title: Human disease from influenza A (H5N1), Thailand, 2004.
abstract: Influenza A (H5N1) is endemic in poultry across much of Southeast Asia, but limited information exists on the distinctive features of the few human cases. In Thailand, we instituted nationwide surveillance and tested respiratory specimens by polymerase chain reaction and viral isolation. From January 1 to March 31, 2004, we reviewed 610 reports and identified 12 confirmed and 21 suspected cases. All 12 confirmed case-patients resided in villages that experienced abnormal chicken deaths, 9 lived in households whose backyard chickens died, and 8 reported direct contact with dead chickens. Seven were children <14 years of age. Fever preceded dyspnea by a median of 5 days, and lymphopenia significantly predicted acute respiratory distress syndrome development and death. Among hundreds of thousands of potential human cases of influenza A (H5N1) in Asia, a history of direct contact with sick poultry, young age, pneumonia and lymphopenia, and progression to acute respiratory distress syndrome should prompt specific laboratory testing for H5 influenza.
authors.affiliation: Queen Sirikit National Institute of Child Health, Bangkok, Thailand.
authors.forename: Tawee
authors.initials: T
authors.lastname: Chotpitayasunondh
authors.forename: Kumnuan
authors.initials: K
authors.lastname: Ungchusak
authors.forename: Wanna
authors.initials: W
authors.lastname: Hanshaoworakul
authors.forename: Supamit
authors.initials: S
authors.lastname: Chunsuthiwat
authors.forename: Pathom
authors.initials: P
authors.lastname: Sawanpanyalert
authors.forename: Rungruen
authors.initials: R
authors.lastname: Kijphati
authors.forename: Sorasak
authors.initials: S
authors.lastname: Lochindarat
authors.forename: Panida
authors.initials: P
authors.lastname: Srisan
authors.forename: Pongsan
authors.initials: P
authors.lastname: Suwan
authors.forename: Yutthasak
authors.initials: Y
authors.lastname: Osotthanakorn
authors.forename: Tanakorn
authors.initials: T
authors.lastname: Anantasetagoon
authors.forename: Supornchai
authors.initials: S
authors.lastname: Kanjanawasri
authors.forename: Sureeporn
authors.initials: S
authors.lastname: Tanupattarachai
authors.forename: Jiranun
authors.initials: J
authors.lastname: Weerakul
authors.forename: Ruangsri
authors.initials: R
authors.lastname: Chaiwirattana
authors.forename: Monthira
authors.initials: M
authors.lastname: Maneerattanaporn
authors.forename: Rapol
authors.initials: R
authors.lastname: Poolsavathitikool
authors.forename: Kulkunya
authors.initials: K
authors.lastname: Chokephaibulkit
authors.forename: Anucha
authors.initials: A
authors.lastname: Apisarnthanarak
authors.forename: Scott F
authors.initials: SF
authors.lastname: Dowell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D053124:Influenza A Virus, H5N1 Subtype; D009980:Influenza A virus / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011201:Poultry Diseases / Q000453:epidemiology* / Q000821:virology; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013785:Thailand / Q000453:epidemiology; D015047:Zoonoses / Q000453:epidemiology*
chemical_list: D012367:RNA, Viral