Jan 31, 2005 (CIDRAP News) – Two Vietnamese girls died of avian influenza over the weekend, and the disease may have claimed its first human victim in Cambodia, according to news services.

A 13-year-old girl and a 10-year-old girl became the 11th and 12th people to die of H5N1 avian flu in Vietnam since late December, according to reports. Their illnesses were first reported in the news media Jan 28.

The 13-year-old girl, who lived in Dong Thap province in southern Vietnam, died early on Jan 29, according to an Agence France-Presse (AFP) report. Her 35-year-old mother had died of avian flu Jan 21.

AFP quoted state media reports as saying the girl and her mother had slaughtered an infected duck for a meal. Previous reports said the girl had fallen ill Jan 13 and been hospitalized Jan 20. The Associated Press (AP) said experts were still trying to determine if the two cases involved person-to-person transmission.

The 10-year-old girl, who lived in the southern province of Long An, died yesterday, according to a Reuters report. China"e;s official news agency, Xinhua, quoted a physician at a hospital in Ho Chi Minh City as saying the girl had had contact with dead chickens.

With the latest deaths, the apparent total of deaths caused by avian flu has increased to 44, including 32 in Vietnam and 12 in Thailand. The World Health Organization (WHO) said on Jan 28 it had received reports of the two girls"e; cases, but it has not yet listed the cases as confirmed.

The total number of human cases since late 2003 appears to be at least 57. That includes 27 cases reported in Vietnam before December 2004 and another 13 cases since then, for a total of 40. The 13 recent cases include a 42-year-old man from northern Vietnam who recovered and, according to Reuters, was released from a hospital Jan 28. Thailand has had 17 cases, including 12 fatal ones, but has not had a case since October 2004.

(The latest WHO case count, updated Jan 26, listed a total of 54 human cases, including 41 deaths.)

A 25-year-old Cambodian woman died yesterday in a southern Vietnam hospital with lung damage suspected to have been caused by avian flu, according to Reuters and AP reports.

The woman"e;s family said she became ill after dead poultry were found in her village, the AP report said. Reuters quoted a physician named Nguyen Van Hung as saying that the case was worrisome because the woman"e;s brother had died of respiratory failure before he could be brought to a hospital.

If the woman"e;s case is confirmed, she will be the first Cambodian known to have had H5N1 avian flu. Cambodia"e;s last H5N1 outbreak in poultry was in September 2004, according to records of the World Organization for Animal Health (OIE).

All serious cases of H5N1 avian flu since the disease re-emerged in late 2003 have been in Vietnam and Thailand, though evidence of a few mild or asymptomatic cases has been reported in Japan. The first known human cases of H5N1 occurred in Hong Kong in 1997, when 18 people fell ill and 6 of them died.

Avian flu was also suspected to have killed a 39-year-old man who died yesterday in the central Vietnam city of Da Nang, according to a Reuters story citing a report in a Ho Chi Minh City newspaper. Test results were awaited, the story said.

In addition, a Xinhua story said that seven people from northern Vietnam were admitted to the Topical Disease Institute in Hanoi on Jan 29 and 30 with avian flu symptoms. But the report didn"e;t identify the source of that information.

In other developments, the US Centers for Disease Control and Prevention last week cautioned travelers to Vietnam to take steps to avoid avian flu. The "travel health precaution" warns travelers to avoid areas where live poultry are kept and to make sure foods containing poultry or eggs are thoroughly cooked, among other steps. A separate notice for travelers visiting family and friends in Vietnam listed more detailed measures.