Fatal H5N1 Case in Xinjiang China Raises Clade 7 Concerns

Commentary

Recombinomics Commentary 15:50
January 24, 2009

张某某patients, female, 31 years old, living in Urumqi City头屯河区. Patients January 10, 2009 the disease exacerbations after hospital treatment. Because patients in a critical condition, after all rescue measures proved ineffectual, was at 4:40 on January 23 deaths.

January 22, the Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention collected specimens of patients with laboratory analysis, results for the H5N1 avian influenza virus nucleic acid positive. January 24, the Chinese Center for Disease Control and Prevention on samples of patients with respiratory secretions of the review of testing, results showed that H5N1 avian influenza virus nucleic acid positive. Epidemiological survey found that patients have a live poultry market before exposure history.

The above comments, from the Ministry of Health website, raise additional questions about the recent H5N1 fatalities. Urumqi is in the far northwest (see updated map) and has not reported H5N1 in poultry. However, many of these locations were linked together in the 2005/2006 season when China reported a series of poultry outbreaks which were difficult to control. Many or all involved clade 7, which is markedly different than clade 1 or 2, which are the common targets of poultry or human vaccines. There were multiple outbreaks near Urumqi as well as Beijing.

This season those regions have not reported H5N1 outbreaks, but have reported human cases. Clade 7 was confirmed in Jiangsu last month, which preceded the outbreaks in China. Clade 7 was also reported in Vietnam, where there have also been recent human cases.

A/Beijing/1/2009 was said to be like other H5N1 in China isolates between 2005-2008, which would match clade 7, but is also true for clade 2.3.4, which has been associated with human cases previously.

More information on the H5N1 from recent human cases, including clade number, would be useful.