Human infection with highly pathogenic avian influenza virus (H5N1) in northern Vietnam, 2004-2005

Abstract

We performed a retrospective case-series study of patients with influenza A (H5N1) admitted to the National Institute of Infectious and Tropical Diseases in Hanoi, Vietnam, from January 2004 through July 2005 with symptoms of acute respiratory tract infection, a history of high-risk exposure or chest radiographic findings such as pneumonia, and positive findings for A/H5 viral RNA by reverse transcription-PCR. We investigated data from 29 patients (mean age 35.1 years) of whom 7 (24.1%) had died. Mortality rates were 20% (5/25) and 50% (2/4) among patients treated with or without oseltamivir (p = 0.24), respectively, and were 33.3% (5/15) and 14.2% (2/14) among patients treated with and without methylprednisolone (p = 0.39), respectively. After exact logistic regression analysis was adjusted for variation in severity, no significant effectiveness for survival was observed among patients treated with oseltamivir or methylprednisolone.

Figure

Clinical course of 29 patients infected with highly pathogenic avian influenza virus (H5N1), northern Vietnam, 2004–2005. Zero days on horizontal axis represent days of hospitalization at the National Institute of Infectious and Tropical Diseases. Shaded bars, days between disease onset and hospitalization; open bars, days between hospitalization and discharge; dots, start of oseltamivir treatment. Information on the right shows date of hospitalization, age in years, sex, and leukocyte count per microliter.