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Commentary

M230I Re-emergence in Egypt?

Recombinomics Commentary 17:30
December 26, 2007

Women and children have borne the brunt of the virus due to their role in taking care of domestic fowl. A 10-year-old girl was the last person to die from the disease in Egypt in June.

Egypt's location on major bird migration routes and the widespread practice of keeping domestic fowl near living quarters have led to it being the hardest-hit country outside Asia.

The government says it is conducting a vigorous campaign to combat the spread of the virus through vaccinations and raising awareness, but cases continue to appear.

The above comments note the prior fatal case in Egypt. However, that case was the only fatality in the 17 confirmed cases preceding the latest case.  In contrast, the first 7 cases in Egypt last season died.  Most of those early cases had M230I.  Since all cases with M230I died, the current case raises the possibility that M230I has re-emerged in Egypt.

Last season there was a convergence of M230I at the beginning of the season.  It was encoded with sequences that traced back to an eagle owl in Germany, or H7 sequences circulating in Europe.  H7 was subsequently identified in birds in EgyptM230I is also present in human seasonal flu, including influenza B.

M230I was found in a chicken from Beni Suef, isolated March 8, 2007 as well as a chicken in Gharbiya, isolated February 15, 2007.  These poultry isolates raise the possibility of a re-emergence of M230I was more birds migrate into the region and sequences in Egypt become more complex.

The large number of domestic poultry cases (see satellite map of OIE cases here here here here here), coupled with overlapping flyways and endemic H5N1 provide an opportunity for significant H5N1 evolution in Egypt.

Release of sequence data on the latest case would be useful.

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