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More H5N1 Clinical Cases in Northern Iraq
Recombinomics Commentary
February 6, 2006
There are five other people whose clinical condition gives grounds for suspecting that they could have the disease, although they have not been seen by the WHO team on the ground in northern Iraq, WHO spokesman Dick Thompson said.
The above comments on the clinical condition of five additional H5N1 patients in northern Iraq suggest the number of human cases may be significant. Earlier WHO described a confirmed fatal case, her uncle who also died, and a distant relative, who has been hospitalized since January 18. Another report described a cousin who had died and several additional cases.
It is not clear if these additional cases are included in the five cases described about. False negatives in Iraq and Turkey suggest that the clinical presentation of these cases may be a better indicator of H5N1 infections.
The growing number of cases in Iraq, coupled with the confirmed cases in Turkey, raises questions about human cases in neighboring countries. Prior to te reported cases in Turkey, the Qinghai strain of H5N1 had not been confirmed in humans. However, the isolate from the index case had acquired HA S227N, which has been associated with an increased binding affinity for human receptors in the upper respiratory tract. It seems likely that this change is transported by wild birds, so expansion into countries bordering Turkey would be likely.
The growing number of human cases in Iraq adds to concerns.
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