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Commentary

Another H5N1 Confirmed Toddler in Egypt
Recombinomics Commentary 13:40
March 27, 2009

bird flu was confirmed on Thursday night to a girl named Israa Said Shafi at the age of two years and six months of Nejj Abushok Center Dandara governorate of Qena.

onset of symptoms, they were on Monday, entered the hospital admitted to Qena on Tuesday, with high fever and cough after exposure to dead birds suspected of being infected with bird flu.

Her condition was described as stable after she given the required medications.

The above comments describe another H5N1 confirmed toddler in Egypt (see updated map) that appears to be mild.  Although this is the ninth confirmed case in 2009, none have died.  Most appear to be mild, and pneumonia is not indicated.  The prior case was symptomatic for four days.

These mild cases are similar to reports in the spring of 2007, when 16/17 cases recovered.  However, the case fatality rate last year, and cases in late 2006 / early 2007 was high, suggesting the mild cases were due in part to the sequence of the H5N1.  Sequences from this season have not been released, but in 2007 the vast majority of the recovered cases were infected with H5N1 with a Mongolian cleavage site or a 3 BP deletion.

This year, 8 of the 9 cases were between 1 ½ and 2 ½ years of age, raising concern that H5N1 are more widespread and infections of other age groups are not reported because these milder cases are not tested.

Release of sequences from patients and poultry this season would be useful.

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