Commentary
Concerns
On Diagnosis Delay On Prince of Wales Island Alaska
Recombinomics Commentary
12:37
October 4, 2008
How can there be confirmed cases when
they don't know what the cause is?
The above remarks in a ProMED
commentary requesting information on the respiratory
disease on Prince of Wales Island in Alaska is telling. The
media report indicates there are “confirmed” and “suspect” cases, yet a
patient cannot be confirmed without a diagnosis, but the Department of
Health maintains that there is no diagnosis yet, even though the CDC is
involved and the original media story
was posted October 1.
The location of the island and the timing of the outbreak raise
concerns of an H5N1 outbreak. In South
Korea, a soldier/culler was PCR
positive for H5 last spring, but South Korea denied
an H5N1 infection because they failed to isolate the virus from the
patient. Today, South Korea confirmed
a suspected bird flu outbreak (see
satellite
map), and local media has indicated the bird flu is
H5. Last spring, Japan implemented “enhanced” surveillance, when
South Korea confirmed H5N1 on duck farms, and Japan immediately
identified H5N1
in dead whooper swans. The dead swans were found at multiple
locations in northern Japan and the sequences were those of a Fujian
reassortant with a clade 2.3.2
HA and 2.3.4
for the other seven genes. The same reassortant was found in Primorie,
which was initially reported on a farm, but significant spread to
migratory bird regions to the south and west of the commercial farm
outbreak was subsequently acknowledged. Japan is currently
expanding its surveillance / response programs for H5N1.
Last spring the H5N1 infected wild birds were migrating to the north,
and excessive
poultry deaths were reported on Kamchatka, but H5N1 was
denied. The whooper swans and other long range migratory birds in
northern Japan would have summered in northern Siberia and Alaska,
raising concerns of Fujian H5N1 spread to Alaska.
Consequently, the failure to disclose the diagnosis on the “confirmed”
respiratory cases is cause for concern. Release of test results
on the “confirmed” cases would be useful.
Recombinomics Presentations
Recombinomics
Publications
Recombinomics
Paper
at Nature Precedings