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H5N1 Human Cluster in Iraq Raises Concerns
Recombinomics Commentary
February 1, 2006
Tijan Abdel-Qader died on 17 January and two days later the WHO declared Iraqi tests had shown she had not died of bird flu. "There were also no reports of dead chickens in the area, and she seemed to have another illness," Dick Thompson, a WHO spokesman, told New Scientist.
Fortunately, he says, her doctors asked for a second opinion. On Monday 30 January, the US Navy Medical Research Unit in Cairo, Egypt, confirmed H5N1 in samples from the girl. On Tuesday evening, the National Institute for Medical Research at Mill Hill in London, one of the WHO's official collaborating centres for flu, also confirmed the virus.
The above comments by WHO are causes for concern. The evidence for H5N1 in wild birds and poultry in northern Iraq was overwhelming, yet WHO considered the lack of reports of H5N1 as reason to "discount" a case that was clearly bird flu based on clinical presentation.
The Qinghai version of H5N1 was easily traced. The sequences was readily distinguished from other H5N1 strains in Asia and all isolates from Qinghai had the PB2 polymorphisms E627K. This marker had never been reported in a bird H5N1 isolate prior to Qinghai Lake in May, 2005. The H5N1 migrated to southern Siberia for the summer and was detected at Chany Lake in Russia and Erhel Lake in Mongolia.
As expected, the H5N1 then migrated into European Russia as well as the Volga Delta and Danube Delta. The report of H5N1 in western Turkey provided further evidence that H5N1 was migrating along a route that would pass through the Middle East into Africa.
The lack of H5N1 reports in the Middle East was highly suspect. Large die-offs of wild and domestic poultry were reported. A wide range of causes was cited, but there was little doubt that H5N1 had migrated through the Middle East.
The data for northern Iraq was even stronger. In January Turkey filed a number of OIE reports detailing H5N1 outbreaks throughout Turkey dating back to mid-November. In addition, Turkey reported human cases throughout the country that appeared simultaneously, indicating the H5N1 in humans was being transmitted and transported by wild birds.
Thus, when the fatal case in northern Iraq was reported with symptoms that matched the fatal human cases in Turkey, there was little doubt that H5N1 in humans had been detected. This infection was support by the death of the index case's uncle, who cared for the index case and also had bird flu symptoms.
WHO has been given addition authority, beginning January 1, 2006 to investigate infectious disease that could cross international borders. H5N1 has clearly crossed Turkey's borders into all neighboring countries, including Iraq, yet WHO discounts a fatal case in humans due to a lack of reports of H5N1 in birds.
WHO has consistently try to find data to support its preconceived notions on H5N1 transmission. Iraq, like Turkey, China, Indonesia, and Cambodia was not considered to have a human case until there was a familial cluster that almost certainly involved human-to-human transmission.
WHO continues to misrepresent the frequency of human-to-human transmission and withheld disease onset dates and familial relationships in its updates on Turkey.
These commissions by omission deserve a third party investigation
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