Human transmission likely in 2004 Thai avian flu cases

first_imgJan 24, 2005 (CIDRAP News) – Researchers who analyzed a family cluster of three cases of H5N1 avian influenza in Thailand say in an article published today that two family members probably acquired the disease from the third.The mother and an aunt of an 11-year-old girl who died of probable avian influenza last September most likely caught the disease from the girl when they cared for her in a hospital, according to the report published online by the New England Journal of Medicine.The findings appear to be the strongest evidence so far of person-to-person transmission of H5N1 avian flu since the disease became widespread in Southeast Asia last year. But the authors say they found no sign of any further transmission and no evidence of mutations that could enable the H5N1 virus to spread easily among people. Disease experts fear that such mutations could lead to a flu pandemic.The 11-year-old girl, who lived with her 32-year-old aunt, died of pneumonia on Sep 8, 2004, according to the report by Kumnuan Ungchusak, MD, MPH, of the Thai Ministry of Public Health, and colleagues from Thailand and the US Centers for Disease Control and Prevention. The girl had fallen ill 3 or 4 days after having contact with dying chickens.While the girl was in a hospital, her 26-year-old mother, who worked in a distant city, came to be at her bedside, providing “16 to 18 hours of unprotected nursing care,” the report says. The mother, who had no known exposure to poultry, became ill with a fever Sep 11 and died Sep 20.The girl’s aunt also helped care for her in the hospital, spending about 12 hours at her bedside on Sep 7. The aunt in turn fell ill with fever Sep 16 and eventually experienced pneumonia, but she gradually recovered and was discharged Oct 7.Because no adequate tissue samples were preserved, investigators could not confirm that the girl had avian flu, but her case had all the cardinal features of previous cases, the report says. Laboratory tests (reverse-transcriptase polymerase chain reaction) confirmed the disease in her mother and aunt.The mother made a 10-minute visit to her daughter’s household Sep 7 but had no known exposure to poultry before she became ill on Sep 11, the article says. The aunt’s last known exposure to poultry was 17 days before she fell ill, a period longer than the typical incubation period of 2 to 10 days.”We believe that the most likely explanation for the family clustering of these three cases of avian influenza is that the virus was transmitted directly from the infected index patient to her mother and to her aunt,” the report states.Epidemiologic investigation revealed no other human cases associated with the family cluster. In addition, RT-PCR analysis and phylogenetic analysis of the virus showed no changes that could equip it for efficient person-to-person transmission.The report says avian flu has spread from person to person before. For example, in Hong Kong’s 1997 outbreak of H5N1, some healthcare workers were found to have antibodies to the virus, and one reported mild symptoms. However, “The current family cluster is unique in that the secondary infections resulted in severe disease and death and in that the epidemiologic circumstances and laboratory findings made it possible to rule out transmission from poultry.”The lack of further transmission in the family cluster should not be an excuse for complacency, the authors write. If H5N1 avian flu remains endemic for years in the affected countries, “it is likely that such clusters will occur again, and it will be necessary to investigate each one rapidly and thoroughly to determine whether a critical change in the virus has occurred,” they conclude.Ungchusak K, Auewarakul P, Dowell SF, et al. Probable person-to-person transmission of avian influenza A (H5N1). N Engl J Med 3005;352(4):333-40 [Full text]last_img read more

CNTB opens online applications for the Annual Croatian Tourist Awards

first_imgThe award is also given for an agency worker, a tourist guide, an employee in a hotel or camp, an employee in a restaurant or bar, a private landlord, a host of a tourist farm, a maritime worker, a road worker and a salesman. The Days of Croatian Tourism, the largest gathering of tourist workers in Croatia, will not be held this year due to the coronavirus epidemic. Candidates for the selection of employees of the year can be submitted by tourist boards exclusively through the county tourist board, professional associations, companies, local self-government units, the Ministry of Health, the Ministry of the Interior, other Ministries of the Republic of Croatia and the Croatian Institute of Public Health. Croatian National Tourist Board already the eighteenth year awards prizes Man – the key to success, employee of the year. The awards are part of the program to mark the Day of Croatian Tourism, the largest gathering of tourism workers in Croatia. The public call is available on the official website Croatian National Tourist Board, and the application form is available via LINKS. Applications are accepted exclusively through the online application form until 11 November 2020 by 12:00. Photo: HTZ Following this, this year the Croatian National Tourist Board will reward employees who have made a significant contribution to the quality of tourist services and safety, health and protection during the tourist season 2020, and has opened online applications for Annual Croatian Tourist Awards 2020 in the category “Man – the key to success, employee of the year”.center_img Man – the key to success, employee of the year The goal of this award is raising the quality of service and hospitality of employees in tourism and other tourism-related activities, which directly affects raising the level of guest satisfaction, spreading the positive image of Croatian tourism and the overall experience of Croatia as a tourist destination. Reward “Man – the key to success, employee of the year” this year is awarded in total 12 categories. From that three are new: for border police officers, health care workers and civil protection workers. Man – the key to success, employee of the year However, the Croatian National Tourist Board has decided to reward employees who have done their job well, dedicatedly and in the best possible way in significantly more difficult conditions. Photo: HTZlast_img read more