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H5N1 Postive Girl in Turkey is Aysegul Ozkan?
Recombinomics Commentary
January 7, 2006
The British lab has not yet confirmed the diagnosis of the fourth child, a nine-year-old girl who lives in the province of Van. But Cheng said the WHO is accepting testing done by the national laboratory in Istanbul as proof the girl has H5N1 avian flu.
The above comments indicate that the fourth confirmed H5N1 case in Turkey is a nine-year old girl. Although the above report states that she lived in Van, the only nine-year old girl listed among the initial 15 patients at the hospital in Van was Aysegul Ozkan. She and two siblings, Yusuf Ozkan (3M) and Hatice Ozkan (15M), were the first three members of the Ozkan family admitted. Aysegul and Yusuf were transferred to the ICU along with Yusuf Tunik, who was the other patient who was confirmed to be H5N1 positive.
Yusuk Tunik was admitted on the same day as the 4 Kocygit siblings. The two oldest siblings are the other two confirmed H5N1 patients. Media reports indicated all of the initial admissions had the same symptoms of pneumonia, fever, and bleeding from the throat.
If Ayesegil Ozkan is the unnamed confirmed H5N1 case, then it is likely that some or all of her 9 relatives (8 siblings and her mother) also are H5N1 positive. The largest previous confirmed cluster was 5 family members in Haiphong in April 2005. In Turkey, 14 of the hospitalized or deceased bird flu patients come from just two families. The development of bird flu symptoms in such larges numbers suggests H5N1 infections of humans in Turkey are more efficient.
The H5N1 confirmation of 3 members of two large clusters also raises questions about the inability to diagnose H5N1 in the other members, including one who has died. At this time the clinical presentation is more useful than lab results on nasal and throat swabs. Since the disease onset date for the siblings was within 24 hours of admission, the negative nasal swabs may indicate that the H5N1 did not enter via the upper respiratory tract.
Media reports indicate seven additional patients have pneumonia and bleeding from the throat, but at this time only two have been reported to be positive on PCR tests. Thus, the clinical presentation again indicates that these patients are H5N1 positive and the PCR data on nasal swabs generates false negatives.
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