Aug 5, 2005 (CIDRAP News) – Three more cases of H5N1 avian influenza in Vietnam, two of them fatal, were officially recognized today by the World Health Organization (WHO) after confirmation came from that country"e;s Health Ministry, bringing the count to 90 cases with 40 deaths.

The two deaths were in a 24-year-old man from southern Tra Vinh province and a 26-year-old woman from Ho Chi Minh City. They both died the last week of July and had been reported on previously in the media but not officially recognized by the government. The source of infection in both is considered to be chicken they had eaten.

The third new case involves a 49-year-old woman from Ha Tay province in the north. She remains hospitalized, and her illness, too, apparently stems from eating chicken she bought locally.

Vietnam began vaccinating large numbers of chickens and ducks in northern Nam Dinh and southern Tien Giang provinces this week in the largest such program ever undertaken there. Plans are to vaccinate over 2.9 million birds by the end of this month, according to Chinese news agency Xinhua, and to cover all of Vietnam starting in October. More than 400 million doses of vaccine are expected to be used in all, at a cost of about $37 million dollars, reports an Associated Press (AP) story.

Birds are to receive three doses over a period of several months, according to the Vietnam News Service. The H5N1 vaccine is being imported from China, and an H5N2 vaccine from the Netherlands.

WHO and the UN Food and Agricultural Organization (FAO) both support Vietnam"e;s actions, although the country is being cautioned that healthy birds can carry the virus. Challenges inherent in the vaccination program are many, according to the AP, including the facts that the vaccine needs to be kept cool and that milions of the birds are running freely and have to be caught for vaccine administration each time a dose is given.

Close to 70% of the waterfowl in the Mekong delta have tested positive for H5N1, according to a story in the Vietnamese paper Labor, says an item posted on ProMED Wednesday. This number is similar to findings reported last spring (see CIDRAP News story cited below).