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Tracking the next pandemic: Avian Flu Talk

WSJ’s summary of all WHO H5N1 cases
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    Posted: June 21 2006 at 11:41pm
A long chart, but interesting.  At least they're keeping records now.
 
AVIAN INFLUENZA

A Closer Look at Bird Flu's Victims

THE WALL STREET JOURNAL ONLINE
June 21, 2006

Researchers will never know precisely how all the 130 people who have died of H5N1 avian influenza acquired the disease. But the details of their investigations offer glimpses into the lives of the victims -- who have been largely young, in close contact with poultry, and mostly from Southeast Asia. While the fatality count has slowly ticked higher, the victims' stories -- or what little we know of them -- have sometimes been overshadowed by broader concerns about food safety, bird migratory patterns and feared mutations that could make the virus easily transmissible between people, potentially sparking a global pandemic.

Here is a look at the victims, based on updates on avian flu from the WHO. Click on the highlighted column headers to re-sort by country or age.

Date of Death Country Province/Region Age Sex Case Description
06/14/06 Indonesia South Jakarta 13 M He developed symptoms one week after helping his grandfather slaughter diseased chickens at the family home. His grandfather remains healthy.
06/01/06 Indonesia Tangerang 7 F The girl developed symptoms on May 26, was hospitalized on May 30, and died on June 1. Her 10-year-old brother died of respiratory disease on May 29, but no specimens were taken for testing and the cause of his death cannot be determined. An investigation found a history of chicken deaths in the household and neighborhood prior to symptom onset. Laboratory testing of surviving family members and close contacts has been conducted and no further cases were found.
05/30/06 Indonesia Tasikmalaya District,
West Java Province		 15 M An investigation conducted by provincial health authorities found a history of contact with sick and dying chickens in the boy's household in the week before the onset of his symptoms. Monitoring of family members and close contacts has detected no cases of influenza-like illness.
05/23/06 Indonesia Bandung, West Java 10 F This girl's brother also died. Both children had a history of close contact with sick and dying chickens at their home in the week before symptom onset.
05/23/06 Indonesia Bandung, West Java 18 M This boy's sister also died. Identical onset dates for the siblings strongly suggest they acquired their infection following a shared exposure to poultry, and not from each other.
05/22/06 Indonesia Kubu Sembelang village,
Karo District, of North Sumatra		 32 M This man was also part of the family cluster in the Kubu Sembelang village. He was the brother of the 37-year-old initial case and the father of the 10 year old. He provided close care for his son throughout the boy's hospital stay. (2 -- see footnote at bottom)
05/18/06 Egypt Al Minya 75 F  
05/14/06 Indonesia Kubu Sembelang,
North Sumatra		 1 F This is the niece of the initial victim in the Kubu family cluster. (2)
05/13/06 Indonesia Kubu Sembelang,
North Sumatra		 10 M This is the nephew of the initial victim in the Kubu family cluster. (2)
05/13/06 Indonesia Bekasi in East Jakarta 12 M  
05/12/06 Indonesia Surabaya, in East Java 38 F  
05/12/06 Indonesia Kubu Sembelang,
North Sumatra		 17 M This victim, also from the Kubu family cluster, was the son of the 37-year-old initial case. (2)
05/10/06 Indonesia Kubu Sembelang,
North Sumatra		 28 F This young woman was the sister of the initial victim in the Kubu family cluster. (2)
05/09/06 Indonesia Kubu Sembelang,
North Sumatra		 15 M This young man was the first reported of six confirmed cases in Kubu Sembelang village, Karo District, of North Sumatra. The Kubu Sembelang outbreak is associated with a seventh family member, a 37-year-old woman. (2)
05/04/06 Egypt Cairo 27 F  
04/26/06 Indonesia Jakarta 30 M He lived in close proximity to pens where animals, including poultry, were kept.
04/19/06 China Hubei Province 21 M  
04/14/06 Egypt Minufiyah governorate,
north of Cairo		 18 F  
04/08/06 Indonesia Tangerang,
near Greater Jakarta		 24 M  
04/06/06 Egypt Minufiyah governorate,
north of Cairo		 18 F  
04/05/06 Cambodia Prey Veng 12 M Numerous chicken deaths and some duck deaths were noted to have occurred in the neighborhood in recent weeks. The child reportedly gathered dead chickens for distribution to village families for consumption.
03/27/06 Egypt Qaliubiya 30 F She developed symptoms on March 12 following the home slaughter of chickens.
03/23/06 Indonesia Kapuk, West Jakarta 1 F A field investigation found a history of deaths in a chicken flock near her home about one week prior to symptom onset.
03/21/06 Cambodia Kampong Speu 3 F The child is known to have played with chickens, including those that showed signs of illness.
03/21/06 China Shanghai 29 F This migrant worker was hospitalized with pneumonia on March 15. The woman's close contacts were placed under medical observation.
03/17/06 Egypt Qaliubiya 30 F This woman was Egypt's first bird flu death.
03/12/06 Thailand Ayudhaya Province 39 F She developed symptoms March 1 and went to the hospital on March 3. She died on March 12 as Thailand's eighth fatal case.
03/10/06 Azerbaijan Salyan Rayon 16 M  
03/09/06 Azerbaijan Tarter Rayon 21 F  
03/08/06 Azerbaijan Salyan Rayon 17 F This woman is a close friend of the family, of Azerbaijan's first victim.
03/06/06 China Zhejiang Province 9 F Symptom onset followed a visit to relatives in the adjacent province of Anhui. No animal outbreaks had been reported in Zhejiang Province since 2004.
03/03/06 Azerbaijan Salyan Rayon 20 F  
03/02/06 China Guangdong Province 32 M This man was unemployed.
03/01/06 Indonesia Central Java 12 F Chickens in her household died before she got sick. The girl's 10-year-old brother also fell ill and died on Feb. 28. No testing for H5N1 was carried out. It will therefore never be known whether he may have died following co-infection H5N1 avian influenza.
02/28/06 Indonesia Central Java 4 M Chickens had died in the boy's neighborhood before his illness.
02/23/06 Azerbaijan Salyan Rayon 17 F  
02/20/06 Indonesia West Java 27 F Investigations found evidence of poultry deaths in her neighborhood four days prior to the onset of her symptoms.
02/10/06 Indonesia West Java 22 F  
02/10/06 Indonesia West Java 27 F  
02/10/06 Indonesia East Jakarta 23 M He was employed as an egg seller in a market.
02/04/06 China Hunan Province 20 F This farmer, 20 years old, experienced symptoms after the culling of poultry raised by her household. She developed symptoms on Jan. 27 and died on Feb. 4.
02/01/06 Indonesia West Java 15 M Chickens deaths were reported near his home prior to the onset of his symptoms.
01/27/06 Iraq Sulaimaniyah 39 M He was the uncle of a girl who also died of H5N1. He provided care for her during her illness.
01/26/06 Indonesia West Java 22 M He was a banana vendor at a market in East Jakarta, where poultry meat was sold. Also neighbors near his home reported poultry deaths prior to the onset of his symptoms.
01/23/06 China Sichuan, Chengdu City 29 F  
01/17/06 Indonesia NA 4 M This victim's sister died of H5N1 infection as well. Another sister and his father also came down with symptoms. Chickens kept by the family began to die days before the first patient developed symptoms. All of the family members had close contact with the diseased chickens and assisted in the removal of the dead birds.
01/17/06 Iraq Raniya, near Sulaimaniyah 15 F This girl's 39-year-old uncle, who cared for her during her disease, also died later of severe respiratory disease on January 27.
01/15/06 Turkey Agri Province 14 F Ducks began dying in her family's household flock on Jan. 1. On that day the girl and her brother, who later fell ill, slaughtered a duck for food. Both children developed symptoms within a few days.
01/14/06 Indonesia NA 13 F  
01/11/06 Indonesia Jakarta 29 F This woman worked as a midwife in a Jakarta hospital. Investigations conducted by the Ministry of Health found evidence of poultry deaths in her neighborhood two weeks prior to her illness. Other findings indicated that the patient had visited a live-bird market to select and buy freshly slaughtered chicken in the days immediately prior to the onset of her symptoms.
01/11/06 China Sichuan 35 F This woman was employed as a poultry culler.
01/07/06 Turkey Agri Province 12 F Two of this girl's siblings died of bird flu.
01/05/06 Turkey Agri Province 15 F This 15-year-old girl and her brother marked the first confirmed cases of Avian Flu outside of east Asia.
01/01/06 Turkey Agri Province 14 M This 14-year-old and his sister marked the first confirmed cases of Avian Flu outside of east Asia.
12/21/05 China Fujian 41 F  
12/16/05 China Jiangxi 35 M  
12/15/05 Indonesia Central Jakarta 8 M  
12/12/05 Indonesia East Jakarta 39 M  
12/07/05 China Guangxi 10 F  
12/07/05 Thailand Nakhonnayok 5 M Results of an early investigation indicated the boy may have acquired the infection from dead poultry in his neighborhood.
11/25/05 Indonesia Tangerang 25 F A field investigation found a history of exposure to sick poultry around her house.
11/22/05 China Anhui 35 F This woman worked as a poultry farmer.
11/19/05 Indonesia West Jakarta 35 M  
11/12/05 Indonesia Jakarta 20 F  
11/10/05 China Anhui 24 F This woman worked as a poultry farmer.
11/08/05 Indonesia Jakarta 16 F  
10/29/05 Vietnam Hanoi 35 M  
10/28/05 Indonesia Tangerang 19 F  
10/19/05 Thailand Kanchanaburi Province 48 M Authorities linked this man's death to close proximity to diseased poultry during slaughter.
09/30/05 Indonesia Bogor, West Java 23 M An investigation uncovered exposure to infected poultry.
09/26/05 Indonesia Jakarta 27 F An initial investigation revealed that this woman had direct contact with diseased and dying chickens in her household shortly before she became ill.
09/10/05 Indonesia Jakarta 37 F This woman developed symptoms Aug. 31. She resided in an area with multiple opportunities for exposure to chickens and ducks but no poultry deaths had been reported in the area.
07/31/05 Vietnam Ben Tre 35 M This man was a farmer.
07/25/05 Vietnam Tra Vinh Province 26 F  
07/25/05 Vietnam Ho Chi Minh City 24 M  
07/12/05 Indonesia Tangerang 38 M This man was the country's first confirmed case of H5N1 avian flu, his two daughters, 1 and 8 years old, died in July as well, of severe pneumonia illness compatible with H5N1 infection.
05/19/05 Vietnam Hung Yen 46 M  
05/19/05 Indonesia West Jakarta 39 M The investigation determined that the man cleaned pigeon feces from blocked roof gutters at his home shortly before symptom onset. No further potential source of exposure was identified.
04/24/05 Vietnam Quang Binh 36 F  
04/19/05 Cambodia Kampot Province 20 F  
04/07/05 Cambodia Kampot Province 8 F The country third confirmed case.
03/27/05 Vietnam Hanoi 10 F  
03/22/05 Cambodia Kampot Province 28 M The country's second confirmed case of avian influenza.
03/12/05 Vietnam Ha Tay Province 33 M  
02/23/05 Vietnam Thai Binh Province 69 M  
01/30/05 Cambodia Kampot Province 25 F This Cambodian woman went to Vietnam for care after developing respiratory symptoms on Jan. 21, 2005. At the Pasteur Institute in Ho Chi Minh City she was confirmed as Cambodia's first case of H5 infection. This woman's 14-year-old brother died after experiencing respiratory problems and was thought to have been a victim of Avian influenza. But no diagnostic samples were obtained before his cremation.
01/30/05 Vietnam Long An 10 F  
01/28/05 Vietnam Dong Thap 13 F This child from Dong Thap Province developed the symptoms as her mother was dying from H5 infection.
01/27/05 Vietnam Phu Tho 30 M  
01/21/05 Vietnam Dong Thap 35 F  
01/19/05 Vietnam Tien Giang Province 18 F  
01/14/05 Vietnam Bac Lieu 17 M  
01/10/05 Vietnam Hau Giang Province 18 F  
01/09/05 Vietnam Thai Binh Province 46 M  
01/08/05 Vietnam Tay Ninh 16 F  
01/04/05 Vietnam Tra Vinh Province 9 M  
12/30/04 Vietnam Dong Thap 6 M  
10/19/04 Thailand Sukhothai Province 14 F Chickens at her household died suddenly in late September.
10/03/04 Thailand Phetchabun Province 9 F An investigation of the case identified exposure to diseased chickens as the most likely cause of infection. Following the death of chicken's in the child's household, she assisted in preparation of the birds for cooking, including the plucking of feathers.
09/20/04 Thailand NA 26 F This Bangkok resident's death was investigated as part of a family cluster of infection. (1)
09/08/04 Thailand Prachinburi Province,
in easter Thailand		 18 M He had been exposed to sick chickens. He was admitted to the hospital on Sept. 5 and died from acute respiratory distress on Sept. 8.
08/06/04 Vietnam Hau Giang Province 25 F  
08/04/04 Vietnam Ha Tay Province 11 mos. F  
08/02/04 Vietnam Ha Tay Province 4 M  
03/15/04 Vietnam Souther Part of Country 12 M This boy was hospitalized on March 13 and died two days later.
02/17/04 Vietnam NA 4 M  
02/13/04 Thailand Chaiyaphum Province 13 M A preliminary investigation linked this case to contact with diseased chickens near his home.
02/03/04 Thailand Suphanburi Province 6 M  
02/03/04 Thailand Khon Kaen Province,
a northeastern province		 4 M He was Thailand's seventh fatal case. His family raised chickens and many had died before the onset of his symptons.
02/03/04 Vietnam Souther Part of Country 16 F  
02/03/04 Vietnam NA 6 M  
02/03/04 Vietnam NA 24 M  
02/02/04 Vietnam Central Highlands 18 M This was the first confirmed case from Vietnam's Central Highlands.
01/27/04 Thailand Sukhothai Province 6 NA This boy was Thailand's second confirmed H5N1 death.
01/27/04 Thailand NA 58 F This woman fell ill on Jan. 19 and died Jan. 27.
01/27/04 Vietnam Souther Part of Country 17 F  
01/25/04 Thailand Kanchanaburi Province 6 M He developed a fever Jan. 6, followed a week later with severe pneumonia with acute respiratory distress syndrome. The boy died Jan. 25 in Bankok hospital.
01/24/04 Thailand Kanchanaburi Province 6 M Thailand's fifth confirmed bird flu victim developed the illness on Jan.24 and died on Feb. 2.
01/23/04 Vietnam Thai Binh Province 23 F This woman along with her sister fell ill on Jan. 10 was admitted to the hospital on Jan. 13 and died on Jan. 23. She and her sister were part of a cluster of four cases of severe respiratory illness in a family from Thai Binh province.
01/23/04 Vietnam Thai Binh Province 30 F This woman along with her sister was part of a cluster of four cases of severe respiratory illness in a family from Thai Binh province. A brother 31 years old was also hospitalized and died but no tests were made. An investigation revealed that the family members gathered in late December for a brother's wedding. The man and one sister were reported to have handled ducks while preparing a meal on Jan. 4.
01/22/04 Vietnam NA 13 M  
01/17/04 Vietnam Hanoi 8 F  
01/17/04 Vietnam Tra Vinh Province 35 F This woman had slaughtered a sick duck, according to the WHO.
NA Vietnam NA NA NA  
NA Vietnam NA NA NA  
NA Vietnam NA NA NA  
NA Vietnam NA NA NA  
NA Vietnam NA 19 M  
NA Vietnam Lam Dong Province 3 M  
NA Vietnam NA NA NA  
NA Vietnam Nam Dinh 17 F  
           

Footnotes:
(1) The initial case in cluster was this victim's 11-year-old daughter, who lived with her aunt in the northern province of Kamphaeng Phet. She died of pneumonia on Sept. 8. This was listed as probable H5N1 infection, though testing was impossible as no specimens were available. Both the girl and her aunt, who was later confirmed with H5N1, had contact with chickens. Though the girl's mother lived in Bangkok, she provided bedside care for her daughter while she was hospitalized and up until the child's death. The 26-year-old mother fell ill upon her return to Bangkok, where she died Sept. 20.
  
(2) The was the first confirmed case of a family cluster in the village of Kubu Simbelang, Karo District, North Sumatra. All cases were members of an extended family -- sisters and brothers and their children -- who resided in four households, three of which were next-door neighbours in Kubu Simbelang. The fourth household was about 10 kilometers away in the village of Kabanjahe.
  

The initial case in this family cluster developed symptoms on April 24 and died of respiratory disease on 4 May. Though no specimens were obtained before her burial, and the cause of her death could not be confirmed, she is considered the initial case in this family cluster. This 37-year-old woman sold fruits and chilies at a market in the village of Tigapanah. And her stand was located about 15 meters away from a stand where live chickens were sold. An investigation uncovered no reports of poultry die-offs in the market. But the woman also kept a small number of backyard chickens, which she allowed into the house at night. Three of her chickens reportedly died before she became ill. She is also known to have used chicken feces from household chickens to fertilize her garden.

  

On the night of 29 April, at a time when the initial victim was severely ill and coughing heavily, nine of her family members spent the night in a small room with her. These family members included her three sons; her brother from Kabanjahe village, his wife, and their two children; the 21-year-old daughter of another brother (who did not become infected); and another young male visitor.

  

The confirmed cases include five males and two females. Six out of the seven cases were fatal. Fatalities in this cluster include two of the initial victim’s sons, ages 15 and 17, her sister, 28, a niece less than two years old, her 10-year-old nephew, and the boy’s father, 32. The last case in the cluster provided close care for his son throughout his hospital stay, from May 9–13. The son was a frequent visitor in the home of the initial case and was present there on April 29.

  
Sources: World Health Organization, WSJ.com Research


Write to the Online Journal's editors at newseditors@wsj.com


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: June 22 2006 at 8:13am

Interesting observation of these cases from this year alone…

Cluster #1

1-1-6 (14 M)

1-5-6 (15 F)

1-7-6 (12 F)

All 3 are siblings. No mention of contact with birds.

Turkey Agri Province.

Cluster #2

1-15-6 (14 F)

Brother had also become ill.

Claimed ducks began dying in their flock Jan. 1st

Turkey Agri Province.

Cluster #3

1-17-6 (15 F )

1-27-6 (39 M) Uncle of girl above. Cared for her as she was dying. No mention of contact with birds.

Iraq Raniya, near Sulaimaniyah

Cluster #4

1-17-6 (4 M)

Victims sister also died of HN51, another sister and father came down with symptoms.

Chickens kept by family died days before.

Indonesia NA

Cluster #5

3-1-6 (12 F)

Her 10 yr. Old brother fell ill and died Feb. 28th, but not tested.

Chickens in household died before she got sick.

Indonesia Central Java

Cluster # 6

2-23-6 (17 F)

3-8-6 (17 F) She was close family friend of girl above. No mention of contact with birds.

Note: There were also a (20 F) that died on 3-3-6, (21 F) died on 3-9-6, and (16 M) died on 3-10-6, all of same area, but not mentioned to be related.

Azerbaijan Salyan Rayon

Cluster #7

37 year old woman died but not tested.

5-9-6 (15 M) ?

5-10-6 (28 F) sister of initial victim

5-12-6 (17 M) son of 37 yr. woman

5-13-6 (10 M) nephew of initial victim

5-14-6 (1 F) niece of initial victim

5-22-6 (32 M) Brother of 37 yr. Old and father of 10 yr. Old

Indonesia Kubu Sembelang, North Sumatra

Cluster # 8

5-23-6 (18 M)

5-23-6 (10 F)

Identical onset dates suggest they caught the infection from same source (poultry).

Cluster # 9

6-1-6 (7 F)

Her 10 yr. Old brother also died, 5-29-6, but no tests were done.

History of chicken deaths in household and neighborhood.

Indonesia Tangerang

 My definition of clusters may differ from others, but I found my observation of these interesting enough to post here...

 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: June 22 2006 at 8:24am
It does not look good.Dead
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: June 26 2006 at 6:38am
Update to my clusters listed above (seems the cluster is true and there were more than previously listed, and they were related which was NOT mentioned before. Just really makes you wonder how much is not told!):
Cluster # 6

2-23-6 (17 F)

3-3-6 (20 F) first cousin of first 17 yr. Old.

3-8-6 (17 F) She was close family friend of cluster.

3-10-6 (16 M) brother of 20 yr. Old.

Note: 21 F died on 3-9-6, was from western rayon of Tarter. Additional two cases in Salyan involve a 10-year-old boy, who has recovered, and a 15-year-old girl, who is (was?) hospitalized in critical condition.

Two additional patients, from Salyan and the adjacent rayon of Neftchela, have been hospitalized with symptoms of bilateral pneumonia. Testing of these patients is (was?) presently under way.

Azerbaijan Salyan Rayon

See here for a lot more info. on this update http://www.avianflutalk.com/forum_posts.asp?TID=10169&PID=87367#87367
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: June 26 2006 at 6:49am
A very informative post. I do see the often emphasized theme of close contact poultry present in most human cases. 
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Points: 308 Post Options Post Options   Thanks (0) Thanks(0)   Quote Oisanatta Quote  Post ReplyReply Direct Link To This Post Posted: June 26 2006 at 9:19pm
Great accounting!  AN eye-opener.
The only thing worse than a brutal lie is the brutal truth. (M Twain) I waited patiently for the LORD; He turned to me and heard my cry. He lifted me out of the pit; He set my feet on a rock. Psalm40
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