Another H5N1 Fatality
Reported In Anhui, China
By Dr. Henry L. Niman, PhD
"A 35-year-old woman farmer surnamed Xu in Xiuning County of Anhui developed fever and pneumonia-like symptoms on Nov. 11 after contacts with sick and dead poultry. She died on Nov. 22."
The above case is the third H5N1 fatality reported in China.  Two of the three confirmed cases have died and the third death is a highly suspect case who was the 12 year-old sister of the only confirmed H5N1 case who has survived.
These four cases are beginning to form clusters, with two cases in Hunan and two in Anhui.  Although the number of reported cases is small. The association with outbreaks linked to migratory birds is cause for concern.
This season the first reported H5N1 outbreak in China was in Inner Mongolia.  This was followed by outbreaks in Anhui and Hunan.  The time and location of these outbreaks suggest they are linked to the widespread H5N1 in Mongolia reported over the summer.  Included in the Mongolia bird cases are three swan isolates with a novel HA cleavage site, which could reflect changes in the pathogenicity of these isolates.
In addition to the repeated outbreaks in Anhui and Hunan, there are also outbreaks in nearby Liaoning province (see map) and third party reports indicate there are 77 human fatalities associated with cullers trying to bring these outbreaks under control.  Although the 77 human H5N1 cases have not been verified, the increasing number of official fatal cases in eastern China raises additional concerns.
Outbreaks in China are being reported on a daily basis and many of these outbreaks are in localized regions indicating a failure to control the outbreaks with culling and vaccinationmeasures.
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