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A Growing H5N1 Human Cluster in Iraq?
Recombinomics Commentary
February 6, 2006
The responsible Iraqi also announced that one of the cousins of the girl deceased for the virus she died in the same city, but the results of the analyses had not confirmed, for the time being, that it was about a case of aviária grippe.
The above comments suggest the cluster linked to Iraq’s index case is growing. The index case’s uncle has also died and the 54F who has been hospitalized since January 18 may be a distant relative.
Confirmatory lab tests are becoming increasingly suspect. Of the 21 H5N1 positives in Turkey, only 12 have been confirmed. The negative data on the other nine raises question about the collection, storage, and shipment of samples. The inability to confirm H5N1 positives by outside agencies is rare, but reliance on clinical presentation is becoming increasingly important. The index case in Iraq was initially said to be negative, as were the four siblings in Turkey.
Although H5N1 has become increasingly prevalent since the explosion of infections in Asia in 2004, the testing appears to be getting increasingly unreliable. This unreliability is most obvious in clusters. It will be of interest to see which of the 9 samples in Turkey were not confirmed. Since many of these samples were paired, two false positives or a positive and negative in two related samples would be unlikely.
More information, in addition to H5N1 test results on suspect cases in Iraq would be useful, especially relationships between cases and disease onset dates.
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