New Suspect H5N1 Case in Pakistan
Recombinomics Commentary 2:12
December 27, 2007
John Rainford, a WHO spokesman in Geneva, told CIDRAP News he expected confirmatory test results would probably be released tomorrow. But he said the results of genetic sequencing of the viruses will take longer.
"The sequencing is on a different track [from the confirmatory tests], and that can take a week or possibly longer," Rainford said.
He also said there may be a new suspected H5N1 case in Pakistan, but information so far was very sketchy.
The above comments suggest there may be a new suspect H5N1 case in Pakistan. New cases would not be a surprise because the October cull resulted in at least three independent infections. One involved the large cluster with the veterinarian as an index case. Another cluster involved a culler and his daughter or niece, while a third positive was in a case unrelated to the two clusters.
The multiple infections in October indicated the H5N1 in circulation was more efficiently transmitted to humans, which was supported by the large size of the one cluster, which included one or two health care workers based on media reports.
The release of a WHO update with disease onset dates, hospitalization dates and dates of death should provide clarity on contradictory media reports. The situation update should also clarify the relationship between the confirmed positive cases.
Changes in the receptor binding domain would not be a surprise. All prior clusters linked to the Qinghai strain (clade 2.2) have had receptor binding domain changes (in Turkey, Iraq, Azerbaijan, and Egypt).
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