-
FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website. -
We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.
Cairo's First Human Bird Flu Infection Confirmed [died]
- Thread starter HenryN
- Start date
Theresa42
Well-known member
AlaskaDenise
In Memoriam
Re: Cairo's First Human Bird Flu Infection Confirmed [died]
</TD><TD style="VERTICAL-ALIGN: top; WIDTH: 515px" colSpan=5><BIG><BIG></BIG></BIG><BIG><BIG>Commentary</BIG></BIG>
H5N1 Confirmation in Fatal Cairo Teenager Case
Recombinomics Commentary
April 11, 2007
Case number 34
Reported on 8 April 2007 This case is a female adolescent, 15 years old from Cairo Governorate. Date of onset of illness was on March 30. She was hospitalized into Abbasya Chest hospital on the 5th of April and the sample was taken on the 7th. It was confirmed positive for H5N1 in both MOH (7 April) and NAMRU-3 (8 April) laboratories. At the beginning, the patient denied exposure to sick poultry from the market one week before the onset of symptoms.
She died on April 10 at 7:30 pm at Abbasya Chest Hospital due to respiratory failure resulted from bi-lateral pneumonia.
The above details on the latest confirmed case in Egypt detail the differences between this case and the recent mild cases in central and southern Egypt. The initial cases this season in Egypt were confirmed in late 2006 and were from the Gharbiya governorate and all four were fatal. Sequences were generated from three of the cases and all had M230I, a change adjacent to the receptor binding domain which matches human strains (H1N1, H3N2, influenza B).
This change was in the last fatal case prior to the case in Cairo, and was also in a chicken isolate from Gharbiya in February, 2007. The poultry isolate shared a number of polymorphisms found in the Gharbiya cluster, including HA M230I and V223I, although Tamiflu (oseltamivir) resistance (N294S) was not found in the chicken isolate. However, the sequence had mixed signals at a number of positions indicating the chicken was infected with multiple strains of H5N1. Plaque purification of this isolate would be required to rule out N294S.
The latest case, like the earlier cases developed bi-lateral pneumonia in spite of Tamiflu treatment. The sequence of the isolate would help determine if the treatment failure was due to the time lag between the disease onset and treatment, or was due to genetic changes such as HA M230I or NA N294S.
The linkage to poultry a week before the onset of symptoms is also unclear because of the time lag. More poultry sequences from the Cairo area would be useful.
.
</TD></TR></TBODY></TABLE>
<TABLE style="WIDTH: 775px; COLOR: rgb(190,5,1); FONT-FAMILY: helvetica,arial,sans-serif; TEXT-ALIGN: left" cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD style="VERTICAL-ALIGN: top; WIDTH: 40px">
</TD><TD style="VERTICAL-ALIGN: top; WIDTH: 515px" colSpan=5><BIG><BIG></BIG></BIG><BIG><BIG>Commentary</BIG></BIG>
H5N1 Confirmation in Fatal Cairo Teenager Case
Recombinomics Commentary
April 11, 2007
Case number 34
Reported on 8 April 2007 This case is a female adolescent, 15 years old from Cairo Governorate. Date of onset of illness was on March 30. She was hospitalized into Abbasya Chest hospital on the 5th of April and the sample was taken on the 7th. It was confirmed positive for H5N1 in both MOH (7 April) and NAMRU-3 (8 April) laboratories. At the beginning, the patient denied exposure to sick poultry from the market one week before the onset of symptoms.
She died on April 10 at 7:30 pm at Abbasya Chest Hospital due to respiratory failure resulted from bi-lateral pneumonia.
The above details on the latest confirmed case in Egypt detail the differences between this case and the recent mild cases in central and southern Egypt. The initial cases this season in Egypt were confirmed in late 2006 and were from the Gharbiya governorate and all four were fatal. Sequences were generated from three of the cases and all had M230I, a change adjacent to the receptor binding domain which matches human strains (H1N1, H3N2, influenza B).
This change was in the last fatal case prior to the case in Cairo, and was also in a chicken isolate from Gharbiya in February, 2007. The poultry isolate shared a number of polymorphisms found in the Gharbiya cluster, including HA M230I and V223I, although Tamiflu (oseltamivir) resistance (N294S) was not found in the chicken isolate. However, the sequence had mixed signals at a number of positions indicating the chicken was infected with multiple strains of H5N1. Plaque purification of this isolate would be required to rule out N294S.
The latest case, like the earlier cases developed bi-lateral pneumonia in spite of Tamiflu treatment. The sequence of the isolate would help determine if the treatment failure was due to the time lag between the disease onset and treatment, or was due to genetic changes such as HA M230I or NA N294S.
The linkage to poultry a week before the onset of symptoms is also unclear because of the time lag. More poultry sequences from the Cairo area would be useful.
.
</TD></TR></TBODY></TABLE>
Re: Cairo's First Human Bird Flu Infection Confirmed [died]
Commentary at
http://www.recombinomics.com/News/04140701/H5N1_Evolution_Egypt_Russia.html
Commentary at
http://www.recombinomics.com/News/04140701/H5N1_Evolution_Egypt_Russia.html
AlaskaDenise
In Memoriam
Re: Cairo's First Human Bird Flu Infection Confirmed [died]
Simultaneous H5N1 Acquisitions in Russia and Egypt
Recombinomics Commentary
April 14, 2007
Recently, US NAMRU-3 has sequenced the latest confirmed cases in Egypt, including the sibling from Qena (4M), A/Egypt/2629-NAMRU3/2007; the child from Sohag (7M), A/Egypt/2630-NAMRU3/2007; the child from Qalubiea (4F), A/Egypt/2631-NAMRU3/2007; the child from Menia (2F), A/Egypt/2750-NAMRU3/2007; and the teenager from Shoubra in Cairo (15F), A/Egypt/2751-NAMRU3.
These sequences had much in common with previous sequences from Egypt. The Qena sibling sequence matched the index case (6F), A/Egypt/2621-NAMRU-3/2007 (see slide 54) and the Qalubiea sequence was also very similar, including the HA 3 BP deletion (see slide 53) that was also in the Beni Suef (27F), A/Egypt/0636/2007, and Fayyoum sequences (17F). The Menia sequence was closely related to the sequences from Aswan, while the Shourbra sequences were like poultry sequences from Gharbiya (A/chicken/Egypt/1891N3-CLEVB.2007 and A/chicken/Egypt/1890-HK45/2007). The Sohag sequence was unique. The NA sequence had the common Egyptian markers C150T, C236T, A703G, A740G, T1088C, and G1280A. However, appended onto this Egyptian, Qinghai genetic background was A743G. A743G was in a large subset of the recently released sequences from northern Germany, as well as earlier Bavaria sequences, which were from dead wild birds or carnivores, collected in February, 2006.
As noted earlier, A743G was in chicken isolates in Gharbiya, collected a year later in February, 2007. It was also in the Qena siblings, who were confirmed this month. Thus, A743G has appeared in six recent Egyptian isolates in Gharbiya, Sohag, and Qena. The HA and NA sequences from the isolates fall into three readily distinguishable isolates, yet they all contain A743G. Moreover, the recent isolates from Moscow (A/chicken/Moscow/2/2007 and A/chicken/Russia_Moscow oblast_Odintsovo/1/2007) also have A743G, appended onto another easily distinguishable Clade 2.2 genetic background, similar to Azerbaijan isolates from last season.
The simultaneous appearance of A743G on four genetically distinguishable backgrounds is most easily explained by recombination.
Polymorphism tracing indicates the polymorphism moved from H5N1 in South Korea / Japan in 2004 to Clade 1 in southeast Asia in 2005, to Clade 2.1 and 2.3 isolates in China and Indonesia in 2006, to Clade 2.2 in Germany in 2006, and to readily distinguishable Clade 2.2 isolates in Moscow and three locations in Egypt in 2007. The 2007 infections were between mid-February and early April.
The simultaneous A743G acquisitions onto genetically distinguishable Clade 2.2 isolates in Russia and Egypt are striking.
.
Commentary
Simultaneous H5N1 Acquisitions in Russia and Egypt
Recombinomics Commentary
April 14, 2007
Recently, US NAMRU-3 has sequenced the latest confirmed cases in Egypt, including the sibling from Qena (4M), A/Egypt/2629-NAMRU3/2007; the child from Sohag (7M), A/Egypt/2630-NAMRU3/2007; the child from Qalubiea (4F), A/Egypt/2631-NAMRU3/2007; the child from Menia (2F), A/Egypt/2750-NAMRU3/2007; and the teenager from Shoubra in Cairo (15F), A/Egypt/2751-NAMRU3.
These sequences had much in common with previous sequences from Egypt. The Qena sibling sequence matched the index case (6F), A/Egypt/2621-NAMRU-3/2007 (see slide 54) and the Qalubiea sequence was also very similar, including the HA 3 BP deletion (see slide 53) that was also in the Beni Suef (27F), A/Egypt/0636/2007, and Fayyoum sequences (17F). The Menia sequence was closely related to the sequences from Aswan, while the Shourbra sequences were like poultry sequences from Gharbiya (A/chicken/Egypt/1891N3-CLEVB.2007 and A/chicken/Egypt/1890-HK45/2007). The Sohag sequence was unique. The NA sequence had the common Egyptian markers C150T, C236T, A703G, A740G, T1088C, and G1280A. However, appended onto this Egyptian, Qinghai genetic background was A743G. A743G was in a large subset of the recently released sequences from northern Germany, as well as earlier Bavaria sequences, which were from dead wild birds or carnivores, collected in February, 2006.
As noted earlier, A743G was in chicken isolates in Gharbiya, collected a year later in February, 2007. It was also in the Qena siblings, who were confirmed this month. Thus, A743G has appeared in six recent Egyptian isolates in Gharbiya, Sohag, and Qena. The HA and NA sequences from the isolates fall into three readily distinguishable isolates, yet they all contain A743G. Moreover, the recent isolates from Moscow (A/chicken/Moscow/2/2007 and A/chicken/Russia_Moscow oblast_Odintsovo/1/2007) also have A743G, appended onto another easily distinguishable Clade 2.2 genetic background, similar to Azerbaijan isolates from last season.
The simultaneous appearance of A743G on four genetically distinguishable backgrounds is most easily explained by recombination.
Polymorphism tracing indicates the polymorphism moved from H5N1 in South Korea / Japan in 2004 to Clade 1 in southeast Asia in 2005, to Clade 2.1 and 2.3 isolates in China and Indonesia in 2006, to Clade 2.2 in Germany in 2006, and to readily distinguishable Clade 2.2 isolates in Moscow and three locations in Egypt in 2007. The 2007 infections were between mid-February and early April.
The simultaneous A743G acquisitions onto genetically distinguishable Clade 2.2 isolates in Russia and Egypt are striking.
.