Avian influenza update - situations in Indonesia and China

The Ministry of Health in China has confirmed the country's 21st case of human infection with the H5N1 avian influenza virus.

The case occurred in a 62-year-old male farmer from the north-western province of Xinjiang. He developed symptoms on 19 June and died on 12 July. Initial tests on patient specimens produced negative results. As a precautionary measure, tests were repeated during July and August and eventually produced positive results, which were confirmed today by the Ministry of Health.

An epidemiological investigation of the case was unable to uncover a history of exposure to dead or diseased birds. The man had no history of travel during the month prior to symptom onset. No recent poultry outbreaks have been reported in the vicinity of the man's home. Xinjiang Province had not previously reported a human case.

Of the 21 cases confirmed to date in China, 14 have been fatal.

The Ministry of Health in Indonesia has confirmed the country's 57th case of human infection with the H5N1 avian influenza virus.

The case is a 17-year-old male from a remote village in Garut district, West Java Province. He developed symptoms on 26 July and was referred to hospital on 9 August. At the hospital, medical staff suspected H5N1 infection based on his respiratory symptoms and a history of exposure to dead poultry. Because of this suspicion, specimens were collected from the patient and sent for testing. Results received on 12 August were positive for H5N1 infection. The patient is presently recovering.

A thorough field investigation found that chicken and duck deaths occurred in the patient's household and neighborhood during the week prior to symptom onset. The case reportedly had direct contact with diseased chickens during the disposal of carcasses.

The investigation also obtained information about a 20-year-old male who lived in a neighbouring household where chickens were also dying. The man developed symptoms on 26 July and sought care at the local health centre on 5 August. He died of respiratory disease on 6 August, before arrangements could be made for transfer to hospital and before samples could be taken for testing. The cause of his illness and death remain undetermined.

Of the 57 cases confirmed to date in Indonesia, 44 have been fatal.