Wednesday, May 13, 2009

H1N1 in Thailand: Concerns for Mixing of H5N1 & H1N1?

The US CDC confirmed two cases of H1N1 after testing two specimens in the US lab sent from Thailand yesterday. These are the first cases in Southeast Asia. (In the Asian region, there was one case in Hong Kong, and 3 in the Republic of Korea). There are suspected cases (awaiting lab-confirmation) of H1N1 in Indonesia as well.

"There were two confirmed cases of type A (H1N1), both of them contracted in Mexico," the Thai Public Health Minister said. "These persons are now well, not sick, without fever. They are now in a normal condition after undergoing a five-day antiviral regimen. The patients have fully recovered and returned home."

As CDC and WHO officials said this week, there is concern that with H1N1 circulating alongside seasonal flu strains and H5N1 (avian influenza) there is a greater risk that the H1N1 (or other viruses) will combine, reassort, and mutate into a different virus strain.

It's certainly too early to tell whether this will happen or not, but world health officials are urging vigilance. Dr. Schuchat, during a CDC press briefing over the weekend, noted that surveillance at the animal-human interface and in regions where multiple influenza type-A viruses are circulating will provide timely information about any reassortment or genetic shifts in the viruses.

Thailand has already alerted its vast village health volunteer network, which has been used for surveillance for H5N1 (avian influenza), to be on the lookout for severe influenza-like illness and inform the health ministry of any suspected cases.

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