Commentary
Hong Kong Hospitals on H5N1 Alert
Recombinomics Commentary 21:58
June 11, 2008
Hong Kong also found that local poultry retailers chicken feces samples showed positive for the H5N1 avian flu, the Hospital Authority on the 11th night that it would further strengthen in the public hospitals under severe strain-level implementation of infection control measures,
The spokesman said that if required hospitalization, will arrange for them to stay at Princess Margaret Hospital's infectious disease centre HA treated in isolation, the Centre has been ready to receive bird flu cases.
To further enhance rapid testing laboratory support services, public hospitals network of laboratories will, in conjunction with the Department of Health Public Health Laboratory Centre, stand extended. The laboratory network including the Princess Margaret Hospital, Prince of Wales Hospital, Queen Elizabeth Hospital, Queen Mary Hospital and Tuen Mun Hospital.
The above translation describes hospitals in Hong Kong going on alert due to the detection of H5N1 throughout the city (see satellite map). Although Hong Kong has reported H5N1 in wild birds each year, there have been no H5N1 positive poultry reports in the past five years. The latest outbreak is of concern because the chickens are asymptomatic. It is unclear if the H5N1 shedding by asymptomatic chickens is due to partial immunity due to a poor match between the vaccine and H5N1, adaptive changes by the chickens, or changes by the virus.
However, one of the arguments against H5N1 poultry vaccinations is viral shedding by poultry that appear healthy. The silent spread of H5N1 can quickly lead to a much larger genetic reservoir, creating conditions for more rapid evolution. The asymptomatic infections also increase potential for an expanded geographical reach.
In the past several years, the H5N1 in wild birds in Hong Kong have been Fujian clade 2.3.2 and 2.3.4. Sequences from 2007 and 2008 have been withheld, but the vaccine target for clade 2.3.2 is a wild bird isolate collected in Hong Kong in 2007. The similarity between that isolate and the H5N1 in South Korea, Japan and Primorsky suggests that the H5N1 in Hong Kong is also the Fujian strain, which may be linked to a global expansion of the Fujian strain.
The recent reports of avian influenza in North Korea have increased concerns. Although denied by the government, reports describe birds deaths in proximity to patient with bird flu symptoms, including at least one fatal infection (see satellite map).
Sequence information of the H5N1 in Hong Kong this year and last year, as well as more detail on the avian and human cases in North Korea would be useful.
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