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A total of 204 patients, residents and staff fitted the outbreak case definition; 17 (8.3%) were laboratory-confirmed. Foodborne origin was suspected in the 114 patient and resident cases with onset 15 18 March.
The global geographic H5N1 dataset registers each outbreak case at the location of the nearest village or township.
Findings from our investigation suggest that this lethal outbreak (case fatality ratio 25%) was caused by toxic poisoning from ghagra shak, also known as Xanthium strumarium.
All the viruses isolated from the Osaka/Kobe outbreak case [5] belonged to the small sub-cluster 1.2, which had a cluster 2-like nucleoprotein [12].
HCWs were classified as SARS if they had antibodies to SARS-CoV detected in their convalescent serum, or if they met the SARS outbreak case definition [8] and did not have serology performed.
Moreover, the first outbreak case consisted of the reassortant viruses between the primitive lineage and the New York lineage, which is likely to emerge late in the epidemic in US and Mexico.
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The remaining 66 patients were classified as outbreak case-patients.
All 66 outbreak case-patient isolates carried Ambler class A β-lactamases.
Hospital charts for 9 or the 10 outbreak case-patients were reviewed retrospectively.
The antimicrobial drug treatment regimen was known for 1 outbreak case-patient who received oral azithromycin.
‡A determination could be made for only 15 of the 22 outbreak case-patients.
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