H5N1 Confirmed in Child in Minya Egypt
Recombinomics Commentary 23:55
February 25, 2008
A 4-year-old Egyptian girl tested positive for bird flu on Monday
Ministry of Health spokesman Abdel Rahman Shaheen said the girl had been treated with the antiviral drug tamiflu and had been transferred from Minya province to a hospital in Cairo, the agency said.
The girl is suffering from a high fever and is having trouble breathing because she has inflammation of one of her lungs.
The above comments describe a new confirmed H5N1 case in Egypt. The had been five confirmed cases early in the season, but this is the first case this month, which parallels last year when cases in the south began to be reported in March and April. Last season the early cases were fatal, but the cases later in the season were mild and largely from central or southern Egypt, including Minya
The above description suggests this case, from central Egypt, has already developed pneumonia, raising concerns that the upping cases will be more severe than cases a year ago. Although the H5N1 sequences from the human cases have not been released, the poultry sequences raise significant concerns.
The H5N1 in Egypt is evolving rapidly and appending new polymorphisms onto the genetic backgrounds from last season. Sequences with the receptor binding domain changes V223I and M230I, which were in the Gharbiya cluster, were in circulation this season, but there were many changes added onto this background, including the consensus polybasic cleavage site, RERRRKKR, instead of the Qinghai cleavage site of GERRRKKR.
The acquisition of the original site, first reported in 1996 in the Guangdong goose, may signal a more virulent strain, since the sequences almost certainly have retained the human PB2 polymorphism, E627K. Thus, the combining of the traditional polybasic cleavage site with the human receptor binding domain change M230I and the human E627K could generate a more lethal and transmissible H5N1.
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