in the WHO cumulative table of laboratory-confirmed cases with those officially issued by the Ministry of Health. Prior to the revision, the cases did not meet the WHO case definition for serologically confirmed avian influenza H5N1 infection. The first retrospectively confirmed case was an 8-year-old female from Tangerang in Banten Province. She developed symptoms on 24 June 2005 and died on 14 July 2005. She was part of a family cluster reported to WHO in July 2005. The second retrospectively confirmed case is a 45-year-old male from Magelang, Central Java Province. He developed symptoms on 25 November 2005 following direct contact with diseased poultry and subsequently recovered.

WHO report in brief : Since 2004, to 8 September 2006, there had been 244 H5N1 confirmed reported cases, with 143 deaths in 10 countries; Vietnam 93 cases with 42 deaths; 24 cases with 16 deaths in Thailand; 63 cases with 48 deaths in Indonesia; Six confirmed dead cases in Cambodia; 21 cases with 14 deaths in China; 14 cases with 6 deaths in Turkey; Two confirmed dead cases in Iraq; 8 cases with 5 deaths in Azerbaijan; 14 cases with 6 deaths in Egypt; and one confirmed case in Djibouti. (Table 1)

Table 1 : Details of confirmed H5N1 cases from WHO reports.

Year/	2003		2004		2005		2006		TOTAL
Country	Cases	Deaths	Cases	Deaths	Cases	Deaths	Cases	Deaths	Cases	Deaths
Azerbaijan	0	0	0	0	0	0	8	5	8	5
Cambodia	0	0	0	0	4	4	2	2	6	6
China	1	1	0	0	8	5	12	8	21	14
Djibouti	0	0	0	0	0	0	1	0	1	0
Egypt	0	0	0	0	0	0	14	6	14	6
Indonesia	0	0	0	0	19	12	44	36	63	48
Iraq	0	0	0	0	0	0	2	2	2	2
Thailand	0	0	17	12	5	2	2	2	24	16
Turkey	0	0	0	0	0	0	12	4	12	4
Viet Nam	3	3	29	20	61	19	0	0	93	42
TOTAL	4	4	46	32	97	42	97	65	244	143

III. Domestic Avian Influenza in poultry situation

The poultry situation reported from Avian Influenza control center, Department of Livestock Development since January 1, till September 8, 2006, revealed 262 tambons in 43 provinces, are the areas where sick and dead poultry had been reported and waiting laboratory confirmation. Detail could be found from www.dld.go.th website.

IV. International Avian Influenza in Animals (Type H5)

Avian influenza in animals on the Office International des Epizooties (OIE), World Organisation for Animal Health web site (http://www.oie.int/eng/en_index.htm or www.dld.go.th); since January 1 to June 25, 2006; confirmed infected poultry of avian influenza in 53 countries.

*Case definitions for Avian Influenza in Humans in Thailand (15 May 2006)

1. Suspect: An individual

· whose body temperature is more than 38°C and who has at least one of the following symptoms: muscle pain, cough, breathing difficulty, or shortness of breath, or physician suspects pneumonia or influenza, and

· who has a history of direct contact with sick or dead poultry in the last 7 days or there were reports of unusual poultry deaths in the village in the last 14 days or had been looking after another pneumonia patient in the last 10 days before illness onset, but

· who does not have a specimen which complies with the recommendation for laboratory testing for Influenza A/H5.

2. Probable case: a suspect

· who developed signs and symptoms of, or died from, acute respiratory failure.

3. Confirmed case: a suspect

· who has a final standard laboratory confirmation of Influenza A/H5 through at least one of the following methods:

A. Single RT-PCR method using two primer/probe sets, or using specimens collected from at least two different locations (such as throat swab and nasopharyngeal aspirate, etc.), or using at least two specimens collected from a patient at different period of illness),

B. Viral culture

C. Neutralization test (four-fold antibody increase between acute and convalescent serum)

4. Case under investigate: a patient

· whose additional clinical information, and/or history of exposure to risk factors, and/or laboratory results are needed before any conclusion can be made.

5. Excluded case: a patient

· who does not fall under any of the above definitions and is therefore excluded.

See Also:

http://thaigcd.ddc.moph.go.th/AI_case_report_060908.html

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