Faculty Bibliography

The cluster in Vietnam brings to 10 the number of human infections in Vietnam from the A(H5N1) strain of avian influenza. Eight have died, one has recovered and one is in a hospital. Health officials have linked all human cases in Vietnam, except possibly for some of those in the family group, to contact with infected poultry. Vietnam was the first country where avian influenza was detected this winter. Tests showed that the A(H5N1) strain had mutated from the one that had caused outbreaks in Hong Kong in 1997 and 2003. The disease, which is spread mainly in feces but also in saliva and respiratory secretions, is widespread in Vietnam

The cluster brings to 10 the number of human infections in Vietnam from the A(H5N1) strain of avian influenza. Eight have died. A ninth has recovered. The tenth is in a hospital. [The deputy director of the Tropical Disease Hospital in Ho Chi Minh City, Tran Tinh Hien, said Monday that an 18-year-old patient there, the 11th case in Vietnam, had died of bird flu, Agence France-Presse reported.] Vietnamese health officials have linked all human cases there, except possibly for some in the family group, to contact with infected poultry. Vietnam was the first country where bird flu was detected this winter. Tests showed that the A(H5N1) strain had mutated from the one that caused outbreaks in Hong Kong in 1997 and 2003. The disease, which is spread mainly in feces but also in saliva and respiratory secretions, is widespread in Vietnam. Scientists are also analyzing the molecular structure of the virus isolated from the cluster to determine if it differs from that found among other cases in Vietnam. If small changes were found, Dr. [Klaus Stohr] said, they would be of interest to virologists but would be unlikely to have public health significance. But if the virus has picked up genes from a human flu virus, it will be of concern to health officials everywhere

Because the virus apparently 'vanished' after causing the cluster of infections, [Klaus Stoehr] said his agency does not consider the possible person-to-person spread a major public health threat. Similar transmission limited to a short chain of people and with a definite end occurred in earlier avian influenza outbreaks in Hong Kong, he said. The cluster in Vietnam brings to 10 the number of human infections in Vietnam from the A(H5N1) strain of avian influenza, or bird flu. Eight have died, one has recovered and one is in a hospital. Health officials have linked all human cases in Vietnam, except possibly for some of those in the family group, to contact with infected poultry

The official, Dr. Klaus Stohr, said that on Friday his agency learned that initial genetic tests showed that the A(H5N1) strain was resistant to the less expensive class of anti-influenza virals. The class includes amantadine (Symmetrel) and rimantadine (Flumadiine). The number of human cases is small, and the A(H5N1) strain contains only avian genes. But WHO officials said they were concerned that the bird strain might pick up genes from a human virus to create an entirely new virus that could spread easily among people. It would take a combination of events, each of low probability, to produce a large outbreak. But the health agency said the implications for public health were so important that precautionary measures must be taken. Knowing that anti-influenza drugs may be needed in an outbreak of human bird flu and as part of the surveillance process, laboratories in the network have been testing the A(H5N1) strain's susceptibility to the small number of such drugs. The tests are being done at the Centers for Disease Control in Atlanta, and in London and in Hong Kong

If the man has SARS now and had it before, his would be the first known case of reactivated SARS, adding a new problem for doctors and health officials in diagnosing and controlling SARS. Reactivated or recurrent SARS ''is among the theories we are considering'' in the case of the man, who is recuperating well in a hospital in Guangdong, said Dr. Julie L. Hall, the SARS team leader in Beijing for the World Health Organization. The man's illness last winter, when SARS was spreading, and the results of current tests have raised the theory of reactivated SARS. At China's invitation, the World Health Organization has sent three experts to Guangdong to find more details about his case and to search for other cases. One aim is to determine what medical care the man sought last winter and whether blood or other specimens taken then remain for tests that may yield clues now

Reactivated or recurrent SARS is among the theories we are considering in the case of the man, who is recuperating well in a Guangdong hospital, said Dr. Julie Hall, the SARS team leader in Beijing for the WHO. The man's illness last winter, when SARS was spreading, and the results of current tests have raised the theory of reactivated SARS. His isolated case would make even more imperative the need to determine where the SARS virus hides in nature, said Dr. Klaus Stoehr, who helped lead the WHO investigation of SARS last year. Scientists suspect that certain animals harbor the virus, but are not certain which ones

Officials in Guangdong Province in southeastern China ordered this morning the immediate killing of every civet cat in captivity in the province after researchers found that a Guangdong man had fallen ill with a new strain of SARS virus that is genetically similar to a strain found in civet cats. Dr. [Zhong] joined Hong Kong University microbiologists at a news conference here this morning to announce that they had jointly completed a detailed study of SARS-like viruses in civet cats together with a genetic analysis of viral samples taken from a 32-year-old man in Guangzhou who is suspected of having SARS. Initial research last spring had shown that the SARS virus that infected more than 8,000 people around the world was genetically very similar to a virus in civet cats. New research this winter shows that the virus in civet cats has mutated to form a new ''sublineage'' of the virus, said Dr. K.Y. Yuen, the head of the microbiology department at Hong Kong University.Dr. Yuen said that a genetic sequencing of samples from the man in Guangzhou who has SARS had found that the main ''spike'' protein was exactly identical, down to the last amino acid, to the new sublineage of the virus found in civet cats. Dr. Guan Yi, another Hong Kong University microbiologist, said that it was too soon to say whether the new sublineage was any more or less infectious or lethal in people than the SARS virus that spread last spring

''The precautionary killing of civets is the right decision, but it must not divert attention from the fact that our knowledge about SARS is incomplete'' and the source of SARS in nature is unknown, Dr. [Klaus Stohr] said in a telephone interview on Monday. He was a leader in the W.H.O. efforts to stop transmission of severe acute respiratory syndrome last summer and later spent three weeks in China to review studies by scientists there . SARS is believed to have first jumped from an animal species to humans in Guangdong Province in November 2002. Dr. Stohr and some other scientists have criticized China for not having conducted the comprehensive studies that are needed to determine the source of the SARS virus in nature and how the virus is transmitted from animals to other species, as well as to humans. In experiments, scientists at Hong Kong University are injecting the civet SARS virus into monkeys to help determine its virulence for other species, said Dr. David Ho, who directs the Aaron Diamond AIDS Research Center in Manhattan. He also directed a joint AIDS-SARS laboratory at Hong Kong University

The Thai government has vehemently denied for the last week that there was any avian influenza in Thailand, insisting that it was bird cholera. But Jakrapob Penkair, the government's chief spokesman, said in a telephone interview on Friday night that the government had known for a few weeks that chickens were dying of avian influenza. ''It was kept from the public, but full-scale operations have been under way'' to control the problem, he said. The Thai operations, conducted jointly with the country's biggest agricultural businesses, involved killing chickens at farms where there were infections or halting the sale of these chickens, while quietly testing for bird flu all Thai chicken going to the country's main export markets, Mr. Penkair said. Japan buys half of Thailand's chicken exports and the European Union buys another third. Cambodia confirmed Friday that bird flu had been killing chickens there. Laos said earlier this week that it was investigating chicken deaths but believed them to be bird cholera. Agence France-Presse reported from the Indonesian island of Bali on Friday that a provincial official had acknowledged the death of thousands of chickens, but blamed it on the Newcastle virus

Thailand reported that two boys from different provinces had become infected with the bird flu and that six more people were suspected of having it. Vietnam already has reported five confirmed fatal cases in people near Hanoi, and the country is testing seven additional suspected cases. Chickens from South Korea, Japan, Vietnam and Thailand have been dying from the same disease. The Thai government has vehemently denied for the last week that there was any avian influenza in Thailand, insisting that it was bird cholera. But Jakrapob Penkair, the government's chief spokesman, said in a telephone interview on Friday night that the government had known for a few weeks that chickens were dying of avian influenza. The Thai operations, conducted jointly with the country's biggest agricultural businesses, involved killing chickens at farms where there were infections or halting the sale of these chickens, while quietly testing Thai chickens going to the country's main export markets, Penkair said. Japan buys half of Thailand's chicken exports and the European Union buys a third