Thailand:Avian Influenza surveillance in human(As at October 31, 2005)

Thailand:Avian Influenza surveillance in human(As at October 31, 2005)
submited by kickingbird at Nov, 2, 2005 8:46 AM from Department of Disease Control MOPH, Thailand

I. Avian Influenza in human situation 2005

Since January 1, 2005 to October 31, 2005, the Bureau of Epidemiology has received reports of influenza or pneumonia cases in Avian Influenza Surveillance Network from the Provincial Health Offices and Disease Prevention and Control Regional Offices. The investigation and analysisi were summarized as follows:

Cumulative number of patients under surveillance are 1,434 cases; 70 provinces. Today reports are 30 cases with one pneumonitis case mortality, of which investigation revealed history of chicken rearing with no death and laboratory investigation of avian influenza virus by PCR method from the Medical Science department was negative hence this case was discared.
Confirmed human cases of avian influenza are 3 cases with one death from Kanchanaburi province. The additional case is from Bangkok Metropolitan, detail as followed:

A 50 years old female, resident of Bagkoknoi district, Bangkok metropolitan had the onset on October 26, 2005 as fever 38.4°C and cough. She received the treatment in the hospital on October 29, 2005. The findings were pneumonitis and negative rapid test of influenza A virus. The antivirus drug (Tamilflu) was prescribed. On October 31, 2005, preliminary result of secretion from nasal cavity testing revealed genetic material of avian influenza virus. The patient told that she does not have any chickens in her house and no history of poultry death nearby but during October 9-15, 2005 she had gone to visit and stay with her husband in Moo3, tambon Pimolraj, Bangbuathong district, Nonthaburi province. The house has rearing around 30 cock fighters and bantams, after which all died since October 22, 2005. The area of Moo3, tambon Pimolraj, Bangbuathong district, Nonthaburi, had been declared by the Department of Livestock Development as Avian influenza virus detected in poultry on October 23, 2005.
There is no suspect cases reported.

Conclusion:
· In 2005, there are 2 confirmed human cases of avian influenza.

· No patient from man-to-man transmission reported.

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

Since 26 December 2004, to 24 October 2005, there had been 121 H5N1 confirmed reported cases, with 62 deaths in 4 countries; Vietnam = 91, with 41 deaths; Four confirmed dead cases from Cambodia; 19 cases with 13 deaths in Thailand; and 7 from Indonesia with 4 deaths. (Table 1)

Table 1 : Details of confirmed H5N1 cases from WHO reports.

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 - 24 October 2005	7	4	4	4	2	1	64	21	77	30
Summary	7	4	4	4	19	13	91	41	121	62

III. 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 31, 2005; 6 province, 14 tambons; Kanchanaburi (4 tambons), Suphanburi (4 tambon), Nonthaburi (2 tambons), Kalasin (2 tambons), Kamphaengphet (1 tambons), and Nakhonpathom (1 tambons) were infected areas and the areas where 21 days of surveillance are not completed. The areas waiting for laboratory result = 39 provinces; 234 tambons.

*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.

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