Pneumonia in H5N1 Patients in Egypt
Recombinomics Commentary 21:13
March 4, 2008
The Ministry of Health of Egyptian human infection No. 46 avian influenza illness of a child age 11 in the village of dams Menoufiya Governorate.
The ministry said in a statement today that the situation has entered a hospital salt worries on February 26 last to suffer from high temperature and shortness of breath and pneumonia
The above translation indicates the most recent confirmed H5N1 case in Egypt has developed pneumonia. Thus, all three confirmed Egyptian cases in the past week have been more severe than the cases at this time last year.
Last year, the H5N1 sequences in the south were markedly different than the sequences in the Nile Delta. One change, M230I, was widespread in the north, and all patients with M230I died. This year the recently released poultry sequences indicated M230I and M230V are widespread, especially in the north.
Moreover, the recent sequences have a large number of non synonymous changes, which may be associated with a more aggressive H5N1. At the end of 2007 there were five confirmed cases. Four of the five died, but the H5N1 sequences have not been released..
The situation in Egypt is growing more serious. There have been three confirmed pneumonia cases in a week. None of the patients have been discharged and one has died.
The sequence data from vaccinated flocks signal significant problems, and the WHO report on vaccine selection fails to appreciate the degree of heterogeneity in Egypt or the rapid H5N1 evolution. The sequences from the Gharbya cluster are not only not targeted, they are not included in the phylogenetic tree in the report.
Release of the human H5N1 sequences as well as the NA sequences from the poultry isolates would be useful.
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