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

Arsenal provide positive update on Bernd Leno’s knee injury

first_imgAdvertisement Advertisement Arteta reacts to Arsenal beating champions Liverpool 2-1To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video Play VideoLoaded: 0%0:00Progress: 0%PlayMuteCurrent Time 0:00/Duration Time 5:36FullscreenArteta reacts to Arsenal beating champions Liverpool 2-1https://metro.co.uk/video/arteta-reacts-arsenal-beating-champions-liverpool-2-1-2211612/This is a modal window.Beginning of dialog window. Escape will cancel and close the window.TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal DialogEnd of dialog window.Scans showed the Germany goalkeeper had sustained a moderate ligament sprain and the time frame for his return is believed to be between four and six weeks.AdvertisementAdvertisementADVERTISEMENTA statement from Arsenal on Friday morning said: ‘Now participating in outside running, with the aim of starting ball drills in the next few days.’Emiliano Martinez has massively impressed in Leno’s absence, starting every match since the side’s defeat at Brighton and conceding just five goals.Recent reports suggest that Martinez’s outstanding performances had convinced Arteta to ditch plans to bring in a new goalkeeper in the summer transfer window. Martinez has impressed in Leno’s absence (Picture: Getty)The Gunners also delivered an update on Gabriel Martinelli’s fitness on Thursday evening and confirmed that they do not expect the young forward to return until the end of 2020.The 19-year-old Brazilian went down injured in training last month and underwent surgery to repair a lesion in the cartilage of his left knee.More: Arsenal FCArsenal flop Denis Suarez delivers verdict on Thomas Partey and Lucas Torreira movesThomas Partey debut? Ian Wright picks his Arsenal starting XI vs Manchester CityArsene Wenger explains why Mikel Arteta is ‘lucky’ to be managing Arsenal‘Currently recovering in a knee brace after his operation, which took place during the last week of June,’ Arsenal said. ‘Surgery was successful, with consultants and our medical team very encouraged with Gabi’s current progress at this stage of his recovery. ‘Currently at our training centre every day receiving specialist attention and support from our medical team. ‘Will continue his recovery throughout the close season, with the aim of a return to full training by the end of 2020.’Will Arsenal qualify for the Europa League?Yes0%No0%Share your resultsShare your resultsTweet your resultsFollow Metro Sport across our social channels, on Facebook, Twitter and Instagram. For more stories like this, check our sport page.MORE: Virgil van Dijk compared to Manchester United hero Eric Cantona by Liverpool legend Phil ThompsonMORE: ‘He sat him down!’ – Rio Ferdinand’s brilliant reaction to Marcus Rashford’s goal against Crystal Palace Metro Sport ReporterFriday 17 Jul 2020 10:58 amShare this article via facebookShare this article via twitterShare this article via messengerShare this with Share this article via emailShare this article via flipboardCopy link374Sharescenter_img Comment Bernd Leno’s injury is not as severe as initially feared (Picture: Getty)Arsenal have revealed that Bernd Leno has returned to outdoor running and will begin ball drills over the coming days.There were initial fears that Leno, 28, could be set for a nine-month spell on the sidelines after he suffered a horrendous-looking knee injury in the Gunners’ 2-1 defeat at Brighton last month. But Leno’s injury was not as severe as it first looked and it soon became clear he had not sustained an ACL problem. Arsenal provide positive update on Bernd Leno’s knee injurylast_img read more