H5N1 Re-emergence in Minya Egypt
Recombinomics Commentary
November 3, 2007
Last week 30 birds were culled in Minya after testing positive
The above comments suggest H5N1 has re-emerged in Egypt again. This is not a surprise. The first H5N1 reported in Africa was a healthy teal in the Nile Delta. The sample was collected in December, 2005, prior to acknowledgement by any country in the Middle East or Africa or any country in western Europe.
The teal in the Nile Delta was not a surprise because of the proximity to overlapping flyways and earlier reports of H5N1 in Siberia, Mongolia, and eastern European countries bordering the Black Sea.
The detection in December, 2005 was followed by human cases in the Middle East, including Turkey and Egypt, as well as approximately 50 countries in Europe, the Middle East, and Africa. In Egypt, after H5N1 reports declined over the summer, it re-emerged in the fall of 2006 and peaked in early 2007.
Thus, after a decline, a re-emergence was expected. The re-emergence was also signaled by recent reports of H5N1 in Krasnodar, which followed a large outbreak in Germany and adjacent countries over the summer.
The sequences of the new infections should be of interest. In 2007, the H5N1 in Egypt was more complex than early 2006. Included were isolates with changes in or near the receptor binding domain, as well as oseltamivir (Tamiflu) resistance (in the Ghabiya cluster). The M230I change adjacent to the receptor binding domain was linked to fatal infections in patients. Milder cases were reported in central and southern Egypt. The cases included sequences with a 3 PB deletion as well as a novel cleavage site previously seen in Mongolia.
In addition, many of the 2007 isolates had acquired NA G743A, which was appended onto multiple genetic backgrounds in Egypt, as well as 2007 isolates in Moscow and Ghana. The same acquisition by the recent Krasnodar isolate suggests that more G743A acquisitions will be found this season.
Moreover, the Krasnodar sequence was most closely related to earlier isolates from Mongolia and Tyva, which matches the description of the H5N1 found in wild birds and poultry in Germany this summer. These outbreaks in Germany and Krasnodar may lead to similar acquisitions in Egypt this season.
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