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Hospitalized Doctor Raises Pandemic Concerns in Pakistan

Recombinomics Commentary
December 19, 2007

“Two people have been discharged while the third one, a KTH doctor, is suspected to be infected and officials are awaiting his test reports from the National Institute of Health (NIH) Islamabad,” he added.

The above comments describe a male health care worker hospitalized at Khyber Teaching Hospital (KTH).  Earlier media reports described a female health care worker who had tested positive for H5N1.  It is not clear if these two reports refer to the same health care worker, or if there are two who are either lab confirmed or hospitalized.  Earlier media reports indicated the lab positive health care worker was not hospitalized.

A hospitalized health care work at this time is cause for concern.  Although no official onset dates have been released, the consensus in media reports indicates the index case for the larger familial cluster was a veterinarian who organized a cull October 21-23.  He developed symptoms on October 25 and was hospitalized at KTH.  Two of his brothers, who were students and were not involved in the cull, visited him at the hospital and were subsequently hospitalized there.  These two brothers died November 19 and 29.  One was tested and was H5N1 positive as were two other brothers and a cousin.  The above comments suggest at least one of the surviving relatives was also hospitalized at KTH.

If the above health care work is H5N1 confirmed, a long transmission chain is likely, based on the disease onset date of the index cases on October 25 and the dates of the deaths of the two brothers, November 19 and 29. 

Disease onset dates and contact dates are required to detail the chain, but a chain for almost two months would be an H5N1 record and increase pandemic concerns.


Details, including disease onset dates and confirming lab tests, as well as sequence data, would be useful.

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