PULMONARY FINDINGS OF AVIAN INFLUENZA A (H5N1) PNEUMONIA OF A FAMILY CLUSTER IN KAMPHAENGPHET OUTBREAK.

Abstract

Until now, avian influenza pneumonia is very hot issue and life threatening disease in Kamphaengphet, in Thailand and in Asian countries. Recent outbreak of avian influenza A (H5SN1) in rural areas of Kamphaengphet Province and human infection with this virus were occurred in September 2004 (second outbreak in Thailand).

The object of this report was to show the epidemiology, clinical features and pattern of pulmonary findings that could be found in avian influenza pneumonia, which might be helpful for future diagnosis and comparison of this disease with the next outbreaks.

We reviewed the pulmonary findings ofa family cluster of three involved patients. Two confirmed cases were mother and aunt. They have been confirmed as cause by H5N1 strain by viral study. The mother was dead but the aunt has been survived. One probable case was the index girl. She was the first fatal case and was under investigation for HSN1 on admission due to initial diagnosis was dengue hemorrhagic shock syndrome. However, her retrospective diagnosis was presumed bya history of exposure to infected household chickens, and clinical features that corresponding to cardinal features of previously reported cases, and her mother's death from severe HSN1 pneumonia after having close contact with her.

In fact, the mother had no history of exposure to poultry, so we believe that the avian influenza HSN1 virus was probably transmitted directly from the infected girl to the mother after unprotected bedside care. No additional cases were identified among contacts.

The radiographs of these three involved patients were abnormal on admission. All pulmonary findings were air space patterns, including unilateral and bilateral lesions, patchy infiltration and lobar consolidations.