Jan 20, 2005 (CIDRAP News) – The death of an 18-year-old woman from a southern province was Vietnam"e;s sixth avian influenza death since late December, Vietnamese officials were quoted as saying today.

The young woman, who died in Ho Chi Minh City yesterday after 13 days in a hospital there, was from Tien Gang, Health Ministry spokesman Tran Duc Long told Agence France-Presse (AFP).

The woman had eaten an infected chicken. Her family members, including a sister who slaughtered the bird, haven"e;t fallen ill, AFP reported.

Vietnam"e;s fifth recent fatal case of avian flu was that of a 35-year-old woman from Tra Vinh province who died Jan 18 in a Ho Chi Minh City hospital, AFP reported yesterday. She had been admitted to the hospital Jan 11.

The World Health Organization (WHO) currently lists 37 confirmed H5N1 avian flu deaths since January 2004, with 51 total cases of the disease in Thailand and Vietnam. The case count was last updated Jan 19.

Meanwhile, the first suspected human case of H5N1 flu in northern Vietnam was reported yesterday, under potentially troubling circumstances. Some media reports said a middle-aged man who might not have had contact with infected poultry was found to have avian flu, the Chinese news agency Xinhua reported. Details remained hazy today.

The World Health Organization (WHO) responded immediately with a Web posting yesterday that said in part: "The patient is alive but his older brother, a 45 year-old man from Thai Binh province, fell ill in early January and subsequently died of a respiratory illness. Laboratory tests on the deceased man are reportedly negative for influenza A/H5. WHO is seeking confirmation from the Ministry of Health."

Although Vietnam appears to be the epicenter of the latest round of avian flu outbreaks, Thailand has announced two outbreaks of H5N1 in poultry.

Thai authorities were on high alert, and both districts with outbreaks were placed under a 21-day surveillance regimen, with no chicken imports or exports, according to an AFP story.

In Cambodia, with the countries to the west and east reporting poultry outbreaks, officials warned residents again not to import or eat chicken from Vietnam, Xinhua reported today. Cambodia had already banned importation of poultry from both Vietnam and Thailand on Dec 31, Xinhua noted.

Meanwhile in Geneva, the WHO issued a report on the avian flu situation in connection with the agency"e;s executive board meeting, which continues through Jan 25.

The authors of the "influenza pandemic preparedness and response" report assessed the threat in dire terms: "The present situation may resemble that leading to the 1918 pandemic."

The 1918 pandemic is believed to have killed more than 40 million people, preying especially on young adults. The recent H5N1 cases have found many victims among previously healthy children and young adults.

The report calls farmers and their families "the most important risk group," urging governments in affected countries to continue education efforts. In particular, the report describes a dangerous practice among subsistence farmers of killing and eating poultry once birds in a flock fall ill or begin to die. It calls rapid culling of sick birds essential.

The report also emphasizes the importance of a wide range of nonmedical interventions, including personal hygiene, quarantine, and travel restrictions, in slowing the spread of pandemic flu among people. Unfortunately, experience with t SARS (severe acute respiratory syndrome) may not prove the best preparation for pandemic flu, the report says.

"Many of the public health interventions that successfully contained SARS will not be effective against a disease that is far more contagious, has a short incubation period, and can be transmitted before the onset of symptoms," the report states.

The authors say it is not possible to calculate a reliable case-fatality rate for the disease, because mild cases may be occurring but going undetected. The case-fatality rate for confirmed cases so far (51 cases with 37 deaths) is 72.5%.