H5N1 Positive Cullers in Kuwait
Recombinomics Commentary
April 4, 2007
Preliminary tests for bird flu on four Bangladeshi workers who had been culling chickens infected with the disease were "positive," a Kuwaiti medical source told AFP.
"The first test on the four men was positive," the source said, requesting anonymity. "We have taken blood samples for a second test to reconfirm the initial results. We expect the outcome within hours."
The above comments describe initial positive H5N1 results on cullers in Kuwait. Positive infections in workers would not be unexpected. In the past, infections of cullers has not been high, other than the H7N7 outbreak in the Netherlands, when cullers and contacts developed eye infections, or were asymptomatic but developed H7 antibodies. The culling methods used in Kuwait increase the risk to the cullers, and there has been recent cluster of human cases in Egypt.
Like all H5N1 outbreaks in Europe, the Middle East, and Africa, the Kuwait infections are almost certainly the Qinghai (clade 2.2) strain, and the sequences may be closely related to sequences in southern Egypt, based on the shared overlapping East Africa / West Asia and Black Sea / Mediterranean flyways.
There has been a spike in human cases in upper (southern) Egypt. The isolates from Aswan and Mena have the novel Mongolian cleavage site, RERRRRKR, and the initial cases have recovered. A second sub-clade, with a 3 BP HA deletion has been isolated from the index case in Qena and the isolate from the sibling is being sequenced by NAMRU-3. Media reports indicate the Kuwait positives have been sent to NAMRU-3 for confirmation.
Sequence data from the H5N1 positive birds in Kuwait would be useful. The HA (see slide 53) and NA (see slide 54) have characteristic Egyptian regional and sub-regional markers, which extend upstream to Europe, and downstream to western Africa. Further linkages to Kuwait would be expected.
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