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Cambodian Human H5N1 Strain Designations from 2005-2013

B

Biological

Closed. Please see Biological100
This is the most recent in chronological order from Instiutut Pasteur in Cambodia by Buchy 2009, Sorn 2012 and Horm 2013..

Buchy et al. 2009 Molecular Epidemiology of Clade 1 Influenza A Viruses (H5N1), Southern Indochina Peninsula, 2004?2007 Volume 15, Number 10?October 2009 - Emerging Infectious Disease journal ? CDC-http://wwwnc.cdc.gov/eid/article/15/10/09-0115_article.htm

Sorn, S., et al. Dynamic of H5N1 virus in Cambodia and emergence of a novel endemic sub-clade. Infect. Genet. Evol. (2012), http://dx.doi.org/10.1016/j.meegid.2012.05.013 http://www.sciencedirect.com/science/article/pii/S1567134812002158

and now

Horm et al.2013 Influenza A(H5N1) Virus Surveillance at Live Poultry Markets, Cambodia, 2011 - Vol. 19 No. 2 - February 2013 - Emerging Infectious Disease journal CDC
http://wwwnc.cdc.gov/eid/article/19/2/12-1201_article.htm


(Also in 2009 see Guti?rrez, Ramona A.; Naughtin, Monica J.; Horm, Srey V.; San, Sorn; Buchy, Philippe et al. 2009. "A(H5N1) Virus Evolution in South East Asia." Viruses 1, no. 3: 335-361. 6 October 2009
http://www.mdpi.com/1999-4915/1/3/335

The following chronological articles of Cambodian isolates in HA clade1, 1.1 and proposed 1.1A by researchers with epidemiological evidence of proposed sublinaeges 1-6!

Notable strain designation A/Cambodian/W0329318/2012 is an HA 1.1 clade however is a new designation which I haven?t come across in GISAID or any other public database!

It's "W0" is similar to anther human case in January A/Cambodia/W0112303/2012 or CB19 in Influenza Virus Traceability Mechanism (IVTM)

----------------------------------------------------------------------
Summary of Diagnostic Results
Influenza type A (H5N1): 1 of 1 materials

Source IVTM-SRC363, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes CDC ID# 2012788593
CB19
Deceased
Created on 29-Aug-2012 15:38:03 | Last modified on 29-Aug-2012 15:38:03

Original Specimen IVTM-ORG703, Human, Cambodia
Date of
collection 10-Jan-2012
IVTM Parent IVTM-SRC363
Notes CDC ID# 2012788593
CB19
Deceased
Influenza type A (H5N1)
Specimen Type virus isolate cell culture
Place of collection Cambodia
Created on 29-Aug-2012 15:38:53 | Last modified on 29-Aug-2012 15:38:53

Influenza Virus Traceability Mechanism
https://extranet.who.int/ivtm/Tree.aspx?matid=703

Case CB19 background:

"Avian influenza ? situation in Cambodia
16 January 2012 - The Ministry of Health (MoH) of the Kingdom of Cambodia has announced a confirmed case of human infection with avian influenza A (H5N1) virus.

The case was a 2 year-old male from Banteay Meanchey Province. He developed symptoms on 3 January 2012 and was admitted to hospital on 9 January 2012. He is on Tamiflu and has been ventilated.

There have been reports that the boy was exposed to sick poultry in his village. He is the 19th person in Cambodia to become infected with the H5N1 virus; to date, 16 of these cases have died from complications of the disease.

The National and local Rapid Response Teams (RRT) are conducting outbreak investigation and response following the national protocol. Hospital staff who had contact with the case have been offered oseltamivir. To date, none of the human contacts have tested positive for A (H5N1)."

or see

Joint Statement by the Ministry of Health, Kingdom of Cambodia and World Health Organization (WHO). Nineteenth Human Case of Avian Influenza H5N1 in Cambodia.13 January 2012
http://www.cdcmoh.gov.kh/PressRelease/Preeses_release H5N1_19th_2012_en.pdf

-------------------------------------------------------------------------

The other cases are CB "case" 20 and CB "case" 21 in 2012

-----------------------------------------------------------------------

Influenza Virus Traceability Mechanism:WHO

Summary of Diagnostic Results
Influenza type A (H5N1): 1 of 1 materials

Source IVTM-SRC364, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes CDC ID# 2012788599
CB20
Deceased
Created on 29-Aug-2012 15:39:42 | Last modified on 29-Aug-2012 15:39:42

Original Specimen IVTM-ORG704, Human, Cambodia
Date of collection 28-Mar-2012
IVTM Parent IVTM-SRC364
Notes CDC ID# 2012788599
CB20
Deceased
Influenza type A (H5N1)
Specimen Type virus isolate cell culture
Place of collection Cambodia
Created on 29-Aug-2012 15:39:42 | Last modified on 29-Aug-2012 15:39:42

Influenza Virus Traceability Mechanism
https://extranet.who.int/ivtm/Tree.aspx?matid=704

Case CB20 background:

Avian influenza ? situation in Cambodia ? update
5 April 2012 - The Ministry of Health (MoH) of the Kingdom of Cambodia has announced a confirmed case of human infection with avian influenza A (H5N1) virus.

"The 6 year-old female from Kampong Chhnang Province developed symptoms on 22 March 2012. After initial treatment at the village, she was later admitted to hospital in Phnom Penh on 28 March. She died on 30 March. Infection with avian influenza A (H5N1) virus was confirmed by Institut Pasteur du Cambodge on 30 March.

It was reported that the patient had contact with sick or dead poultry prior to onset of illness.

The National and local Rapid Response Teams (RRT) are conducting outbreak investigation and response following the national protocol. In addition, a public health education campaign is being conducted to inform families on how to protect themselves from contracting avian influenza.

To date, of the 20 cases reported in Cambodia since 2005, 18 have been fatal."

or see

Joint Statement by the Ministry of Health, Kingdom of Cambodia and World Health Organization (WHO). Twentieth Human Case of Avian Influenza H5N1 in Cambodia.2 April 2012
http://www.cdcmoh.gov.kh/PressRelease/Preeses_release H5N1_20th_2012_en.pdf

-----------------------------------------------
Summary of Diagnostic Results
Influenza type A (H5N1): 1 of 1 materials

Source IVTM-SRC365, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes CDC ID# 2012788600
CB21
Deceased
Created on 29-Aug-2012 15:41:20 | Last modified on 29-Aug-2012 15:41:20

Original Specimen IVTM-ORG705, Human, Cambodia
Date of collection 25-May-2012
IVTM Parent IVTM-SRC365
Notes CDC ID# 2012788600
CB21
Deceased
Influenza type A (H5N1)
Specimen Type virus isolate cell culture
Place of collection Cambodia
Created on 29-Aug-2012 15:42:11 | Last modified on 29-Aug-2012 15:42:11

Influenza Virus Traceability Mechanism
https://extranet.who.int/ivtm/Tree.aspx?matid=705

Case CB21 background:

WHO | Avian influenza ? situation in Cambodia ? update
http://www.who.int/csr/don/2012_05_29/en/index.html

"Avian influenza ? situation in Cambodia ? update
29 May 2012 - The Ministry of Health (MoH) of the Kingdom of Cambodia has announced a confirmed case of human infection with avian influenza A (H5N1) virus.

The case was a 10 years old female from Kampong Speu Province. She developed symptoms on 20 May 2012 and after initial treatment at the village was eventually admitted to the hospital on 25 May with symptoms of fever and shortness of breath. Infection with avian influenza A(H5N1) virus was confirmed by Institute Pasteur du Cambodge on 26 May 2012, however, despite intensive medical care, she died on 27 May 2012.

There are reports of recent deaths among poultry in her village and the patient prepared sick chicken for food prior to becoming sick.

The girl is the twenty-first person in Cambodia to become infected with A(H5N1) virus and 19 have died from the disease.

The National and local Rapid Response Teams (RRT) are conducting outbreak investigation and response following the national protocol. In addition, a public health education campaign is being conducted in the village to inform families on how to protect themselves from contracting avian influenza."

or see

Joint Statement by the Ministry of Health, Kingdom of Cambodia and World Health Organization (WHO). Twenty first Human Case of Avian Influenza H5N1 in Cambodia.28 May 2012
http://www.cdcmoh.gov.kh/PressRelease/Preeses_release H5N1_21th_2012_en.pdf


------

Strain designation A/Cambodian/W0329318/2012 must be either CB20 or CB21 respectfully!

See: Proposed new HA clade 1.1A and Lineages 1 to 6

Snip:
http://wwwnc.cdc.gov/eid/article/19/2/12-1201-f2.htm
Figure 2. . Phylogenetic relationship of the hemagglutinin (HA) gene among various influenza A(H5N1) strains; HA sequences for 48 strains (36 from Cambodia, 11 from Vietnam and one from China) were included in the analysis. Black triangles indicate viruses detected during this study of environmental samples from live poultry markets in Cambodia. Phylogenetic trees were generated by using the distance method and applying the neighbor-joining algorithm with bootstrap analysis (1,000 replicates). Analysis was based on nt 1?1,661 of the HA gene. The trees were rooted to A/goose/China/Guangdong/1/96 (H5N1). Numbers above and below branch nodes indicate bootstrap value of >70%. Scale bar represents the number of nucleotide changes per site. Lineage numbers 1?6, clades, and subclades indicate strains that are grouped in closely related phylogenetic lineages, as described (14). All sequences included in the analysis are available in GenBank. :confused:
Horm SV, Sorn S, Allal L, Buchy P. Influenza A(H5N1) virus surveillance at live poultry markets, Cambodia, 2011. Emerg Infect Dis. 2013 Feb http://dx.doi.org/10.3201/eid1902.121201

------------------------------------------------------------------------

WHO HA Clades:HA Clade 1 ,HA Clade 1.1

Cases: Strain designation

Case 1: A/Cambodia/JP52a/2005 (Odagiri et al. 2005 and Buchy et al. 09 only case in January); IRD: RERRRKKR
Case 2: A/Cambodia/P0322095/2005; IRD: RERRRKKR; M2 Ser31Asn
Case 3: A/Cambodia/408008/2005; IRD: RERRRKKR; PB2-E627K; M2-Ser31Asn
Case 4: A/Cambodia/VN05-103/2005; IRD: RERRRKKR
Case 5: A/Cambodia/Q0321176/2006; IRD: M2-31N
Case 6: A/Cambodia/Q0405047/2006; IRD: RERRRKKR
Case 7: A/Cambodia/R0405050/2007; IRD: M2-Ser31Asn; (VC-NIBRG-88*)
Case 8: A/Cambodia/S1211394/2008; IRD: M2-Ser31Asn
Case 9: N/A
Case 10:A/Cambodia/U0417030/2010; IRD: PB1-F2 N66S; M2-Ser31Asn
Case 11:A/Cambodia/V0203306/2011; IRD: PB1-F2 N66S; PB2 E627K; M2-Ser31Asn
Case 12:N/A
Case 13:A/Cambodia/V0219301/2011; IRD: PB1-F2 N66S; M2-Ser31Asn
Case 14:A/Cambodia/V0401301/2011; IRD: PB1-F2 N66S; M2-Ser31Asn
Case 15:A/Cambodia/V0417301/2011; IRD: PB1-F2 N66S; M2-Ser31Asn
Case 16:A/Cambodia/V0606311/2011; IRD: HA S227N; M2-Ser31Asn and A/Cambodia/V0606321/2011; No Comment for:NA and NS (both collected 6-June in Prey Veng)
Case 17:A/Cambodia/V0719348/2011; IRD: M2-Ser31Asn
Case 18:A/Cambodia/V0813302/2011; IRD: M2-Ser31Asn
Case 19:A/Cambodia/W0112303/2012; IRD: PB1-F2 N66S; PB2 D701N; M2 31N
Case 20:CB20 IVTM pending designation (Original sample CDC ID# 2012788599)
Case 21: CB21 IVTM pending designation (Original sample CDC ID# 2012788600)
Case 22:Pending
Case 23:Pending
Case 24:Pending
Case 25:Pending
Case 26:Pending
Case 27:Pending
Case 28:Pending

"Mutations comments do show increase in Mutations/Motifs possibly related to increase adaptation, virulence, and pathogenicity of Cambodian 1 and 1.1 HA Clades"

To support this personal comment see:
H5N1 Genetic Changes Inventory
http://www.cdc.gov/flu/pdf/avianflu/h5n1-inventory.pdf

Michael Fraser RN (Biological)
:tiphat:
 
Re: Cambodian Human H5N1 Strain Designations from 2005-2013

Options for the Control of Influenza VIII Cape Town, South Africa 5-10 September 2013
http://optionsviii.controlinfluenza.com/


P1-239 (Evolution, Systems Biology,and Pathogenesis pg 183)

A new genotype resulting from the reassortment of clade 1.1 and 2.3.2.1 at the
origin of the human and animal H5N1 virus cases in Cambodia in 2013

V Duong1, S Rith1, SV Horm1, S Ly2, S Sorn3, S Chuop4, S Buth4, R Tsuyuoka5, D Laurent6, B
Richner6, H Seng2, B Sar7, D Holl3, P Kitsutani8, S Ung4, A Tarantola1, T Sok2, P Buchy1*
1Institut Pasteur in Cambodia, Phnom Penh, Cambodia; 2Communicable Disease Department,
Ministry of Health, Phnom Penh, Cambodia; 3National Veterinary Research Institute, Ministry of
Agriculture, Phnom Penh, Cambodia; 4National Institute of Public Health, Phnom Penh,
Cambodia; 5World Health Organization, Phnom Penh, Cambodia; 6Kantha Bopha Hospitals
Foundation, Phnom Penh, Cambodia; 7Centers for Disease Control and Prevention, Cambodia office,
Phnom Penh, Cambodia; 8Centers for Disease Control and Prevention, Atlanta, Georgia, United
States

Background: In Cambodia since 2004, A(H5N1) virus has been detected in 39 poultry outbreaks and
32 patients (27 deaths) to May 1, 2013. Until 2012, all A(H5N1) strains isolated in Cambodia
belonged to clades 1 and 1.1, of which six distinct lineages were identified. Lineage 1 viruses shared
the same ancestor with viruses from Thailand, while all the lineages detected since 2005 were closely
related to viruses detected in Southern Vietnam.

Materials and Methods: Samples were obtained
between January and March 2013. The samples comprised 10 confirmed human cases, 6 poultry
outbreak investigations and samples from environmental surveillance of live poultry markets. All
samples included in this study tested positive for A(H5N1) virus by real-time RT-PCR. Full genome
sequences were generated from 31 strains amplified after inoculation into MDCK cells, embryonated
eggs, or directly from the original specimen. Phylogenetic analyses were performed using the
maximum likelihood method on all the genes. Antigenic analyses were also performed using
reference antisera.

Results: The phylogenetic analysis of 8 genes revealed that the 31 A(H5N1)
strains isolated and sequenced in Cambodia in 2013 resulted from reassortment between clade 1.1
and clade 2.3.2.1 viruses. While the HA and NA genes belong to the clade 1.1, genotype Z, the 6
internal genes are closely related to the viruses of the clade 2.3.2.1 (A/Hubei/1/2011-like). Antigenic
analysis demonstrated a significant antigenic drift.

Conclusions: In this study we report the emergence
of a new genotype of clade 1.1 A(H5N1) virus in Cambodia associated with a significant antigenic
drift. The link between the emergence of this new genotype and the increase in human cases
observed in 2013 is yet to be determined.

http://optionsviii.controlinfluenza....racts_2013.pdf
 
Re: Cambodian Human H5N1 Strain Designations from 2005-2013

First set from WHO IVTM were
1. Original Specimen IVTM-ORG770, Human, Cambodia
An Original specimen of type A (H5N1) collected (nose swab) from a human in Cambodia on/in 2013-01-11.

Influenza type A (H5N1): 1 of 1 materials
Source IVTM-SRC386, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes CDC ID# 2013759796
Laboratory CDC Atlanta, USA

Original Specimen IVTM-ORG770, Human, Cambodia

Date ofcollection 11-Jan-2013
IVTM Parent IVTM-SRC386
Notes CDC ID# 2013759796
Influenza type A (H5N1)
Specimen Type nose swab
Place of collection Cambodia

Created on 12-Apr-2013 20:16:10 | Last modified on 12-Apr-2013 20:16:10

Influenza Virus Traceability Mechanism
https://extranet.who.int/ivtm/Tree.aspx?matid=770

2. Original Specimen IVTM-ORG771, Human, Cambodia Click to draw the trace of this material
An Original specimen of type A (H5N1) collected (nose swab) from a human in Cambodia on/in 2013-01-21.

Influenza type A (H5N1): 1 of 1 materials
Source IVTM-SRC387, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes CDC ID# 2013759806
Laboratory CDC Atlanta, USA

Original Specimen IVTM-ORG771, Human, Cambodia

Date ofcollection 21-Jan-2013
IVTM Parent IVTM-SRC387
Notes CDC ID# 2013759806
Influenza type A (H5N1)
Specimen Type nose swab
Place of collection Cambodia
Laboratory CDC Atlanta, USA


Created on 12-Apr-2013 20:17:54 | Last modified on 12-Apr-2013 20:17:54

Influenza Virus Traceability Mechanism
https://extranet.who.int/ivtm/Tree.aspx?matid=771

3. An Original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-01-21.

Original Specimen IVTM-ORG771, Human, Cambodia
An Original specimen of type A (H5N1) collected (nose swab) from a human in Cambodia on/in 2013-01-21.

Summary of Diagnostic Results

Influenza type A (H5N1): 2 of 2 materials
Source IVTM-SRC390, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes ...
Laboratory NIC CAMBODIA

Original Specimen IVTM-ORG775, Human, Cambodia
Date ofcollection 21-Jan-2013
IVTM Parent IVTM-SRC390
Notes ....
Influenza type A (H5N1)
Specimen Type virus isolate cell culture
Place of collection Cambodia
Laboratory NIC CAMBODIA

Created on 18-Apr-2013 05:19:08 | Last modified on 18-Apr-2013 05:24:14

https://extranet.who.int/ivtm/Tree.aspx?matid=775

Virus IVTM-VIR780, A/Cambodia/X0123311/2013
Current Designation A/Cambodia/X0123311/2013
Creation Date 18-Apr-2013
IVTM Parent IVTM-ORG775
Notes CDC ID# 2013759190
C1/E1(4/18/13)
Influenza type A (H5N1)
Isolation System Virus isolate egg
Is Reference Virus? No
Is Candidate Vaccine Virus? No
Laboratory CDC Atlanta, USA

Created on 19-Apr-2013 22:04:31 | Last modified on 19-Apr-2013 22:04:31

https://extranet.who.int/ivtm/Tree.aspx?matid=780

4. Original Specimen IVTM-ORG776, Human, Cambodia
An Original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-01-23.

Summary of Diagnostic Results

Influenza type A (H5N1): 2 of 2 materials
Source IVTM-SRC391, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes ...
Laboratory NIC CAMBODIA

Original Specimen IVTM-ORG776, Human, Cambodia
Date ofcollection 23-Jan-2013
IVTM Parent IVTM-SRC391
Notes ....
Influenza type A (H5N1)
Specimen Type virus isolate cell culture
Place of collection Cambodia
Laboratory NIC CAMBODIA
Created on 18-Apr-2013 05:30:27 | Last modified on 18-Apr-2013 05:30:27

https://extranet.who.int/ivtm/Tree.aspx?matid=776

Virus IVTM-VIR781, A/Cambodia/X0123312/2013
Current Designation A/Cambodia/X0123312/2013
Creation Date 18-Apr-2013
IVTM Parent IVTM-ORG776
Notes CDC ID# 2013759191
C1/E1(4/18/13)
Influenza type A (H5N1)
Isolation System Virus isolate egg
Is Reference Virus? No
Is Candidate Vaccine Virus? No
Laboratory CDC Atlanta, USA
Created on 19-Apr-2013 22:05:58 | Last modified on 19-Apr-2013 22:05:58

https://extranet.who.int/ivtm/Tree.aspx?matid=781

5. Original Specimen IVTM-ORG777, Human, Cambodia
An Original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-01-25.

Summary of Diagnostic Results

Influenza type A (H5N1): 1 of 1 materials
Source IVTM-SRC392, Human, Cambodia
Source Type Human
Country/Area Cambodia
Notes ...
Laboratory NIC CAMBODIA

Original Specimen IVTM-ORG777, Human, Cambodia
Date ofcollection 25-Jan-2013
IVTM Parent IVTM-SRC392
Notes ....
Influenza type A (H5N1)
Specimen Type virus isolate cell culture
Place of collection Cambodia
Laboratory NIC CAMBODIA
Created on 18-Apr-2013 05:33:05 | Last modified on 18-Apr-2013 05:33:05

https://extranet.who.int/ivtm/Tree.aspx?matid=777


Virus IVTM-VIR782, A/Cambodia/X0125302/2013

Current Designation A/Cambodia/X0125302/2013
Creation Date 18-Apr-2013
IVTM Parent IVTM-ORG777
Notes CDC ID# 2013759192
C2/E1(4/18/13)
Influenza type A (H5N1)
Isolation System Virus isolate egg
Is Reference Virus? No
Is Candidate Vaccine Virus? No
Laboratory
CDC Atlanta, USA
Created on 19-Apr-2013 22:07:21 | Last modified on 19-Apr-2013 22:07:21

https://extranet.who.int/ivtm/Tree.aspx?matid=782

6. A/Cambodia/X0621333/2013
unknown new Sept 2013 on same tree as X0125302
Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness
September 2013
http://www.who.int/influenza/vaccines/virus/201309_h5h7h9vaccinevirusupdate.pdf


------

WHO IVTM noted 6 Original Specimen 2 weeks ago (Placed in chronological order of collection date) and a further update noted strain designations on the 20 December 2013

1. Original Specimen IVTM-ORG951, Human, Cambodia
A wildtype original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-02-18.
A/Cambodia/X0219301/2013
https://extranet.who.int/ivtm/Tree.aspx?matid=951

2. Original Specimen IVTM-ORG952, Human, Cambodia
A wildtype original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-06-28.
A/Cambodia/X0628313/2013
https://extranet.who.int/ivtm/Tree.aspx?matid=952

3. Original Specimen IVTM-ORG953, Human, Cambodia
A wildtype original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-07-23.
A/Cambodia/X0817302/2013
https://extranet.who.int/ivtm/Tree.aspx?matid=953

4. Original Specimen IVTM-ORG950, Human, Cambodia
A wildtype original specimen of type A (H5N1) collected ( virus isolate egg) from a human in Cambodia on/in 2013-08-09.
A/Cambodia/X0810301/2013
https://extranet.who.int/ivtm/Tree.aspx?matid=950

5. Original Specimen IVTM-ORG954, Human, Cambodia
A wildtype original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-08-28.
A/Cambodia/X0828324/2013
https://extranet.who.int/ivtm/Tree.aspx?matid=954

6. Original Specimen IVTM-ORG955, Human, Cambodia
A wildtype original specimen of type A (H5N1) collected (virus isolate cell culture) from a human in Cambodia on/in 2013-09-16.
Virus IVTM-VIR956, A/Cambodia/X0916322/2013
https://extranet.who.int/ivtm/Tree.aspx?matid=955


Influenza Virus Traceability Mechanism
https://extranet.who.int/ivtm/Default.aspx

I'm reviewing and researching case/strain designation by date... (GISAID) unable to view!
If anybody has any further information from GISAID I would appreciate an update or a message!

If interested please see:
Changing Demographics and Mortality of Human Influenza A/H5N1 virus of Avian Origin in Cambodia 2005-2013 (version 1.1) - FluTrackers
http://www.flutrackers.com/forum/showthread.php?t=213753

Cambodia - FluTrackers H5N1 Bird Flu 2013 WHO FAO MOH Confirmed & Current Suspected Case List + Links - FluTrackers
http://www.flutrackers.com/forum/showthread.php?t=200513
 
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