- 2/7 "And in Najaf three individuals
met from a single family in towards Al Abasia their death yesterday [Feb
06] the effect of doubts with their injury with influenza disease the birds
and the Iraqi news agency correspondent in City of Najaf reported that
three individuals, two men he exceeds their age the thirty and a woman
an old they departed the life affected by a non discovered disease, after
their taking before two days a food including the chickens.... [Deaths
reported as pneumonia but] ...they will send samples of the deceased blood
to Baghdad and hence they send to Egypt to be submitted to accurate analyses."
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- The above translation suggests another
H5N1 familial cluster has been identified in Iraq. These three fatal cases
were in the city of Najaf. The victims developed a fatal pneumonia after
eating chicken. Samples have been sent out for testing, but testing in
Iraq and elsewhere has been problematic at a number of levels for a number
of reasons. Testing for H5N1 appears to be getting less reliable, and a
diagnosis based on clinical descriptions may be more useful.
-
- The index case in Iraq was "discounted"
because of an initial lack of a connection with reported H5N1 infections
in birds, although the clinical signs clearly indicated H5N1. In addition,
like every index cluster for every country reporting human H5N1 cases since
2005, false negatives were reported. In Turkey, not only are false negatives
common, but even positives have tested negative after shipment to Weybridge.
-
- The reliance on lab confirmation has
led to delays and a very distorted database of H5N1 infected people. Obvious
H5N1 infections are excluded because of lack of samples or poorly collected
samples. The current WHO is useful for identifying a full set of clusters,
because more have one or more members excluded by lab tests (or lack of
lab tests).
-
- The above cluster adds to a growing list
of clusters linked to the Qinghai strain of H5N1. The first cluster was
reported in Turkey and is easily the longest and largest cluster recorded
for H5N1. This first cluster was linked to HA S227N identified in the index
case.
- The index case was the first confirmed
human H5N1 case caused by the Qinghai strain. It seems likely that this
change, which increases the affinity of HA in H5N1 for human receptors
would create more efficient transmission of H5N1 to humans. This increased
efficiency would generate additional clusters, as has been seen in northern
and southern Iraq.
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- © 2006 Recombinomics. All rights
reserved.
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