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At least two of the three patients were known to have had contact with poultry, while the deceased doctor had no known contact with poultry, Dang said. The doctor was also not known to have had contact with any of the three suspected bird-flu patients, he said.
``He worked in a different ward,'' Dang said. ``We don't think there's any connection between the doctor's case and the cases of these three other people.'' <<
The linkage of the 34 year-old physician to a facility with two confirmed and one suspect bird flu case is clearly cause for concern. The physician's death was so sudden that he was being tested for SARS. He was admitted on Friday and died on Sunday. Although test results have not been released, four cases at the same hospital over a short time frame create a geographical cluster in Quang Ninh. Since these are the only four cases reported in the province, yet are all at Vietnam-Sweden Hospital, the suspicion level is extremely high. It coincides with the executive order in the United States authorizing quarantine of bird flu patients.
The death is the first reported fatality for a health care worker closely linked to H5N1. There were two previous cases in Thai Binh. Although the second health care worker in the Thai Binh cluster tested negative, there was little doubt that both had been infected with bird flu. They were both at a facility that treated two confirmed cases, and the index case of the familial cluster was a patient treated by the first health care worker. In that cluster, only the index case remains hospitalized. His sister and the two health care workers recovered.
The physician fatality, linked to three patients not treated by the physician, is a classic example of efficient transmission of a virus in a health care setting (nosocomial infection).
more
http://www.recombinomics.com/News/04060503/Quang_Ninh_H2H.htmlBTW, this site --
http://www.recombinomics.com/in_the_news.html -- is really good for following the bird flu story outside of the propaganda of governmental organizations.