More H5N1 Clustering in Fayoum and Menofia Egypt
Recombinomics Commentary 22:41
March 12, 2008
Sources official from the Egyptian Ministry of Health found new cases of infection contracted avian influenza governorates of Menoufiya, Fayyoum rising incidence of the disease in Egypt that to 49 cases.
The above translation describes two more confirmed cases in Egypt, raising the total to 49. The two most recent cases are from Menofia and Fayoum, the same locations as the past three confirmed cases. Thus, if the above translation is correct, the five confirmed H5N1 cases this month are all from these two provinces. This type of clustering remains a cause for concern. Either the H5N1 in this region is becoming more efficiently transmitted to humans, or the level of surveillance has increased due to recently confirmed cases. However, 5 cases in two weeks from a relatively small area demands more detail.
Recently released bird sequences from Egypt identified an alarmingly high number of non synonymous changes, signaling a vaccine failure and rapid evolution. Thus far, in contrast to this time last year, all confirmed cases have developed pneumonia. Last season, most of the fatal cases were associated with M230I, which is widespread in poultry this season.
It has been almost three months since the December, 2007 cases were confirmed, yet no sequences from human cases have been released. The reasons for these delays in unclear. Last year, NAMRU-3, to its credit, promptly released sequence data. After NAMRU-3 became a WHO regional reference center, the transparency dropped dramatically.
Release of the sequences from December, 2007 is long overdue. Release of sequences from the spate of recent cases would also be useful.
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