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Commentary

WHO Confirms H5N1 Cluster In Fayoum Egypt
Recombinomics Commentary 05:45
January 20, 2012

The second case is a 31 year-old male from Fayium governorate. He developed symptoms on 1 January 2012, received oseltamivir on 14 January 2012 and is still hospitalised under the critical care unit. The case was confirmed by the Central Public Health Laboratory, a National Influenza Center of the WHO Global Influenza Surveillance Network.
 
The above WHO confirmation of an H5N1 case in Fayoum matches the case (30M) described in local media who was the brother of a case (22F) who died with H5N1 symptoms and who also was linked to a symptomatic contact.  The above WHO report fails to not the death of the sister or the status of the contact, raising serious transparency concerns. 

This confirmed case follows the confirmation of a cluster in Dakahlia in which the mother died on December 3.  Her death was followed by two additional adult deaths, and was preceded by an adult who recovered after being in critical condition and on a ventilator.  The above case is also in a critical care unit, and his sister died, raising concerns that the H5N1 associated with these sever and fatal cases is the vaccine resistant clade 2.2.1 F.

Although human cases involving clade 2.2.1 F have not been reported, no sequences have been released from human cases since March of 2010, raising additional concerns about the lack of transparency in Egypt by two WHO regional centers (NARMRU-3 and the US CDC).

These concerns were increased by the release of poultry clade 2.2.1 F sequences from 2010 which had recombined PB1 and PB2 gene segments with H1N1pdm09 and seasonal H1N1 sequences, as well as matches with H3N2v sequences from Pennsylvania and Indiana cases.

These clear examples of recombination in H5N1 increase concerns that the combination of receptor binding domain changes censored by Nature and Science will be demonstrated in natural H5N1 sequences sooner rather than later, and increase concerns that the censorship will put the world’s health at risk.

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