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BMJ 2008; 336 doi: (Published 17 April 2008) Cite this as: BMJ 2008;336:856

China confirms likely transmission of avian flu H5N1 between humans

Infection control authorities in China have reported the likely transmission of the avian influenza virus H5N1 from a young man to his father. The 24 year old salesman became ill six days after visiting a local poultry market and was eventually diagnosed in hospital only 24 hours before he died. His father, a 52 year old engineer, cared for him at home and in hospital. He became ill the day after his son’s funeral, but he survived after prompt treatment with oseltamivir, rimantidine, and a transfusion of plasma from a woman who had been vaccinated against the virus in a preliminary trial.

Genome sequencing of viral isolates confirmed that both patients were infected with an almost identical strain. The team of specialists that investigated the outbreak says the most likely explanation is that the son infected his father. But it is unclear exactly when or how transmission occurred. The investigators are unable to rule out the possibility that both cases were infected by contact with local poultry. The father had visited a market eight days before he became ill, but he says he went nowhere near the stalls selling chickens.

The investigators tested another 91 close contacts including friends, family, and healthcare workers. None had evidence of infection with H5N1.

Acyclovir won’t prevent HIV in women with HSV-2

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HIV has no cure. While many scientists continue to look for one, others are equally busy searching for ways to prevent infection. The journey has been littered with disappointments and setbacks, says one comment article (p 1543). Vaccines are decades away, and barriers such as vaginal microbicidal gels and diaphragms don’t protect against HIV. Even interventions that change risky behaviour have more effect on other sexually transmitted diseases than on HIV. …

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