Another H5N1 Toddler in Egypt Raises Evolution Concerns
Recombinomics Commentary 07:30
February 9, 2009
She explained that the child was suffering from high fever and cough after being exposed to birds, noting the child was given a drug (Tamiflu) as soon as he suspected that the disease condition stabilized after that.
The above translation describes the second confirmed H5N1 case in Egypt in the past four days (see updated map). The translation describes a bird exposure, but external monitoring H5N1 in poultry is somewhat compromised by Egypt’s announcement that H5N1 was endemic, leading to OIE reports at 6 month intervals. H5N1 in Egypt has been a concern because of the emergence of a vaccine resistant strain a year ago. This H5N1 was isolated from vaccinated flocks and was widespread in Egypt, and also detected in Israel. The new sequence had a number of non-synonymous changes, including changes in the receptor binding domain. One of the last reported cases in the 2007/2008 season was a Cairo case infected with the vaccine resistant strain.
The outbreak in Egypt follows a spate of cases in China and northern Vietnam. The human cases in China are likely due to clade 7, and clade 7 polymorphisms have been previously acquired by Egyptian isolates, raising concerns of additional evolution and cases.
Similarly, the fixing of H274Y in seasonal H1N1 flu raises concerns of transfer to H5N1 in countries where H5N1 and H1N1 are co-circulating, which includes Egypt. Sequence data on recent cases, including NA sequences would be useful.
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