Apr 22, 2003 (CIDRAP News) – The death last week of a57-year-old Dutch veterinarian who had worked among chickens infected withhighly pathogenic avian influenza (HPAI) was apparently due to the samedisease.

A report by the Dutch secretary of health, Clemence Ross-vanDorp, stated that the man died of pneumonia, and HPAI virus was detected in hislungs. Because no other explanation for his death was found, "there is astrong indication" that his death was due to the virus, the report stated.The report was published on the ProMED-mail Web site, a disease reportingservice of the International Society for Infectious Diseases.

HPAI is usually fatal for chickens but rarely causes seriousillness in humans. However, an avian influenza outbreak in Hong Kong in 1997crossed into the human population and caused six deaths.

The veterinarian, whose name was not disclosed, became sick2 days after working on a farm where HPAI was present, Ross-van Dorp stated."This is a very rare situation," he wrote. Previously, HPAI hadcaused conjunctivitis in a few Dutch workers exposed to infected chickens, butthe veterinarian had no conjunctivitis, Ross-van Dorp reported.

He said influenza experts in Rotterdam would investigatewhether the man was infected with a mutant form of the virus. A BBC News reporttoday said that investigators had determined that he had the normal form of thevirus.

The health secretary´s report said the veterinarian had notbeen taking antiviral drugs. Dutch health officials have been advising peopleat risk for HPAI exposure to take oseltamivir, which has been found effectivein preventing infection, according to the report.

The Netherlands has been struggling since the end of Februaryto control the HPAI outbreak. The BBC report said 16 million chickens have beenkilled in the effort, out of a total of about 100 million chickens in thecountry. Last week the disease crossed into Belgium, and authorities wereplanning to destroy 250,000 chickens and other birds on two farms near theDutch border, the Associated Press reported Apr 20.

The outbreak reportedly has caused Dutch agriculturalofficials to worry that avian and human influenza virus could mix in pigs andproduce a new form that would be highly virulent for humans. Ross-van Dorp"e;sreport said that antibodies against avian influenza recently were detected in pigson five farms in the outbreak area. He said the pigs were being removed from thefarms and that further testing on those farms has shown no further spread ofthe virus.