Thailand:Avian Influenza surveillance in human As at October 13, 2005

Avian Influenza surveillance in human
As at October 13, 2005.
Bureau of Epidemiology, Department of Diseases Control, Ministry of Public Health

I. Avian Influenza in human situation 2005

Since January 1, 2005 to October 13, 2005, the Bureau of Epidemiology has received 1,086 cumulative reports, 66 provinces of influenza or pneumonia cases in Avian Influenza Surveillance Network from the Provincial Health Offices and Disease Prevention and Control Regional Offices. The results of preliminary investigation were summarized as follows:

No new confirm case.
New case = 8; 4 provinces; Five cases from Sukhothai, and one each from Pathumthani, Samutsakhon and Phichit.
Case under investigation, either additional clinical information or past history of risk factors are needed = 5; 2 provinces; Four cases from Sukhothai and 1 from Phichit. (Table 1)
Excluded cases, either the findings did not comply with the definitions or laboratory result revealed other causes : 1,081 cases.

II. Avian Influenza in human situation 2004

Confirmed cases by laboratory detection of Influenza A (H5N1).
Total = 17; recovered = 5 and deaths = 12

Probable case, because the signs complied with the definitions or died or respiratory failure or preliminary laboratory result.
revealed influenza group A infection = 1; death = 1

Suspected cases, which the signs complied with the definitions.
Total = 22; recovered = 13 and deaths = 9

III. Avian Influenza International Situation, www.who.int

World Health Organization had reported H5N1 confirmed cases since 26 December 2004, to 10 October 2005 = 117, with 60 deaths in 4 countries; Vietnam = 91, with 41 deaths; Four confirmed dead cases from Cambodia; 17 cases with 12 deaths in Thailand; and Indonesia = 5, with 3 deaths. (Table 2)

IV. Domestic Avian Influenza in poultry situation

Avian influenza in poultry situation on the Department of Livestock Development web site (www.dld.go.th); since July 1 to October 13, 2005; 4 province, 10 tambons; Kamphaengphet (4 tambons), Nakhonpathom (2 tambons), Kanchanaburi (2 tambons) and Suphanburi (1 tambon) were infected areas and the areas where 21 days of surveillance are not completed. The areas waiting for laboratory result = 15 provinces; 44 tambons.

Table 1 : Details of 5 cases under investigation.

No.	Sex	Age (yrs.)	Province	Contact poultry	Dead poultry	Contact pneumonia patient	Onset	Diagnosis	Laboratory result
1	M	13	Sukhothai	No	Yes	No	Oct 11, 2005	Pneumonia	waiting
2	F	6	Sukhothai	No	Yes	No	Oct 11, 2005	Influenza	waiting
3	M	65	Sukhothai	Yes	No	No	Oct 11, 2005	Influenza	waiting
4	M	4	Sukhothai	No	No	No	Oct 11, 2005	Influenza	waiting
5	M	41	Phichit	Yes	Yes	No	Oct 10, 2005	URI	waiting

Table 2 : Details of confirmed H5N1 cases.

Duration	Indonesia		Cambodia		Thailand		Vietnamm		TOTAL
	Case	Dead	Case	Dead	Case	Dead	Case	Dead	Case	Dead
26 December - 10 March 2004	0	0	0	0	12	8	23	16	35	24
19 July - 8 October 2004	0	0	0	0	5	4	4	4	9	8
16 December 2004 - 10 October 2005	5	3	4	4	0	0	64	21	73	28
Summary	5	3	4	4	17	12	91	41	117	60

*Patient definition:

Suspected : Individual who has body temperature 38°C and one of these symptoms; muscle pain, cough, breathing difficulty, or shortness of breath, or the physician suspicious of pneumonia or influenza plus history of direct contacting sick or dead poultry within the last 7 days or unusual dead of poultry in the village within the last 14 days,
Probable : suspected case with preliminary laboratory result of influenza A infection but strain not known either human or avian influenza yet or respiratory failure or dead,
Confirmed : suspected case with final laboratory result indicated influenza A (H5) of which is avian strain by PCR or by virus culture,
Excluded : any patient who is not compatible with the aforementioned definition or laboratory result proved to be other causes.
Being under investigation : any patient, whose additional data or information either clinical or contact history in risk area are needed before any conclusion could be made.