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Commentary

H1N1 Swine Flu Fatal Cluster and Spread In Libya
Recombinomics Commentary
December 29, 2014 02:30

Technical Committee to follow up pandemics National Center for combating diseases held an emergency meeting at the Centre appeared Sunday, 12/28/2014, during which the study of the current situation with regard to the emergence of cases of severe pneumonia was found registration number (10) cases of acute her pneumonia same common symptoms which "cough - heat - phlegm accompanied by blood - acute respiratory failure," died, including 5 cases were as follows: - the Tripoli Medical Center ((two cases of Moatntan pregnant women in their thirties from work and one of them proved experimentally infected with H1N1 and Asalta subsurface artificial respiration superior care - the third case of a young man in the forties is still in the intensive care waiting for lab results - the fourth case of a young man in his thirties died and proven results Almuamm, was diagnosed with influenza type A - A fifth case of the young man in his thirties was still receiving treatment in the intensive care unit and in waiting for the results Alhaleil - sixth case for citizenship holder of the same symptoms have been converted from the Tripoli Medical Center to Asabieh Hospital and died at the hospital)) cases city of Tobruk ((registered 4 cases with the same symptoms of whom died three patients, two of them brothers aged 28 and 40-year-old who died was not a sample is taken of them - the second case Feb died in Egypt and there is no sufficient information about the patient and the fourth case, it is a laboratory technician is still under the care and through the presentation of these cases, the Committee emphasizes that the current situation does not constitute an outbreak in accordance with current data and began to communicate with hospitals to prepare for any emergency

The above comments from the Libya Ministry of Health web page offer considerable detail on the fatal and hospitalized severe pneumonia cases in Tripoli and Tobruk.  The cases are previously healthy young adults including 2 or 3 who were pregnant.  There is no indication of a poultry exposure or any indications that these patients have bird flu.
 
One has been H1N1pdm09 confirmed, while another is influenza A positive, consistent with an H1N1pdm09 infections.  The ages of the patients match those most susceptible to H1N1pdm09, which will be the likely diagnosis for all of the above cases.
 
Media reports had cited 10 bird flu infections.  Some said the strain had not been identified, while others cited H5N1, which is not supported by the above report.
 
WHO is sending an investigative team, and  sequences of the H1N1pdm09 isolates would be useful.  This outbreak has similarities with the 2009 H1N1pdm09 outbreak in Ukraine, where direct sequencing of lung samples from fatal cases had D225G, D225N, or both.

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