Apr 14, 2005 (CIDRAP News) –Vietnamese officials today announced that three more human cases of H5N1 influenza have occurred since April 2 and said the virus appears to be changing into a less virulent, faster-spreading form.

One of the patients, a 21-year-old woman from the northern province of Quang Ninh, is co-infected with HIV and H5N1, Reuters news service reported today. She was hospitalized in late March with fever and coughing, Nguyen Van Thich, head of the Center for Preventive Medicine in Quang Ninh, told Reuters. He described the woman as having no fever and being in stable condition.

The World Health Organization (WHO) said it was seeking more information on her case from Vietnam.

"There are possible public-health implications, including the potential in any person with immunodeficiency to display greater virus excretion and more chronic infection," said Peter Cordingley, spokesman for the WHO"e;s Western Pacific Regional Office in Manila, as reported by Agence France-Presse (AFP). "We need to study such patients carefully and encourage Vietnamese clinicians to do so and share their findings."

The WHO said the Vietnamese government had notified it of eight confirmed H5N1 cases, although it is not clear whether the woman from Quang Ninh was among them. Two cases mentioned in a WHO news release today involve people from the northern provinces of Hung Yen and Ha Tay who are still alive, the WHO announced, without giving any other details about the patients.

"The other six cases are thought to have been detected prior to 2 April," the WHO news release said. "WHO is seeking further details from the authorities on (these) six cases."

The numbers bring Vietnam"e;s unofficial tally to 41 cases from 18 cities and provinces since the current outbreak began in mid-December. Of those cases, 16 people have died and 6 remain under medical care, the WHO said.

Dr. Nguyen Tran Hien, director of Vietnam"e;s National Institute of Hygiene and Epidemiology, was quoted in state media today as saying that tests on the H5N1 virus show it is changing. Recent tests indicate its virulence has decreased but it is spreading more quickly, according to his remarks as reported by Reuters.

Some samples of the virus have been sent for more testing in the United States, Hien added. Final results are expected later this month.

Despite the continued human cases of H5N1 flu, the Vietnamese agriculture ministry reported that poultry outbreaks have greatly declined. The only reported outbreaks are in the southern province of Tra Vinh, in the Mekong Delta, the Reuters story noted.