Commentary
Sustained H5N1 Transmission in Shanxi China Raises Concerns
Recombinomics Commentary 00:48
January 20, 2009
The above translation includes the disease onset date for the index case in the Hunan / Shanxi cluster. The 2 year old daughter developed symptoms on January 7, when her mother died, signaling transmission of H5N1 from mother to daughter. The daughter was then taken to Shanxi, where she was hospitalized.
However, another report indicates two other family members were hospitalized in Shanxi, signaling transmission of H5N1 from the daughter to the Shanxi relatives (see updated map).
Thus, although there is only one confirmed case and the WHO update indicates all contacts are “healthy”, media reports describe three additional family members infected in the H2H2H transmission chain.
This transmission chain is the longest reported to date form China. Clusters of two have been reported previously, but the cluster of four and two transmission events has not been reported previously.
This transmission chain, coupled with the symptomatic health care worker in Beijing, as well as confirmed cases in Shandong and Guizhou, represent confirmed or suspect H5N1 cases that have died or have been hospitalized this month.
More information on the contacts of the Hunan case, and release of sequence data from the confirmed H5N1 cases, would be useful.
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