Two Emus that died Thursday in Kibbutz Ein Gedi’s menagerie succumbed to a deadly strain of the Avian flu virus, Israel Radio reported. Ministry of Agriculture tests conducted on the birds identified the nature of the disease. Officials estimated that the Emus were infected by migrating birds.
The above comments confirm H5N1 in an Israel petting zoo. The suggestion that the Emus were infected by migratory birds raises concerns that the Fujian strain (clade 2.3.2) may have migrated to the Middle East. Earlier this year Israel reported another outbreak of H5N1, (Snip) A year ago Fujian H5N1 was found in migratory birds at Uvs late, setting the stage for migration south in 2009, and a return in the spring of 2010. The above infection may signal that migration.
Recently released sequences from human H5N1 cases in Egypt, by NAMRU-3, have been exclusively clade 2.2.1 with 125del (3 BP deletion), which has become fixed in Egypt. However, these infections may now be linked to human to human transmission, based on the close similarities between sequences. Poultry sequences in Egypt have also been clade 2.2.1, but poultry sequences have been more diverse and include the vaccine resistant sub-clade.
(Snip) shared polymorphisms indicate that much of the evolution of H5N1 in Egypt, including the donkey H5N1, has been driven by recombination between clade 2.2.1 sequences in Egypt.
Recombinomics: Fixing of 125del In Human H5N1 In Egypt
NAMRU-3 has recently released HA and NA sequences from recent H5N1 cases in Egypt (11 from 2009 and 12 from 2010). All 23 HA sequences had 125del (3 BP deletion), indicating the deletion is becoming fixed in human H5N1 in Egypt. An earlier paper, “Characterization of conserved properties of hemagglutinin of H5N1 and human influenza viruses: possible consequences for therapy and infection control” had noted similarities between H5N1and seasonal H1N1, raising concerns of increased human transmission (H2H) of H5N1 with 125del. This concern was increased by the recent paper describing the detection of H5N1 in donkeys and serological evidence of widespread H5N1 antibodies in donkeys.
Concerns of human to human H5N1 transmission in Egypt were raised when mild cases in children were reported in the spring of 2007. Several had the 3 BP deletion and sequences were closely related. There children had a mild course, which did not include pneumonia. In early 2009, mild cases were reported in toddlers. The large number of cases reduced the case fatality rate for H5N1 in 2009 to approximately 10%. The sequences from these toddlers also had 125del, (Snip)
Poultry H5N1 sequences collected in the past year were more diverse and included vaccine resistant H5N1. (Snip) all human sequences contained 125del and many of the 2010 sequences were closely related to each other raising additional concerns that H5N1 is transmitting H2H. Since Egypt does not H5N1 test patients who do not have a poultry contact, the full extent of H5N1 remains largely unknown. Serological testing has been discussed for over a year. During that time a serological survey on donkeys was conducted, which showed widespread antibodies in donkey serum. Results for a comparable test in humans, using a 125del H5N1 target is long overdue.
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