Sep 1, 2005 (CIDRAP News) – A 58-year-old Vietnamese has died of a probable case of avian influenza, the first such fatality in a month, news services reported today.

The victim, a Hanoi resident who was not named, died Aug 24 and tested positive for an H5 virus, according to an Agence France-Presse (AFP) report quoting Nguyen Tran Hien, director of an epidemiology institute in Hanoi.

Hien said further tests are needed to ascertain if the virus was H5N1. But Peter Horby, a World Health Organization epidemiologist in Hanoi, told AFP the virus was almost certainly H5N1, because that"e;s the only H5 strain known to be circulating in Vietnam.

If confirmed, the case will mean Asia has had 121 cases with 63 deaths since late 2003, including 96 cases with 44 deaths in Vietnam, according to CIDRAP"e;s unofficial count. The WHO"e;s current official count is 112 cases with 57 deaths.

The last human death attributed to avian flu in Vietnam occurred Jul 31 in Ho Chi Minh City, according to AFP.

FAO issues warning
In other developments, the United Nations Food and Agriculture Organization (FAO) warned yesterday that wild waterfowl are likely to carry H5N1 avian flu to the Middle East, Europe, South Asia, and Africa. The warning followed detection of the virus in Siberian Russia, Kazakhstan, and Mongolia in recent weeks.

"Birds flying from Siberia, where the H5N1 virus has been recently detected, may carry the virus to the Caspian and Black Sea in the foreseeable future," the FAO said. "These regions and countries in the Balkans could become a potential gateway to central Europe for the virus."

"FAO is concerned that poor countries in southeast Europe, where wild birds from Asia mingle with others from northern Europe, may lack the capacity to detect and deal with outbreaks of bird flu," said Joseph Domenech, FAO"e;s chief veterinary officer.

Bird migration routes also cross Azerbaijan, Iran, Iraq, Georgia, Ukraine, and some Mediterranean countries, where avian flu outbreaks are possible, the agency said. Also at risk are India and Bangladesh, which have large numbers of domestic ducks and lie along a major migration route.

The FAO warning echoed concerns raised by researchers in two scientific journal reports early in July. Scientists who studied the outbreak of H5N1 avian flu at Qinghai Lake wildlife refuge in north-central China suggested that birds that visit the refuge could spread the virus to Europe, India, Siberia, Australia, and New Zealand. About 6,000 wild birds died of the disease at the refuge in late spring.

However, European veterinary experts who met in Brussels last week saw little immediate risk that the virus would spread to Europe. They said it was not clear to what extent wild birds were responsible for the recent expansion of the virus"e;s range.

Agency cites northwestward spread
The FAO statement cited the Qinghai Lake outbreak and recent outbreaks in Russia, Kazakhstan, Mongolia, and Tibet. Domenech said, "These new outbreaks show that the highly pathogenic H5N1 virus is spreading progressively northwestwards and is not restricted to South East Asia any more. In Russia and Kazakhstan, we believe contact between domestic poultry and wild waterfowl at lakes and wetlands is the primary source of infection in poultry."

The agency urged countries at risk to increase surveillance of poultry and wild birds and to prepare national emergency plans. It said close contact between humans, poultry, and wildlife should be reduced and closely monitored and that domestic birds should be separated from wildlife as much as possible.

The statement also referred to the avian flu control strategy recently developed by the FAO and the World Organization for Animal health (OIE). So far, donors have pledged about $25 million to support the plan, which is expected to cost more than $100 million, the FAO said.

Two days ago, the OIE appealed for funds to help affected countries control avian flu in poultry populations.