Weizhong Yang (Chinese Center for Disease Control & Prevention, Beijing, China) and colleagues detail the case of a12-year-old girl from rural Hunan, China, who developed a fever, sore throat, and cough on Oct 8, 2005 and died of acute respiratory distress syndrome 9 days later. They also report on her 9-year-old brother who developed fever and cough on October 10. The boy was admitted to hospital on Oct 17 where he responded to treatment, which included the antiviral amantadine. He was discharged on Nov 12 and has remained symptom free. The researchers found that the patients' close contacts – totalling 191 persons – were all healthy. They also report that the family had 22 chickens and five ducks in cages in a confined area adjacent to the bathroom and toilets within the house, and that between Oct 6 and Oct 12 up to six birds died per day.
Professor Yang states: "Our investigation highlights the major public health challenges in the unique setting of backyard farming where infection control measures remain to be improved, and where access to diagnosis and treatment is often limited. Hopefully, lessons from this and other cases will be translated into effective strategies to minimise the adverse impact of pathogenic H5N1 infections."
Contact: Professor Weizhong Yang, Office for Disease Control & Emergency Response, Chinese Center for Disease Control & Prevention (China CDC), 27 Nanwei Road, Beijing 100050, China (Peoples Republic) T) +8610 831 65348 ywz126@vip.sina.com
Journal
The Lancet