Qinghai H5N1 in Ivory Coast
Recombinomics Commentary
January 26, 2007
The recent report of Tamiflu resistance in two family members from the Gharbiya governorate in Egypt has focused attention on NA sequences from Qinghai isolates in Europe, the Middle East, and Africa. The detection of N294S in samples collected two days after the start of Tamiflu treatment strongly suggests the N294S was present in the H5N1 prior to Tamiflu treatment. This is supported by the failure to find wild type N294 sequences in either patient, as well as prior detection of N294S in ducks in China.
The database of recent Qinghai NA sequences is lacking. NAMRU-3 has made public NA sequences from four of the five recent cases in Egypt, including the two cluster members. However, additional sequences have been limited because most countries with H5N1 infections have failed to report outbreaks.
Recent reports of H5N1 in Nigeria and Hungary provide further support for reporting / detection failures in neighboring countries in Europe, the Middle East, and Africa.
Today’s update of Qinghai H5N1 samples submitted to the NIAID genome sequencing project includes a number of Qinghai isolates from Africa (Egypt, Sudan, and the Ivory Coast). Included are three turkey samples from the Ivory Coast, collected last month (A/turkey/Ivory Coast/4372-2/2006, A/turkey/Ivory Coast/4372-3/2006, A/turkey/Ivory Coast/4372-4/2006), adding additional support for recent H5N1 outbreaks in countries neighboring Nigeria in western Africa.
Release of recent H5N1 samples or sequences by countries neighboring the countries acknowledging outbreaks is important for determination of the distribution of Tamiflu resistance. NA sequences from poultry in Egypt are currently being generated.
These sequences are critical for the evaluation of anti-viral treatment options. H5N1 in patients have already been reported in Egypt, and a cluster in Nigeria is under investigation. All H5N1 infected patients in the area (Turkey, Azerbaijan, Iraq, Egypt, Djbouti) have been the Qinghai strain as have all recent high path H5N1 infections in birds Europe, the Middle East, and Africa.
Withholding of H5N1 samples and sequences remains hazardous to the world’s health.
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