From: Dr. Kumnuan Ungchusak <kum@health.moph.go.th>


The Bureau of Epidemiology, Department of Disease Control, received a report
of 1 pneumonia death on the morning of 8 Sep 2004 suspected to be due to
avian influenza.  The patient is an 18 year old male who lived in Prachinburi
in the eastern region (3 hours drive from Bangkok) of Thailand.   He raised
30 fighting cocks in his back yard.  The chickens started falling ill and
died one by one since mid August 2004.  He had very close contact to those
fighting cocks by carrying and helping to clear up the mucous secretion from
the throat of the cock during the fighting game by using his mouth.  He
developed symptoms of fever, cough and diarrhea  on 31 Aug 2004 and did not
go to the community hospital until 4 Sep 2004 when he was admitted.  His
chest x-ray showed rapid progress of infiltration on the left lung and
progressed to respiratory distress syndrome on 7 Sep 2004 and died on the
next morning [8 Sep 2004].

Although the rapid  test for Influenza A was negative during hospitalization,
the nasopharyngeal secretion was positive for H5N1 by 2 methods of PCR
testing at the National Institute of Health (also a WHO Collaborating
Center).  The Surveillance and Rapid Response Team (SRRT) of the Prachinburi
province and the Bureau of Epidemiology with WHO and US CDC has together
planned and started an in-depth investigation in the community. The immediate
control measure of culling the remaining backyard chickens in the village is
underway by the Department of Livestock Development.  All 20 household
families  in the affected village and health care personnel who took care of
the patient will be under close surveillance for the next 7 days.  So far, 1
teen-aged  male whose fighting cock also died was put under observation in
the hospital because he complained of feeling unwell.  His temperature and
chest x-ray so far are normal.  We are waiting for the PCR result.

The Ministry has already made a press release of this new avian flu human
case this evening. This is the 13th confirmed case of avian influenza in
humans, with 9 deaths.   The press release is aimed to raise the awareness of
the public so as not to neglect the risk and to avoid panicking.  The
Ministry will pursue its high vigilance for avian flu and share the
information to the ASEAN+3 and other countries which are facing the same
threat.

--
Kumnuan Ungchusak
Director, Bureau of Epidemiology
Department of Diseases Control.  Ministry of Public Health
Tivanonda Road, Nonthaburi 11000   Thailand
<kum@health.moph.go.th>