Vietnam: Avian influenza threatens to reappear?

In early August last year, two more suspected cases of H5N1 were found on people who died despite a negative test. While the weather in the last months of the year is suitable for the flu virus to grow.

Assoc. Prof. Dr. Nguyen Thi Kim Tien gave the above warnings at the workshop ' Strengthening surveillance and proactive prevention of avian influenza and influenza A / H5N1 in humans ' on August 16.

Two deaths from influenza A / H5N1

Male patient named BNQ, born in 1951, resides in area 1, ward 5, Vi Thanh town, Hau Giang province. On August 3, the patient began to experience the first symptoms: fever and chills.

The patient was hospitalized at 6g40 on August 4 at Hau Giang General Hospital with a diagnosis: Stab of intestinal infection. At admission, the patient's temperature was 36oC. Symptoms include: cough, sore throat, difficulty breathing, sweating, chest pain, vomiting, diarrhea. Status of patients: struggling, difficult to catch vessels, blood pressure cannot be measured.

However, at 1750 on the same day, Hau Giang General Hospital transferred Q. patient to Ho Chi Minh City Hospital for Tropical Diseases because the disease was not relieved.

Monitoring suspected cases of influenza A / H5N1:

- Suspected cases: 38 ° F or more; have one of the respiratory symptoms such as coughing, difficulty breathing; There are epidemiological factors such as having been exposed to patients infected with influenza A / H5N1 (+), sick poultry, or coming out of an area circulating avian influenza within 14 days.

- Ca can: Have suspicious diagnostic criteria;There is at least one evidence of evidence suggesting influenza virus pneumonia such as rapid progressive X-ray images consistent with influenza, normal or decreased white blood cell counts.

Epidemiologically, within the past 3 months, Q's patient's home does not have poultry or other feathers. In the 2 weeks before the onset of illness, patients do not go to farms with dead poultry, do not contact with transport means of sick, dead poultry, do not eat poultry products that are sick, dead, do not participate in killing. Poultry surgery of unknown origin.

In areas where patients live without sick or dead poultry, there are no people suffering from severe respiratory infections. But, on August 1, the patient ate poultry products (with veterinary organs stamped) with the type of food: duck cooked with chao (cooked).

When the patient had just been hospitalized, the doctors diagnosed a stun infection. During the transfer, the patient was diagnosed with acute viral pneumonia. Besides, X-ray of the patient Q shows that the lung must be blurred 2/3 above.

Samples from patient's throat and serum were taken on August 4 and sent to Ho Chi Minh City Pasteur Institute. H5N1 results in this patient are negative. But the patient died shortly after that on August 6.

Before that, on 12g30 on July 30, 2006, the 31-year-old NVC patient was admitted to Kien Giang General Hospital, in high fever and respiratory failure. Patients in Thanh Nguyen hamlet, Thanh Hung commune, Giong Rieng district, Kien Giang.

The family members of Mr. C's family directly took meat and ate duck meat. However, after that, the new family provided the exact information that Mr. C directly slaughtered a live duck. It is a lost duck caught in the field. In addition to Mr. C, his family consisted of a father, wife and two children who ate the duck meat. However, only Mr. C was hospitalized with high fever and respiratory failure.

Workshop to strengthen surveillance and proactive prevention of avian influenza
and influenza A / H5N1 in humans on August 16. (Photo: H.Cat)

At 8:00 on July 31, Mr. X's chest X-ray was normal but by 18:00 on the same day, his chest X-ray showed that Mr. C's right lung was damaged. Then another X-ray showed that Mr. C's right lung was damaged. The patient is isolated. Patients were given Tamiflu and supported ventilator.

From August 2 until August 6, X-ray of the lungs showed better condition. Arterial blood gas is normal unlike other deaths from H5N1. On August 4, the Pasteur Institute in Ho Chi Minh City also said that the patient's test results were negative for H5N1. But there were abnormal tests such as decreased white blood cells, decreased platelets until the day C died at 8 hours on 8/8.

"The re-emergence of avian influenza in Vietnam?" Associate Prof. Dr. Nguyen Thi Kim Tien, Director of the Pasteur Institute in Ho Chi Minh City is worried . (Photo: H.Cat)

In this conference, the doctor of Kien Giang General Hospital said that the patient had hematological disorders, coagulopathy. Severe liver and kidney damage, while lung damage progresses rapidly but does not reduce the amount of oxygen in the blood. The clinical condition of patient M is loss of perception, not respiratory failure.

Negative but .

According to Assoc. Prof. Dr. Nguyen Thi Kim Tien, Director of the Pasteur Institute in Ho Chi Minh City, expressed her doubts when asking the question, " Is bird flu re-appearing in Vietnam?".

In his report, Associate Professor Dr. Kim Tien said, influenza A / H5N1 has appeared in countries with complicated developments. While some provinces tested H5N1 positive on poultry such as Ho Chi Minh City, Ben Tre, Tien Giang, Long An and Tay Ninh. At the same time, the weather in the last months of the year is favorable for the development of H5N1 virus.

At the same time, in early August, there were two more suspected cases of H5N1 on people who died and tested negative.

From 2003 to August 14, 2006, there were 236 cases of H5N1 in the world, of which 138 died. Particularly in Vietnam, although the number of people suffering from 93, and death is 42, in 2006 there has been no announcement of people infected or dying from H5N1 flu.

Agree with the opinion of Associate Professor Dr. Kim Tien, Deputy Minister of Health Trinh Quan Huan also expressed concern until this time the seasonal flu syndrome has increased compared to last year. In particular, type B flu increased by 11.2% while in 2005, this rate was only 2.2%.

The outstanding feature of influenza virus is the change of antigens during circulation in the community.Small changes occur continuously every year, often causing small epidemics.

Therefore, influenza A / H5N1 virus can completely transform into a virus capable of easily transmitted from person to person in the near future.With this trend, the World Health Organization has warned of the possibility of a human influenza pandemic with tens of millions of people suffering and 2 - 7 million deaths.

Moreover, Vietnam is one of the countries announcing the occurrence of influenza in humans. By the end of 2005 in early 2006, 59 countries on 5 continents had A / H5N1 influenza epidemic, spreading to some countries in the European gateway such as Iraq and Turkey.

Deputy Minister of Health Trinh Quan Huan emphasized, 'In the face of the siege of H5N1 flu, if the monitoring work is not done well, it can be outbreaked a week before it is discovered. In a week, with the speed of cars or even with the speed of aircraft, the outbreak not only broke out across the country but also spread to other countries. '

Some provinces like Kien Giang have duck and dead chickens not reported. Some people even eat ducks - chickens died of unknown causes. The reason is that the commune veterinary network has only one person, so poultry are not monitored on the spot in a timely manner.

However, Ms. Nguyen Viet Nga, Director of the Veterinary Department of Tien Giang province, was annoyed that the government officials still could not manage it, how to know which house to raise, especially in the scale. small livestock.

'The sick also go to the hospital for treatment and die. If the chickens, sick ducks, and farmers want to cure them, they want to eat and eat, they will know when they eat and report .

Besides, according to Ms Nga, although the veterinary force is thin, they come to each household at least twice to propagate about bird flu.

Chicken and ducks are kept side by side at a slaughterhouse . The risk of flu outbreaks!(Photo: H.Cat)

. But one side, people's behavior is very difficult to change. On the other hand, life was too miserable while it was known when it broke out, in 2010 or 2015. Therefore, every household raised not many children, but many types and ages.

Meanwhile, Dr. Ngo Thanh Long - Head of Epidemiological Diagnosis Department of HCMC Regional Animal Health Center reported, after injecting the second vaccination for poultry, one month later, in general, chickens - Safe duck is satisfactory, but after 4 months, this safety is reduced.

'The repeated vaccination time for ducks is 4 months and for chickens it is 5 months but the protection period for the vaccine is less than 4 months,' said Dr Ngo Thanh Long.

In addition, Dr. Long is also afraid to mention some countries' experiences about the recombination of viruses. In 1999, international experts discovered H10N7 influenza virus on migratory birds. By 2000, they discovered a new virus H7N7. The two viruses will form 256 different genes, including the highly virulent H7N7 gene that experts discovered three years later.

Back to the situation in Vietnam, Dr. Long emphasized that at present, Ho Chi Minh City Animal Health Center monitors parent virus strains within a radius of 500m - 1km. The best solution today is to isolate ducks - chickens. Because only one life of exposure, like HxN1 in combination with H5Nx, can produce highly virulent H5N1 virus.

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