Mar 25, 2005 (CIDRAP News) – A teen-age girl with no known exposure to infected poultry has died of H5N1 avian influenza, and a 40-year-old woman has tested positive for the virus, Vietnamese authorities said today.

The girl, a 17-year-old from Nam Dinh province, south of Hanoi, died yesterday, the Associated Press (AP) reported today. Officials aren’t sure how she contracted avian flu, because poultry in her village have not had the disease, said Vu Huu Viet, head of the provincial medical center.

The 40-year-old woman is from Quang Ninh province near the Chinese border, the AP reported. She ate chicken on Mar 10 and began experiencing fever, coughing, and breathing difficulties 4 days later, said Nguyen Van Thich, with the province’s medical center. The woman was in stable condition in a Hanoi hospital, the story said.

The cases reported today bring the unofficial overall total to 74 cases, including 49 deaths, since late 2003.

In addition to the two latest confirmed cases, Vietnam continues to wrestle with a number of possible cases, although media accounts vary. Five family members from the northern port city of Haiphong were hospitalized Mar 23 with suspected avian flu, according to a Reuters report, which attributed the information to the state-run Hanoi Moi newspaper.

The head of Haiphong’s health department, Nguyen Van Vy, said poultry at the family’s home had been slaughtered earlier to stop an outbreak, according to the story.

In the central province of Quang Binh, media reports of about 195 sick people are prompting close scrutiny by Vietnamese officials. Provincial doctors and district healthcare center employees have examined each family in Kinh Chau village and offered guidance to improve safety, according to a story published today by Vietnam News Service (VNS).

More than 1,000 poultry have been culled in Kinh Chau village as well, VNS reported.

Officials have denied finding any new avian flu cases in Quang Binh since the death of a 5-year-old boy in mid-March, although VNS reported today that some residents of the village, including relatives and neighbors of the boy, remain under close medical observation. The story reported that residents are reluctant to be hospitalized.

The national steering committee for preventing respiratory inflammation has asked local branches across Vietnam to promote a month-long campaign to clean poultry farms. The push is to begin next Friday, VNS reported.

The disease continues to spread outside of Vietnam as well. In Indonesia, the Jakarta Post reported today that avian flu was still spreading in South Sulawesi, affecting the regencies of Sidenreng Rappang, Wajo, Soppeng, and Maros. About 128,000 chickens have been affected so far, that paper reported.

In Cambodia, officials said an 18-year-old man who is hospitalized with a fever and cough is being tested for avian flu, according to an Agence-France Presse report today. Officials said the man had killed and eaten sick chickens and is from Kampot, the same province where Cambodia"e;s first two confirmed human cases occurred.