.
Fatma Ozman Dies Muhammet Ozcan H5N1 Positive in Van
Recombinomics Commentary
January 15, 2006
A 12-year-old girl who died of suspected bird flu today tested negative for the disease, health officials announced.
But the five-year-old brother of Fatma Ozcan has tested positive for the deadly bird flu strain H5N1, increasing the number of infected people in Turkey to 19.
The above results raises additional concerns about familial clusters at the Van hospital The negative result in the fatality is almost certainly false as were the initial results of the first three fatalities in Turkey, all members of the Kocigit family and also from Dogubeyazit. The H5N1 positive result raises the number of confirmed H5N1 cases to 19, but increases doubts about the lack of confirmation of the other 10 Ozcan patients.
The initial Ozcan admissions were on January 4 and included 9 year-old Ayesugul and 3 year-old Yusuf. Both were in the ICU and both tested positive for H5N1. Other family members were admitted on January 5 and 6, but the WHO update describing the positive siblings failed to give their disease onset dates or the fact that 8 family members were hospitalized.
Recently four more Ozcans were admitted. The relationship, if any, to the 10 patients described above was not given, although all 14 patients are from Dogubeyazit. Two of these Ozcans were also put in the ICU and as noted above, the older sibling died and the younger sibling was H5N1 positive. There was no update on the younger Ozcans, 3 year-old Yavuz and 2 year-old Volkan.
Thus, at this time 14 Ozcans have been admitted. Three are H5N1 positive and a fourth patient has died. Most of the other Ozcans remain hospitalized, but have not been added to the list of H5N1 confirmed cases.
The false negative above again raises questions about the PCR testing. For more advanced cases, the H5N1 can be found in lung samples, but not nasal and throat swaps. Patient listings for Van include a large number of patients with the same last name and media reports suggest several large families have been admitted. A much larger number of patients have come to Van and have not been admitted and some of the admissions have been discharged.
The continued hospitalization of relatives of H5N1 patients has raised concerns about the total number of H5N1 infected patients at Van. At this point there have been nine confirmed cases and eight of the nine have a last name of Kocigit, Mumak, or Ozcan. An additional 11 patients with the same last name have been hospitalized, so the true number of infected patients, or the size of these clusters remains uncertain.
More detail, including disease onset dates and current clinical picture of these and other clustered cases at Van would be useful.
Map
Media Resources