Nov 16, 2005 (CIDRAP News) – China today reported two confirmed human cases of H5N1 avian influenza, marking the first time the government has confirmed cases on the mainland.

The disease was confirmed in a 9-year-old boy from Hunan province, who has recovered, and in a 24-year-old woman from Anhui province, who died Nov 10, according to the Chinese news agency Xinhua.

In addition, avian flu is suspected in the Oct 17 death of the boy"e;s 12-year-old sister, but the case can"e;t be confirmed because of a lack of good samples for testing, according to Xinhua and Agence France-Presse (AFP).

China joins Vietnam, Thailand, Cambodia, and Indonesia on the list of countries with confirmed human cases. The World Health Organization (WHO) currently lists 126 cases with 64 deaths since December 2003 (the Chinese cases were not yet included at this writing). Vietnam accounts for 92 cases and 42 deaths.

The confirmation of China"e;s first human cases follows a series of 11 poultry outbreaks in several provinces over the past month. Yesterday the government announced its intention to vaccinate all poultry, estimated at 5.2 billion birds, against avian flu. China reported its first poultry outbreaks of H5N1 flu in February 2004.

The 9-year-old boy, surnamed He, from Xiangtan County, fell ill with fever and pneumonia-like symptoms on Oct 10, Xinhua reported. A poultry outbreak had occurred in his village.

The boy had high levels of H5 antibodies, and experts from China"e;s health ministry and the WHO concluded that he had the H5N1 virus, according to Xinhua. He was released from a hospital Nov 12.

The woman from Anhui in eastern China fell ill Nov 1 and died of "prostration of breathing" Nov 10, the report said. She was a farmer who had chickens and ducks that died 1 to 2 weeks before she got sick.

The 9-year-old boy"e;s 12-year-old sister had symptoms like her brother"e;s, Xinhua said. "The experts from the [health] ministry suspected the girl of being a human case of H5N1 bird flu, but cannot confirm it by WHO standards due to insufficient evidence from laboratory tests," the story stated.

According to AFP, WHO spokesman Dick Thompson said his agency recognizes the boy"e;s and young woman"e;s cases as confirmed. But the samples available from the 12-year-old girl "weren"e;t of a quality that could be used to determine whether or not she did indeed have bird flu," he said.

The cases announced today are the first to be officially confirmed in mainland China. The first known human cases of H5N1 infection occurred in Hong Kong in 1997, when 18 people fell ill and six died. In February 2003, two Hong Kong residents, a 33-year-old man and his 9-year-old son, became infected with the virus while visiting Fujian province in China. They were diagnosed after returning to Hong Kong. The father died but his son recovered.