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New H5N1 Wild Bird and Poultry Deaths in Turkey
Recombinomics Commentary
January 7, 2006
wild pigeons in the provinces of Erzincan and Bitlis tested positive for the disease
Tests on the remains of two wild ducks found dead on a reservoir (near Ankara) showed that the birds had died from the deadly disease
The disease was detected in the northwestern province of Bursa, some 1400km from the worst-hit areas in the east. Dead chicken in the village of Karahidir tested positive for bird flu and slaughter of poultry in the area began, local farming official Serdar Kavasoglu told Anatolia.
The above comments on recent test results on wild birds and a new poultry outbreak indicated H5N1 is widespread in Turkey. In addition to the wild birds above, Turkey has filed recent OIE reports detail additional infections in Igdir, Eruzum, and Sanliufra Provinces.
In October H5N1 was identified in Balikesir Province and although domestic poultry was dying in Igdir and Sanliufra Provinces, the first OIE reports for these regions (Aralik and Merez in Igdir, Hilvan in Sanliufra, Horasan in Eruzum, and Dogubeyazit in Agri) were filed on outbreaks that begun in November or December. The widespread detection of H5N1 in recent deaths of ducks, geese, chickens, and turkeys, coupled with H5N1 detection in wild birds in three separate provinces suggests H5N1 has been in Turkey for several months. Moreover, it is likely that H5N1 has also been in adjacent countries for a significant time also because millions of migratory birds pass through Turkey en route to points south on the Arabian Peninsula and Africa.
The outbreak of suspected and confirmed human cases in Turkey suggests that the H5N1 wildly detected in birds has now become more efficient at infecting humans. Confirmed humans cases had previously been limited to eastern Asia. The cases in Turkey are the first reported near Europe, and the size and number of familial clusters suggest transmission to humans from birds has become more efficient than transmission of more severe H5N1 cases in Asia.
Two of the three fatal cases in Turkey have been H5N1 confirmed, but the third case had bird flu symptoms and was a sister of the other two fatalities, suggesting all three fatalities in Turkey were H5N1 infected. Over 50 suspect patients are being tested, but nasal swabs have generated false negatives, and sample collection remains suspect because the samples are being collected from advanced cases.
The failure to detect H5N1 in birds in eastern Turkey prior to the recent OIE filing is cause for concern, as are the false negatives on the human cases.
These false negatives raise concerns about wild bird deaths in adjacent countries and raise serious concerns about the effectiveness of enhanced surveillance, which fail to detect the widespread H5N1 in Europe, the Middle East, and Africa.
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