H5N1 Fatality in Fayoum Egypt Raises Concerns
Recombinomics Commentary 17:30
March 4, 2008
The case is a 25 years old female from Sennoris District, Fayum Governorate. She developed symptoms on 24 February and was hospitalized on 27 February. Her death has now been confirmed by the Ministry of Health and Population.
The above comments from the most recent WHO update are not a surprise. H5N1 in Egypt appears to be more aggressive this year. A year ago there was an increase in H5N1 cases in March and April, but the vast majority of the cases were mild. Only one in seventeen were fatal, and most did not develop pneumonia.
The above case developed pneumonia in both lungs, even though she was hospitalized three days after disease onset. However, she was in critical condition and most H5N1 cases in critical condition do not survive. However, the update fails to mention the hospitalization of the sister of the fatal case or the confirmation of a third case in Egypt in just over a week.
Recently released sequences from poultry in Egypt signals a failed vaccination program, and a rapid evolution of H5N1, including many isolates with the receptor binding domain change of M230I or M230V.
The rapid evolution of H5N1 in Egypt, coupled with more aggressive human cases, is cause for concern.
Release of human sequences from the eight confirmed cases this season, including the five at the end of last year, as well as NA sequences from recent poultry isolates would be useful.
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