.
Are H5N1 Postive Siblings in Turkey Aysegul and Yusuf Ozkan?
Recombinomics Commentary
January 8, 2006
The new cases at the university hospital in Van, which treats the majority of people suspected of being infected, were identified as a girl and a boy, aged nine and three.
The above report appears to be describing two of the Ozkan sublings, Aysegul Ozkan (9) and Yusuf Ozkan (3). Both were among the first 3 Ozkans admitted and both were in intensive care, along with Yusuf Tunc (5) the other Dogubeyazit resident who was H5N1 confirmed. Other media reports also indicated that the 3 year-old and 9 year-old who were confirmed were siblings.
Thus, the confirmed cases are the cases admitted earliest and the two Ozkans that are positive suggest that many or all of the other 8 family members who are hospitalized will also be H5N1 confirmed. These data extend the observations that the H5N1 infected patients are frequently in clusters and the clusters are large and clustered, especially the initial cases from Dogubeyazit.
These data suggest that H5N1 in Turkey is being efficiently transferred. In some cases this transfer may be from a common source. However, some media reports indicate that the first member of the Kocygit family to die, Mohammed Ali, may have been infected as early as December 18 and he showed symptoms prior to his siblings, raising the possibility of human-to-human transmission. Similarly, the two Ozkans that appear to be H5N1 confirmed were also admitted first. More details on disease onset dates would be useful, but bimodal distribution of onset dates signal human-to-human transmission, which would be expected if transmission efficiencies were increased.
The large number of human cases being reported across Turkey indicates many people are being infected directly or indirectly by migratory birds, which have caused a flurry of outbreaks in poultry stretching from eastern Turkey to Istanbul. Migration of these outbreaks to the south is expected, which would impact countries in the Middle East as well as the heavily attended Haj, where large numbers of people are living and gathering in close quarters.
More information on H5N1 sequences and onset dates and relationships of patients in clusters would be useful
Map
Media Resources