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Bird Flu Jumped From Son to Father

Family Members of Bird Flu Cases May Be at Risk

Father Gets Bird Flu from Son continued...

The son, a salesman, lived in an urban area with his mother. He had not been feeling well since August 2007, but on Nov. 24 he came down with a fever. He was given antibiotics and sent home. Three days later he was hospitalized with pneumonia.

Blood cultures on Nov. 28 detected a Salmonella infection (probably the cause of his earlier illness) and he was treated with antibiotics. Five days after entering the hospital, he died -- the same day a sample of lung fluid detected infection with H5N1 bird flu.

Meanwhile, the young man's father had been helping to care for him in the hospital. Even though he performed intimate care -- changing the son's diarrhea-soiled clothing and bed sheets, feeding him, and cleaning out a spittoon used for sputum -- the father was not given protective gear until the son's H5N1 infection was detected.

Two days after his son died, the father developed a fever, chills, and cough. He took a dose of Tamiflu that had been provided. The next morning, he was hospitalized. Despite treatment with flu drugs, he got worse, requiring positive-pressure ventilation.

Four days later, he received two transfusions of plasma from a woman who had received two doses of an experimental H5N1 vaccine in an early-stage clinical trial. That night, the father's fever resolved. He left the hospital 22 days after admission.

Both the father and son were infected with virtually identical H5N1 strains. Six days before his illness, the son visited a market where poultry were slaughtered. Even though he did not visit the poultry booths, the market appears to be his only possible contact with infected poultry -- although nobody else appears to have been infected and there was no known H5N1 outbreak among poultry in the region.

The father, too, had been to a market that slaughtered poultry as recently as eight days before his illness, but given the incubation period for bird flu -- three to six days -- Hua and colleagues feel the father's exposure to the son was a much more likely source of infection.

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