Re: Indonesia - Cats H5N1 Suspected
Archive Number 20060807.2210
Published Date 07-AUG-2006
Subject PRO/AH/EDR> Avian influenza (176) - Iraq, cats
AVIAN INFLUENZA (176) - IRAQ, CATS
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A ProMED-mail post
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International Society for Infectious Diseases
<http://www.isid.org>
[1]
Date: Mon 7 Aug 2006
From: Mary Marshall <tropical.forestry@btinternet.com>
Source: Reuters Alertnet, 6 Aug 2006 [edited]
<http://www.alertnet.org/thenews/newsdesk/N06309606.htm>
Cats infected with bird flu in Iraq - report
-------------------------------------------
Cats that died during an outbreak of bird flu in Iraq last February
[2006] were infected with the H5N1 virus, U.S. naval medical
researchers reported.
Any cat that becomes ill or dies when suspected bird flu is
circulating should be tested for the virus, the Navy team reported in
the August 2006 issue of the journal Emerging Infectious Diseases.
The team at the Naval Medical Research Unit No. 3 or NAMRU-3, based
in Cairo, have been studying bird flu viruses taken from animals and
people in the region.
The H5N1 avian influenza virus spread out of eastern Asia and into
Europe and the Middle East late in 2005. It has been found in 48
countries since it re-emerged in 2003, mostly in birds.
It can infect other animals as well as humans and has so far killed
at least 134 people in 9 countries.
Samuel Yingst, Magdi Saad and Stephen Felt of NAMRU-3 had been
hearing
stories from veterinarians in Turkey and Iraq who said cats
had died where bird flu outbreaks were being reported in January
[2006]. But they could not get any samples from the cats.
"After H5N1 influenza was diagnosed in a person in Sarcapcarn,
Kurdish northern Iraq, the government of Iraq requested a World
Health Organization investigation, which was supported in part by
Naval Medical Research Unit No. 3 veterinarians," they wrote in their report.
People told the WHO team about cats that had died in a house near the
city of Erbil where 51 chickens died. The researchers got the bodies
of 2 of the cats and a sick goose from next door.
The animals had flu virus throughout their bodies, Yingst and
colleagues reported.
The virus found in the cats and goose strongly
resembled the virus from a person who died in Iraq, suggesting it had not become adapted to cats.
The researchers said their findings support the idea that cats can be
infected with H5N1 and may play a role in transmitting it, and that
the virus could possibly mutate in the bodies of cats.
Flu viruses change in 2 ways, by steady mutation, which H5N1 has been
seen to do, and by reassortment, which means swapping genes with
other flu viruses. In 1957 and 1968, pandemic influenza broke out
after the H3N2 viruses reassorted with other viruses.
Cats are mammals and biologically closer to humans than birds are, so
in theory, a virus that can easily infect a cat could infect a person
more easily than a purely avian virus, which H5N1 remains.
"The route of infection in these cats cannot be determined
definitively. How cats behave when eating birds makes both oral and
respiratory infection possible," the researchers added.
A cat died of bird flu in Germany in March 2006 and Austrian experts
said a cat there was infected with H5N1 a week later but did not get sick.
The Iraqi cats were infected with a distinct strain of the H5N1 virus
known as Clade II, which was 1st found in migrating birds in Qinghai
Lake in western China in 2005, the NAMRU team said. "
To our
knowledge, this is the 1st report of a Qinghai-like virus detected in
domestic cats," the report reads.
[Byline: Maggie Fox]
--
ProMED-mail
<promed@promedmail.org>
[Reports about natural H5N1 infections in domestic cats have been
received, in the past, from Thailand, Germany (Ruegen) and Austria;
there have been rumors on cat infections in Indonesia as well.
In view of the significance of NAMRU's observations, we found it
appropriate to copy their letter to the EID editor, slightly
abbreviated, as follows. The original paper, including tables and
references, is available free at the given URL. - Mod.AS]
******
[2]
Date: Mon 7 Aug 2006
From: ProMED-mail <promed@promedmail.org>
Source: EID, Vol. 12, No. 8, August 2006 [abridged, edited]
<http://www.cdc.gov/ncidod/EID/vol12no08/06-0264.htm>
Qinghai-like H5N1 from Domestic Cats, Northern Iraq, A letter to EID
editor By Samuel L. Yingst, Magdi D. Saad and Stephen A. Felt (US
Naval Medical Research Unit No. 3, Cairo, Egypt)
-----------------------------------------------
Literature describing HPAI H5N1 infection of cats is limited to
descriptions of infections with a subset of clade I viruses.
HPAI H5N1 viruses, highly similar to viruses isolated from Qinghai Lake in
western People's Republic of China in spring 2005, are now rapidly
disseminating throughout Eurasia and Africa.
To our knowledge, this is the 1st report of a Qinghai-like virus detected in domestic cats.
This finding is noteworthy because the host range of influenza
viruses is determined by the antigenic characteristics of the
hemagglutinin and neuraminidase molecules; clade II viruses are
antigenically distinct from clade I viruses, and Qinghai-like viruses
are genetically distinct from other clade II viruses.
Personal communications in January 2006 from field veterinarians
noted deaths of domestic cats that were associated with suspected
(eventually confirmed) H5N1 outbreaks in eastern Turkey (2 villages)
and Kurdish northern Iraq (Sarcapcarn in Sulymaniyah Governorate and
Grd Jotyar in Erbil Governorate).
The clinical conditions of the birds did not suggest HPAI to villagers or consulting veterinarians.
In both scenarios in Iraq, results of rapid antigen detection tests
with the Anigen kit (Suwon, Republic of Korea)
[<http://www.anigen.co.kr/product/eng_rapid.asp>],
while positive for influenza A, were negative for H5, so the
outbreaks were not thought to be caused by HPAI, but
concern about
the unusual deaths in cats remained.
Because the regions are remote
and veterinary services limited, such anecdotal reports have rarely
been followed up on.
After H5N1 influenza was diagnosed in a person in Sarcapcarn, Kurdish
northern Iraq, the government of Iraq requested a World Health
Organization investigation, which was supported in part by Naval
Medical Research Unit No. 3 veterinarians. While investigating the
situation in Erbil Governorate,
the team was informed of suspicious
deaths in cats associated with the death of all 51 chickens in a
household in Grd Jotyar (10 km north of Erbil City) [See Iraq map;
Arbil is situated in the north
<http://www.un.org/Depts/Cartographic/map/profile/iraq.pdf>].
From 3 Feb to 5 Feb 2006, 5 cats reportedly died; 2 of these were
available for examination on 8 Feb 2006. A sick goose from an
adjacent household was killed and underwent necropsy with the cats.
Gross pathologic changes in cats were similar to those previously
reported, except that severe hemorrhagic pancreatitis was observed.
Tissues from these animals and archived tissues from one of the 51
chickens were conveyed to Cairo for virologic examination.
An influenza A H5 virus was present in multiple organs in all species
from the outbreak site in Grd Jotyar. cDNA for sequencing was
amplified directly from RNA extracts from pathologic materials
without virus isolation.
On the basis of sequence analysis of the full HA1 gene and 219 amino acids of the HA2 gene, the viruses from the goose and one cat from Grd Jotyar and from the person who died from Sarcapcarn (sequence derived from PCR amplification from 1st-passage egg material) are >99 percent identical at the nucleotide and amino acid levels (GenBank nos. DQ435200-02). Thus, no indication of virus adaptation to cats was found.
The viruses from Iraq are most closely related to currently circulating Qinghai-like viruses, but when compared with A/bar-headed goose/Qinghai/65/2005 (H5N1) (GenBank no. DQ095622), they share only 97.4 percent identity at the nucleic acid level with 3 amino acid substitutions of unknown significance.
On the other hand, the virus from the cat is only 93.4 percent
identical to A/tiger/Thailand/CU-T4/2004(H5N1) (GenBank no.
AY972539). These results are not surprising, given that these strains
are representative of different clades.
Sequencing of 1349 bp of the N gene from cat 1 and the goose (to be submitted to GenBank) show identity at the amino acid level and that the N genes of viruses infecting the cat and goose are >99 percent identical to that of A/bar-headed goose/Qinghai/65/2005(H5N1).
These findings support the notion that cats may be broadly susceptible to circulating H5N1 viruses and thus may play a role in reassortment, antigenic drift, and transmission.
The route of infection in these cats cannot be determined definitively. How cats behave when eating birds makes both oral and respiratory infection possible.
However, the source of infection seems clear in that an identical H5N1 virus was detected in samples from a goose from the same dwelling, and an H5 virus was detected from archived samples from one of 51 chickens that died over the course of a few days.
The potential for horizontal spread cannot be ruled out since we detected viral RNA in gut, stool, and trachea; clinical signs developed in all cats, and all died from the acute illness 2-4 days after the chicken deaths began; therefore, simultaneous exposure seems likely.
Death in cats, spatially and temporally associated with unusual deaths in poultry, especially when the cats show positive results of a rapid antigen detection test for influenza A, should be considered to indicate a presumptive diagnosis of HPAI, and appropriate response should ensue.
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